RespostaGuiaOCIBRIPES
type: StructureDefinition
node role: treeRoot
id:
  v: RespostaGuiaOCIBRIPES
text:
  status:
    v: extensions
  div: Narrativa gerada: StructureDefinition RespostaGuiaOCIBRIPES Nome Bandeiras Card. Tipo Descrição e condicionalismos<img src="[binary]" alt="doco" style="background-color: inherit"/> ClaimResponse 1..* ClaimResponse Resposta a uma solicitação de reembolso ou cobertura de um procedimento de saúde. #xD; Fatias para extension 0..* Extension Extensões utilizadas pela RespostaGuiaOCIBRIPES. Fatia: Não ordenado, Aberto por value:url #xD; extension:PlanoAcaoRegionalClaim 0..1 Reference() Extensão de PlanoAcaoRegionalClaim URL: https://fhir.ecoinfo.ipes.tech/fhir/StructureDefinition/PlanoAcaoRegionalClaim #xD; extension:RegistroRegulacaoAssistencialClaim 0..* Reference() Extensão de RegistroRegulacaoAssistencialClaim URL: https://fhir.ecoinfo.ipes.tech/fhir/StructureDefinition/RegistroRegulacaoAssistencialClaim #xD; status 1..1 code Status da resposta #xD; type 1..1 CodeableConcept Tipo de resposta #xD; coding #xD; system 0..1 uri Identity of the terminology system Valor fixo: https://fhir.ecoinfo.ipes.tech/CodeSystem/claim-type #xD; code 0..1 code Symbol in syntax defined by the system Valor fixo: apac #xD; subType 0..1 CodeableConcept Subtipo de resposta #xD; coding #xD; system 0..1 uri Identity of the terminology system Valor fixo: https://fhir.ecoinfo.ipes.tech/CodeSystem/claim-subtype #xD; code 0..1 code Symbol in syntax defined by the system Vínculo: https://fhir.ecoinfo.ipes.tech/ValueSet/claim-subtype (required) #xD; use 1..1 code Tipo de uso da resposta Valor fixo: claim #xD; patient 1..1 Reference(Paciente) Paciente relacionado ao pedido #xD; created 1..1 dateTime Data de criação da resposta #xD; insurer 1..1 Reference(Organization) Ente responsável pela OCI #xD; display 0..1 string Text alternative for the resource Padrão necessário: SUS #xD; requestor 1..1 Reference(Practitioner | PractitionerRole | Organization) Solicitante do pedido #xD; request 1..1 Reference(Claim) Referência ao pedido original #xD; outcome 1..1 code Resultado do processamento #xD; disposition…
url:
  v: https://fhir.ecoinfo.ipes.tech/fhir/StructureDefinition/RespostaGuiaOCIBRIPES
version:
  v: 0.1.0
name:
  v: RespostaGuiaOCIBRIPES
title:
  v: Resposta Guia OCI
status:
  v: active
experimental:
  v: false
date:
  v: 2025-03-17
publisher:
  v: iPES Publisher
contact:
  name:
    v: iPES Publisher
  telecom:
    system:
      v: url
    value:
      v: https://fhir.ecoinfo.ipes.tech/publisher
description:
  v: Perfil para resposta de guias de autorização no projeto Ecoinfo, baseado no recurso ClaimResponse.
fhir version:
  v: 4.0.1
mapping:
  identity:
    v: workflow
  uri:
    v: http://hl7.org/fhir/workflow
  name:
    v: Workflow Pattern
mapping:
  identity:
    v: w5
  uri:
    v: http://hl7.org/fhir/fivews
  name:
    v: FiveWs Pattern Mapping
mapping:
  identity:
    v: rim
  uri:
    v: http://hl7.org/v3
  name:
    v: RIM Mapping
kind:
  v: resource
abstract:
  v: false
context:
  type:
    v: element
  expression:
    v: ClaimResponse
type:
  v: ClaimResponse
base definition:
  v: http://hl7.org/fhir/StructureDefinition/ClaimResponse
  link: http://hl7.org/fhir/StructureDefinition/ClaimResponse
derivation:
  v: constraint
snapshot:
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version
    value: string
      v: 4.0.1
  element:
    id:
      v: ClaimResponse
    path:
      v: ClaimResponse
    short:
      v: Resposta a uma solicitação de reembolso ou cobertura de um procedimento de saúde.
    definition:
      v: Este recurso representa a resposta a uma solicitação de cobertura, identificando status, valores aprovados e justificativas de erro.
    alias:
      v: Remittance Advice
    min:
      v: 1
    max:
      v: *
    base:
      path:
        v: ClaimResponse
      min:
        v: 0
      max:
        v: *
    constraint:
      key:
        v: dom-2
      severity:
        v: error
      human:
        v: If the resource is contained in another resource, it SHALL NOT contain nested Resources
      expression:
        v: contained.contained.empty()
      xpath:
        v: not(parent::f:contained and f:contained)
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        link: http://hl7.org/fhir/StructureDefinition/DomainResource
    constraint:
      key:
        v: dom-3
      severity:
        v: error
      human:
        v: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
      expression:
        v: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
      xpath:
        v: not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        link: http://hl7.org/fhir/StructureDefinition/DomainResource
    constraint:
      key:
        v: dom-4
      severity:
        v: error
      human:
        v: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
      expression:
        v: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
      xpath:
        v: not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        link: http://hl7.org/fhir/StructureDefinition/DomainResource
    constraint:
      key:
        v: dom-5
      severity:
        v: error
      human:
        v: If a resource is contained in another resource, it SHALL NOT have a security label
      expression:
        v: contained.meta.security.empty()
      xpath:
        v: not(exists(f:contained/*/f:meta/f:security))
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        link: http://hl7.org/fhir/StructureDefinition/DomainResource
    constraint:
      extension:
        value: boolean
      extension:
        value: markdown
      key:
        v: dom-6
      severity:
        v: warning
      human:
        v: A resource should have narrative for robust management
      expression:
        v: text.`div`.exists()
      xpath:
        v: exists(f:text/h:div)
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        link: http://hl7.org/fhir/StructureDefinition/DomainResource
    is modifier:
      v: false
    is summary:
      v: false
    mapping:
      identity:
        v: rim
      map:
        v: Entity. Role, or Act
    mapping:
      identity:
        v: workflow
      map:
        v: Event
  element:
    id:
      v: ClaimResponse.id
    path:
      v: ClaimResponse.id
    short:
      v: Logical id of this artifact
    definition:
      v: The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
    comment:
      v: The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
    min:
      v: 0

boolean
v: true

markdown
v: When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.

v: 1

path:
  v: Resource.id
min:
  v: 0
max:
  v: 1

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
  value: url
    v: id
code:
  v: http://hl7.org/fhirpath/System.String

v: false

v: true

id:
  v: ClaimResponse.meta
path:
  v: ClaimResponse.meta
short:
  v: Metadata about the resource
definition:
  v: The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.meta
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Meta
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: ClaimResponse.implicitRules
path:
  v: ClaimResponse.implicitRules
short:
  v: A set of rules under which this content was created
definition:
  v: A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
comment:
  v: Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.implicitRules
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: true
is modifier reason:
  v: This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
is summary:
  v: true

id:
  v: ClaimResponse.language
path:
  v: ClaimResponse.language
short:
  v: Language of the resource content
definition:
  v: The base language in which the resource is written.
comment:
  v: Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.language
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet
    value: canonical
      v: http://hl7.org/fhir/ValueSet/all-languages
      link: http://hl7.org/fhir/ValueSet/all-languages
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: Language
  strength:
    v: preferred
  description:
    v: A human language.
  value set:
    v: http://hl7.org/fhir/ValueSet/languages
    link: http://hl7.org/fhir/ValueSet/languages

id:
  v: ClaimResponse.text
path:
  v: ClaimResponse.text
short:
  v: Text summary of the resource, for human interpretation
definition:
  v: A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
comment:
  v: Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
alias:
  v: narrative
alias:
  v: html
alias:
  v: xhtml
alias:
  v: display
min:
  v: 0
max:
  v: 1
base:
  path:
    v: DomainResource.text
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Narrative
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: Act.text?

