AdjudicationValueCodes

Adjudication Value Codes

draftExtensions for Using Data Elements from FHIR R5 in FHIR R40.1.0complete8 concepts

This value set includes a smattering of Adjudication Value codes which includes codes to indicate the amounts eligible under the plan, the amount of benefit, copays etc.

Metadata

hl7.org/fhir

Canonical URL: http://terminology.hl7.org/CodeSystem/adjudication
ID: adjudication
Version: 0.1.0
Publisher: Financial Management
Case Sensitive: Yes

Concepts (8)

Code	Display	Definition
`submitted`	Submitted Amount	The total submitted amount for the claim or group or line item.
`copay`	CoPay	Patient Co-Payment
`eligible`	Eligible Amount	Amount of the change which is considered for adjudication.
`deductible`	Deductible	Amount deducted from the eligible amount prior to adjudication.
`unallocdeduct`	Unallocated Deductible	The amount of deductible which could not allocated to other line items.
`eligpercent`	Eligible %	Eligible Percentage.
`tax`	Tax	The amount of tax.
`benefit`	Benefit Amount	Amount payable under the coverage