### ----------------------------------------------------
### -- FHIR
### -- Licenses: Artistic-2.0
### -- Authors: Hugh Simpson
### -- File: t/resources/structureDefinition/ClaimResponse.json
### ----------------------------------------------------
### -- Chunk 25 of 26
ClaimResponse.request",
      "short" : "Id of resource triggering adjudication",
      "definition" : "Original request resource reference.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Claim"]
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Event.basedOn"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.why[x]"
      }]
    },
    {
      "id" : "ClaimResponse.outcome",
      "path" : "ClaimResponse.outcome",
      "short" : "queued | complete | error | partial",
      "definition" : "The outcome of the claim, predetermination, or preauthorization processing.",
      "comment" : "The resource may be used to indicate that: the request has been held (queued) for processing; that it has been processed and errors found (error); that no errors were found and that some of the adjudication has been undertaken (partial) or that all of the adjudication has been undertaken (complete).",
      "requirements" : "To advise the requestor of an overall processing outcome.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "code"
      }],
      "isSummary" : true,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "RemittanceOutcome"
        }],
        "strength" : "required",
        "description" : "The result of the claim processing.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.0"
      }
    },
    {
      "id" : "ClaimResponse.disposition",
      "path" : "ClaimResponse.disposition",
      "short" : "Disposition Message",
      "definition" : "A human readable description of the status of the adjudication.",
      "requirements" : "Provided for user display.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "string"
      }],
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Event.note"
      }]
    },
    {
      "id" : "ClaimResponse.preAuthRef",
      "path" : "ClaimResponse.preAuthRef",
      "short" : "Preauthorization reference",
      "definition" : "Reference from the Insurer which is used in later communications which refers to this adjudication.",
      "comment" : "This value is only present on preauthorization adjudications.",
      "requirements" : "On subsequent claims, the insurer may require the provider to quote this value.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "string"
      }]
    },
    {
      "id" : "ClaimResponse.preAuthPeriod",
      "path" : "ClaimResponse.preAuthPeriod",
      "short" : "Preauthorization reference effective period",
      "definition" : "The time frame during which this authorization is effective.",
      "requirements" : "To convey to the provider when the authorized products and services must be supplied for the authorized adjudication to apply.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Period"
      }]
    },
    {
      "id" : "ClaimResponse.payeeType",
      "path" : "ClaimResponse.payeeType",
      "short" : "Party to be paid any benefits payable",
      "definition" : "Type of Party to be reimbursed: subscriber, provider, other.",
      "requirements" : "Need to know who should receive payment with the most common situations being the Provider (assignment of benefits) or the Subscriber.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "PayeeType"
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean" : true
        }],
        "strength" : "example",
        "description" : "A code for the party to be reimbursed.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/payeetype"
      }
    },
    {
      "id" : "ClaimResponse.item",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "Item"
      }],
      "path" : "ClaimResponse.item",
      "short" : "Adjudication for claim line items",
      "definition" : "A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details.",
      "requirements" : "The adjudication for items provided on the claim.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "BackboneElement"
      }]
    },
    {
      "id" : "ClaimResponse.item.itemSequence",
      "path" : "ClaimResponse.item.itemSequence",
      "short" : "Claim item instance identifier",
      "definition" : "A number to uniquely reference the claim item entries.",
      "requirements" : "Necessary to provide a mechanism to link the adjudication result to the submitted claim item.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "positiveInt"
      }]
    },
    {
      "id" : "ClaimResponse.item.noteNumber",
      "path" : "ClaimResponse.item.noteNumber",
      "short" : "Applicable note numbers",
      "definition" : "The numbers associated with notes below which apply to the adjudication of this item.",
      "requirements" : "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "positiveInt"
      }]
    },
    {
      "id" : "ClaimResponse.item.adjudication",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "Adjudication"
      }],