id:
  v: ClaimResponse.contained
path:
  v: ClaimResponse.contained
short:
  v: Contained, inline Resources
definition:
  v: These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
comment:
  v: This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
alias:
  v: inline resources
alias:
  v: anonymous resources
alias:
  v: contained resources
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.contained
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Resource
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.extension
path:
  v: ClaimResponse.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  rules:
    v: open
short:
  v: Extensões utilizadas pela RespostaGuiaOCIBRIPES.
definition:
  v: An Extension
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.extension:PlanoAcaoRegionalClaim
path:
  v: ClaimResponse.extension
slice name:
  v: PlanoAcaoRegionalClaim
short:
  v: Extensão de PlanoAcaoRegionalClaim
definition:
  v: Extensão simples contendo a referência à PlanoAcaoRegionalClaim
min:
  v: 0
max:
  v: 1
base:
  path:
    v: DomainResource.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
  profile:
    v: https://fhir.ecoinfo.ipes.tech/fhir/StructureDefinition/PlanoAcaoRegionalClaim
    link: https://fhir.ecoinfo.ipes.tech/fhir/StructureDefinition/PlanoAcaoRegionalClaim
condition:
  v: ele-1
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.extension:RegistroRegulacaoAssistencialClaim
path:
  v: ClaimResponse.extension
slice name:
  v: RegistroRegulacaoAssistencialClaim
short:
  v: Extensão de RegistroRegulacaoAssistencialClaim
definition:
  v: Extensão simples contendo a referência à RegistroRegulacaoAssistencialClaim
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
  profile:
    v: https://fhir.ecoinfo.ipes.tech/fhir/StructureDefinition/RegistroRegulacaoAssistencialClaim
    link: https://fhir.ecoinfo.ipes.tech/fhir/StructureDefinition/RegistroRegulacaoAssistencialClaim
condition:
  v: ele-1
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.modifierExtension
path:
  v: ClaimResponse.modifierExtension
short:
  v: Extensions that cannot be ignored
definition:
  v: May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.identifier
path:
  v: ClaimResponse.identifier
short:
  v: Business Identifier for a claim response
definition:
  v: A unique identifier assigned to this claim response.
requirements:
  v: Allows claim responses to be distinguished and referenced.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.identifier
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: workflow
  map:
    v: Event.identifier
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.identifier

id:
  v: ClaimResponse.status
path:
  v: ClaimResponse.status
short:
  v: Status da resposta
definition:
  v: The status of the resource instance.
comment:
  v: This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
requirements:
  v: Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.status
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: true
is modifier reason:
  v: This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: ClaimResponseStatus
  strength:
    v: required
  description:
    v: A code specifying the state of the resource instance.
  value set:
    v: http://hl7.org/fhir/ValueSet/fm-status|4.0.1
    link: 4.0
    link: .1
mapping:
  identity:
    v: workflow
  map:
    v: Event.status
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.status

id:
  v: ClaimResponse.type
path:
  v: ClaimResponse.type
short:
  v: Tipo de resposta
definition:
  v: A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.
comment:
  v: This may contain the local bill type codes, for example the US UB-04 bill type code or the CMS bill type.
requirements:
  v: Some jurisdictions need a finer grained claim type for routing and adjudication.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.type
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: ClaimType
  strength:
    v: extensible
  description:
    v: The type or discipline-style of the claim.
  value set:
    v: http://hl7.org/fhir/ValueSet/claim-type
    link: http://hl7.org/fhir/ValueSet/claim-type
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.class

id:
  v: ClaimResponse.type.id
path:
  v: ClaimResponse.type.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.type.extension
path:
  v: ClaimResponse.type.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.type.coding
path:
  v: ClaimResponse.type.coding
short:
  v: Code defined by a terminology system
definition:
  v: A reference to a code defined by a terminology system.
comment:
  v: Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
requirements:
  v: Allows for alternative encodings within a code system, and translations to other code systems.
min:
  v: 0
max:
  v: *
base:
  path:
    v: CodeableConcept.coding
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Coding
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.1-8, C*E.10-22
mapping:
  identity:
    v: rim
  map:
    v: union(., ./translation)
mapping:
  identity:
    v: orim
  map:
    v: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

id:
  v: ClaimResponse.type.coding.id
path:
  v: ClaimResponse.type.coding.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.type.coding.extension
path:
  v: ClaimResponse.type.coding.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.type.coding.system
path:
  v: ClaimResponse.type.coding.system
short:
  v: Identity of the terminology system
definition:
  v: The identification of the code system that defines the meaning of the symbol in the code.
comment:
  v: The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
requirements:
  v: Need to be unambiguous about the source of the definition of the symbol.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Coding.system
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
fixed: uri
  v: https://fhir.ecoinfo.ipes.tech/CodeSystem/claim-type
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.3
mapping:
  identity:
    v: rim
  map:
    v: ./codeSystem
mapping:
  identity:
    v: orim
  map:
    v: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

id:
  v: ClaimResponse.type.coding.version
path:
  v: ClaimResponse.type.coding.version
short:
  v: Version of the system - if relevant
definition:
  v: The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
comment:
  v: Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Coding.version
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.7
mapping:
  identity:
    v: rim
  map:
    v: ./codeSystemVersion
mapping:
  identity:
    v: orim
  map:
    v: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

id:
  v: ClaimResponse.type.coding.code
path:
  v: ClaimResponse.type.coding.code
short:
  v: Symbol in syntax defined by the system
definition:
  v: A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
requirements:
  v: Need to refer to a particular code in the system.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Coding.code
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
fixed: code
  v: apac
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.1
mapping:
  identity:
    v: rim
  map:
    v: ./code
mapping:
  identity:
    v: orim
  map:
    v: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

id:
  v: ClaimResponse.type.coding.display
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable
  value: boolean
    v: true
path:
  v: ClaimResponse.type.coding.display
short:
  v: Representation defined by the system
definition:
  v: A representation of the meaning of the code in the system, following the rules of the system.
requirements:
  v: Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Coding.display
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.2 - but note this is not well followed
mapping:
  identity:
    v: rim
  map:
    v: CV.displayName
mapping:
  identity:
    v: orim
  map:
    v: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

id:
  v: ClaimResponse.type.coding.userSelected
path:
  v: ClaimResponse.type.coding.userSelected
short:
  v: If this coding was chosen directly by the user
definition:
  v: Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
comment:
  v: Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
requirements:
  v: This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Coding.userSelected
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: Sometimes implied by being first
mapping:
  identity:
    v: rim
  map:
    v: CD.codingRationale
mapping:
  identity:
    v: orim
  map:
    v: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

id:
  v: ClaimResponse.type.text
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable
  value: boolean
    v: true
path:
  v: ClaimResponse.type.text
short:
  v: Plain text representation of the concept
definition:
  v: A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
comment:
  v: Very often the text is the same as a displayName of one of the codings.
requirements:
  v: The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CodeableConcept.text
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.9. But note many systems use C*E.2 for this
mapping:
  identity:
    v: rim
  map:
    v: ./originalText[mediaType/code="text/plain"]/data
mapping:
  identity:
    v: orim
  map:
    v: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

