PDexAdjudication

PDex Adjudication

activeDa Vinci PDex2.1.014 concepts

Describes the various amount fields used when payers receive and adjudicate a claim. It includes the values defined in http://terminology.hl7.org/CodeSystem/adjudication, as well as those defined in the C4BB Adjudication CodeSystem.

Metadata

hl7.org/fhir

Canonical URL: http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexAdjudication
ID: PDexAdjudication
Name: PDexAdjudication

`http://terminology.hl7.org/CodeSystem/adjudication`

5 codes

Code	Display
`submitted`	-
`copay`	-
`eligible`	-
`deductible`	-
`benefit`	-

`http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication`

9 codes

Code	Display
`coinsurance`	Coinsurance
`noncovered`	Noncovered
`priorpayerpaid`	Prior payer paid
`paidbypatient`	Paid by patient
`paidtopatient`	Paid to patient
`paidtoprovider`	Paid to provider
`memberliability`	Member liability
`discount`	Discount
`drugcost`	Drug cost