      "path" : "ClaimResponse.item.adjudication",
      "short" : "Adjudication details",
      "definition" : "If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item.",
      "requirements" : "The adjudication results conveys the insurer's assessment of the item provided in the claim under the terms of the patient's insurance coverage.",
      "min" : 1,
      "max" : "*",
      "type" : [{
        "code" : "BackboneElement"
      }]
    },
    {
      "id" : "ClaimResponse.item.adjudication.category",
      "path" : "ClaimResponse.item.adjudication.category",
      "short" : "Type of adjudication information",
      "definition" : "A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item.",
      "comment" : "For example codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
      "requirements" : "Needed to enable understanding of the context of the other information in the adjudication.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "Adjudication"
        }],
        "strength" : "example",
        "description" : "The adjudication codes.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/adjudication"
      }
    },
    {
      "id" : "ClaimResponse.item.adjudication.reason",
      "path" : "ClaimResponse.item.adjudication.reason",
      "short" : "Explanation of adjudication outcome",
      "definition" : "A code supporting the understanding of the adjudication result and explaining variance from expected amount.",
      "comment" : "For example may indicate that the funds for this benefit type have been exhausted.",
      "requirements" : "To support understanding of variance from adjudication expectations.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "AdjudicationReason"
        }],
        "strength" : "example",
        "description" : "The adjudication reason codes.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/adjudication-reason"
      }
    },
    {
      "id" : "ClaimResponse.item.adjudication.amount",
      "path" : "ClaimResponse.item.adjudication.amount",
      "short" : "Monetary amount",
      "definition" : "Monetary amount associated with the category.",
      "comment" : "For example: amount submitted, eligible amount, co-payment, and benefit payable.",
      "requirements" : "Most adjuciation categories convey a monetary amount.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Money"
      }]
    },
    {
      "id" : "ClaimResponse.item.adjudication.value",
      "path" : "ClaimResponse.item.adjudication.value",
      "short" : "Non-monetary value",
      "definition" : "A non-monetary value associated with the category. Mutually exclusive to the amount element above.",
      "comment" : "For example: eligible percentage or co-payment percentage.",
      "requirements" : "Some adjudication categories convey a percentage or a fixed value.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "decimal"
      }]
    },
    {
      "id" : "ClaimResponse.item.detail",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "ItemDetail"
      }],
      "path" : "ClaimResponse.item.detail",
      "short" : "Adjudication for claim details",
      "definition" : "A claim detail. Either a simple (a product or service) or a 'group' of sub-details which are simple items.",
      "requirements" : "The adjudication for details provided on the claim.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "BackboneElement"
      }]
    },
    {
      "id" : "ClaimResponse.item.detail.detailSequence",
      "path" : "ClaimResponse.item.detail.detailSequence",
      "short" : "Claim detail instance identifier",
      "definition" : "A number to uniquely reference the claim detail entry.",
      "requirements" : "Necessary to provide a mechanism to link the adjudication result to the submitted claim detail.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "positiveInt"
      }]
    },
    {
      "id" : "ClaimResponse.item.detail.noteNumber",
      "path" : "ClaimResponse.item.detail.noteNumber",
      "short" : "Applicable note numbers",
      "definition" : "The numbers associated with notes below which apply to the adjudication of this item.",
      "requirements" : "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "positiveInt"
      }]
    },
    {
      "id" : "ClaimResponse.item.detail.adjudication",
      "path" : "ClaimResponse.item.detail.adjudication",
      "short" : "Detail level adjudication details",
      "definition" : "The adjudication results.",
      "min" : 1,
      "max" : "*",
      "contentReference" : "#ClaimResponse.item.adjudication"
    },
    {
      "id" : "ClaimResponse.item.detail.subDetail",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "SubDetail"
      }],
      "path" : "ClaimResponse.item.detail.subDetail",
      "short" : "Adjudication for claim sub-details",
      "definition" : "A sub-detail adjudication of a simple product or service.",
      "requirements" : "The adjudication for sub-details provided on the claim.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "BackboneElement"
      }]
    },
    {