id:
  v: ClaimResponse.subType
path:
  v: ClaimResponse.subType
short:
  v: Subtipo de resposta
definition:
  v: A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.
comment:
  v: This may contain the local bill type codes, for example the US UB-04 bill type code or the CMS bill type.
requirements:
  v: Some jurisdictions need a finer grained claim type for routing and adjudication.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.subType
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: ClaimSubType
  strength:
    v: example
  description:
    v: A more granular claim typecode.
  value set:
    v: http://hl7.org/fhir/ValueSet/claim-subtype
    link: http://hl7.org/fhir/ValueSet/claim-subtype
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.class

id:
  v: ClaimResponse.subType.id
path:
  v: ClaimResponse.subType.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.subType.extension
path:
  v: ClaimResponse.subType.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.subType.coding
path:
  v: ClaimResponse.subType.coding
short:
  v: Code defined by a terminology system
definition:
  v: A reference to a code defined by a terminology system.
comment:
  v: Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
requirements:
  v: Allows for alternative encodings within a code system, and translations to other code systems.
min:
  v: 0
max:
  v: *
base:
  path:
    v: CodeableConcept.coding
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Coding
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.1-8, C*E.10-22
mapping:
  identity:
    v: rim
  map:
    v: union(., ./translation)
mapping:
  identity:
    v: orim
  map:
    v: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

id:
  v: ClaimResponse.subType.coding.id
path:
  v: ClaimResponse.subType.coding.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.subType.coding.extension
path:
  v: ClaimResponse.subType.coding.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.subType.coding.system
path:
  v: ClaimResponse.subType.coding.system
short:
  v: Identity of the terminology system
definition:
  v: The identification of the code system that defines the meaning of the symbol in the code.
comment:
  v: The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
requirements:
  v: Need to be unambiguous about the source of the definition of the symbol.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Coding.system
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
fixed: uri
  v: https://fhir.ecoinfo.ipes.tech/CodeSystem/claim-subtype
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.3
mapping:
  identity:
    v: rim
  map:
    v: ./codeSystem
mapping:
  identity:
    v: orim
  map:
    v: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

id:
  v: ClaimResponse.subType.coding.version
path:
  v: ClaimResponse.subType.coding.version
short:
  v: Version of the system - if relevant
definition:
  v: The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
comment:
  v: Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Coding.version
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.7
mapping:
  identity:
    v: rim
  map:
    v: ./codeSystemVersion
mapping:
  identity:
    v: orim
  map:
    v: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

id:
  v: ClaimResponse.subType.coding.code
path:
  v: ClaimResponse.subType.coding.code
short:
  v: Symbol in syntax defined by the system
definition:
  v: A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
requirements:
  v: Need to refer to a particular code in the system.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Coding.code
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
binding:
  strength:
    v: required
  value set:
    v: https://fhir.ecoinfo.ipes.tech/ValueSet/claim-subtype
    link: https://fhir.ecoinfo.ipes.tech/ValueSet/claim-subtype
mapping:
  identity:
    v: v2
  map:
    v: C*E.1
mapping:
  identity:
    v: rim
  map:
    v: ./code
mapping:
  identity:
    v: orim
  map:
    v: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

id:
  v: ClaimResponse.subType.coding.display
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable
  value: boolean
    v: true
path:
  v: ClaimResponse.subType.coding.display
short:
  v: Representation defined by the system
definition:
  v: A representation of the meaning of the code in the system, following the rules of the system.
requirements:
  v: Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Coding.display
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.2 - but note this is not well followed
mapping:
  identity:
    v: rim
  map:
    v: CV.displayName
mapping:
  identity:
    v: orim
  map:
    v: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

id:
  v: ClaimResponse.subType.coding.userSelected
path:
  v: ClaimResponse.subType.coding.userSelected
short:
  v: If this coding was chosen directly by the user
definition:
  v: Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
comment:
  v: Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
requirements:
  v: This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Coding.userSelected
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: Sometimes implied by being first
mapping:
  identity:
    v: rim
  map:
    v: CD.codingRationale
mapping:
  identity:
    v: orim
  map:
    v: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

id:
  v: ClaimResponse.subType.text
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable
  value: boolean
    v: true
path:
  v: ClaimResponse.subType.text
short:
  v: Plain text representation of the concept
definition:
  v: A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
comment:
  v: Very often the text is the same as a displayName of one of the codings.
requirements:
  v: The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CodeableConcept.text
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.9. But note many systems use C*E.2 for this
mapping:
  identity:
    v: rim
  map:
    v: ./originalText[mediaType/code="text/plain"]/data
mapping:
  identity:
    v: orim
  map:
    v: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

id:
  v: ClaimResponse.use
path:
  v: ClaimResponse.use
short:
  v: Tipo de uso da resposta
definition:
  v: A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.
requirements:
  v: This element is required to understand the nature of the request for adjudication.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.use
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: code
fixed: code
  v: claim
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: Use
  strength:
    v: required
  description:
    v: Claim, preauthorization, predetermination.
  value set:
    v: http://hl7.org/fhir/ValueSet/claim-use|4.0.1
    link: 4.0
    link: .1
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.class

id:
  v: ClaimResponse.patient
path:
  v: ClaimResponse.patient
short:
  v: Paciente relacionado ao pedido
definition:
  v: The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for facast reimbursement is sought.
requirements:
  v: The patient must be supplied to the insurer so that confirmation of coverage and service hstory may be considered as part of the authorization and/or adjudiction.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.patient
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: Reference
  target profile:
    v: https://fhir.ecoinfo.ipes.tech/fhir/StructureDefinition/PatientBRIPES
    link: https://fhir.ecoinfo.ipes.tech/fhir/StructureDefinition/PatientBRIPES
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.subject[x]
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.subject

id:
  v: ClaimResponse.created
path:
  v: ClaimResponse.created
short:
  v: Data de criação da resposta
definition:
  v: The date this resource was created.
requirements:
  v: Need to record a timestamp for use by both the recipient and the issuer.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.created
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: dateTime
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.occurrence[x]
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.recorded

id:
  v: ClaimResponse.insurer
path:
  v: ClaimResponse.insurer
short:
  v: Ente responsável pela OCI
definition:
  v: The party responsible for authorization, adjudication and reimbursement.
requirements:
  v: To be a valid claim, preauthorization or predetermination there must be a party who is responsible for adjudicating the contents against a policy which provides benefits for the patient.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.insurer
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Organization
    link: http://hl7.org/fhir/StructureDefinition/Organization
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.performer

id:
  v: ClaimResponse.insurer.id
path:
  v: ClaimResponse.insurer.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.insurer.extension
path:
  v: ClaimResponse.insurer.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.insurer.reference
path:
  v: ClaimResponse.insurer.reference
short:
  v: Literal reference, Relative, internal or absolute URL
definition:
  v: A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
comment:
  v: Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Reference.reference
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
condition:
  v: ref-1
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.insurer.type
path:
  v: ClaimResponse.insurer.type
short:
  v: Type the reference refers to (e.g. "Patient")
definition:
  v: The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
comment:
  v: This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Reference.type
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: FHIRResourceTypeExt
  strength:
    v: extensible
  description:
    v: Aa resource (or, for logical models, the URI of the logical model).
  value set:
    v: http://hl7.org/fhir/ValueSet/resource-types
    link: http://hl7.org/fhir/ValueSet/resource-types
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.insurer.identifier
path:
  v: ClaimResponse.insurer.identifier
short:
  v: Logical reference, when literal reference is not known
definition:
  v: An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
comment:
  v: When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Reference.identifier
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: .identifier

