HL7 Vietnam
VN Core FHIR
Implementation Guide
Bộ Hướng dẫn Triển khai Core FHIR cho Việt Nam
0.5.1 - Draft for Community Review
VN
Bộ Hướng dẫn Triển khai Core FHIR cho Việt Nam - Draft for Community Review (v0.5.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Draft tại thời điểm 2026-03-21 |
Biểu diễn TTL của vn-core-claim-response hồ sơ tài nguyên.
@prefix fhir: <http://hl7.org/fhir/> . @prefix owl: <http://www.w3.org/2002/07/owl#> . @prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> . @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> . @prefix xsd: <http://www.w3.org/2001/XMLSchema#> . # - resource ------------------------------------------------------------------- a fhir:StructureDefinition ; fhir:nodeRole fhir:treeRoot ; fhir:id [ fhir:v "vn-core-claim-response"] ; # fhir:language [ fhir:v "vi"] ; # fhir:text [ fhir:status [ fhir:v "extensions" ] ; fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: StructureDefinition vn-core-claim-response</b></p><a name=\"vn-core-claim-response\"> </a><a name=\"hcvn-core-claim-response\"> </a><table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"The logical name of the element\">Name</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Information about the use of the element\">Flags</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Minimum and Maximum # of times the element can appear in the instance\">Card.</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px; width: 100px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Reference to the type of the element\">Type</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Additional information about the element\">Description & Constraints</a><span style=\"float: right\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_resource.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Resource\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse\">ClaimResponse</a><a name=\"ClaimResponse\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/claimresponse.html\">ClaimResponse</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Response to a claim predetermination or preauthorization</span></td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic; font-style: italic\" href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.identifier\">Slices for identifier</a><a name=\"ClaimResponse.identifier\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000; font-style: italic\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"opacity: 0.5; font-style: italic\">0</span><span style=\"opacity: 0.5; font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">*</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; font-style: italic; opacity: 0.5; font-style: italic\" href=\"http://hl7.org/fhir/R4/datatypes.html#Identifier\">Identifier</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\">Định danh kết quả xử lý, bao gồm mã phản hồi gateway nếu có</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Open by value:system</span></td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.identifier:gatewayResponseId\" title=\"Slice gatewayResponseId: Mã phản hồi của Cổng tiếp nhận dữ liệu cho hồ sơ/bảng XML1. Không dùng thay cho MA_LK.\">identifier:gatewayResponseId</a><a name=\"ClaimResponse.identifier.2\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Identifier\">Identifier</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Mã phản hồi Cổng tiếp nhận BHYT (XML1_ID)</td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1251.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.identifier:gatewayResponseId.type\">type</a><a name=\"ClaimResponse.identifier.type\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Description of identifier</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck12501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(Complex)</span></td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">http://fhir.hl7.org.vn/core/CodeSystem/vn-identifier-type-cs</span></td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">BHYT_XML1_ID</span></td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1250.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.identifier:gatewayResponseId.system\">system</a><a name=\"ClaimResponse.identifier.system\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">The namespace for the identifier value</span><br/><span style=\"font-weight:bold\">Fixed Value: </span><span style=\"color: darkgreen\">http://fhir.hl7.org.vn/core/sid/bhyt-gateway-response-id</span></td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1240.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.identifier:gatewayResponseId.value\">value</a><a name=\"ClaimResponse.identifier.value\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Giá trị XML1_ID hoặc mã phản hồi tương đương</td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.status\">status</a><a name=\"ClaimResponse.status\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Trạng thái kết quả: active | cancelled | draft | entered-in-error</td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.type\">type</a><a name=\"ClaimResponse.type\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Loại: institutional (nội trú) | professional (ngoại trú)</td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.use\">use</a><a name=\"ClaimResponse.use\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Mục đích: claim | preauthorization | predetermination</td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_reference.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Reference to another Resource\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.patient\">patient</a><a name=\"ClaimResponse.patient\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/references.html\">Reference</a>(<a href=\"StructureDefinition-vn-core-patient.html\">Bệnh nhân VN Core — VN Core Patient Profile</a>)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Bệnh nhân</td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.created\">created</a><a name=\"ClaimResponse.created\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#dateTime\">dateTime</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Ngày tạo kết quả</td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_reference.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Reference to another Resource\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.insurer\">insurer</a><a name=\"ClaimResponse.insurer\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/references.html\">Reference</a>(<a href=\"StructureDefinition-vn-core-organization.html\">Cơ sở y tế VN Core — VN Core Organization Profile</a>)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Cơ quan BHXH giải quyết</td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_reference.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Reference to another Resource\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.request\">request</a><a name=\"ClaimResponse.request\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/references.html\">Reference</a>(<a href=\"StructureDefinition-vn-core-claim.html\">Yêu cầu thanh toán KCB VN Core — VN Core Claim Profile</a>)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Yêu cầu thanh toán gốc (VNCoreClaim)</td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.outcome\">outcome</a><a name=\"ClaimResponse.outcome\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Kết quả: queued | complete | error | partial</td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.item\">item</a><a name=\"ClaimResponse.item\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Kết quả từng dòng chi phí</td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.item.itemSequence\">itemSequence</a><a name=\"ClaimResponse.item.itemSequence\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#positiveInt\">positiveInt</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Claim item instance identifier</span></td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck101.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.item.adjudication\">adjudication</a><a name=\"ClaimResponse.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Phân bổ chi phí: đề nghị, đủ ĐK, cùng chi trả, BHYT thanh toán</td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.item.adjudication.category\" title=\"Category giám định từng dòng. Ưu tiên HL7 adjudication (`submitted`, `eligible`, `copay`, `benefit`) cho line-level adjudication; các subtotal cục bộ của VN Core không dùng ở line-level.\">category</a><a name=\"ClaimResponse.item.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Loại: submitted | eligible | copay | benefit<br class=\"binding\"/><span style=\"font-weight:bold\" title=\"null\" class=\"binding\">Binding: </span><a href=\"http://hl7.org/fhir/R4/valueset-adjudication.html\" title=\"http://hl7.org/fhir/ValueSet/adjudication\" class=\"binding\">AdjudicationValueCodes</a><span title=\"null\" class=\"binding\"> (</span><a href=\"http://hl7.org/fhir/R4/terminologies.html#extensible\" title=\"To be conformant, the concept in this element SHALL be from the specified value set if any of the codes within the value set can apply to the concept being communicated. If the value set does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.\" class=\"binding\">extensible</a><span title=\"null\" class=\"binding\">)</span></td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.item.adjudication.amount\">amount</a><a name=\"ClaimResponse.item.adjudication.amount\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Money\">Money</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Số tiền (VND)</td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.total\">total</a><a name=\"ClaimResponse.total\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Tổng adjudication</td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.total.category\" title=\"Category tổng hợp tài chính/adjudication. Dùng ConceptMap `vn-cm-bhyt-financial-field-to-adjudication` để map các trường tổng tiền BHYT như `T_TONGCHI`, `T_TONGCHI_BH`, `T_BHTT`, `T_BNCCT`, `T_BNTT`, `T_NGUONKHAC`, `T_NGOAIDS`, `T_THUOC`, `T_VTYT`. Không encode công thức quyền lợi hoặc adjudication business rule tại profile.\">category</a><a name=\"ClaimResponse.total.category\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ<br class=\"binding\"/><span style=\"font-weight:bold\" title=\"null\" class=\"binding\">Binding: </span><a href=\"ValueSet-vn-bhyt-adjudication-category-vs.html\" title=\"http://fhir.hl7.org.vn/core/ValueSet/vn-bhyt-adjudication-category-vs\" class=\"binding\">Loại adjudication BHYT — BHYT Adjudication Category ValueSet</a><span title=\"null\" class=\"binding\"> (</span><a href=\"http://hl7.org/fhir/R4/terminologies.html#extensible\" title=\"To be conformant, the concept in this element SHALL be from the specified value set if any of the codes within the value set can apply to the concept being communicated. If the value set does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.\" class=\"binding\">extensible</a><span title=\"null\" class=\"binding\">)</span></td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.total.amount\">amount</a><a name=\"ClaimResponse.total.amount\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Money\">Money</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Financial total for the category</span></td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.payment\">payment</a><a name=\"ClaimResponse.payment\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Thông tin thanh toán</td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.payment.amount\">amount</a><a name=\"ClaimResponse.payment.amount\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Money\">Money</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Số tiền BHXH thanh toán</td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.error\" title=\"Issue-level carrier cho phản hồi giám định, giảm trừ, yêu cầu điều chỉnh hoặc lỗi tiếp nhận có liên kết tới claim. `VNBHYTReviewIssueVS` chỉ là taxonomy baseline cục bộ từ TT 12/2026; không phải catalog payer/gateway chính thức đầy đủ.\">error</a><a name=\"ClaimResponse.error\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Nhóm issue giám định/từ chối hoặc yêu cầu điều chỉnh</td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.error.itemSequence\">itemSequence</a><a name=\"ClaimResponse.error.itemSequence\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#positiveInt\">positiveInt</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Dòng chi phí liên quan nếu có</td></tr>#xD;\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-vn-core-claim-response-definitions.html#ClaimResponse.error.code\" title=\"Mã nhóm issue để liên kết `ClaimResponse` với `OperationOutcome`, bảng kê từ chối hoặc biên bản giám định. Căn cứ pháp lý chi tiết và số tiền vẫn nằm ở tài liệu giám định/payer response cụ thể.\">code</a><a name=\"ClaimResponse.error.code\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: #D50000\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Nhóm issue/lý do BHYT<br class=\"binding\"/><span style=\"font-weight:bold\" title=\"null\" class=\"binding\">Binding: </span><a href=\"ValueSet-vn-bhyt-review-issue-vs.html\" title=\"http://fhir.hl7.org.vn/core/ValueSet/vn-bhyt-review-issue-vs\" class=\"binding\">Nhóm issue giám định BHYT cục bộ — VN BHYT Review Issue ValueSet</a><span title=\"null\" class=\"binding\"> (</span><a href=\"http://hl7.org/fhir/R4/terminologies.html#extensible\" title=\"To be conformant, the concept in this element SHALL be from the specified value set if any of the codes within the value set can apply to the concept being communicated. If the value set does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.\" class=\"binding\">extensible</a><span title=\"null\" class=\"binding\">)</span></td></tr>#xD;\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"^^rdf:XMLLiteral ] ] ; # fhir:url [ fhir:v "http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-claim-response"^^xsd:anyURI ; fhir:l <http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-claim-response> ] ; # fhir:version [ fhir:v "0.5.1"] ; # fhir:name [ fhir:v "VNCoreClaimResponse"] ; # fhir:title [ fhir:v "Kết quả giải quyết BHYT VN Core — VN Core ClaimResponse Profile"] ; # fhir:status [ fhir:v "draft"] ; # fhir:date [ fhir:v "2026-03-21"^^xsd:date] ; # fhir:publisher [ fhir:v "Omi HealthTech / VN Core FHIR Community Initiative"] ; # fhir:contact ( [ fhir:name [ fhir:v "Omi HealthTech / VN Core FHIR Community Initiative" ] ; ( fhir:telecom [ fhir:system [ fhir:v "url" ] ; fhir:value [ fhir:v "https://hl7.org.vn" ] ] [ fhir:system [ fhir:v "email" ] ; fhir:value [ fhir:v "info@hl7.org.vn" ] ] ) ] [ fhir:name [ fhir:v "Omi HealthTech (OmiGroup)" ] ; ( fhir:telecom [ fhir:system [ fhir:v "url" ] ; fhir:value [ fhir:v "https://omihealthtech.vn" ] ] [ fhir:system [ fhir:v "url" ] ; fhir:value [ fhir:v "https://omigroup.vn" ] ] [ fhir:system [ fhir:v "email" ] ; fhir:value [ fhir:v "healthtech@omigroup.vn" ] ] ) ] ) ; # fhir:description [ fhir:v "Profile ClaimResponse cho Việt Nam. Kết quả xử lý yêu cầu thanh toán BHYT.\nBao gồm adjudication chi tiết: tổng đề nghị, đủ điều kiện, cùng chi trả, BHYT thanh toán.\nCặp đôi với VNCoreClaim — Claim là yêu cầu, ClaimResponse là kết quả.\nMã phản hồi gateway như XML1_ID được biểu diễn bằng identifier slice riêng; không thay thế MA_LK của Claim/Bundle.