      "id" : "ClaimResponse.item.detail.subDetail.subDetailSequence",
      "path" : "ClaimResponse.item.detail.subDetail.subDetailSequence",
      "short" : "Claim sub-detail instance identifier",
      "definition" : "A number to uniquely reference the claim sub-detail entry.",
      "requirements" : "Necessary to provide a mechanism to link the adjudication result to the submitted claim sub-detail.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "positiveInt"
      }]
    },
    {
      "id" : "ClaimResponse.item.detail.subDetail.noteNumber",
      "path" : "ClaimResponse.item.detail.subDetail.noteNumber",
      "short" : "Applicable note numbers",
      "definition" : "The numbers associated with notes below which apply to the adjudication of this item.",
      "requirements" : "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "positiveInt"
      }]
    },
    {
      "id" : "ClaimResponse.item.detail.subDetail.adjudication",
      "path" : "ClaimResponse.item.detail.subDetail.adjudication",
      "short" : "Subdetail level adjudication details",
      "definition" : "The adjudication results.",
      "min" : 0,
      "max" : "*",
      "contentReference" : "#ClaimResponse.item.adjudication"
    },
    {
      "id" : "ClaimResponse.addItem",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "AddedItem"
      }],
      "path" : "ClaimResponse.addItem",
      "short" : "Insurer added line items",
      "definition" : "The first-tier service adjudications for payor added product or service lines.",
      "requirements" : "Insurers may redefine the provided product or service or may package and/or decompose groups of products and services. The addItems allows the insurer to provide their line item list with linkage to the submitted items/details/sub-details. In a preauthorization the insurer may use the addItem structure to provide additional information on authorized products and services.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "BackboneElement"
      }]
    },
    {
      "id" : "ClaimResponse.addItem.itemSequence",
      "path" : "ClaimResponse.addItem.itemSequence",
      "short" : "Item sequence number",
      "definition" : "Claim items which this service line is intended to replace.",
      "requirements" : "Provides references to the claim items.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "positiveInt"
      }]
    },
    {
      "id" : "ClaimResponse.addItem.detailSequence",
      "path" : "ClaimResponse.addItem.detailSequence",
      "short" : "Detail sequence number",
      "definition" : "The sequence number of the details within the claim item which this line is intended to replace.",
      "requirements" : "Provides references to the claim details within the claim item.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "positiveInt"
      }]
    },
    {
      "id" : "ClaimResponse.addItem.subdetailSequence",
      "path" : "ClaimResponse.addItem.subdetailSequence",
      "short" : "Subdetail sequence number",
      "definition" : "The sequence number of the sub-details within the details within the claim item which this line is intended to replace.",
      "requirements" : "Provides references to the claim sub-details within the claim detail.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "positiveInt"
      }]
    },
    {
      "id" : "ClaimResponse.addItem.provider",
      "path" : "ClaimResponse.addItem.provider",
      "short" : "Authorized providers",
      "definition" : "The providers who are authorized for the services rendered to the patient.",
      "requirements" : "Insurer may provide authorization specifically to a restricted set of providers rather than an open authorization.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Practitioner",
        "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
        "http://hl7.org/fhir/StructureDefinition/Organization"]
      }],
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.source"
      }]
    },
    {
      "id" : "ClaimResponse.addItem.productOrService",
      "path" : "ClaimResponse.addItem.productOrService",
      "short" : "Billing, service, product, or drug code",
      "definition" : "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.",
      "comment" : "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.",
      "requirements" : "Necessary to state what was provided or done.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "ServiceProduct"
        }],
        "strength" : "example",
        "description" : "Allowable service and product codes.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/service-uscls"
      }
    },
    {
      "id" : "ClaimResponse.addItem.modifier",
      "path" : "ClaimResponse.addItem.modifier",
      "short" : "Service/Product billing modifiers",
      "definition" : "Item typification or modifiers codes to convey additional context for the product or service.",
      "comment" : "For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.",
      "requirements" : "To support inclusion of the item for adjudication or to charge an elevated fee.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "Modifiers"