id:
  v: ClaimResponse.insurer.display
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable
  value: boolean
    v: true
path:
  v: ClaimResponse.insurer.display
short:
  v: Text alternative for the resource
definition:
  v: Plain text narrative that identifies the resource in addition to the resource reference.
comment:
  v: This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Reference.display
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
pattern: string
  v: SUS
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.requestor
path:
  v: ClaimResponse.requestor
short:
  v: Solicitante do pedido
definition:
  v: The provider which is responsible for the claim, predetermination or preauthorization.
comment:
  v: Typically this field would be 1..1 where this party is responsible for the claim but not necessarily professionally responsible for the provision of the individual products and services listed below.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.requestor
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Practitioner
    link: http://hl7.org/fhir/StructureDefinition/Practitioner
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/PractitionerRole
    link: http://hl7.org/fhir/StructureDefinition/PractitionerRole
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Organization
    link: http://hl7.org/fhir/StructureDefinition/Organization
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.source

id:
  v: ClaimResponse.request
path:
  v: ClaimResponse.request
short:
  v: Referência ao pedido original
definition:
  v: Original request resource reference.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.request
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Claim
    link: http://hl7.org/fhir/StructureDefinition/Claim
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.basedOn
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.why[x]

id:
  v: ClaimResponse.outcome
path:
  v: ClaimResponse.outcome
short:
  v: Resultado do processamento
definition:
  v: The outcome of the claim, predetermination, or preauthorization processing.
comment:
  v: The resource may be used to indicate that: the request has been held (queued) for processing; that it has been processed and errors found (error); that no errors were found and that some of the adjudication has been undertaken (partial) or that all of the adjudication has been undertaken (complete).
requirements:
  v: To advise the requestor of an overall processing outcome.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.outcome
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: RemittanceOutcome
  strength:
    v: required
  description:
    v: The result of the claim processing.
  value set:
    v: http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1
    link: 4.0
    link: .1

id:
  v: ClaimResponse.disposition
path:
  v: ClaimResponse.disposition
short:
  v: Mensagem explicativa do resultado
definition:
  v: A human readable description of the status of the adjudication.
requirements:
  v: Provided for user display.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.disposition
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: workflow
  map:
    v: Event.note

id:
  v: ClaimResponse.preAuthRef
path:
  v: ClaimResponse.preAuthRef
short:
  v: Preauthorization reference
definition:
  v: Reference from the Insurer which is used in later communications which refers to this adjudication.
comment:
  v: This value is only present on preauthorization adjudications.
requirements:
  v: On subsequent claims, the insurer may require the provider to quote this value.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.preAuthRef
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.preAuthPeriod
path:
  v: ClaimResponse.preAuthPeriod
short:
  v: Preauthorization reference effective period
definition:
  v: The time frame during which this authorization is effective.
requirements:
  v: To convey to the provider when the authorized products and services must be supplied for the authorized adjudication to apply.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.preAuthPeriod
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Period
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.payeeType
path:
  v: ClaimResponse.payeeType
short:
  v: Party to be paid any benefits payable
definition:
  v: Type of Party to be reimbursed: subscriber, provider, other.
requirements:
  v: Need to know who should receive payment with the most common situations being the Provider (assignment of benefits) or the Subscriber.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.payeeType
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: PayeeType
  strength:
    v: example
  description:
    v: A code for the party to be reimbursed.
  value set:
    v: http://hl7.org/fhir/ValueSet/payeetype
    link: http://hl7.org/fhir/ValueSet/payeetype

id:
  v: ClaimResponse.item
path:
  v: ClaimResponse.item
short:
  v: Itens processados no pedido
definition:
  v: A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details.
requirements:
  v: The adjudication for items provided on the claim.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.item
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.id
path:
  v: ClaimResponse.item.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.item.extension
path:
  v: ClaimResponse.item.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.item.modifierExtension
path:
  v: ClaimResponse.item.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.item.itemSequence
path:
  v: ClaimResponse.item.itemSequence
short:
  v: Sequência do item
definition:
  v: A number to uniquely reference the claim item entries.
requirements:
  v: Necessary to provide a mechanism to link the adjudication result to the submitted claim item.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.item.itemSequence
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.noteNumber
path:
  v: ClaimResponse.item.noteNumber
short:
  v: Applicable note numbers
definition:
  v: The numbers associated with notes below which apply to the adjudication of this item.
requirements:
  v: Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.item.noteNumber
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.adjudication
path:
  v: ClaimResponse.item.adjudication
short:
  v: Detalhes da adjudicação
definition:
  v: If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item.
requirements:
  v: The adjudication results conveys the insurer's assessment of the item provided in the claim under the terms of the patient's insurance coverage.
min:
  v: 1
max:
  v: *
base:
  path:
    v: ClaimResponse.item.adjudication
  min:
    v: 1
  max:
    v: *
type:
  code:
    v: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.adjudication.id
path:
  v: ClaimResponse.item.adjudication.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.item.adjudication.extension
path:
  v: ClaimResponse.item.adjudication.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.item.adjudication.modifierExtension
path:
  v: ClaimResponse.item.adjudication.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.item.adjudication.category
path:
  v: ClaimResponse.item.adjudication.category
short:
  v: Categoria da adjudicação
definition:
  v: A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item.
comment:
  v: For example codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.
requirements:
  v: Needed to enable understanding of the context of the other information in the adjudication.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.item.adjudication.category
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: Adjudication
  strength:
    v: example
  description:
    v: The adjudication codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/adjudication
    link: http://hl7.org/fhir/ValueSet/adjudication

id:
  v: ClaimResponse.item.adjudication.reason
path:
  v: ClaimResponse.item.adjudication.reason
short:
  v: Explanation of adjudication outcome
definition:
  v: A code supporting the understanding of the adjudication result and explaining variance from expected amount.
comment:
  v: For example may indicate that the funds for this benefit type have been exhausted.
requirements:
  v: To support understanding of variance from adjudication expectations.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.item.adjudication.reason
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: AdjudicationReason
  strength:
    v: example
  description:
    v: The adjudication reason codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/adjudication-reason
    link: http://hl7.org/fhir/ValueSet/adjudication-reason

