| Source | URL | Version | Realm | Type | Description |
|---|---|---|---|---|---|
| ClaimResponse | |||||
| hl7.fhir.us.davinci-pas#current | http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber|1.2.0 | 4.0.1 | us | string | A string assigned by the UMO to the original disallowed review outcome associated with this service item. Profile Paths: Claim.item, ClaimResponse.item, ExplanationOfBenefit.item |
| hl7.fhir.us.davinci-pas#current | http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator|1.2.0 | 4.0.1 | us | boolean | An indicator of whether early and periodic screen for diagnosis and treatment of children is involved. Profile Paths: Claim.item |
| hl7.fhir.us.davinci-pas#current | http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeLevelOfCare|1.2.0 | 4.0.1 | us | CodeableConcept | A code specifying the level of care provided by a nursing home facility. (SV120, SV210) Profile Paths: Claim.item |
| hl7.fhir.us.davinci-pas#current | http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-productOrServiceCodeEnd|1.2.0 | 4.0.1 | us | CodeableConcept | Used to provide the last code in a series of codes for the service being requested. Profile Paths: Claim.item, ServiceRequest |
| hl7.fhir.us.davinci-pas#current | http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueUnitRateLimit|1.2.0 | 4.0.1 | us | decimal | The limit on the rate per unit of revenue for hospital accomodation. (SV206) Profile Paths: Claim.item |
| ClaimResponse.addItem | |||||
| hl7.fhir.us.carin-rtpbc#1.0.0 | http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-benefitRestriction|1.0.0 | 4.0.1 | us | Coding | This extension conveys benefit restrictions that may apply to a prescription product and pharmacy combination. Profile Paths: ClaimResponse.addItem, ClaimResponse.item |
| hl7.fhir.us.carin-rtpbc#1.0.0 | http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-isAlternative|1.0.0 | 4.0.1 | us | boolean | This extension indicates that this added line item is to be interpreted as one of possibly multiple alternatives to the requested product or service. When isAlternative is true, the added line item is to be considered independently from any other added line items associated with the requested product or service. Profile Paths: ClaimResponse.addItem |
| hl7.fhir.be.etariff#current | https://www.ehealth.fgov.be/standards/fhir/etariff/StructureDefinition/be-ext-etariff-item-commitment|1.0.0 | 4.0.1 | be | string | tariff commitment number Profile Paths: ClaimResponse.addItem |
| hl7.fhir.be.mycarenet#current | https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-mycarenet-item-patientfee|2.1.0 | 4.0.1 | be | Money | Sum to be paid by the patient per item Profile Paths: ClaimResponse.addItem |
| hl7.fhir.be.mycarenet#current | https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-mycarenet-item-reimbursement|2.1.0 | 4.0.1 | be | Money | Reimbursement for the patient per item Profile Paths: ClaimResponse.addItem |
| ClaimResponse.addItem.adjudication | |||||
| hl7.fhir.be.etariff#current | https://www.ehealth.fgov.be/standards/fhir/etariff/StructureDefinition/be-ext-etariff-adjudication-refusalservicedate|1.0.0 | 4.0.1 | be | date | Date of the refusal service Profile Paths: ClaimResponse.addItem.adjudication |
| hl7.fhir.be.etariff#current | https://www.ehealth.fgov.be/standards/fhir/etariff/StructureDefinition/be-ext-etariff-adjudication-refusalserviceidentifier|1.0.0 | 4.0.1 | be | CodeableConcept | Id of the preauthorization of the item Profile Paths: ClaimResponse.addItem.adjudication |
| ClaimResponse.error | |||||
| hl7.fhir.us.davinci-pas#current | http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorElement|1.2.0 | 4.0.1 | us | string | The specific loop, segment, or element that this error information is about. Profile Paths: ClaimResponse.error |
| hl7.fhir.us.davinci-pas#current | http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorFollowupAction|1.2.0 | 4.0.1 | us | CodeableConcept | A code representing what action must occur to resolve this error. Profile Paths: ClaimResponse.error |
| hl7.fhir.us.davinci-pas#current | http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorPath|1.2.0 | 4.0.1 | us | string | The FHIRPath expression that indicates which FHIR element that this error information is about. Profile Paths: ClaimResponse.error |
| ClaimResponse.item | |||||
| hl7.fhir.us.carin-rtpbc#1.0.0 | http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-benefitRestriction|1.0.0 | 4.0.1 | us | Coding | This extension conveys benefit restrictions that may apply to a prescription product and pharmacy combination. Profile Paths: ClaimResponse.addItem, ClaimResponse.item |
| hl7.fhir.us.davinci-pas#current | http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber|1.2.0 | 4.0.1 | us | string | A string assigned by the UMO to an authorized review outcome associated with this service item. Profile Paths: Claim.item, ClaimResponse.item, ExplanationOfBenefit.item |
| hl7.fhir.us.davinci-pas#current | http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDetail|1.2.0 | 4.0.1 | us | (complex) | The details of what has been authorized for this item if different from what was requested. Profile Paths: ClaimResponse.item, ExplanationOfBenefit.item |
| hl7.fhir.us.davinci-pas#current | http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider|1.2.0 | 4.0.1 | us | (complex) | The specific provider who has been authorized to provide this item. Profile Paths: ClaimResponse.item, ExplanationOfBenefit.item |
| hl7.fhir.us.davinci-pas#current | http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate|1.2.0 | 4.0.1 | us | date | The date when this item's preauthorization was issued. Profile Paths: ClaimResponse.item, ExplanationOfBenefit.item |
| hl7.fhir.us.davinci-pas#current | http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod|1.2.0 | 4.0.1 | us | Period | The date/period when this item's preauthorization is valid. Profile Paths: ClaimResponse.item, ExplanationOfBenefit.item |
| hl7.fhir.us.davinci-pas#current | http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemRequestedServiceDate|1.2.0 | 4.0.1 | us | dateTime, Period | The original date/period that was requested by the submitter for this item. Profile Paths: ClaimResponse.item |
| hl7.fhir.us.davinci-pas#current | http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber|1.2.0 | 4.0.1 | us | Identifier | Uniquely identifies this claim item. (2000F-TRN) Profile Paths: Claim.item, ClaimResponse.item, ExplanationOfBenefit.item |
| hl7.fhir.us.davinci-pas#current | http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService|1.2.0 | 4.0.1 | us | Reference | The details of the service being requested. Profile Paths: Claim.item |
| ClaimResponse.item.adjudication | |||||
| hl7.fhir.us.davinci-pas#current | http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction|1.2.0 | 4.0.1 | us | (complex) | The details of the review action that is necessary for the authorization. Profile Paths: ClaimResponse.item.adjudication |
| hl7.fhir.us.davinci-pas#current | http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewActionCode|1.2.0 | 4.0.1 | us | CodeableConcept | The code describing the result of the review. Profile Paths: Claim.item |
| ClaimResponse.item.adjudication.extension | |||||
| hl7.fhir.us.davinci-pas#current | http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewActionCode|1.2.0 | 4.0.1 | us | CodeableConcept | The code describing the result of the review. Profile Paths: Claim.item |