        }],
        "strength" : "example",
        "description" : "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/claim-modifiers"
      },
      "mapping" : [{
        "identity" : "rim",
        "map" : "24.C, 24.D mods"
      }]
    },
    {
      "id" : "ClaimResponse.addItem.programCode",
      "path" : "ClaimResponse.addItem.programCode",
      "short" : "Program the product or service is provided under",
      "definition" : "Identifies the program under which this may be recovered.",
      "comment" : "For example: Neonatal program, child dental program or drug users recovery program.",
      "requirements" : "Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "ProgramCode"
        }],
        "strength" : "example",
        "description" : "Program specific reason codes.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/ex-program-code"
      },
      "mapping" : [{
        "identity" : "rim",
        "map" : "24.H"
      }]
    },
    {
      "id" : "ClaimResponse.addItem.serviced[x]",
      "path" : "ClaimResponse.addItem.serviced[x]",
      "short" : "Date or dates of service or product delivery",
      "definition" : "The date or dates when the service or product was supplied, performed or completed.",
      "requirements" : "Needed to determine whether the  service or product was provided during the term of the insurance coverage.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "date"
      },
      {
        "code" : "Period"
      }],
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.done[x]"
      },
      {
        "identity" : "rim",
        "map" : "24.A"
      }]
    },
    {
      "id" : "ClaimResponse.addItem.location[x]",
      "path" : "ClaimResponse.addItem.location[x]",
      "short" : "Place of service or where product was supplied",
      "definition" : "Where the product or service was provided.",
      "requirements" : "The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      },
      {
        "code" : "Address"
      },
      {
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Location"]
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "ServicePlace"
        }],
        "strength" : "example",
        "description" : "Place of service: pharmacy, school, prison, etc.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/service-place"
      },
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.where[x]"
      },
      {
        "identity" : "rim",
        "map" : "24.B"
      }]
    },
    {
      "id" : "ClaimResponse.addItem.quantity",
      "path" : "ClaimResponse.addItem.quantity",
      "short" : "Count of products or services",
      "definition" : "The number of repetitions of a service or product.",
      "requirements" : "Required when the product or service code does not convey the quantity provided.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Quantity",
        "profile" : ["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]
      }],
      "mapping" : [{
        "identity" : "rim",
        "map" : "24.G"
      }]
    },
    {
      "id" : "ClaimResponse.addItem.unitPrice",
      "path" : "ClaimResponse.addItem.unitPrice",
      "short" : "Fee, charge or cost per item",
      "definition" : "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.",
      "requirements" : "The amount charged to the patient by the provider for a single unit.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Money"
      }]
    },
    {
      "id" : "ClaimResponse.addItem.factor",
      "path" : "ClaimResponse.addItem.factor",
      "short" : "Price scaling factor",
      "definition" : "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
      "comment" : "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).",
      "requirements" : "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "decimal"
      }]
    },
    {
      "id" : "ClaimResponse.addItem.net",
      "path" : "ClaimResponse.addItem.net",
      "short" : "Total item cost",
      "definition" : "The quantity times the unit price for an additional service or product or charge.",
      "comment" : "For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.",
      "requirements" : "Provides the total amount claimed  for the group (if a grouper) or the line item.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Money"
      }],
      "mapping" : [{
        "identity" : "rim",
        "map" : "24.F"
      }]
    },
    {
      "id" : "ClaimResponse.addItem.bodySite",
      "path" : "ClaimResponse.addItem.bodySite",
      "short" : "Anatomical location",
      "definition" : "Physical service site on the patient (limb, tooth, etc.).",
      "comment" : "For example: Providing a tooth code allows an insurer to identify a provider performing a filling on a tooth that was previously removed.",
      "requirements" : "Allows insurer to validate specific procedures.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "OralSites"
        }],
        "strength" : "example",