id:
  v: ClaimResponse.item.adjudication.amount
path:
  v: ClaimResponse.item.adjudication.amount
short:
  v: Valor da adjudicação
definition:
  v: Monetary amount associated with the category.
comment:
  v: For example: amount submitted, eligible amount, co-payment, and benefit payable.
requirements:
  v: Most adjuciation categories convey a monetary amount.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.item.adjudication.amount
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.adjudication.value
path:
  v: ClaimResponse.item.adjudication.value
short:
  v: Non-monetary value
definition:
  v: A non-monetary value associated with the category. Mutually exclusive to the amount element above.
comment:
  v: For example: eligible percentage or co-payment percentage.
requirements:
  v: Some adjudication categories convey a percentage or a fixed value.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.item.adjudication.value
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: decimal
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.detail
path:
  v: ClaimResponse.item.detail
short:
  v: Detalhes da adjudicação
definition:
  v: A claim detail. Either a simple (a product or service) or a 'group' of sub-details which are simple items.
requirements:
  v: The adjudication for details provided on the claim.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.item.detail
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.detail.id
path:
  v: ClaimResponse.item.detail.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.item.detail.extension
path:
  v: ClaimResponse.item.detail.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.item.detail.modifierExtension
path:
  v: ClaimResponse.item.detail.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.item.detail.detailSequence
path:
  v: ClaimResponse.item.detail.detailSequence
short:
  v: Sequência do detalhe
definition:
  v: A number to uniquely reference the claim detail entry.
requirements:
  v: Necessary to provide a mechanism to link the adjudication result to the submitted claim detail.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.item.detail.detailSequence
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.detail.noteNumber
path:
  v: ClaimResponse.item.detail.noteNumber
short:
  v: Número da nota
definition:
  v: The numbers associated with notes below which apply to the adjudication of this item.
requirements:
  v: Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.item.detail.noteNumber
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.detail.adjudication
path:
  v: ClaimResponse.item.detail.adjudication
short:
  v: detalhes da adjudicação do detail
definition:
  v: The adjudication results.
min:
  v: 1
max:
  v: *
base:
  path:
    v: ClaimResponse.item.detail.adjudication
  min:
    v: 1
  max:
    v: *
content reference:
  v: http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.detail.subDetail
path:
  v: ClaimResponse.item.detail.subDetail
short:
  v: Subdetalhes da adjudicação
definition:
  v: A sub-detail adjudication of a simple product or service.
requirements:
  v: The adjudication for sub-details provided on the claim.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.item.detail.subDetail
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.detail.subDetail.id
path:
  v: ClaimResponse.item.detail.subDetail.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.item.detail.subDetail.extension
path:
  v: ClaimResponse.item.detail.subDetail.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.item.detail.subDetail.modifierExtension
path:
  v: ClaimResponse.item.detail.subDetail.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.item.detail.subDetail.subDetailSequence
path:
  v: ClaimResponse.item.detail.subDetail.subDetailSequence
short:
  v: Sequência do subdetalhe
definition:
  v: A number to uniquely reference the claim sub-detail entry.
requirements:
  v: Necessary to provide a mechanism to link the adjudication result to the submitted claim sub-detail.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.item.detail.subDetail.subDetailSequence
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.detail.subDetail.noteNumber
path:
  v: ClaimResponse.item.detail.subDetail.noteNumber
short:
  v: Número da nota
definition:
  v: The numbers associated with notes below which apply to the adjudication of this item.
requirements:
  v: Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.item.detail.subDetail.noteNumber
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.detail.subDetail.adjudication
path:
  v: ClaimResponse.item.detail.subDetail.adjudication
short:
  v: detalhes da adjudicação do subDetail
definition:
  v: The adjudication results.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.item.detail.subDetail.adjudication
  min:
    v: 0
  max:
    v: *
content reference:
  v: http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem
path:
  v: ClaimResponse.addItem
short:
  v: Insurer added line items
definition:
  v: The first-tier service adjudications for payor added product or service lines.
requirements:
  v: Insurers may redefine the provided product or service or may package and/or decompose groups of products and services. The addItems allows the insurer to provide their line item list with linkage to the submitted items/details/sub-details. In a preauthorization the insurer may use the addItem structure to provide additional information on authorized products and services.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.id
path:
  v: ClaimResponse.addItem.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.addItem.extension
path:
  v: ClaimResponse.addItem.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.addItem.modifierExtension
path:
  v: ClaimResponse.addItem.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.addItem.itemSequence
path:
  v: ClaimResponse.addItem.itemSequence
short:
  v: Item sequence number
definition:
  v: Claim items which this service line is intended to replace.
requirements:
  v: Provides references to the claim items.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.itemSequence
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detailSequence
path:
  v: ClaimResponse.addItem.detailSequence
short:
  v: Detail sequence number
definition:
  v: The sequence number of the details within the claim item which this line is intended to replace.
requirements:
  v: Provides references to the claim details within the claim item.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.detailSequence
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.subdetailSequence
path:
  v: ClaimResponse.addItem.subdetailSequence
short:
  v: Subdetail sequence number
definition:
  v: The sequence number of the sub-details within the details within the claim item which this line is intended to replace.
requirements:
  v: Provides references to the claim sub-details within the claim detail.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.subdetailSequence
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.provider
path:
  v: ClaimResponse.addItem.provider
short:
  v: Authorized providers
definition:
  v: The providers who are authorized for the services rendered to the patient.
requirements:
  v: Insurer may provide authorization specifically to a restricted set of providers rather than an open authorization.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.provider
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Practitioner
    link: http://hl7.org/fhir/StructureDefinition/Practitioner
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/PractitionerRole
    link: http://hl7.org/fhir/StructureDefinition/PractitionerRole
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Organization
    link: http://hl7.org/fhir/StructureDefinition/Organization
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.source

id:
  v: ClaimResponse.addItem.productOrService
path:
  v: ClaimResponse.addItem.productOrService
short:
  v: Billing, service, product, or drug code
definition:
  v: When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.
comment:
  v: If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.
requirements:
  v: Necessary to state what was provided or done.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.productOrService
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: ServiceProduct
  strength:
    v: example
  description:
    v: Allowable service and product codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/service-uscls
    link: http://hl7.org/fhir/ValueSet/service-uscls

id:
  v: ClaimResponse.addItem.modifier
path:
  v: ClaimResponse.addItem.modifier
short:
  v: Service/Product billing modifiers
definition:
  v: Item typification or modifiers codes to convey additional context for the product or service.
comment:
  v: For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.
requirements:
  v: To support inclusion of the item for adjudication or to charge an elevated fee.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.modifier
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: Modifiers
  strength:
    v: example
  description:
    v: Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
  value set:
    v: http://hl7.org/fhir/ValueSet/claim-modifiers
    link: http://hl7.org/fhir/ValueSet/claim-modifiers
mapping:
  identity:
    v: rim
  map:
    v: 24.C, 24.D mods

id:
  v: ClaimResponse.addItem.programCode
path:
  v: ClaimResponse.addItem.programCode
short:
  v: Program the product or service is provided under
definition:
  v: Identifies the program under which this may be recovered.
comment:
  v: For example: Neonatal program, child dental program or drug users recovery program.
requirements:
  v: Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.programCode
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: ProgramCode
  strength:
    v: example
  description:
    v: Program specific reason codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/ex-program-code
    link: http://hl7.org/fhir/ValueSet/ex-program-code
mapping:
  identity:
    v: rim
  map:
    v: 24.H

id:
  v: ClaimResponse.addItem.serviced[x]
path:
  v: ClaimResponse.addItem.serviced[x]
short:
  v: Date or dates of service or product delivery
definition:
  v: The date or dates when the service or product was supplied, performed or completed.
requirements:
  v: Needed to determine whether the service or product was provided during the term of the insurance coverage.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.serviced[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: date
type:
  code:
    v: Period
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.done[x]
mapping:
  identity:
    v: rim
  map:
    v: 24.A

id:
  v: ClaimResponse.addItem.location[x]
path:
  v: ClaimResponse.addItem.location[x]
short:
  v: Place of service or where product was supplied
definition:
  v: Where the product or service was provided.
requirements:
  v: The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.location[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
type:
  code:
    v: Address
type:
  code:
    v: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Location
    link: http://hl7.org/fhir/StructureDefinition/Location
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: ServicePlace
  strength:
    v: example
  description:
    v: Place of service: pharmacy, school, prison, etc.
  value set:
    v: http://hl7.org/fhir/ValueSet/service-place
    link: http://hl7.org/fhir/ValueSet/service-place
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.where[x]
mapping:
  identity:
    v: rim
  map:
    v: 24.B