\nCăn cứ:\n- QĐ 130/QĐ-BYT → QĐ 4750/QĐ-BYT → QĐ 3176/QĐ-BYT (chuẩn dữ liệu BHXH hiện hành)\n- QĐ 697/QĐ-BYT (19/3/2026) — Mẫu bảng kê chi phí KCB\n- Luật 51/2024/QH15 (27/11/2024) — sửa đổi Luật BHYT, hiệu lực 01/7/2025\n- NĐ 188/2025/NĐ-CP — ban hành 01/7/2025, hiệu lực 15/8/2025 — Hướng dẫn Luật BHYT\n- NĐ 90/2026/NĐ-CP (ban hành 30/03/2026, hiệu lực 15/05/2026 — future-effective) — xử phạt VPHC y tế, tham chiếu khi hồ sơ giám định/thanh toán sai lệch\nNguồn thiết kế: OHP Data Processor (ClaimResponse adjudication mapping)."] ; # fhir:jurisdiction ( [ ( fhir:coding [ fhir:system [ fhir:v "urn:iso:std:iso:3166"^^xsd:anyURI ; fhir:l <urn:iso:std:iso:3166> ] ; fhir:code [ fhir:v "VN" ] ; fhir:display [ fhir:v "Viet Nam" ] ] ) ] ) ; # fhir:fhirVersion [ fhir:v "4.0.1"] ; # fhir:mapping ( [ fhir:identity [ fhir:v "workflow" ] ; fhir:uri [ fhir:v "http://hl7.org/fhir/workflow"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/workflow> ] ; fhir:name [ fhir:v "Workflow Pattern" ] ] [ fhir:identity [ fhir:v "w5" ] ; fhir:uri [ fhir:v "http://hl7.org/fhir/fivews"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/fivews> ] ; fhir:name [ fhir:v "FiveWs Pattern Mapping" ] ] [ fhir:identity [ fhir:v "rim" ] ; fhir:uri [ fhir:v "http://hl7.org/v3"^^xsd:anyURI ; fhir:l <http://hl7.org/v3> ] ; fhir:name [ fhir:v "RIM Mapping" ] ] ) ; # fhir:kind [ fhir:v "resource"] ; # fhir:abstract [ fhir:v false] ; # fhir:type [ fhir:v "ClaimResponse"^^xsd:anyURI ; fhir:l fhir:ClaimResponse ] ; # fhir:baseDefinition [ fhir:v "http://hl7.org/fhir/StructureDefinition/ClaimResponse"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/ClaimResponse> ] ; # fhir:derivation [ fhir:v "constraint"] ; # fhir:snapshot [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version> ] ; fhir:value [ a fhir:String ; fhir:v "4.0.1" ] ] ) ; ( fhir:element [ fhir:id [ fhir:v "ClaimResponse" ] ; fhir:path [ fhir:v "ClaimResponse" ] ; fhir:short [ fhir:v "Response to a claim predetermination or preauthorization" ] ; fhir:definition [ fhir:v "This resource provides the adjudication details from the processing of a Claim resource." ] ; ( fhir:alias [ fhir:v "Remittance Advice" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:constraint [ fhir:key [ fhir:v "dom-2" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "If the resource is contained in another resource, it SHALL NOT contain nested Resources" ] ; fhir:expression [ fhir:v "contained.contained.empty()" ] ; fhir:xpath [ fhir:v "not(parent::f:contained and f:contained)" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/DomainResource"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/DomainResource> ] ] [ fhir:key [ fhir:v "dom-3" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir: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" ] ; fhir:expression [ fhir: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()" ] ; fhir:xpath [ fhir: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='#'])]))" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/DomainResource"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/DomainResource> ] ] [ fhir:key [ fhir:v "dom-4" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" ] ; fhir:expression [ fhir:v "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" ] ; fhir:xpath [ fhir:v "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/DomainResource"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/DomainResource> ] ] [ fhir:key [ fhir:v "dom-5" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "If a resource is contained in another resource, it SHALL NOT have a security label" ] ; fhir:expression [ fhir:v "contained.meta.security.empty()" ] ; fhir:xpath [ fhir:v "not(exists(f:contained/*/f:meta/f:security))" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/DomainResource"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/DomainResource> ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice> ] ; fhir:value [ a fhir:Boolean ; fhir:v true ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation> ] ; fhir:value [ a fhir:Markdown ; fhir: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." ] ] ) ; fhir:key [ fhir:v "dom-6" ] ; fhir:severity [ fhir:v "warning" ] ; fhir:human [ fhir:v "A resource should have narrative for robust management" ] ; fhir:expression [ fhir:v "text.`div`.exists()" ] ; fhir:xpath [ fhir:v "exists(f:text/h:div)" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/DomainResource"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/DomainResource> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "Entity. Role, or Act" ] ] [ fhir:identity [ fhir:v "workflow" ] ; fhir:map [ fhir:v "Event" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.id" ] ; fhir:path [ fhir:v "ClaimResponse.id" ] ; fhir:short [ fhir:v "Logical id of this artifact" ] ; fhir:definition [ fhir:v "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." ] ; fhir:comment [ fhir: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." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Resource.id" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type> ] ; fhir:value [ a fhir:Url ; fhir:v "id"^^xsd:anyURI ; fhir:l fhir:id ] ] ) ; fhir:code [ fhir:v "http://hl7.org/fhirpath/System.String"^^xsd:anyURI ; fhir:l <http://hl7.org/fhirpath/System.String> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.meta" ] ; fhir:path [ fhir:v "ClaimResponse.meta" ] ; fhir:short [ fhir:v "Metadata about the resource" ] ; fhir:definition [ fhir: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." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Resource.meta" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Meta"^^xsd:anyURI ; fhir:l fhir:Meta ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.implicitRules" ] ; fhir:path [ fhir:v "ClaimResponse.implicitRules" ] ; fhir:short [ fhir:v "A set of rules under which this content was created" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir: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." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Resource.implicitRules" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "uri"^^xsd:anyURI ; fhir:l fhir:uri ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v true ] ; fhir:isModifierReason [ fhir: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" ] ; fhir:isSummary [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.language" ] ; fhir:path [ fhir:v "ClaimResponse.language" ] ; fhir:short [ fhir:v "Language of the resource content" ] ; fhir:definition [ fhir:v "The base language in which the resource is written." ] ; fhir:comment [ fhir: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)." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Resource.language" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "code"^^xsd:anyURI ; fhir:l fhir:code ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet> ] ; fhir:value [ a fhir:Canonical ; fhir:v "http://hl7.org/fhir/ValueSet/all-languages"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/all-languages> ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "Language" ] ] ) ; fhir:strength [ fhir:v "preferred" ] ; fhir:description [ fhir:v "A human language." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/languages|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/languages?version=4.0.1> ] ] ] [ fhir:id [ fhir:v "ClaimResponse.text" ] ; fhir:path [ fhir:v "ClaimResponse.text" ] ; fhir:short [ fhir:v "Text summary of the resource, for human interpretation" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir: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." ] ; ( fhir:alias [ fhir:v "narrative" ] [ fhir:v "html" ] [ fhir:v "xhtml" ] [ fhir:v "display" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "DomainResource.text" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Narrative"^^xsd:anyURI ; fhir:l fhir:Narrative ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "Act.text?" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.contained" ] ; fhir:path [ fhir:v "ClaimResponse.contained" ] ; fhir:short [ fhir:v "Contained, inline Resources" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir: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." ] ; ( fhir:alias [ fhir:v "inline resources" ] [ fhir:v "anonymous resources" ] [ fhir:v "contained resources" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "DomainResource.contained" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Resource"^^xsd:anyURI ; fhir:l fhir:Resource ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "N/A" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.extension" ] ; fhir:path [ fhir:v "ClaimResponse.extension" ] ; fhir:short [ fhir:v "Additional content defined by implementations" ] ; fhir:definition [ fhir:v "May be used to represent additional information that is not part of the basic definition of the resource. 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." ] ; fhir:comment [ fhir: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." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "DomainResource.extension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "N/A" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.modifierExtension" ] ; fhir:path [ fhir:v "ClaimResponse.modifierExtension" ] ; fhir:short [ fhir:v "Extensions that cannot be ignored" ] ; fhir:definition [ fhir: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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ] ; fhir:comment [ fhir: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." ] ; fhir:requirements [ fhir: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)." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "DomainResource.modifierExtension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v true ] ; fhir:isModifierReason [ fhir:v "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "N/A" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.identifier" ] ; fhir:path [ fhir:v "ClaimResponse.identifier" ] ; fhir:slicing [ ( fhir:discriminator [ fhir:type [ fhir:v "value" ] ; fhir:path [ fhir:v "system" ] ] ) ; fhir:description [ fhir:v "Phân loại identifier kết quả xử lý theo hệ thống định danh" ] ; fhir:rules [ fhir:v "open" ] ] ; fhir:short [ fhir:v "Định danh kết quả xử lý, bao gồm mã phản hồi gateway nếu có" ] ; fhir:definition [ fhir:v "A unique identifier assigned to this claim response." ] ; fhir:requirements [ fhir:v "Allows claim responses to be distinguished and referenced." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.identifier" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Identifier"^^xsd:anyURI ; fhir:l fhir:Identifier ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "workflow" ] ; fhir:map [ fhir:v "Event.identifier" ] ] [ fhir:identity [ fhir:v "w5" ] ; fhir:map [ fhir:v "FiveWs.identifier" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.identifier:gatewayResponseId" ] ; fhir:path [ fhir:v "ClaimResponse.identifier" ] ; fhir:sliceName [ fhir:v "gatewayResponseId" ] ; fhir:short [ fhir:v "Mã phản hồi Cổng tiếp nhận BHYT (XML1_ID)" ] ; fhir:definition [ fhir:v "Mã phản hồi của Cổng tiếp nhận dữ liệu cho hồ sơ/bảng XML1. Không dùng thay cho MA_LK." ] ; fhir:requirements [ fhir:v "Allows claim responses to be distinguished and referenced." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.identifier" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Identifier"^^xsd:anyURI ; fhir:l fhir:Identifier ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "workflow" ] ; fhir:map [ fhir:v "Event.identifier" ] ] [ fhir:identity [ fhir:v "w5" ] ; fhir:map [ fhir:v "FiveWs.identifier" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.identifier:gatewayResponseId.id" ] ; fhir:path [ fhir:v "ClaimResponse.identifier.id" ] ; ( fhir:representation [ fhir:v "xmlAttr" ] ) ; fhir:short [ fhir:v "Unique id for inter-element referencing" ] ; fhir:definition [ fhir:v "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Element.id" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type> ] ; fhir:value [ a fhir:Url ; fhir:v "string"^^xsd:anyURI ; fhir:l fhir:string ] ] ) ; fhir:code [ fhir:v "http://hl7.org/fhirpath/System.String"^^xsd:anyURI ; fhir:l <http://hl7.org/fhirpath/System.String> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.identifier:gatewayResponseId.extension" ] ; fhir:path [ fhir:v "ClaimResponse.identifier.extension" ] ; fhir:slicing [ ( fhir:discriminator [ fhir:type [ fhir:v "value" ] ; fhir:path [ fhir:v "url" ] ] ) ; fhir:description [ fhir:v "Extensions are always sliced by (at least) url" ] ; fhir:rules [ fhir:v "open" ] ] ; fhir:short [ fhir:v "Additional content defined by implementations" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir: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." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "Element.extension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.identifier:gatewayResponseId.use" ] ; fhir:path [ fhir:v "ClaimResponse.identifier.use" ] ; fhir:short [ fhir:v "usual | official | temp | secondary | old (If known)" ] ; fhir:definition [ fhir:v "The purpose of this identifier." ] ; fhir:comment [ fhir:v "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." ] ; fhir:requirements [ fhir:v "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Identifier.use" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "code"^^xsd:anyURI ; fhir:l fhir:code ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v true ] ; fhir:isModifierReason [ fhir:v "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one." ] ; fhir:isSummary [ fhir:v true ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "IdentifierUse" ] ] ) ; fhir:strength [ fhir:v "required" ] ; fhir:description [ fhir:v "Identifies the purpose for this identifier, if known ." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/identifier-use?version=4.0.1> ] ] ; ( fhir:mapping [ fhir:identity [ fhir:v "v2" ] ; fhir:map [ fhir:v "N/A" ] ] [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "Role.code or implied by context" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.identifier:gatewayResponseId.type" ] ; fhir:path [ fhir:v "ClaimResponse.identifier.type" ] ; fhir:short [ fhir:v "Description of identifier" ] ; fhir:definition [ fhir:v "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." ] ; fhir:comment [ fhir:v "This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type." ] ; fhir:requirements [ fhir:v "Allows users to make use of identifiers when the identifier system is not known." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Identifier.type" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; fhir:pattern [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://fhir.hl7.org.vn/core/CodeSystem/vn-identifier-type-cs"^^xsd:anyURI ; fhir:l <http://fhir.hl7.org.vn/core/CodeSystem/vn-identifier-type-cs> ] ; fhir:code [ fhir:v "BHYT_XML1_ID" ] ] ) ] ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v true ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "IdentifierType" ] ] ) ; fhir:strength [ fhir:v "extensible" ] ; fhir:description [ fhir:v "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/identifier-type|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/identifier-type?version=4.0.1> ] ] ; ( fhir:mapping [ fhir:identity [ fhir:v "v2" ] ; fhir:map [ fhir:v "CX.5" ] ] [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "Role.code or implied by context" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.identifier:gatewayResponseId.system" ] ; fhir:path [ fhir:v "ClaimResponse.identifier.system" ] ; fhir:short [ fhir:v "The namespace for the identifier value" ] ; fhir:definition [ fhir:v "Establishes the namespace for the value - that is, a URL that describes a set values that are unique." ] ; fhir:comment [ fhir:v "Identifier.system is always case sensitive." ] ; fhir:requirements [ fhir:v "There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Identifier.system" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "uri"^^xsd:anyURI ; fhir:l fhir:uri ] ] ) ; fhir:fixed [ a fhir:Uri ; fhir:v "http://fhir.hl7.org.vn/core/sid/bhyt-gateway-response-id"^^xsd:anyURI ; fhir:l <http://fhir.hl7.org.vn/core/sid/bhyt-gateway-response-id> ] ; ( fhir:example [ fhir:label [ fhir:v "General" ] ; fhir:value [ a fhir:Uri ; fhir:v "http://www.acme.com/identifiers/patient"^^xsd:anyURI ; fhir:l <http://www.acme.com/identifiers/patient> ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v true ] ; ( fhir:mapping [ fhir:identity [ fhir:v "v2" ] ; fhir:map [ fhir:v "CX.4 / EI-2-4" ] ] [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "II.root or Role.id.root" ] ] [ fhir:identity [ fhir:v "servd" ] ; fhir:map [ fhir:v "./IdentifierType" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.identifier:gatewayResponseId.value" ] ; fhir:path [ fhir:v "ClaimResponse.identifier.value" ] ; fhir:short [ fhir:v "Giá trị XML1_ID hoặc mã phản hồi tương đương" ] ; fhir:definition [ fhir:v "The portion of the identifier typically relevant to the user and which is unique within the context of the system." ] ; fhir:comment [ fhir:v "If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [Rendered Value extension](http://hl7.org/fhir/R4/extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Identifier.value" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "string"^^xsd:anyURI ; fhir:l fhir:string ] ] ) ; ( fhir:example [ fhir:label [ fhir:v "General" ] ; fhir:value [ a fhir:String ; fhir:v "123456" ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v true ] ; ( fhir:mapping [ fhir:identity [ fhir:v "v2" ] ; fhir:map [ fhir:v "CX.1 / EI.1" ] ] [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" ] ] [ fhir:identity [ fhir:v "servd" ] ; fhir:map [ fhir:v "./Value" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.identifier:gatewayResponseId.period" ] ; fhir:path [ fhir:v "ClaimResponse.identifier.period" ] ; fhir:short [ fhir:v "Time period when id is/was valid for use" ] ; fhir:definition [ fhir:v "Time period during which identifier is/was valid for use." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Identifier.period" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Period"^^xsd:anyURI ; fhir:l fhir:Period ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v true ] ; ( fhir:mapping [ fhir:identity [ fhir:v "v2" ] ; fhir:map [ fhir:v "CX.7 + CX.8" ] ] [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "Role.effectiveTime or implied by context" ] ] [ fhir:identity [ fhir:v "servd" ] ; fhir:map [ fhir:v "./StartDate and ./EndDate" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.identifier:gatewayResponseId.assigner" ] ; fhir:path [ fhir:v "ClaimResponse.identifier.assigner" ] ; fhir:short [ fhir:v "Organization that issued id (may be just text)" ] ; fhir:definition [ fhir:v "Organization that issued/manages the identifier." ] ; fhir:comment [ fhir:v "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Identifier.assigner" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Reference"^^xsd:anyURI ; fhir:l fhir:Reference ] ; ( fhir:targetProfile [ fhir:v "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Organization?version=4.0.1> ] ) ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v true ] ; ( fhir:mapping [ fhir:identity [ fhir:v "v2" ] ; fhir:map [ fhir:v "CX.4 / (CX.4,CX.9,CX.10)" ] ] [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper" ] ] [ fhir:identity [ fhir:v "servd" ] ; fhir:map [ fhir:v "./IdentifierIssuingAuthority" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.status" ] ; fhir:path [ fhir:v "ClaimResponse.status" ] ; fhir:short [ fhir:v "Trạng thái kết quả: active | cancelled | draft | entered-in-error" ] ; fhir:definition [ fhir:v "The status of the resource instance." ] ; fhir:comment [ fhir:v "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid." ] ; fhir:requirements [ fhir: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'." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.status" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "code"^^xsd:anyURI ; fhir:l fhir:code ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v true ] ; fhir:isModifierReason [ fhir: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" ] ; fhir:isSummary [ fhir:v true ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "ClaimResponseStatus" ] ] ) ; fhir:strength [ fhir:v "required" ] ; fhir:description [ fhir:v "A code specifying the state of the resource instance." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/fm-status|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/fm-status?version=4.0.1> ] ] ; ( fhir:mapping [ fhir:identity [ fhir:v "workflow" ] ; fhir:map [ fhir:v "Event.status" ] ] [ fhir:identity [ fhir:v "w5" ] ; fhir:map [ fhir:v "FiveWs.status" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.type" ] ; fhir:path [ fhir:v "ClaimResponse.type" ] ; fhir:short [ fhir:v "Loại: institutional (nội trú) | professional (ngoại trú)" ] ; fhir:definition [ fhir:v "A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service." ] ; fhir:comment [ fhir:v "This may contain the local bill type codes, for example the US UB-04 bill type code or the CMS bill type." ] ; fhir:requirements [ fhir:v "Some jurisdictions need a finer grained claim type for routing and adjudication." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.type" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v true ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "ClaimType" ] ] ) ; fhir:strength [ fhir:v "extensible" ] ; fhir:description [ fhir:v "The type or discipline-style of the claim." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/claim-type|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/claim-type?version=4.0.1> ] ] ; ( fhir:mapping [ fhir:identity [ fhir:v "w5" ] ; fhir:map [ fhir:v "FiveWs.class" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.subType" ] ; fhir:path [ fhir:v "ClaimResponse.subType" ] ; fhir:short [ fhir:v "More granular claim type" ] ; fhir:definition [ fhir:v "A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service." ] ; fhir:comment [ fhir:v "This may contain the local bill type codes, for example the US UB-04 bill type code or the CMS bill type." ] ; fhir:requirements [ fhir:v "Some jurisdictions need a finer grained claim type for routing and adjudication." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.subType" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "ClaimSubType" ] ] ) ; fhir:strength [ fhir:v "example" ] ; fhir:description [ fhir:v "A more granular claim typecode." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/claim-subtype|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/claim-subtype?version=4.0.1> ] ] ; ( fhir:mapping [ fhir:identity [ fhir:v "w5" ] ; fhir:map [ fhir:v "FiveWs.class" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.use" ] ; fhir:path [ fhir:v "ClaimResponse.use" ] ; fhir:short [ fhir:v "Mục đích: claim | preauthorization | predetermination" ] ; fhir:definition [ fhir: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." ] ; fhir:requirements [ fhir:v "This element is required to understand the nature of the request for adjudication." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.use" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "code"^^xsd:anyURI ; fhir:l fhir:code ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v true ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "Use" ] ] ) ; fhir:strength [ fhir:v "required" ] ; fhir:description [ fhir:v "Claim, preauthorization, predetermination." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/claim-use|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/claim-use?version=4.0.1> ] ] ; ( fhir:mapping [ fhir:identity [ fhir:v "w5" ] ; fhir:map [ fhir:v "FiveWs.class" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.patient" ] ; fhir:path [ fhir:v "ClaimResponse.patient" ] ; fhir:short [ fhir:v "Bệnh nhân" ] ; fhir:definition [ fhir: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." ] ; fhir:requirements [ fhir: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." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.patient" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Reference"^^xsd:anyURI ; fhir:l fhir:Reference ] ; ( fhir:targetProfile [ fhir:v "http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-patient"^^xsd:anyURI ; fhir:l <http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-patient> ] ) ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v true ] ; ( fhir:mapping [ fhir:identity [ fhir:v "w5" ] ; fhir:map [ fhir:v "FiveWs.subject[x]" ] ] [ fhir:identity [ fhir:v "w5" ] ; fhir:map [ fhir:v "FiveWs.subject" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.created" ] ; fhir:path [ fhir:v "ClaimResponse.created" ] ; fhir:short [ fhir:v "Ngày tạo kết quả" ] ; fhir:definition [ fhir:v "The date this resource was created." ] ; fhir:requirements [ fhir:v "Need to record a timestamp for use by both the recipient and the issuer." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.created" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "dateTime"^^xsd:anyURI ; fhir:l fhir:dateTime ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v true ] ; ( fhir:mapping [ fhir:identity [ fhir:v "workflow" ] ; fhir:map [ fhir:v "Event.occurrence[x]" ] ] [ fhir:identity [ fhir:v "w5" ] ; fhir:map [ fhir:v "FiveWs.recorded" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.insurer" ] ; fhir:path [ fhir:v "ClaimResponse.insurer" ] ; fhir:short [ fhir:v "Cơ quan BHXH giải quyết" ] ; fhir:definition [ fhir:v "The party responsible for authorization, adjudication and reimbursement." ] ; fhir:requirements [ fhir: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." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.insurer" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Reference"^^xsd:anyURI ; fhir:l fhir:Reference ] ; ( fhir:targetProfile [ fhir:v "http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-organization"^^xsd:anyURI ; fhir:l <http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-organization> ] ) ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v true ] ; ( fhir:mapping [ fhir:identity [ fhir:v "workflow" ] ; fhir:map [ fhir:v "Event.performer" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.requestor" ] ; fhir:path [ fhir:v "ClaimResponse.requestor" ] ; fhir:short [ fhir:v "Party responsible for the claim" ] ; fhir:definition [ fhir:v "The provider which is responsible for the claim, predetermination or preauthorization." ] ; fhir:comment [ fhir: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." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.requestor" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Reference"^^xsd:anyURI ; fhir:l fhir:Reference ] ; ( fhir:targetProfile [ fhir:v "http://hl7.org/fhir/StructureDefinition/Practitioner|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Practitioner?version=4.0.1> ] [ fhir:v "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/PractitionerRole?version=4.0.1> ] [ fhir:v "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Organization?version=4.0.1> ] ) ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "w5" ] ; fhir:map [ fhir:v "FiveWs.source" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.request" ] ; fhir:path [ fhir:v "ClaimResponse.request" ] ; fhir:short [ fhir:v "Yêu cầu thanh toán gốc (VNCoreClaim)" ] ; fhir:definition [ fhir:v "Original request resource reference." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.request" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Reference"^^xsd:anyURI ; fhir:l fhir:Reference ] ; ( fhir:targetProfile [ fhir:v "http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-claim"^^xsd:anyURI ; fhir:l <http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-claim> ] ) ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v true ] ; ( fhir:mapping [ fhir:identity [ fhir:v "workflow" ] ; fhir:map [ fhir:v "Event.basedOn" ] ] [ fhir:identity [ fhir:v "w5" ] ; fhir:map [ fhir:v "FiveWs.why[x]" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.outcome" ] ; fhir:path [ fhir:v "ClaimResponse.outcome" ] ; fhir:short [ fhir:v "Kết quả: queued | complete | error | partial" ] ; fhir:definition [ fhir:v "The outcome of the claim, predetermination, or preauthorization processing." ] ; fhir:comment [ fhir: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)." ] ; fhir:requirements [ fhir:v "To advise the requestor of an overall processing outcome." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.outcome" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "code"^^xsd:anyURI ; fhir:l fhir:code ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v true ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "RemittanceOutcome" ] ] ) ; fhir:strength [ fhir:v "required" ] ; fhir:description [ fhir:v "The result of the claim processing." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/remittance-outcome?version=4.0.1> ] ] ] [ fhir:id [ fhir:v "ClaimResponse.disposition" ] ; fhir:path [ fhir:v "ClaimResponse.disposition" ] ; fhir:short [ fhir:v "Disposition Message" ] ; fhir:definition [ fhir:v "A human readable description of the status of the adjudication." ] ; fhir:requirements [ fhir:v "Provided for user display." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.disposition" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "string"^^xsd:anyURI ; fhir:l fhir:string ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "workflow" ] ; fhir:map [ fhir:v "Event.note" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.preAuthRef" ] ; fhir:path [ fhir:v "ClaimResponse.preAuthRef" ] ; fhir:short [ fhir:v "Preauthorization reference" ] ; fhir:definition [ fhir:v "Reference from the Insurer which is used in later communications which refers to this adjudication." ] ; fhir:comment [ fhir:v "This value is only present on preauthorization adjudications." ] ; fhir:requirements [ fhir:v "On subsequent claims, the insurer may require the provider to quote this value." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.preAuthRef" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "string"^^xsd:anyURI ; fhir:l fhir:string ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.preAuthPeriod" ] ; fhir:path [ fhir:v "ClaimResponse.preAuthPeriod" ] ; fhir:short [ fhir:v "Preauthorization reference effective period" ] ; fhir:definition [ fhir:v "The time frame during which this authorization is effective." ] ; fhir:requirements [ fhir:v "To convey to the provider when the authorized products and services must be supplied for the authorized adjudication to apply." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.preAuthPeriod" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Period"^^xsd:anyURI ; fhir:l fhir:Period ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.payeeType" ] ; fhir:path [ fhir:v "ClaimResponse.payeeType" ] ; fhir:short [ fhir:v "Party to be paid any benefits payable" ] ; fhir:definition [ fhir:v "Type of Party to be reimbursed: subscriber, provider, other." ] ; fhir:requirements [ fhir:v "Need to know who should receive payment with the most common situations being the Provider (assignment of benefits) or the Subscriber." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.payeeType" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "PayeeType" ] ] ) ; fhir:strength [ fhir:v "example" ] ; fhir:description [ fhir:v "A code for the party to be reimbursed." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/payeetype|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/payeetype?version=4.0.1> ] ] ] [ fhir:id [ fhir:v "ClaimResponse.item" ] ; fhir:path [ fhir:v "ClaimResponse.item" ] ; fhir:short [ fhir:v "Kết quả từng dòng chi phí" ] ; fhir:definition [ fhir: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." ] ; fhir:requirements [ fhir:v "The adjudication for items provided on the claim." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.item" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "BackboneElement"^^xsd:anyURI ; fhir:l fhir:BackboneElement ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.item.id" ] ; fhir:path [ fhir:v "ClaimResponse.item.id" ] ; ( fhir:representation [ fhir:v "xmlAttr" ] ) ; fhir:short [ fhir:v "Unique id for inter-element referencing" ] ; fhir:definition [ fhir:v "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Element.id" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type> ] ; fhir:value [ a fhir:Url ; fhir:v "string"^^xsd:anyURI ; fhir:l fhir:string ] ] ) ; fhir:code [ fhir:v "http://hl7.org/fhirpath/System.String"^^xsd:anyURI ; fhir:l <http://hl7.org/fhirpath/System.String> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.item.extension" ] ; fhir:path [ fhir:v "ClaimResponse.item.extension" ] ; fhir:short [ fhir:v "Additional content defined by implementations" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir: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." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "Element.extension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.item.modifierExtension" ] ; fhir:path [ fhir:v "ClaimResponse.item.modifierExtension" ] ; fhir:short [ fhir:v "Extensions that cannot be ignored even if unrecognized" ] ; fhir:definition [ fhir: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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ] ; fhir:comment [ fhir: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." ] ; fhir:requirements [ fhir: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)." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] [ fhir:v "modifiers" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "BackboneElement.modifierExtension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v true ] ; fhir:isModifierReason [ fhir:v "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ] ; fhir:isSummary [ fhir:v true ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "N/A" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.item.itemSequence" ] ; fhir:path [ fhir:v "ClaimResponse.item.itemSequence" ] ; fhir:short [ fhir:v "Claim item instance identifier" ] ; fhir:definition [ fhir:v "A number to uniquely reference the claim item entries." ] ; fhir:requirements [ fhir:v "Necessary to provide a mechanism to link the adjudication result to the submitted claim item." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.item.itemSequence" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "positiveInt"^^xsd:anyURI ; fhir:l fhir:positiveInt ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.item.noteNumber" ] ; fhir:path [ fhir:v "ClaimResponse.item.noteNumber" ] ; fhir:short [ fhir:v "Applicable note numbers" ] ; fhir:definition [ fhir:v "The numbers associated with notes below which apply to the adjudication of this item." ] ; fhir:requirements [ fhir:v "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.item.noteNumber" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "positiveInt"^^xsd:anyURI ; fhir:l fhir:positiveInt ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.item.adjudication" ] ; fhir:path [ fhir:v "ClaimResponse.item.adjudication" ] ; fhir:short [ fhir:v "Phân bổ chi phí: đề nghị, đủ ĐK, cùng chi trả, BHYT thanh toán" ] ; fhir:definition [ fhir: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." ] ; fhir:requirements [ fhir: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." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.item.adjudication" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "BackboneElement"^^xsd:anyURI ; fhir:l fhir:BackboneElement ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.item.adjudication.id" ] ; fhir:path [ fhir:v "ClaimResponse.item.adjudication.id" ] ; ( fhir:representation [ fhir:v "xmlAttr" ] ) ; fhir:short [ fhir:v "Unique id for inter-element referencing" ] ; fhir:definition [ fhir:v "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Element.id" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type> ] ; fhir:value [ a fhir:Url ; fhir:v "string"^^xsd:anyURI ; fhir:l fhir:string ] ] ) ; fhir:code [ fhir:v "http://hl7.org/fhirpath/System.String"^^xsd:anyURI ; fhir:l <http://hl7.org/fhirpath/System.String> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.item.adjudication.extension" ] ; fhir:path [ fhir:v "ClaimResponse.item.adjudication.extension" ] ; fhir:short [ fhir:v "Additional content defined by implementations" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir: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." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "Element.extension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.item.adjudication.modifierExtension" ] ; fhir:path [ fhir:v "ClaimResponse.item.adjudication.modifierExtension" ] ; fhir:short [ fhir:v "Extensions that cannot be ignored even if unrecognized" ] ; fhir:definition [ fhir: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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ] ; fhir:comment [ fhir: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." ] ; fhir:requirements [ fhir: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)." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] [ fhir:v "modifiers" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "BackboneElement.modifierExtension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v true ] ; fhir:isModifierReason [ fhir:v "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ] ; fhir:isSummary [ fhir:v true ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "N/A" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.item.adjudication.category" ] ; fhir:path [ fhir:v "ClaimResponse.item.adjudication.category" ] ; fhir:short [ fhir:v "Loại: submitted | eligible | copay | benefit" ] ; fhir:definition [ fhir:v "Category giám định từng dòng. Ưu tiên HL7 adjudication (`submitted`, `eligible`, `copay`, `benefit`) cho line-level adjudication; các subtotal cục bộ của VN Core không dùng ở line-level." ] ; fhir:comment [ fhir:v "For example codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc." ] ; fhir:requirements [ fhir:v "Needed to enable understanding of the context of the other information in the adjudication." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.item.adjudication.category" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ fhir:strength [ fhir:v "extensible" ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/adjudication"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/adjudication> ] ] ] [ fhir:id [ fhir:v "ClaimResponse.item.adjudication.reason" ] ; fhir:path [ fhir:v "ClaimResponse.item.adjudication.reason" ] ; fhir:short [ fhir:v "Explanation of adjudication outcome" ] ; fhir:definition [ fhir:v "A code supporting the understanding of the adjudication result and explaining variance from expected amount." ] ; fhir:comment [ fhir:v "For example may indicate that the funds for this benefit type have been exhausted." ] ; fhir:requirements [ fhir:v "To support understanding of variance from adjudication expectations." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.item.adjudication.reason" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "AdjudicationReason" ] ] ) ; fhir:strength [ fhir:v "example" ] ; fhir:description [ fhir:v "The adjudication reason codes." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/adjudication-reason|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/adjudication-reason?version=4.0.1> ] ] ] [ fhir:id [ fhir:v "ClaimResponse.item.adjudication.amount" ] ; fhir:path [ fhir:v "ClaimResponse.item.adjudication.amount" ] ; fhir:short [ fhir:v "Số tiền (VND)" ] ; fhir:definition [ fhir:v "Monetary amount associated with the category." ] ; fhir:comment [ fhir:v "For example: amount submitted, eligible amount, co-payment, and benefit payable." ] ; fhir:requirements [ fhir:v "Most adjuciation categories convey a monetary amount." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.item.adjudication.amount" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Money"^^xsd:anyURI ; fhir:l fhir:Money ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.item.adjudication.value" ] ; fhir:path [ fhir:v "ClaimResponse.item.adjudication.value" ] ; fhir:short [ fhir:v "Non-monetary value" ] ; fhir:definition [ fhir:v "A non-monetary value associated with the category. Mutually exclusive to the amount element above." ] ; fhir:comment [ fhir:v "For example: eligible percentage or co-payment percentage." ] ; fhir:requirements [ fhir:v "Some adjudication categories convey a percentage or a fixed value." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.item.adjudication.value" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "decimal"^^xsd:anyURI ; fhir:l fhir:decimal ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.item.detail" ] ; fhir:path [ fhir:v "ClaimResponse.item.detail" ] ; fhir:short [ fhir:v "Adjudication for claim details" ] ; fhir:definition [ fhir:v "A claim detail. Either a simple (a product or service) or a 'group' of sub-details which are simple items." ] ; fhir:requirements [ fhir:v "The adjudication for details provided on the claim." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.item.detail" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "BackboneElement"^^xsd:anyURI ; fhir:l fhir:BackboneElement ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.item.detail.id" ] ; fhir:path [ fhir:v "ClaimResponse.item.detail.id" ] ; ( fhir:representation [ fhir:v "xmlAttr" ] ) ; fhir:short [ fhir:v "Unique id for inter-element referencing" ] ; fhir:definition [ fhir:v "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Element.id" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type> ] ; fhir:value [ a fhir:Url ; fhir:v "string"^^xsd:anyURI ; fhir:l fhir:string ] ] ) ; fhir:code [ fhir:v "http://hl7.org/fhirpath/System.String"^^xsd:anyURI ; fhir:l <http://hl7.org/fhirpath/System.String> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.item.detail.extension" ] ; fhir:path [ fhir:v "ClaimResponse.item.detail.extension" ] ; fhir:short [ fhir:v "Additional content defined by implementations" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir: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." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "Element.extension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.item.detail.modifierExtension" ] ; fhir:path [ fhir:v "ClaimResponse.item.detail.modifierExtension" ] ; fhir:short [ fhir:v "Extensions that cannot be ignored even if unrecognized" ] ; fhir:definition [ fhir: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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ] ; fhir:comment [ fhir: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." ] ; fhir:requirements [ fhir: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)." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] [ fhir:v "modifiers" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "BackboneElement.modifierExtension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v true ] ; fhir:isModifierReason [ fhir:v "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ] ; fhir:isSummary [ fhir:v true ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "N/A" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.item.detail.detailSequence" ] ; fhir:path [ fhir:v "ClaimResponse.item.detail.detailSequence" ] ; fhir:short [ fhir:v "Claim detail instance identifier" ] ; fhir:definition [ fhir:v "A number to uniquely reference the claim detail entry." ] ; fhir:requirements [ fhir:v "Necessary to provide a mechanism to link the adjudication result to the submitted claim detail." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.item.detail.detailSequence" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "positiveInt"^^xsd:anyURI ; fhir:l fhir:positiveInt ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.item.detail.noteNumber" ] ; fhir:path [ fhir:v "ClaimResponse.item.detail.noteNumber" ] ; fhir:short [ fhir:v "Applicable note numbers" ] ; fhir:definition [ fhir:v "The numbers associated with notes below which apply to the adjudication of this item." ] ; fhir:requirements [ fhir:v "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.item.detail.noteNumber" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "positiveInt"^^xsd:anyURI ; fhir:l fhir:positiveInt ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.item.detail.adjudication" ] ; fhir:path [ fhir:v "ClaimResponse.item.detail.adjudication" ] ; fhir:short [ fhir:v "Detail level adjudication details" ] ; fhir:definition [ fhir:v "The adjudication results." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.item.detail.adjudication" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; fhir:contentReference [ fhir:v "http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication> ] ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.item.detail.subDetail" ] ; fhir:path [ fhir:v "ClaimResponse.item.detail.subDetail" ] ; fhir:short [ fhir:v "Adjudication for claim sub-details" ] ; fhir:definition [ fhir:v "A sub-detail adjudication of a simple product or service." ] ; fhir:requirements [ fhir:v "The adjudication for sub-details provided on the claim." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.item.detail.subDetail" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "BackboneElement"^^xsd:anyURI ; fhir:l fhir:BackboneElement ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.item.detail.subDetail.id" ] ; fhir:path [ fhir:v "ClaimResponse.item.detail.subDetail.id" ] ; ( fhir:representation [ fhir:v "xmlAttr" ] ) ; fhir:short [ fhir:v "Unique id for inter-element referencing" ] ; fhir:definition [ fhir:v "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Element.id" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type> ] ; fhir:value [ a fhir:Url ; fhir:v "string"^^xsd:anyURI ; fhir:l fhir:string ] ] ) ; fhir:code [ fhir:v "http://hl7.org/fhirpath/System.String"^^xsd:anyURI ; fhir:l <http://hl7.org/fhirpath/System.String> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.item.detail.subDetail.extension" ] ; fhir:path [ fhir:v "ClaimResponse.item.detail.subDetail.extension" ] ; fhir:short [ fhir:v "Additional content defined by implementations" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir: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." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "Element.extension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.item.detail.subDetail.modifierExtension" ] ; fhir:path [ fhir:v "ClaimResponse.item.detail.subDetail.modifierExtension" ] ; fhir:short [ fhir:v "Extensions that cannot be ignored even if unrecognized" ] ; fhir:definition [ fhir: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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ] ; fhir:comment [ fhir: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." ] ; fhir:requirements [ fhir: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)." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] [ fhir:v "modifiers" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "BackboneElement.modifierExtension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v true ] ; fhir:isModifierReason [ fhir:v "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ] ; fhir:isSummary [ fhir:v true ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "N/A" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.item.detail.subDetail.subDetailSequence" ] ; fhir:path [ fhir:v "ClaimResponse.item.detail.subDetail.subDetailSequence" ] ; fhir:short [ fhir:v "Claim sub-detail instance identifier" ] ; fhir:definition [ fhir:v "A number to uniquely reference the claim sub-detail entry." ] ; fhir:requirements [ fhir:v "Necessary to provide a mechanism to link the adjudication result to the submitted claim sub-detail." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.item.detail.subDetail.subDetailSequence" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "positiveInt"^^xsd:anyURI ; fhir:l fhir:positiveInt ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.item.detail.subDetail.noteNumber" ] ; fhir:path [ fhir:v "ClaimResponse.item.detail.subDetail.noteNumber" ] ; fhir:short [ fhir:v "Applicable note numbers" ] ; fhir:definition [ fhir:v "The numbers associated with notes below which apply to the adjudication of this item." ] ; fhir:requirements [ fhir:v "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.item.detail.subDetail.noteNumber" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "positiveInt"^^xsd:anyURI ; fhir:l fhir:positiveInt ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.item.detail.subDetail.adjudication" ] ; fhir:path [ fhir:v "ClaimResponse.item.detail.subDetail.adjudication" ] ; fhir:short [ fhir:v "Subdetail level adjudication details" ] ; fhir:definition [ fhir:v "The adjudication results." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.item.detail.subDetail.adjudication" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; fhir:contentReference [ fhir:v "http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication> ] ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem" ] ; fhir:path [ fhir:v "ClaimResponse.addItem" ] ; fhir:short [ fhir:v "Insurer added line items" ] ; fhir:definition [ fhir:v "The first-tier service adjudications for payor added product or service lines." ] ; fhir:requirements [ fhir: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." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "BackboneElement"^^xsd:anyURI ; fhir:l fhir:BackboneElement ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.id" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.id" ] ; ( fhir:representation [ fhir:v "xmlAttr" ] ) ; fhir:short [ fhir:v "Unique id for inter-element referencing" ] ; fhir:definition [ fhir:v "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Element.id" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type> ] ; fhir:value [ a fhir:Url ; fhir:v "string"^^xsd:anyURI ; fhir:l fhir:string ] ] ) ; fhir:code [ fhir:v "http://hl7.org/fhirpath/System.String"^^xsd:anyURI ; fhir:l <http://hl7.org/fhirpath/System.String> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.extension" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.extension" ] ; fhir:short [ fhir:v "Additional content defined by implementations" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir: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." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "Element.extension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.modifierExtension" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.modifierExtension" ] ; fhir:short [ fhir:v "Extensions that cannot be ignored even if unrecognized" ] ; fhir:definition [ fhir: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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ] ; fhir:comment [ fhir: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." ] ; fhir:requirements [ fhir: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)." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] [ fhir:v "modifiers" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "BackboneElement.modifierExtension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v true ] ; fhir:isModifierReason [ fhir:v "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ] ; fhir:isSummary [ fhir:v true ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "N/A" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.itemSequence" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.itemSequence" ] ; fhir:short [ fhir:v "Item sequence number" ] ; fhir:definition [ fhir:v "Claim items which this service line is intended to replace." ] ; fhir:requirements [ fhir:v "Provides references to the claim items." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.itemSequence" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "positiveInt"^^xsd:anyURI ; fhir:l fhir:positiveInt ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detailSequence" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detailSequence" ] ; fhir:short [ fhir:v "Detail sequence number" ] ; fhir:definition [ fhir:v "The sequence number of the details within the claim item which this line is intended to replace." ] ; fhir:requirements [ fhir:v "Provides references to the claim details within the claim item." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.detailSequence" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "positiveInt"^^xsd:anyURI ; fhir:l fhir:positiveInt ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.subdetailSequence" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.subdetailSequence" ] ; fhir:short [ fhir:v "Subdetail sequence number" ] ; fhir:definition [ fhir:v "The sequence number of the sub-details within the details within the claim item which this line is intended to replace." ] ; fhir:requirements [ fhir:v "Provides references to the claim sub-details within the claim detail." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.subdetailSequence" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "positiveInt"^^xsd:anyURI ; fhir:l fhir:positiveInt ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.provider" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.provider" ] ; fhir:short [ fhir:v "Authorized providers" ] ; fhir:definition [ fhir:v "The providers who are authorized for the services rendered to the patient." ] ; fhir:requirements [ fhir:v "Insurer may provide authorization specifically to a restricted set of providers rather than an open authorization." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.provider" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Reference"^^xsd:anyURI ; fhir:l fhir:Reference ] ; ( fhir:targetProfile [ fhir:v "http://hl7.org/fhir/StructureDefinition/Practitioner|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Practitioner?version=4.0.1> ] [ fhir:v "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/PractitionerRole?version=4.0.1> ] [ fhir:v "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Organization?version=4.0.1> ] ) ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "w5" ] ; fhir:map [ fhir:v "FiveWs.source" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.productOrService" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.productOrService" ] ; fhir:short [ fhir:v "Billing, service, product, or drug code" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir: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'." ] ; fhir:requirements [ fhir:v "Necessary to state what was provided or done." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.productOrService" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "ServiceProduct" ] ] ) ; fhir:strength [ fhir:v "example" ] ; fhir:description [ fhir:v "Allowable service and product codes." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/service-uscls|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/service-uscls?version=4.0.1> ] ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.modifier" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.modifier" ] ; fhir:short [ fhir:v "Service/Product billing modifiers" ] ; fhir:definition [ fhir:v "Item typification or modifiers codes to convey additional context for the product or service." ] ; fhir:comment [ fhir: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." ] ; fhir:requirements [ fhir:v "To support inclusion of the item for adjudication or to charge an elevated fee." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.modifier" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "Modifiers" ] ] ) ; fhir:strength [ fhir:v "example" ] ; fhir:description [ fhir: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." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/claim-modifiers|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/claim-modifiers?version=4.0.1> ] ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "24.C, 24.D mods" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.programCode" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.programCode" ] ; fhir:short [ fhir:v "Program the product or service is provided under" ] ; fhir:definition [ fhir:v "Identifies the program under which this may be recovered." ] ; fhir:comment [ fhir:v "For example: Neonatal program, child dental program or drug users recovery program." ] ; fhir:requirements [ fhir:v "Commonly used in in the identification of publicly provided program focused on population segments or disease classifications." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.programCode" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "ProgramCode" ] ] ) ; fhir:strength [ fhir:v "example" ] ; fhir:description [ fhir:v "Program specific reason codes." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/ex-program-code|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/ex-program-code?version=4.0.1> ] ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "24.H" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.serviced[x]" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.serviced[x]" ] ; fhir:short [ fhir:v "Date or dates of service or product delivery" ] ; fhir:definition [ fhir:v "The date or dates when the service or product was supplied, performed or completed." ] ; fhir:requirements [ fhir:v "Needed to determine whether the service or product was provided during the term of the insurance coverage." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.serviced[x]" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "date"^^xsd:anyURI ; fhir:l fhir:date ] ] [ fhir:code [ fhir:v "Period"^^xsd:anyURI ; fhir:l fhir:Period ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "w5" ] ; fhir:map [ fhir:v "FiveWs.done[x]" ] ] [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "24.A" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.location[x]" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.location[x]" ] ; fhir:short [ fhir:v "Place of service or where product was supplied" ] ; fhir:definition [ fhir:v "Where the product or service was provided." ] ; fhir:requirements [ fhir:v "The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.location[x]" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] [ fhir:code [ fhir:v "Address"^^xsd:anyURI ; fhir:l fhir:Address ] ] [ fhir:code [ fhir:v "Reference"^^xsd:anyURI ; fhir:l fhir:Reference ] ; ( fhir:targetProfile [ fhir:v "http://hl7.org/fhir/StructureDefinition/Location|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Location?version=4.0.1> ] ) ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "ServicePlace" ] ] ) ; fhir:strength [ fhir:v "example" ] ; fhir:description [ fhir:v "Place of service: pharmacy, school, prison, etc." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/service-place|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/service-place?version=4.0.1> ] ] ; ( fhir:mapping [ fhir:identity [ fhir:v "w5" ] ; fhir:map [ fhir:v "FiveWs.where[x]" ] ] [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "24.B" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.quantity" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.quantity" ] ; fhir:short [ fhir:v "Count of products or services" ] ; fhir:definition [ fhir:v "The number of repetitions of a service or product." ] ; fhir:requirements [ fhir:v "Required when the product or service code does not convey the quantity provided." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.quantity" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Quantity"^^xsd:anyURI ; fhir:l fhir:Quantity ] ; ( fhir:profile [ fhir:v "http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/SimpleQuantity?version=4.0.1> ] ) ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "24.G" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.unitPrice" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.unitPrice" ] ; fhir:short [ fhir:v "Fee, charge or cost per item" ] ; fhir:definition [ fhir: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." ] ; fhir:requirements [ fhir:v "The amount charged to the patient by the provider for a single unit." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.unitPrice" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Money"^^xsd:anyURI ; fhir:l fhir:Money ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.factor" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.factor" ] ; fhir:short [ fhir:v "Price scaling factor" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir:v "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)." ] ; fhir:requirements [ fhir:v "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.factor" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "decimal"^^xsd:anyURI ; fhir:l fhir:decimal ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.net" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.net" ] ; fhir:short [ fhir:v "Total item cost" ] ; fhir:definition [ fhir:v "The quantity times the unit price for an additional service or product or charge." ] ; fhir:comment [ fhir:v "For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied." ] ; fhir:requirements [ fhir:v "Provides the total amount claimed for the group (if a grouper) or the line item." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.net" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Money"^^xsd:anyURI ; fhir:l fhir:Money ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "24.F" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.bodySite" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.bodySite" ] ; fhir:short [ fhir:v "Anatomical location" ] ; fhir:definition [ fhir:v "Physical service site on the patient (limb, tooth, etc.)." ] ; fhir:comment [ fhir:v "For example: Providing a tooth code allows an insurer to identify a provider performing a filling on a tooth that was previously removed." ] ; fhir:requirements [ fhir:v "Allows insurer to validate specific procedures." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.bodySite" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "OralSites" ] ] ) ; fhir:strength [ fhir:v "example" ] ; fhir:description [ fhir:v "The code for the teeth, quadrant, sextant and arch." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/tooth|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/tooth?version=4.0.1> ] ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.subSite" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.subSite" ] ; fhir:short [ fhir:v "Anatomical sub-location" ] ; fhir:definition [ fhir:v "A region or surface of the bodySite, e.g. limb region or tooth surface(s)." ] ; fhir:requirements [ fhir:v "Allows insurer to validate specific procedures." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.subSite" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "Surface" ] ] ) ; fhir:strength [ fhir:v "example" ] ; fhir:description [ fhir:v "The code for the tooth surface and surface combinations." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/surface|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/surface?version=4.0.1> ] ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.noteNumber" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.noteNumber" ] ; fhir:short [ fhir:v "Applicable note numbers" ] ; fhir:definition [ fhir:v "The numbers associated with notes below which apply to the adjudication of this item." ] ; fhir:requirements [ fhir:v "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.noteNumber" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "positiveInt"^^xsd:anyURI ; fhir:l fhir:positiveInt ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.adjudication" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.adjudication" ] ; fhir:short [ fhir:v "Added items adjudication" ] ; fhir:definition [ fhir:v "The adjudication results." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.adjudication" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; fhir:contentReference [ fhir:v "http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication> ] ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail" ] ; fhir:short [ fhir:v "Insurer added line details" ] ; fhir:definition [ fhir:v "The second-tier service adjudications for payor added services." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.detail" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "BackboneElement"^^xsd:anyURI ; fhir:l fhir:BackboneElement ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.id" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.id" ] ; ( fhir:representation [ fhir:v "xmlAttr" ] ) ; fhir:short [ fhir:v "Unique id for inter-element referencing" ] ; fhir:definition [ fhir:v "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Element.id" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type> ] ; fhir:value [ a fhir:Url ; fhir:v "string"^^xsd:anyURI ; fhir:l fhir:string ] ] ) ; fhir:code [ fhir:v "http://hl7.org/fhirpath/System.String"^^xsd:anyURI ; fhir:l <http://hl7.org/fhirpath/System.String> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.extension" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.extension" ] ; fhir:short [ fhir:v "Additional content defined by implementations" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir: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." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "Element.extension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.modifierExtension" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.modifierExtension" ] ; fhir:short [ fhir:v "Extensions that cannot be ignored even if unrecognized" ] ; fhir:definition [ fhir: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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ] ; fhir:comment [ fhir: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." ] ; fhir:requirements [ fhir: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)." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] [ fhir:v "modifiers" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "BackboneElement.modifierExtension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v true ] ; fhir:isModifierReason [ fhir:v "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ] ; fhir:isSummary [ fhir:v true ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "N/A" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.productOrService" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.productOrService" ] ; fhir:short [ fhir:v "Billing, service, product, or drug code" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir: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'." ] ; fhir:requirements [ fhir:v "Necessary to state what was provided or done." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.detail.productOrService" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "ServiceProduct" ] ] ) ; fhir:strength [ fhir:v "example" ] ; fhir:description [ fhir:v "Allowable service and product codes." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/service-uscls|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/service-uscls?version=4.0.1> ] ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.modifier" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.modifier" ] ; fhir:short [ fhir:v "Service/Product billing modifiers" ] ; fhir:definition [ fhir:v "Item typification or modifiers codes to convey additional context for the product or service." ] ; fhir:comment [ fhir: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." ] ; fhir:requirements [ fhir:v "To support inclusion of the item for adjudication or to charge an elevated fee." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.detail.modifier" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "Modifiers" ] ] ) ; fhir:strength [ fhir:v "example" ] ; fhir:description [ fhir: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." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/claim-modifiers|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/claim-modifiers?version=4.0.1> ] ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "24.C, 24.D mods" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.quantity" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.quantity" ] ; fhir:short [ fhir:v "Count of products or services" ] ; fhir:definition [ fhir:v "The number of repetitions of a service or product." ] ; fhir:requirements [ fhir:v "Required when the product or service code does not convey the quantity provided." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.detail.quantity" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Quantity"^^xsd:anyURI ; fhir:l fhir:Quantity ] ; ( fhir:profile [ fhir:v "http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/SimpleQuantity?version=4.0.1> ] ) ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "24.G" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.unitPrice" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.unitPrice" ] ; fhir:short [ fhir:v "Fee, charge or cost per item" ] ; fhir:definition [ fhir: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." ] ; fhir:requirements [ fhir:v "The amount charged to the patient by the provider for a single unit." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.detail.unitPrice" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Money"^^xsd:anyURI ; fhir:l fhir:Money ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.factor" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.factor" ] ; fhir:short [ fhir:v "Price scaling factor" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir:v "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)." ] ; fhir:requirements [ fhir:v "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.detail.factor" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "decimal"^^xsd:anyURI ; fhir:l fhir:decimal ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.net" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.net" ] ; fhir:short [ fhir:v "Total item cost" ] ; fhir:definition [ fhir:v "The quantity times the unit price for an additional service or product or charge." ] ; fhir:comment [ fhir:v "For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied." ] ; fhir:requirements [ fhir:v "Provides the total amount claimed for the group (if a grouper) or the line item." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.detail.net" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Money"^^xsd:anyURI ; fhir:l fhir:Money ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "24.F" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.noteNumber" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.noteNumber" ] ; fhir:short [ fhir:v "Applicable note numbers" ] ; fhir:definition [ fhir:v "The numbers associated with notes below which apply to the adjudication of this item." ] ; fhir:requirements [ fhir:v "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.detail.noteNumber" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "positiveInt"^^xsd:anyURI ; fhir:l fhir:positiveInt ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.adjudication" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.adjudication" ] ; fhir:short [ fhir:v "Added items detail adjudication" ] ; fhir:definition [ fhir:v "The adjudication results." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.detail.adjudication" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; fhir:contentReference [ fhir:v "http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication> ] ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.subDetail" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail" ] ; fhir:short [ fhir:v "Insurer added line items" ] ; fhir:definition [ fhir:v "The third-tier service adjudications for payor added services." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "BackboneElement"^^xsd:anyURI ; fhir:l fhir:BackboneElement ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.subDetail.id" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail.id" ] ; ( fhir:representation [ fhir:v "xmlAttr" ] ) ; fhir:short [ fhir:v "Unique id for inter-element referencing" ] ; fhir:definition [ fhir:v "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Element.id" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type> ] ; fhir:value [ a fhir:Url ; fhir:v "string"^^xsd:anyURI ; fhir:l fhir:string ] ] ) ; fhir:code [ fhir:v "http://hl7.org/fhirpath/System.String"^^xsd:anyURI ; fhir:l <http://hl7.org/fhirpath/System.String> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.subDetail.extension" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail.extension" ] ; fhir:short [ fhir:v "Additional content defined by implementations" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir: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." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "Element.extension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.subDetail.modifierExtension" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail.modifierExtension" ] ; fhir:short [ fhir:v "Extensions that cannot be ignored even if unrecognized" ] ; fhir:definition [ fhir: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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ] ; fhir:comment [ fhir: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." ] ; fhir:requirements [ fhir: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)." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] [ fhir:v "modifiers" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "BackboneElement.modifierExtension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v true ] ; fhir:isModifierReason [ fhir:v "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ] ; fhir:isSummary [ fhir:v true ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "N/A" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.subDetail.productOrService" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail.productOrService" ] ; fhir:short [ fhir:v "Billing, service, product, or drug code" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir: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'." ] ; fhir:requirements [ fhir:v "Necessary to state what was provided or done." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail.productOrService" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "ServiceProduct" ] ] ) ; fhir:strength [ fhir:v "example" ] ; fhir:description [ fhir:v "Allowable service and product codes." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/service-uscls|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/service-uscls?version=4.0.1> ] ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.subDetail.modifier" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail.modifier" ] ; fhir:short [ fhir:v "Service/Product billing modifiers" ] ; fhir:definition [ fhir:v "Item typification or modifiers codes to convey additional context for the product or service." ] ; fhir:comment [ fhir: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." ] ; fhir:requirements [ fhir:v "To support inclusion of the item for adjudication or to charge an elevated fee." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail.modifier" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "Modifiers" ] ] ) ; fhir:strength [ fhir:v "example" ] ; fhir:description [ fhir: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." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/claim-modifiers|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/claim-modifiers?version=4.0.1> ] ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "24.C, 24.D mods" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.subDetail.quantity" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail.quantity" ] ; fhir:short [ fhir:v "Count of products or services" ] ; fhir:definition [ fhir:v "The number of repetitions of a service or product." ] ; fhir:requirements [ fhir:v "Required when the product or service code does not convey the quantity provided." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail.quantity" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Quantity"^^xsd:anyURI ; fhir:l fhir:Quantity ] ; ( fhir:profile [ fhir:v "http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/SimpleQuantity?version=4.0.1> ] ) ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "24.G" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.subDetail.unitPrice" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail.unitPrice" ] ; fhir:short [ fhir:v "Fee, charge or cost per item" ] ; fhir:definition [ fhir: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." ] ; fhir:requirements [ fhir:v "The amount charged to the patient by the provider for a single unit." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail.unitPrice" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Money"^^xsd:anyURI ; fhir:l fhir:Money ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.subDetail.factor" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail.factor" ] ; fhir:short [ fhir:v "Price scaling factor" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir:v "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)." ] ; fhir:requirements [ fhir:v "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail.factor" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "decimal"^^xsd:anyURI ; fhir:l fhir:decimal ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.subDetail.net" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail.net" ] ; fhir:short [ fhir:v "Total item cost" ] ; fhir:definition [ fhir:v "The quantity times the unit price for an additional service or product or charge." ] ; fhir:comment [ fhir:v "For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied." ] ; fhir:requirements [ fhir:v "Provides the total amount claimed for the group (if a grouper) or the line item." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail.net" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Money"^^xsd:anyURI ; fhir:l fhir:Money ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "24.F" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.subDetail.noteNumber" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail.noteNumber" ] ; fhir:short [ fhir:v "Applicable note numbers" ] ; fhir:definition [ fhir:v "The numbers associated with notes below which apply to the adjudication of this item." ] ; fhir:requirements [ fhir:v "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail.noteNumber" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "positiveInt"^^xsd:anyURI ; fhir:l fhir:positiveInt ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.addItem.detail.subDetail.adjudication" ] ; fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail.adjudication" ] ; fhir:short [ fhir:v "Added items detail adjudication" ] ; fhir:definition [ fhir:v "The adjudication results." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.addItem.detail.subDetail.adjudication" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; fhir:contentReference [ fhir:v "http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication> ] ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.adjudication" ] ; fhir:path [ fhir:v "ClaimResponse.adjudication" ] ; fhir:short [ fhir:v "Header-level adjudication" ] ; fhir:definition [ fhir:v "The adjudication results which are presented at the header level rather than at the line-item or add-item levels." ] ; fhir:requirements [ fhir:v "Some insurers will receive line-items but provide the adjudication only at a summary or header-level." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.adjudication" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; fhir:contentReference [ fhir:v "http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication> ] ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.total" ] ; fhir:path [ fhir:v "ClaimResponse.total" ] ; fhir:short [ fhir:v "Tổng adjudication" ] ; fhir:definition [ fhir:v "Categorized monetary totals for the adjudication." ] ; fhir:comment [ fhir:v "Totals for amounts submitted, co-pays, benefits payable etc." ] ; fhir:requirements [ fhir:v "To provide the requestor with financial totals by category for the adjudication." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.total" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "BackboneElement"^^xsd:anyURI ; fhir:l fhir:BackboneElement ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.total.id" ] ; fhir:path [ fhir:v "ClaimResponse.total.id" ] ; ( fhir:representation [ fhir:v "xmlAttr" ] ) ; fhir:short [ fhir:v "Unique id for inter-element referencing" ] ; fhir:definition [ fhir:v "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Element.id" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type> ] ; fhir:value [ a fhir:Url ; fhir:v "string"^^xsd:anyURI ; fhir:l fhir:string ] ] ) ; fhir:code [ fhir:v "http://hl7.org/fhirpath/System.String"^^xsd:anyURI ; fhir:l <http://hl7.org/fhirpath/System.String> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.total.extension" ] ; fhir:path [ fhir:v "ClaimResponse.total.extension" ] ; fhir:short [ fhir:v "Additional content defined by implementations" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir: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." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "Element.extension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.total.modifierExtension" ] ; fhir:path [ fhir:v "ClaimResponse.total.modifierExtension" ] ; fhir:short [ fhir:v "Extensions that cannot be ignored even if unrecognized" ] ; fhir:definition [ fhir: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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ] ; fhir:comment [ fhir: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." ] ; fhir:requirements [ fhir: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)." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] [ fhir:v "modifiers" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "BackboneElement.modifierExtension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v true ] ; fhir:isModifierReason [ fhir:v "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ] ; fhir:isSummary [ fhir:v true ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "N/A" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.total.category" ] ; fhir:path [ fhir:v "ClaimResponse.total.category" ] ; fhir:short [ fhir:v "Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ" ] ; fhir:definition [ fhir:v "Category tổng hợp tài chính/adjudication. Dùng ConceptMap `vn-cm-bhyt-financial-field-to-adjudication` để map các trường tổng tiền BHYT như `T_TONGCHI`, `T_TONGCHI_BH`, `T_BHTT`, `T_BNCCT`, `T_BNTT`, `T_NGUONKHAC`, `T_NGOAIDS`, `T_THUOC`, `T_VTYT`. Không encode công thức quyền lợi hoặc adjudication business rule tại profile." ] ; fhir:comment [ fhir:v "For example codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc." ] ; fhir:requirements [ fhir:v "Needed to convey the type of total provided." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.total.category" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v true ] ; fhir:binding [ fhir:strength [ fhir:v "extensible" ] ; fhir:valueSet [ fhir:v "http://fhir.hl7.org.vn/core/ValueSet/vn-bhyt-adjudication-category-vs"^^xsd:anyURI ; fhir:l <http://fhir.hl7.org.vn/core/ValueSet/vn-bhyt-adjudication-category-vs> ] ] ] [ fhir:id [ fhir:v "ClaimResponse.total.amount" ] ; fhir:path [ fhir:v "ClaimResponse.total.amount" ] ; fhir:short [ fhir:v "Financial total for the category" ] ; fhir:definition [ fhir:v "Monetary total amount associated with the category." ] ; fhir:requirements [ fhir:v "Needed to convey the total monetary amount." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.total.amount" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Money"^^xsd:anyURI ; fhir:l fhir:Money ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.payment" ] ; fhir:path [ fhir:v "ClaimResponse.payment" ] ; fhir:short [ fhir:v "Thông tin thanh toán" ] ; fhir:definition [ fhir:v "Payment details for the adjudication of the claim." ] ; fhir:requirements [ fhir:v "Needed to convey references to the financial instrument that has been used if payment has been made." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.payment" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "BackboneElement"^^xsd:anyURI ; fhir:l fhir:BackboneElement ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.payment.id" ] ; fhir:path [ fhir:v "ClaimResponse.payment.id" ] ; ( fhir:representation [ fhir:v "xmlAttr" ] ) ; fhir:short [ fhir:v "Unique id for inter-element referencing" ] ; fhir:definition [ fhir:v "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Element.id" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type> ] ; fhir:value [ a fhir:Url ; fhir:v "string"^^xsd:anyURI ; fhir:l fhir:string ] ] ) ; fhir:code [ fhir:v "http://hl7.org/fhirpath/System.String"^^xsd:anyURI ; fhir:l <http://hl7.org/fhirpath/System.String> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.payment.extension" ] ; fhir:path [ fhir:v "ClaimResponse.payment.extension" ] ; fhir:short [ fhir:v "Additional content defined by implementations" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir: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." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "Element.extension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.payment.modifierExtension" ] ; fhir:path [ fhir:v "ClaimResponse.payment.modifierExtension" ] ; fhir:short [ fhir:v "Extensions that cannot be ignored even if unrecognized" ] ; fhir:definition [ fhir: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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ] ; fhir:comment [ fhir: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." ] ; fhir:requirements [ fhir: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)." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] [ fhir:v "modifiers" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "BackboneElement.modifierExtension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v true ] ; fhir:isModifierReason [ fhir:v "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ] ; fhir:isSummary [ fhir:v true ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "N/A" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.payment.type" ] ; fhir:path [ fhir:v "ClaimResponse.payment.type" ] ; fhir:short [ fhir:v "Partial or complete payment" ] ; fhir:definition [ fhir:v "Whether this represents partial or complete payment of the benefits payable." ] ; fhir:requirements [ fhir:v "To advise the requestor when the insurer believes all payments to have been completed." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.payment.type" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "PaymentType" ] ] ) ; fhir:strength [ fhir:v "example" ] ; fhir:description [ fhir:v "The type (partial, complete) of the payment." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/ex-paymenttype|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/ex-paymenttype?version=4.0.1> ] ] ] [ fhir:id [ fhir:v "ClaimResponse.payment.adjustment" ] ; fhir:path [ fhir:v "ClaimResponse.payment.adjustment" ] ; fhir:short [ fhir:v "Payment adjustment for non-claim issues" ] ; fhir:definition [ fhir:v "Total amount of all adjustments to this payment included in this transaction which are not related to this claim's adjudication." ] ; fhir:comment [ fhir: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." ] ; fhir:requirements [ fhir:v "To advise the requestor of adjustments applied to the payment." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.payment.adjustment" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Money"^^xsd:anyURI ; fhir:l fhir:Money ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.payment.adjustmentReason" ] ; fhir:path [ fhir:v "ClaimResponse.payment.adjustmentReason" ] ; fhir:short [ fhir:v "Explanation for the adjustment" ] ; fhir:definition [ fhir:v "Reason for the payment adjustment." ] ; fhir:requirements [ fhir:v "Needed to clarify the monetary adjustment." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.payment.adjustmentReason" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "PaymentAdjustmentReason" ] ] ) ; fhir:strength [ fhir:v "example" ] ; fhir:description [ fhir:v "Payment Adjustment reason codes." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/payment-adjustment-reason|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/payment-adjustment-reason?version=4.0.1> ] ] ] [ fhir:id [ fhir:v "ClaimResponse.payment.date" ] ; fhir:path [ fhir:v "ClaimResponse.payment.date" ] ; fhir:short [ fhir:v "Expected date of payment" ] ; fhir:definition [ fhir:v "Estimated date the payment will be issued or the actual issue date of payment." ] ; fhir:requirements [ fhir:v "To advise the payee when payment can be expected." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.payment.date" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "date"^^xsd:anyURI ; fhir:l fhir:date ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.payment.amount" ] ; fhir:path [ fhir:v "ClaimResponse.payment.amount" ] ; fhir:short [ fhir:v "Số tiền BHXH thanh toán" ] ; fhir:definition [ fhir:v "Benefits payable less any payment adjustment." ] ; fhir:requirements [ fhir:v "Needed to provide the actual payment amount." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.payment.amount" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Money"^^xsd:anyURI ; fhir:l fhir:Money ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.payment.identifier" ] ; fhir:path [ fhir:v "ClaimResponse.payment.identifier" ] ; fhir:short [ fhir:v "Business identifier for the payment" ] ; fhir:definition [ fhir:v "Issuer's unique identifier for the payment instrument." ] ; fhir:comment [ fhir:v "For example: EFT number or check number." ] ; fhir:requirements [ fhir:v "Enable the receiver to reconcile when payment received." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.payment.identifier" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Identifier"^^xsd:anyURI ; fhir:l fhir:Identifier ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.fundsReserve" ] ; fhir:path [ fhir:v "ClaimResponse.fundsReserve" ] ; fhir:short [ fhir:v "Funds reserved status" ] ; fhir:definition [ fhir:v "A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom." ] ; fhir:comment [ fhir:v "Fund would be release by a future claim quoting the preAuthRef of this response. Examples of values include: provider, patient, none." ] ; fhir:requirements [ fhir:v "Needed to advise the submitting provider on whether the rquest for reservation of funds has been honored." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.fundsReserve" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "FundsReserve" ] ] ) ; fhir:strength [ fhir:v "example" ] ; fhir:description [ fhir:v "For whom funds are to be reserved: (Patient, Provider, None)." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/fundsreserve|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/fundsreserve?version=4.0.1> ] ] ] [ fhir:id [ fhir:v "ClaimResponse.formCode" ] ; fhir:path [ fhir:v "ClaimResponse.formCode" ] ; fhir:short [ fhir:v "Printed form identifier" ] ; fhir:definition [ fhir:v "A code for the form to be used for printing the content." ] ; fhir:comment [ fhir:v "May be needed to identify specific jurisdictional forms." ] ; fhir:requirements [ fhir:v "Needed to specify the specific form used for producing output for this response." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.formCode" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "Forms" ] ] ) ; fhir:strength [ fhir:v "example" ] ; fhir:description [ fhir:v "The forms codes." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/forms|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/forms?version=4.0.1> ] ] ] [ fhir:id [ fhir:v "ClaimResponse.form" ] ; fhir:path [ fhir:v "ClaimResponse.form" ] ; fhir:short [ fhir:v "Printed reference or actual form" ] ; fhir:definition [ fhir:v "The actual form, by reference or inclusion, for printing the content or an EOB." ] ; fhir:comment [ fhir:v "Needed to permit insurers to include the actual form." ] ; fhir:requirements [ fhir:v "Needed to include the specific form used for producing output for this response." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.form" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Attachment"^^xsd:anyURI ; fhir:l fhir:Attachment ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.processNote" ] ; fhir:path [ fhir:v "ClaimResponse.processNote" ] ; fhir:short [ fhir:v "Note concerning adjudication" ] ; fhir:definition [ fhir:v "A note that describes or explains adjudication results in a human readable form." ] ; fhir:requirements [ fhir:v "Provides the insurer specific textual explanations associated with the processing." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.processNote" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "BackboneElement"^^xsd:anyURI ; fhir:l fhir:BackboneElement ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.processNote.id" ] ; fhir:path [ fhir:v "ClaimResponse.processNote.id" ] ; ( fhir:representation [ fhir:v "xmlAttr" ] ) ; fhir:short [ fhir:v "Unique id for inter-element referencing" ] ; fhir:definition [ fhir:v "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Element.id" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type> ] ; fhir:value [ a fhir:Url ; fhir:v "string"^^xsd:anyURI ; fhir:l fhir:string ] ] ) ; fhir:code [ fhir:v "http://hl7.org/fhirpath/System.String"^^xsd:anyURI ; fhir:l <http://hl7.org/fhirpath/System.String> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.processNote.extension" ] ; fhir:path [ fhir:v "ClaimResponse.processNote.extension" ] ; fhir:short [ fhir:v "Additional content defined by implementations" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir: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." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "Element.extension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.processNote.modifierExtension" ] ; fhir:path [ fhir:v "ClaimResponse.processNote.modifierExtension" ] ; fhir:short [ fhir:v "Extensions that cannot be ignored even if unrecognized" ] ; fhir:definition [ fhir: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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ] ; fhir:comment [ fhir: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." ] ; fhir:requirements [ fhir: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)." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] [ fhir:v "modifiers" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "BackboneElement.modifierExtension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v true ] ; fhir:isModifierReason [ fhir:v "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ] ; fhir:isSummary [ fhir:v true ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "N/A" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.processNote.number" ] ; fhir:path [ fhir:v "ClaimResponse.processNote.number" ] ; fhir:short [ fhir:v "Note instance identifier" ] ; fhir:definition [ fhir:v "A number to uniquely identify a note entry." ] ; fhir:requirements [ fhir:v "Necessary to provide a mechanism to link from adjudications." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.processNote.number" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "positiveInt"^^xsd:anyURI ; fhir:l fhir:positiveInt ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.processNote.type" ] ; fhir:path [ fhir:v "ClaimResponse.processNote.type" ] ; fhir:short [ fhir:v "display | print | printoper" ] ; fhir:definition [ fhir:v "The business purpose of the note text." ] ; fhir:requirements [ fhir:v "To convey the expectation for when the text is used." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.processNote.type" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "code"^^xsd:anyURI ; fhir:l fhir:code ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "NoteType" ] ] ) ; fhir:strength [ fhir:v "required" ] ; fhir:description [ fhir:v "The presentation types of notes." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/note-type|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/note-type?version=4.0.1> ] ] ] [ fhir:id [ fhir:v "ClaimResponse.processNote.text" ] ; fhir:path [ fhir:v "ClaimResponse.processNote.text" ] ; fhir:short [ fhir:v "Note explanatory text" ] ; fhir:definition [ fhir:v "The explanation or description associated with the processing." ] ; fhir:requirements [ fhir:v "Required to provide human readable explanation." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.processNote.text" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "string"^^xsd:anyURI ; fhir:l fhir:string ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.processNote.language" ] ; fhir:path [ fhir:v "ClaimResponse.processNote.language" ] ; fhir:short [ fhir:v "Language of the text" ] ; fhir:definition [ fhir:v "A code to define the language used in the text of the note." ] ; fhir:comment [ fhir:v "Only required if the language is different from the resource language." ] ; fhir:requirements [ fhir:v "Note text may vary from the resource defined language." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.processNote.language" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet> ] ; fhir:value [ a fhir:Canonical ; fhir:v "http://hl7.org/fhir/ValueSet/all-languages"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/all-languages> ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName> ] ; fhir:value [ a fhir:String ; fhir:v "Language" ] ] ) ; fhir:strength [ fhir:v "preferred" ] ; fhir:description [ fhir:v "A human language." ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/languages|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/languages?version=4.0.1> ] ] ] [ fhir:id [ fhir:v "ClaimResponse.communicationRequest" ] ; fhir:path [ fhir:v "ClaimResponse.communicationRequest" ] ; fhir:short [ fhir:v "Request for additional information" ] ; fhir:definition [ fhir:v "Request for additional supporting or authorizing information." ] ; fhir:comment [ fhir:v "For example: professional reports, documents, images, clinical resources, or accident reports." ] ; fhir:requirements [ fhir:v "Need to communicate insurer request for additional information required to support the adjudication." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.communicationRequest" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Reference"^^xsd:anyURI ; fhir:l fhir:Reference ] ; ( fhir:targetProfile [ fhir:v "http://hl7.org/fhir/StructureDefinition/CommunicationRequest|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/CommunicationRequest?version=4.0.1> ] ) ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.insurance" ] ; fhir:path [ fhir:v "ClaimResponse.insurance" ] ; fhir:short [ fhir:v "Patient insurance information" ] ; fhir:definition [ fhir:v "Financial instruments for reimbursement for the health care products and services specified on the claim." ] ; fhir:comment [ fhir: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." ] ; fhir:requirements [ fhir:v "At least one insurer is required for a claim to be a claim." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.insurance" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "BackboneElement"^^xsd:anyURI ; fhir:l fhir:BackboneElement ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "Coverage" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.insurance.id" ] ; fhir:path [ fhir:v "ClaimResponse.insurance.id" ] ; ( fhir:representation [ fhir:v "xmlAttr" ] ) ; fhir:short [ fhir:v "Unique id for inter-element referencing" ] ; fhir:definition [ fhir:v "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Element.id" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type> ] ; fhir:value [ a fhir:Url ; fhir:v "string"^^xsd:anyURI ; fhir:l fhir:string ] ] ) ; fhir:code [ fhir:v "http://hl7.org/fhirpath/System.String"^^xsd:anyURI ; fhir:l <http://hl7.org/fhirpath/System.String> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.insurance.extension" ] ; fhir:path [ fhir:v "ClaimResponse.insurance.extension" ] ; fhir:short [ fhir:v "Additional content defined by implementations" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir: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." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "Element.extension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.insurance.modifierExtension" ] ; fhir:path [ fhir:v "ClaimResponse.insurance.modifierExtension" ] ; fhir:short [ fhir:v "Extensions that cannot be ignored even if unrecognized" ] ; fhir:definition [ fhir: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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ] ; fhir:comment [ fhir: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." ] ; fhir:requirements [ fhir: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)." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] [ fhir:v "modifiers" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "BackboneElement.modifierExtension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v true ] ; fhir:isModifierReason [ fhir:v "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ] ; fhir:isSummary [ fhir:v true ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "N/A" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.insurance.sequence" ] ; fhir:path [ fhir:v "ClaimResponse.insurance.sequence" ] ; fhir:short [ fhir:v "Insurance instance identifier" ] ; fhir:definition [ fhir:v "A number to uniquely identify insurance entries and provide a sequence of coverages to convey coordination of benefit order." ] ; fhir:requirements [ fhir:v "To maintain order of the coverages." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.insurance.sequence" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "positiveInt"^^xsd:anyURI ; fhir:l fhir:positiveInt ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.insurance.focal" ] ; fhir:path [ fhir:v "ClaimResponse.insurance.focal" ] ; fhir:short [ fhir:v "Coverage to be used for adjudication" ] ; fhir:definition [ fhir:v "A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true." ] ; fhir:comment [ fhir: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." ] ; fhir:requirements [ fhir:v "To identify which coverage in the list is being used to adjudicate this claim." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.insurance.focal" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "boolean"^^xsd:anyURI ; fhir:l fhir:boolean ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.insurance.coverage" ] ; fhir:path [ fhir:v "ClaimResponse.insurance.coverage" ] ; fhir:short [ fhir:v "Insurance information" ] ; fhir:definition [ fhir: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." ] ; fhir:requirements [ fhir:v "Required to allow the adjudicator to locate the correct policy and history within their information system." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.insurance.coverage" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Reference"^^xsd:anyURI ; fhir:l fhir:Reference ] ; ( fhir:targetProfile [ fhir:v "http://hl7.org/fhir/StructureDefinition/Coverage|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Coverage?version=4.0.1> ] ) ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.insurance.businessArrangement" ] ; fhir:path [ fhir:v "ClaimResponse.insurance.businessArrangement" ] ; fhir:short [ fhir:v "Additional provider contract number" ] ; fhir:definition [ fhir:v "A business agreement number established between the provider and the insurer for special business processing purposes." ] ; fhir:requirements [ fhir:v "Providers may have multiple business arrangements with a given insurer and must supply the specific contract number for adjudication." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.insurance.businessArrangement" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "string"^^xsd:anyURI ; fhir:l fhir:string ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.insurance.claimResponse" ] ; fhir:path [ fhir:v "ClaimResponse.insurance.claimResponse" ] ; fhir:short [ fhir:v "Adjudication results" ] ; fhir:definition [ fhir:v "The result of the adjudication of the line items for the Coverage specified in this insurance." ] ; fhir:comment [ fhir:v "Must not be specified when 'focal=true' for this insurance." ] ; fhir:requirements [ fhir: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." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.insurance.claimResponse" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Reference"^^xsd:anyURI ; fhir:l fhir:Reference ] ; ( fhir:targetProfile [ fhir:v "http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.0.1"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/ClaimResponse?version=4.0.1> ] ) ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.error" ] ; fhir:path [ fhir:v "ClaimResponse.error" ] ; fhir:short [ fhir:v "Nhóm issue giám định/từ chối hoặc yêu cầu điều chỉnh" ] ; fhir:definition [ fhir:v "Issue-level carrier cho phản hồi giám định, giảm trừ, yêu cầu điều chỉnh hoặc lỗi tiếp nhận có liên kết tới claim. `VNBHYTReviewIssueVS` chỉ là taxonomy baseline cục bộ từ TT 12/2026; không phải catalog payer/gateway chính thức đầy đủ." ] ; fhir:comment [ fhir: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." ] ; fhir:requirements [ fhir:v "Need to communicate processing issues to the requestor." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.error" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "BackboneElement"^^xsd:anyURI ; fhir:l fhir:BackboneElement ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.error.id" ] ; fhir:path [ fhir:v "ClaimResponse.error.id" ] ; ( fhir:representation [ fhir:v "xmlAttr" ] ) ; fhir:short [ fhir:v "Unique id for inter-element referencing" ] ; fhir:definition [ fhir:v "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "Element.id" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type> ] ; fhir:value [ a fhir:Url ; fhir:v "string"^^xsd:anyURI ; fhir:l fhir:string ] ] ) ; fhir:code [ fhir:v "http://hl7.org/fhirpath/System.String"^^xsd:anyURI ; fhir:l <http://hl7.org/fhirpath/System.String> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.error.extension" ] ; fhir:path [ fhir:v "ClaimResponse.error.extension" ] ; fhir:short [ fhir:v "Additional content defined by implementations" ] ; fhir:definition [ fhir: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." ] ; fhir:comment [ fhir: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." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "Element.extension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "n/a" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.error.modifierExtension" ] ; fhir:path [ fhir:v "ClaimResponse.error.modifierExtension" ] ; fhir:short [ fhir:v "Extensions that cannot be ignored even if unrecognized" ] ; fhir:definition [ fhir: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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ] ; fhir:comment [ fhir: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." ] ; fhir:requirements [ fhir: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)." ] ; ( fhir:alias [ fhir:v "extensions" ] [ fhir:v "user content" ] [ fhir:v "modifiers" ] ) ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ; fhir:base [ fhir:path [ fhir:v "BackboneElement.modifierExtension" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "*" ] ] ; ( fhir:type [ fhir:code [ fhir:v "Extension"^^xsd:anyURI ; fhir:l fhir:Extension ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] [ fhir:key [ fhir:v "ext-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "Must have either extensions or value[x], not both" ] ; fhir:expression [ fhir:v "extension.exists() != value.exists()" ] ; fhir:xpath [ fhir:v "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Extension"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Extension> ] ] ) ; fhir:isModifier [ fhir:v true ] ; fhir:isModifierReason [ fhir:v "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ] ; fhir:isSummary [ fhir:v true ] ; ( fhir:mapping [ fhir:identity [ fhir:v "rim" ] ; fhir:map [ fhir:v "N/A" ] ] ) ] [ fhir:id [ fhir:v "ClaimResponse.error.itemSequence" ] ; fhir:path [ fhir:v "ClaimResponse.error.itemSequence" ] ; fhir:short [ fhir:v "Dòng chi phí liên quan nếu có" ] ; fhir:definition [ fhir: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." ] ; fhir:requirements [ fhir:v "Provides references to the claim items." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.error.itemSequence" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "positiveInt"^^xsd:anyURI ; fhir:l fhir:positiveInt ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.error.detailSequence" ] ; fhir:path [ fhir:v "ClaimResponse.error.detailSequence" ] ; fhir:short [ fhir:v "Detail sequence number" ] ; fhir:definition [ fhir: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." ] ; fhir:requirements [ fhir:v "Provides references to the claim details within the claim item." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.error.detailSequence" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "positiveInt"^^xsd:anyURI ; fhir:l fhir:positiveInt ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.error.subDetailSequence" ] ; fhir:path [ fhir:v "ClaimResponse.error.subDetailSequence" ] ; fhir:short [ fhir:v "Subdetail sequence number" ] ; fhir:definition [ fhir: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." ] ; fhir:requirements [ fhir:v "Provides references to the claim sub-details within the claim detail." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.error.subDetailSequence" ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "positiveInt"^^xsd:anyURI ; fhir:l fhir:positiveInt ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ] [ fhir:id [ fhir:v "ClaimResponse.error.code" ] ; fhir:path [ fhir:v "ClaimResponse.error.code" ] ; fhir:short [ fhir:v "Nhóm issue/lý do BHYT" ] ; fhir:definition [ fhir:v "Mã nhóm issue để liên kết `ClaimResponse` với `OperationOutcome`, bảng kê từ chối hoặc biên bản giám định. Căn cứ pháp lý chi tiết và số tiền vẫn nằm ở tài liệu giám định/payer response cụ thể." ] ; fhir:requirements [ fhir:v "Required to convey processing errors." ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:base [ fhir:path [ fhir:v "ClaimResponse.error.code" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ] ; ( fhir:type [ fhir:code [ fhir:v "CodeableConcept"^^xsd:anyURI ; fhir:l fhir:CodeableConcept ] ] ) ; ( fhir:constraint [ fhir:key [ fhir:v "ele-1" ] ; fhir:severity [ fhir:v "error" ] ; fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ; fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ; fhir:xpath [ fhir:v "@value|f:*|h:div" ] ; fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/StructureDefinition/Element> ] ] ) ; fhir:mustSupport [ fhir:v true ] ; fhir:isModifier [ fhir:v false ] ; fhir:isSummary [ fhir:v false ] ; fhir:binding [ fhir:strength [ fhir:v "extensible" ] ; fhir:valueSet [ fhir:v "http://fhir.hl7.org.vn/core/ValueSet/vn-bhyt-review-issue-vs"^^xsd:anyURI ; fhir:l <http://fhir.hl7.org.vn/core/ValueSet/vn-bhyt-review-issue-vs> ] ] ] ) ] ; # fhir:differential [ ( fhir:element [ fhir:id [ fhir:v "ClaimResponse" ] ; fhir:path [ fhir:v "ClaimResponse" ] ] [ fhir:id [ fhir:v "ClaimResponse.identifier" ] ; fhir:path [ fhir:v "ClaimResponse.identifier" ] ; fhir:slicing [ ( fhir:discriminator [ fhir:type [ fhir:v "value" ] ; fhir:path [ fhir:v "system" ] ] ) ; fhir:description [ fhir:v "Phân loại identifier kết quả xử lý theo hệ thống định danh" ] ; fhir:rules [ fhir:v "open" ] ] ; fhir:short [ fhir:v "Định danh kết quả xử lý, bao gồm mã phản hồi gateway nếu có" ] ; fhir:mustSupport [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.identifier:gatewayResponseId" ] ; fhir:path [ fhir:v "ClaimResponse.identifier" ] ; fhir:sliceName [ fhir:v "gatewayResponseId" ] ; fhir:short [ fhir:v "Mã phản hồi Cổng tiếp nhận BHYT (XML1_ID)" ] ; fhir:definition [ fhir:v "Mã phản hồi của Cổng tiếp nhận dữ liệu cho hồ sơ/bảng XML1. Không dùng thay cho MA_LK." ] ; fhir:min [ fhir:v "0"^^xsd:nonNegativeInteger ] ; fhir:max [ fhir:v "1" ] ; fhir:mustSupport [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.identifier:gatewayResponseId.type" ] ; fhir:path [ fhir:v "ClaimResponse.identifier.type" ] ; fhir:pattern [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://fhir.hl7.org.vn/core/CodeSystem/vn-identifier-type-cs"^^xsd:anyURI ; fhir:l <http://fhir.hl7.org.vn/core/CodeSystem/vn-identifier-type-cs> ] ; fhir:code [ fhir:v "BHYT_XML1_ID" ] ] ) ] ] [ fhir:id [ fhir:v "ClaimResponse.identifier:gatewayResponseId.system" ] ; fhir:path [ fhir:v "ClaimResponse.identifier.system" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:fixed [ a fhir:Uri ; fhir:v "http://fhir.hl7.org.vn/core/sid/bhyt-gateway-response-id"^^xsd:anyURI ; fhir:l <http://fhir.hl7.org.vn/core/sid/bhyt-gateway-response-id> ] ] [ fhir:id [ fhir:v "ClaimResponse.identifier:gatewayResponseId.value" ] ; fhir:path [ fhir:v "ClaimResponse.identifier.value" ] ; fhir:short [ fhir:v "Giá trị XML1_ID hoặc mã phản hồi tương đương" ] ; fhir:min [ fhir:v "1"^^xsd:nonNegativeInteger ] ; fhir:mustSupport [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.status" ] ; fhir:path [ fhir:v "ClaimResponse.status" ] ; fhir:short [ fhir:v "Trạng thái kết quả: active | cancelled | draft | entered-in-error" ] ; fhir:mustSupport [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.type" ] ; fhir:path [ fhir:v "ClaimResponse.type" ] ; fhir:short [ fhir:v "Loại: institutional (nội trú) | professional (ngoại trú)" ] ; fhir:mustSupport [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.use" ] ; fhir:path [ fhir:v "ClaimResponse.use" ] ; fhir:short [ fhir:v "Mục đích: claim | preauthorization | predetermination" ] ; fhir:mustSupport [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.patient" ] ; fhir:path [ fhir:v "ClaimResponse.patient" ] ; fhir:short [ fhir:v "Bệnh nhân" ] ; ( fhir:type [ fhir:code [ fhir:v "Reference"^^xsd:anyURI ; fhir:l fhir:Reference ] ; ( fhir:targetProfile [ fhir:v "http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-patient"^^xsd:anyURI ; fhir:l <http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-patient> ] ) ] ) ; fhir:mustSupport [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.created" ] ; fhir:path [ fhir:v "ClaimResponse.created" ] ; fhir:short [ fhir:v "Ngày tạo kết quả" ] ; fhir:mustSupport [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.insurer" ] ; fhir:path [ fhir:v "ClaimResponse.insurer" ] ; fhir:short [ fhir:v "Cơ quan BHXH giải quyết" ] ; ( fhir:type [ fhir:code [ fhir:v "Reference"^^xsd:anyURI ; fhir:l fhir:Reference ] ; ( fhir:targetProfile [ fhir:v "http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-organization"^^xsd:anyURI ; fhir:l <http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-organization> ] ) ] ) ; fhir:mustSupport [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.request" ] ; fhir:path [ fhir:v "ClaimResponse.request" ] ; fhir:short [ fhir:v "Yêu cầu thanh toán gốc (VNCoreClaim)" ] ; ( fhir:type [ fhir:code [ fhir:v "Reference"^^xsd:anyURI ; fhir:l fhir:Reference ] ; ( fhir:targetProfile [ fhir:v "http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-claim"^^xsd:anyURI ; fhir:l <http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-claim> ] ) ] ) ; fhir:mustSupport [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.outcome" ] ; fhir:path [ fhir:v "ClaimResponse.outcome" ] ; fhir:short [ fhir:v "Kết quả: queued | complete | error | partial" ] ; fhir:mustSupport [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.item" ] ; fhir:path [ fhir:v "ClaimResponse.item" ] ; fhir:short [ fhir:v "Kết quả từng dòng chi phí" ] ; fhir:mustSupport [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.item.itemSequence" ] ; fhir:path [ fhir:v "ClaimResponse.item.itemSequence" ] ; fhir:mustSupport [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.item.adjudication" ] ; fhir:path [ fhir:v "ClaimResponse.item.adjudication" ] ; fhir:short [ fhir:v "Phân bổ chi phí: đề nghị, đủ ĐK, cùng chi trả, BHYT thanh toán" ] ; fhir:mustSupport [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.item.adjudication.category" ] ; fhir:path [ fhir:v "ClaimResponse.item.adjudication.category" ] ; fhir:short [ fhir:v "Loại: submitted | eligible | copay | benefit" ] ; fhir:definition [ fhir:v "Category giám định từng dòng. Ưu tiên HL7 adjudication (`submitted`, `eligible`, `copay`, `benefit`) cho line-level adjudication; các subtotal cục bộ của VN Core không dùng ở line-level." ] ; fhir:mustSupport [ fhir:v true ] ; fhir:binding [ fhir:strength [ fhir:v "extensible" ] ; fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/adjudication"^^xsd:anyURI ; fhir:l <http://hl7.org/fhir/ValueSet/adjudication> ] ] ] [ fhir:id [ fhir:v "ClaimResponse.item.adjudication.amount" ] ; fhir:path [ fhir:v "ClaimResponse.item.adjudication.amount" ] ; fhir:short [ fhir:v "Số tiền (VND)" ] ; fhir:mustSupport [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.total" ] ; fhir:path [ fhir:v "ClaimResponse.total" ] ; fhir:short [ fhir:v "Tổng adjudication" ] ; fhir:mustSupport [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.total.category" ] ; fhir:path [ fhir:v "ClaimResponse.total.category" ] ; fhir:short [ fhir:v "Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ" ] ; fhir:definition [ fhir:v "Category tổng hợp tài chính/adjudication. Dùng ConceptMap `vn-cm-bhyt-financial-field-to-adjudication` để map các trường tổng tiền BHYT như `T_TONGCHI`, `T_TONGCHI_BH`, `T_BHTT`, `T_BNCCT`, `T_BNTT`, `T_NGUONKHAC`, `T_NGOAIDS`, `T_THUOC`, `T_VTYT`. Không encode công thức quyền lợi hoặc adjudication business rule tại profile." ] ; fhir:mustSupport [ fhir:v true ] ; fhir:binding [ fhir:strength [ fhir:v "extensible" ] ; fhir:valueSet [ fhir:v "http://fhir.hl7.org.vn/core/ValueSet/vn-bhyt-adjudication-category-vs"^^xsd:anyURI ; fhir:l <http://fhir.hl7.org.vn/core/ValueSet/vn-bhyt-adjudication-category-vs> ] ] ] [ fhir:id [ fhir:v "ClaimResponse.total.amount" ] ; fhir:path [ fhir:v "ClaimResponse.total.amount" ] ; fhir:mustSupport [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.payment" ] ; fhir:path [ fhir:v "ClaimResponse.payment" ] ; fhir:short [ fhir:v "Thông tin thanh toán" ] ] [ fhir:id [ fhir:v "ClaimResponse.payment.amount" ] ; fhir:path [ fhir:v "ClaimResponse.payment.amount" ] ; fhir:short [ fhir:v "Số tiền BHXH thanh toán" ] ] [ fhir:id [ fhir:v "ClaimResponse.error" ] ; fhir:path [ fhir:v "ClaimResponse.error" ] ; fhir:short [ fhir:v "Nhóm issue giám định/từ chối hoặc yêu cầu điều chỉnh" ] ; fhir:definition [ fhir:v "Issue-level carrier cho phản hồi giám định, giảm trừ, yêu cầu điều chỉnh hoặc lỗi tiếp nhận có liên kết tới claim. `VNBHYTReviewIssueVS` chỉ là taxonomy baseline cục bộ từ TT 12/2026; không phải catalog payer/gateway chính thức đầy đủ." ] ; fhir:mustSupport [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.error.itemSequence" ] ; fhir:path [ fhir:v "ClaimResponse.error.itemSequence" ] ; fhir:short [ fhir:v "Dòng chi phí liên quan nếu có" ] ; fhir:mustSupport [ fhir:v true ] ] [ fhir:id [ fhir:v "ClaimResponse.error.code" ] ; fhir:path [ fhir:v "ClaimResponse.error.code" ] ; fhir:short [ fhir:v "Nhóm issue/lý do BHYT" ] ; fhir:definition [ fhir:v "Mã nhóm issue để liên kết `ClaimResponse` với `OperationOutcome`, bảng kê từ chối hoặc biên bản giám định. Căn cứ pháp lý chi tiết và số tiền vẫn nằm ở tài liệu giám định/payer response cụ thể." ] ; fhir:mustSupport [ fhir:v true ] ; fhir:binding [ fhir:strength [ fhir:v "extensible" ] ; fhir:valueSet [ fhir:v "http://fhir.hl7.org.vn/core/ValueSet/vn-bhyt-review-issue-vs"^^xsd:anyURI ; fhir:l <http://fhir.hl7.org.vn/core/ValueSet/vn-bhyt-review-issue-vs> ] ] ] ) ] . #
IG © 2026+ Omi HealthTech / VN Core FHIR Community Initiative.
Package hl7.fhir.vn.core#0.5.1 based on FHIR 4.0.1.
Sinh ngày
2026-05-10
Liên kết: Mục lục |
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