        "description" : "The code for the teeth, quadrant, sextant and arch.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/tooth"
      }
    },
    {
      "id" : "ClaimResponse.addItem.subSite",
      "path" : "ClaimResponse.addItem.subSite",
      "short" : "Anatomical sub-location",
      "definition" : "A region or surface of the bodySite, e.g. limb region or tooth surface(s).",
      "requirements" : "Allows insurer to validate specific procedures.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "Surface"
        }],
        "strength" : "example",
        "description" : "The code for the tooth surface and surface combinations.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/surface"
      }
    },
    {
      "id" : "ClaimResponse.addItem.noteNumber",
      "path" : "ClaimResponse.addItem.noteNumber",
      "short" : "Applicable note numbers",
      "definition" : "The numbers associated with notes below which apply to the adjudication of this item.",
      "requirements" : "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "positiveInt"
      }]
    },
    {
      "id" : "ClaimResponse.addItem.adjudication",
      "path" : "ClaimResponse.addItem.adjudication",
      "short" : "Added items adjudication",
      "definition" : "The adjudication results.",
      "min" : 1,
      "max" : "*",
      "contentReference" : "#ClaimResponse.item.adjudication"
    },
    {
      "id" : "ClaimResponse.addItem.detail",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "AddedItemDetail"
      }],
      "path" : "ClaimResponse.addItem.detail",
      "short" : "Insurer added line details",
      "definition" : "The second-tier service adjudications for payor added services.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "BackboneElement"
      }]
    },
    {
      "id" : "ClaimResponse.addItem.detail.productOrService",
      "path" : "ClaimResponse.addItem.detail.productOrService",
      "short" : "Billing, service, product, or drug code",
      "definition" : "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.",
      "comment" : "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.",
      "requirements" : "Necessary to state what was provided or done.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "ServiceProduct"
        }],
        "strength" : "example",
        "description" : "Allowable service and product codes.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/service-uscls"
      }
    },
    {
      "id" : "ClaimResponse.addItem.detail.modifier",
      "path" : "ClaimResponse.addItem.detail.modifier",
      "short" : "Service/Product billing modifiers",
      "definition" : "Item typification or modifiers codes to convey additional context for the product or service.",
      "comment" : "For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.",
      "requirements" : "To support inclusion of the item for adjudication or to charge an elevated fee.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "Modifiers"
        }],
        "strength" : "example",
        "description" : "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/claim-modifiers"
      },
      "mapping" : [{
        "identity" : "rim",
        "map" : "24.C, 24.D mods"
      }]
    },
    {
      "id" : "ClaimResponse.addItem.detail.quantity",
      "path" : "ClaimResponse.addItem.detail.quantity",
      "short" : "Count of products or services",
      "definition" : "The number of repetitions of a service or product.",
      "requirements" : "Required when the product or service code does not convey the quantity provided.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Quantity",
        "profile" : ["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]
      }],
      "mapping" : [{
        "identity" : "rim",
        "map" : "24.G"
      }]
    },
    {
      "id" : "ClaimResponse.addItem.detail.unitPrice",
      "path" : "ClaimResponse.addItem.detail.unitPrice",
      "short" : "Fee, charge or cost per item",
      "definition" : "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.",
      "requirements" : "The amount charged to the patient by the provider for a single unit.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Money"
      }]
    },
    {
      "id" : "ClaimResponse.addItem.detail.factor",
      "path" : "ClaimResponse.addItem.detail.factor",
      "short" : "Price scaling factor",
      "definition" : "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
      "comment" : "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).",
      "requirements" : "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "decimal"
      }]
    },
    {
      "id" : "ClaimResponse.addItem.detail.net",
      "path" : "ClaimResponse.addItem.detail.net",
      "short" : "Total item cost",
      "definition" : "The quantity times the unit price for an additional service or product or charge.",
      "comment" : "For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.",
      "requirements" : "Provides the total amount claimed  for the group (if a grouper) or the line item.",
      "min" : 0,
      "max" : "1