id:
  v: ClaimResponse.addItem.quantity
path:
  v: ClaimResponse.addItem.quantity
short:
  v: Count of products or services
definition:
  v: The number of repetitions of a service or product.
requirements:
  v: Required when the product or service code does not convey the quantity provided.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.quantity
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Quantity
  profile:
    v: http://hl7.org/fhir/StructureDefinition/SimpleQuantity
    link: http://hl7.org/fhir/StructureDefinition/SimpleQuantity
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: 24.G

id:
  v: ClaimResponse.addItem.unitPrice
path:
  v: ClaimResponse.addItem.unitPrice
short:
  v: Fee, charge or cost per item
definition:
  v: If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.
requirements:
  v: The amount charged to the patient by the provider for a single unit.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.unitPrice
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.factor
path:
  v: ClaimResponse.addItem.factor
short:
  v: Price scaling factor
definition:
  v: A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.
comment:
  v: To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).
requirements:
  v: When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.factor
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: decimal
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.net
path:
  v: ClaimResponse.addItem.net
short:
  v: Total item cost
definition:
  v: The quantity times the unit price for an additional service or product or charge.
comment:
  v: For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.
requirements:
  v: Provides the total amount claimed for the group (if a grouper) or the line item.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.net
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: 24.F

id:
  v: ClaimResponse.addItem.bodySite
path:
  v: ClaimResponse.addItem.bodySite
short:
  v: Anatomical location
definition:
  v: Physical service site on the patient (limb, tooth, etc.).
comment:
  v: For example: Providing a tooth code allows an insurer to identify a provider performing a filling on a tooth that was previously removed.
requirements:
  v: Allows insurer to validate specific procedures.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.bodySite
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: OralSites
  strength:
    v: example
  description:
    v: The code for the teeth, quadrant, sextant and arch.
  value set:
    v: http://hl7.org/fhir/ValueSet/tooth
    link: http://hl7.org/fhir/ValueSet/tooth

id:
  v: ClaimResponse.addItem.subSite
path:
  v: ClaimResponse.addItem.subSite
short:
  v: Anatomical sub-location
definition:
  v: A region or surface of the bodySite, e.g. limb region or tooth surface(s).
requirements:
  v: Allows insurer to validate specific procedures.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.subSite
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: Surface
  strength:
    v: example
  description:
    v: The code for the tooth surface and surface combinations.
  value set:
    v: http://hl7.org/fhir/ValueSet/surface
    link: http://hl7.org/fhir/ValueSet/surface

id:
  v: ClaimResponse.addItem.noteNumber
path:
  v: ClaimResponse.addItem.noteNumber
short:
  v: Applicable note numbers
definition:
  v: The numbers associated with notes below which apply to the adjudication of this item.
requirements:
  v: Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.noteNumber
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.adjudication
path:
  v: ClaimResponse.addItem.adjudication
short:
  v: Added items adjudication
definition:
  v: The adjudication results.
min:
  v: 1
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.adjudication
  min:
    v: 1
  max:
    v: *
content reference:
  v: http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail
path:
  v: ClaimResponse.addItem.detail
short:
  v: Insurer added line details
definition:
  v: The second-tier service adjudications for payor added services.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.detail
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.id
path:
  v: ClaimResponse.addItem.detail.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.addItem.detail.extension
path:
  v: ClaimResponse.addItem.detail.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.addItem.detail.modifierExtension
path:
  v: ClaimResponse.addItem.detail.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.addItem.detail.productOrService
path:
  v: ClaimResponse.addItem.detail.productOrService
short:
  v: Billing, service, product, or drug code
definition:
  v: When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.
comment:
  v: If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.
requirements:
  v: Necessary to state what was provided or done.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.productOrService
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: ServiceProduct
  strength:
    v: example
  description:
    v: Allowable service and product codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/service-uscls
    link: http://hl7.org/fhir/ValueSet/service-uscls

id:
  v: ClaimResponse.addItem.detail.modifier
path:
  v: ClaimResponse.addItem.detail.modifier
short:
  v: Service/Product billing modifiers
definition:
  v: Item typification or modifiers codes to convey additional context for the product or service.
comment:
  v: For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.
requirements:
  v: To support inclusion of the item for adjudication or to charge an elevated fee.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.detail.modifier
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: Modifiers
  strength:
    v: example
  description:
    v: Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
  value set:
    v: http://hl7.org/fhir/ValueSet/claim-modifiers
    link: http://hl7.org/fhir/ValueSet/claim-modifiers
mapping:
  identity:
    v: rim
  map:
    v: 24.C, 24.D mods

id:
  v: ClaimResponse.addItem.detail.quantity
path:
  v: ClaimResponse.addItem.detail.quantity
short:
  v: Count of products or services
definition:
  v: The number of repetitions of a service or product.
requirements:
  v: Required when the product or service code does not convey the quantity provided.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.quantity
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Quantity
  profile:
    v: http://hl7.org/fhir/StructureDefinition/SimpleQuantity
    link: http://hl7.org/fhir/StructureDefinition/SimpleQuantity
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: 24.G

id:
  v: ClaimResponse.addItem.detail.unitPrice
path:
  v: ClaimResponse.addItem.detail.unitPrice
short:
  v: Fee, charge or cost per item
definition:
  v: If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.
requirements:
  v: The amount charged to the patient by the provider for a single unit.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.unitPrice
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.factor
path:
  v: ClaimResponse.addItem.detail.factor
short:
  v: Price scaling factor
definition:
  v: A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.
comment:
  v: To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).
requirements:
  v: When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.factor
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: decimal
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.net
path:
  v: ClaimResponse.addItem.detail.net
short:
  v: Total item cost
definition:
  v: The quantity times the unit price for an additional service or product or charge.
comment:
  v: For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.
requirements:
  v: Provides the total amount claimed for the group (if a grouper) or the line item.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.net
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: 24.F

id:
  v: ClaimResponse.addItem.detail.noteNumber
path:
  v: ClaimResponse.addItem.detail.noteNumber
short:
  v: Applicable note numbers
definition:
  v: The numbers associated with notes below which apply to the adjudication of this item.
requirements:
  v: Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.detail.noteNumber
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.adjudication
path:
  v: ClaimResponse.addItem.detail.adjudication
short:
  v: Added items detail adjudication
definition:
  v: The adjudication results.
min:
  v: 1
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.detail.adjudication
  min:
    v: 1
  max:
    v: *
content reference:
  v: http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.subDetail
path:
  v: ClaimResponse.addItem.detail.subDetail
short:
  v: Insurer added line items
definition:
  v: The third-tier service adjudications for payor added services.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.subDetail.id
path:
  v: ClaimResponse.addItem.detail.subDetail.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.addItem.detail.subDetail.extension
path:
  v: ClaimResponse.addItem.detail.subDetail.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.addItem.detail.subDetail.modifierExtension
path:
  v: ClaimResponse.addItem.detail.subDetail.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.addItem.detail.subDetail.productOrService
path:
  v: ClaimResponse.addItem.detail.subDetail.productOrService
short:
  v: Billing, service, product, or drug code
definition:
  v: When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.
comment:
  v: If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.
requirements:
  v: Necessary to state what was provided or done.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.productOrService
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: ServiceProduct
  strength:
    v: example
  description:
    v: Allowable service and product codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/service-uscls
    link: http://hl7.org/fhir/ValueSet/service-uscls

id:
  v: ClaimResponse.addItem.detail.subDetail.modifier
path:
  v: ClaimResponse.addItem.detail.subDetail.modifier
short:
  v: Service/Product billing modifiers
definition:
  v: Item typification or modifiers codes to convey additional context for the product or service.
comment:
  v: For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.
requirements:
  v: To support inclusion of the item for adjudication or to charge an elevated fee.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.modifier
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: Modifiers
  strength:
    v: example
  description:
    v: Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
  value set:
    v: http://hl7.org/fhir/ValueSet/claim-modifiers
    link: http://hl7.org/fhir/ValueSet/claim-modifiers
mapping:
  identity:
    v: rim
  map:
    v: 24.C, 24.D mods

id:
  v: ClaimResponse.addItem.detail.subDetail.quantity
path:
  v: ClaimResponse.addItem.detail.subDetail.quantity
short:
  v: Count of products or services
definition:
  v: The number of repetitions of a service or product.
requirements:
  v: Required when the product or service code does not convey the quantity provided.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.quantity
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Quantity
  profile:
    v: http://hl7.org/fhir/StructureDefinition/SimpleQuantity
    link: http://hl7.org/fhir/StructureDefinition/SimpleQuantity
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: 24.G

id:
  v: ClaimResponse.addItem.detail.subDetail.unitPrice
path:
  v: ClaimResponse.addItem.detail.subDetail.unitPrice
short:
  v: Fee, charge or cost per item
definition:
  v: If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.
requirements:
  v: The amount charged to the patient by the provider for a single unit.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.unitPrice
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.subDetail.factor
path:
  v: ClaimResponse.addItem.detail.subDetail.factor
short:
  v: Price scaling factor
definition:
  v: A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.
comment:
  v: To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).
requirements:
  v: When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.factor
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: decimal
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.subDetail.net
path:
  v: ClaimResponse.addItem.detail.subDetail.net
short:
  v: Total item cost
definition:
  v: The quantity times the unit price for an additional service or product or charge.
comment:
  v: For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.
requirements:
  v: Provides the total amount claimed for the group (if a grouper) or the line item.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.net
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: 24.F

id:
  v: ClaimResponse.addItem.detail.subDetail.noteNumber
path:
  v: ClaimResponse.addItem.detail.subDetail.noteNumber
short:
  v: Applicable note numbers
definition:
  v: The numbers associated with notes below which apply to the adjudication of this item.
requirements:
  v: Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.noteNumber
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.subDetail.adjudication
path:
  v: ClaimResponse.addItem.detail.subDetail.adjudication
short:
  v: Added items detail adjudication
definition:
  v: The adjudication results.
min:
  v: 1
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.adjudication
  min:
    v: 1
  max:
    v: *
content reference:
  v: http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.adjudication
path:
  v: ClaimResponse.adjudication
short:
  v: Header-level adjudication
definition:
  v: The adjudication results which are presented at the header level rather than at the line-item or add-item levels.
requirements:
  v: Some insurers will receive line-items but provide the adjudication only at a summary or header-level.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.adjudication
  min:
    v: 0
  max:
    v: *
content reference:
  v: http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.total
path:
  v: ClaimResponse.total
short:
  v: Adjudication totals
definition:
  v: Categorized monetary totals for the adjudication.
comment:
  v: Totals for amounts submitted, co-pays, benefits payable etc.
requirements:
  v: To provide the requestor with financial totals by category for the adjudication.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.total
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: ClaimResponse.total.id
path:
  v: ClaimResponse.total.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.total.extension
path:
  v: ClaimResponse.total.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.total.modifierExtension
path:
  v: ClaimResponse.total.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.total.category
path:
  v: ClaimResponse.total.category
short:
  v: Type of adjudication information
definition:
  v: A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.
comment:
  v: For example codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.
requirements:
  v: Needed to convey the type of total provided.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.total.category
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: Adjudication
  strength:
    v: example
  description:
    v: The adjudication codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/adjudication
    link: http://hl7.org/fhir/ValueSet/adjudication

id:
  v: ClaimResponse.total.amount
path:
  v: ClaimResponse.total.amount
short:
  v: Financial total for the category
definition:
  v: Monetary total amount associated with the category.
requirements:
  v: Needed to convey the total monetary amount.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.total.amount
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: ClaimResponse.payment
path:
  v: ClaimResponse.payment
short:
  v: Detalhes do pagamento
definition:
  v: Payment details for the adjudication of the claim.
requirements:
  v: Needed to convey references to the financial instrument that has been used if payment has been made.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.payment
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.payment.id
path:
  v: ClaimResponse.payment.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.payment.extension
path:
  v: ClaimResponse.payment.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.payment.modifierExtension
path:
  v: ClaimResponse.payment.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.payment.type
path:
  v: ClaimResponse.payment.type
short:
  v: Tipo de pagamento
definition:
  v: Whether this represents partial or complete payment of the benefits payable.
requirements:
  v: To advise the requestor when the insurer believes all payments to have been completed.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.payment.type
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  strength:
    v: required
  value set:
    v: https://hl7.org/fhir/R5/valueset-payment-type.html
    link: https://hl7.org/fhir/R5/valueset-payment-type.html

id:
  v: ClaimResponse.payment.adjustment
path:
  v: ClaimResponse.payment.adjustment
short:
  v: Payment adjustment for non-claim issues
definition:
  v: Total amount of all adjustments to this payment included in this transaction which are not related to this claim's adjudication.
comment:
  v: Insurers will deduct amounts owing from the provider (adjustment), such as a prior overpayment, from the amount owing to the provider (benefits payable) when payment is made to the provider.
requirements:
  v: To advise the requestor of adjustments applied to the payment.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.payment.adjustment
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.payment.adjustmentReason
path:
  v: ClaimResponse.payment.adjustmentReason
short:
  v: Explanation for the adjustment
definition:
  v: Reason for the payment adjustment.
requirements:
  v: Needed to clarify the monetary adjustment.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.payment.adjustmentReason
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: PaymentAdjustmentReason
  strength:
    v: example
  description:
    v: Payment Adjustment reason codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/payment-adjustment-reason
    link: http://hl7.org/fhir/ValueSet/payment-adjustment-reason

id:
  v: ClaimResponse.payment.date
path:
  v: ClaimResponse.payment.date
short:
  v: Expected date of payment
definition:
  v: Estimated date the payment will be issued or the actual issue date of payment.
requirements:
  v: To advise the payee when payment can be expected.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.payment.date
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: date
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.payment.amount
path:
  v: ClaimResponse.payment.amount
short:
  v: Valor do pagamento
definition:
  v: Benefits payable less any payment adjustment.
requirements:
  v: Needed to provide the actual payment amount.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.payment.amount
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.payment.identifier
path:
  v: ClaimResponse.payment.identifier
short:
  v: Business identifier for the payment
definition:
  v: Issuer's unique identifier for the payment instrument.
comment:
  v: For example: EFT number or check number.
requirements:
  v: Enable the receiver to reconcile when payment received.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.payment.identifier
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.fundsReserve
path:
  v: ClaimResponse.fundsReserve
short:
  v: Funds reserved status
definition:
  v: A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom.
comment:
  v: Fund would be release by a future claim quoting the preAuthRef of this response. Examples of values include: provider, patient, none.
requirements:
  v: Needed to advise the submitting provider on whether the rquest for reservation of funds has been honored.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.fundsReserve
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: FundsReserve
  strength:
    v: example
  description:
    v: For whom funds are to be reserved: (Patient, Provider, None).
  value set:
    v: http://hl7.org/fhir/ValueSet/fundsreserve
    link: http://hl7.org/fhir/ValueSet/fundsreserve

id:
  v: ClaimResponse.formCode
path:
  v: ClaimResponse.formCode
short:
  v: Printed form identifier
definition:
  v: A code for the form to be used for printing the content.
comment:
  v: May be needed to identify specific jurisdictional forms.
requirements:
  v: Needed to specify the specific form used for producing output for this response.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.formCode
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: Forms
  strength:
    v: example
  description:
    v: The forms codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/forms
    link: http://hl7.org/fhir/ValueSet/forms

id:
  v: ClaimResponse.form
path:
  v: ClaimResponse.form
short:
  v: Printed reference or actual form
definition:
  v: The actual form, by reference or inclusion, for printing the content or an EOB.
comment:
  v: Needed to permit insurers to include the actual form.
requirements:
  v: Needed to include the specific form used for producing output for this response.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.form
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Attachment
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.processNote
path:
  v: ClaimResponse.processNote
short:
  v: Note concerning adjudication
definition:
  v: A note that describes or explains adjudication results in a human readable form.
requirements:
  v: Provides the insurer specific textual explanations associated with the processing.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.processNote
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.processNote.id
path:
  v: ClaimResponse.processNote.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.processNote.extension
path:
  v: ClaimResponse.processNote.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.processNote.modifierExtension
path:
  v: ClaimResponse.processNote.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.processNote.number
path:
  v: ClaimResponse.processNote.number
short:
  v: Note instance identifier
definition:
  v: A number to uniquely identify a note entry.
requirements:
  v: Necessary to provide a mechanism to link from adjudications.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.processNote.number
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.processNote.type
path:
  v: ClaimResponse.processNote.type
short:
  v: display | print | printoper
definition:
  v: The business purpose of the note text.
requirements:
  v: To convey the expectation for when the text is used.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.processNote.type
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: NoteType
  strength:
    v: required
  description:
    v: The presentation types of notes.
  value set:
    v: http://hl7.org/fhir/ValueSet/note-type|4.0.1
    link: 4.0
    link: .1

id:
  v: ClaimResponse.processNote.text
path:
  v: ClaimResponse.processNote.text
short:
  v: Note explanatory text
definition:
  v: The explanation or description associated with the processing.
requirements:
  v: Required to provide human readable explanation.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.processNote.text
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.processNote.language
path:
  v: ClaimResponse.processNote.language
short:
  v: Language of the text
definition:
  v: A code to define the language used in the text of the note.
comment:
  v: Only required if the language is different from the resource language.
requirements:
  v: Note text may vary from the resource defined language.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.processNote.language
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet
    value: canonical
      v: http://hl7.org/fhir/ValueSet/all-languages
      link: http://hl7.org/fhir/ValueSet/all-languages
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: Language
  strength:
    v: preferred
  description:
    v: A human language.
  value set:
    v: http://hl7.org/fhir/ValueSet/languages
    link: http://hl7.org/fhir/ValueSet/languages

id:
  v: ClaimResponse.communicationRequest
path:
  v: ClaimResponse.communicationRequest
short:
  v: Request for additional information
definition:
  v: Request for additional supporting or authorizing information.
comment:
  v: For example: professional reports, documents, images, clinical resources, or accident reports.
requirements:
  v: Need to communicate insurer request for additional information required to support the adjudication.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.communicationRequest
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/CommunicationRequest
    link: http://hl7.org/fhir/StructureDefinition/CommunicationRequest
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.insurance
path:
  v: ClaimResponse.insurance
short:
  v: Patient insurance information
definition:
  v: Financial instruments for reimbursement for the health care products and services specified on the claim.
comment:
  v: All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim.
requirements:
  v: At least one insurer is required for a claim to be a claim.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.insurance
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: Coverage

id:
  v: ClaimResponse.insurance.id
path:
  v: ClaimResponse.insurance.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.insurance.extension
path:
  v: ClaimResponse.insurance.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.insurance.modifierExtension
path:
  v: ClaimResponse.insurance.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.insurance.sequence
path:
  v: ClaimResponse.insurance.sequence
short:
  v: Insurance instance identifier
definition:
  v: A number to uniquely identify insurance entries and provide a sequence of coverages to convey coordination of benefit order.
requirements:
  v: To maintain order of the coverages.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.insurance.sequence
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.insurance.focal
path:
  v: ClaimResponse.insurance.focal
short:
  v: Coverage to be used for adjudication
definition:
  v: A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true.
comment:
  v: A patient may (will) have multiple insurance policies which provide reimbursement for healthcare services and products. For example a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for adjudicating this claim. Other claims would be created to request adjudication against the other listed policies.
requirements:
  v: To identify which coverage in the list is being used to adjudicate this claim.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.insurance.focal
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: boolean
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.insurance.coverage
path:
  v: ClaimResponse.insurance.coverage
short:
  v: Insurance information
definition:
  v: Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system.
requirements:
  v: Required to allow the adjudicator to locate the correct policy and history within their information system.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.insurance.coverage
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Coverage
    link: http://hl7.org/fhir/StructureDefinition/Coverage
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.insurance.businessArrangement
path:
  v: ClaimResponse.insurance.businessArrangement
short:
  v: Additional provider contract number
definition:
  v: A business agreement number established between the provider and the insurer for special business processing purposes.
requirements:
  v: Providers may have multiple business arrangements with a given insurer and must supply the specific contract number for adjudication.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.insurance.businessArrangement
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.insurance.claimResponse
path:
  v: ClaimResponse.insurance.claimResponse
short:
  v: Adjudication results
definition:
  v: The result of the adjudication of the line items for the Coverage specified in this insurance.
comment:
  v: Must not be specified when 'focal=true' for this insurance.
requirements:
  v: An insurer need the adjudication results from prior insurers to determine the outstanding balance remaining by item for the items in the curent claim.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.insurance.claimResponse
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/ClaimResponse
    link: http://hl7.org/fhir/StructureDefinition/ClaimResponse
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.error
path:
  v: ClaimResponse.error
short:
  v: Processing errors
definition:
  v: Errors encountered during the processing of the adjudication.
comment:
  v: If the request contains errors then an error element should be provided and no adjudication related sections (item, addItem, or payment) should be present.
requirements:
  v: Need to communicate processing issues to the requestor.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.error
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.error.id
path:
  v: ClaimResponse.error.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.error.extension
path:
  v: ClaimResponse.error.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.error.modifierExtension
path:
  v: ClaimResponse.error.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.error.itemSequence
path:
  v: ClaimResponse.error.itemSequence
short:
  v: Item sequence number
definition:
  v: The sequence number of the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure.
requirements:
  v: Provides references to the claim items.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.error.itemSequence
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.error.detailSequence
path:
  v: ClaimResponse.error.detailSequence
short:
  v: Detail sequence number
definition:
  v: The sequence number of the detail within the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure.
requirements:
  v: Provides references to the claim details within the claim item.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.error.detailSequence
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.error.subDetailSequence
path:
  v: ClaimResponse.error.subDetailSequence
short:
  v: Subdetail sequence number
definition:
  v: The sequence number of the sub-detail within the detail within the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure.
requirements:
  v: Provides references to the claim sub-details within the claim detail.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.error.subDetailSequence
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.error.code
path:
  v: ClaimResponse.error.code
short:
  v: Código do erro
definition:
  v: An error code, from a specified code system, which details why the claim could not be adjudicated.
requirements:
  v: Required to convey processing errors.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.error.code
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())