<status value="active" /> <date value="2024-01-01" /> <description value="Defines the ID Core constraints and extensions on the ClaimResponse resource for the minimal set of data to query and retrieve claim information." /> <fhirVersion value="4.0.1" /> <kind value="resource" /> <abstract value="false" /> <type value="ClaimResponse" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/ClaimResponse" /> <derivation value="constraint" /> <snapshot> <element id="ClaimResponse"> <path value="ClaimResponse" /> <short value="Response to a claim predetermination or preauthorization" /> <definition value="This resource provides the adjudication details from the processing of a Claim resource." /> <alias value="Remittance Advice" /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse" /> <min value="0" /> <max value="*" /> </base> <constraint> <key value="dom-2" /> <severity value="error" /> <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" /> <expression value="contained.contained.empty()" /> <xpath value="not(parent::f:contained and f:contained)" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <constraint> <key value="dom-4" /> <severity value="error" /> <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" /> <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" /> <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <constraint> <key value="dom-3" /> <severity value="error" /> <human value="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" /> <expression value="contained.where(((id.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()" /> <xpath value="not(exists(for $contained in f:contained return $contained[not(exists(parent::*/descendant::f:reference/@value=concat('#', $contained/*/f:id/@value)) or exists(descendant::f:reference[@value='#']))]))" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <constraint> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation"> <valueMarkdown value="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." /> </extension> <key value="dom-6" /> <severity value="warning" /> <human value="A resource should have narrative for robust management" /> <expression value="text.`div`.exists()" /> <xpath value="exists(f:text/h:div)" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <constraint> <key value="dom-5" /> <severity value="error" /> <human value="If a resource is contained in another resource, it SHALL NOT have a security label" /> <expression value="contained.meta.security.empty()" /> <xpath value="not(exists(f:contained/*/f:meta/f:security))" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <mapping> <identity value="rim" /> <map value="Entity. Role, or Act" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event" /> </mapping> <mapping> <identity value="w5" /> <map value="financial.billing" /> </mapping> </element> <element id="ClaimResponse.id"> <path value="ClaimResponse.id" /> <short value="Logical id of this artifact" /> <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." /> <comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." /> <min value="0" /> <max value="1" /> <base> <path value="Resource.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="id" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.meta"> <path value="ClaimResponse.meta" /> <short value="Metadata about the resource" /> <definition value="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." /> <min value="0" /> <max value="1" /> <base> <path value="Resource.meta" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Meta" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.implicitRules"> <path value="ClaimResponse.implicitRules" /> <short value="A set of rules under which this content was created" /> <definition value="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." /> <comment value="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." /> <min value="0" /> <max value="1" /> <base> <path value="Resource.implicitRules" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="true" /> <isModifierReason value="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" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.language"> <path value="ClaimResponse.language" /> <short value="Language of the resource content" /> <definition value="The base language in which the resource is written." /> <comment value="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)." /> <min value="0" /> <max value="1" /> <base> <path value="Resource.language" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet"> <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Language" /> </extension> <strength value="preferred" /> <description value="IETF language tag" /> <valueSet value="http://hl7.org/fhir/ValueSet/languages" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.text"> <path value="ClaimResponse.text" /> <short value="Text summary of the resource, for human interpretation" /> <definition value="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." /> <comment value="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." /> <alias value="narrative" /> <alias value="html" /> <alias value="xhtml" /> <alias value="display" /> <min value="0" /> <max value="1" /> <base> <path value="DomainResource.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Narrative" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="Act.text?" /> </mapping> </element> <element id="ClaimResponse.contained"> <path value="ClaimResponse.contained" /> <short value="Contained, inline Resources" /> <definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope." /> <comment value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels." /> <alias value="inline resources" /> <alias value="anonymous resources" /> <alias value="contained resources" /> <min value="0" /> <max value="*" /> <base> <path value="DomainResource.contained" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Resource" /> </type> <constraint> <key value="dom-r4b" /> <severity value="warning" /> <human value="Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems" /> <expression value="($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)" /> <xpath value="not(f:Citation|f:Evidence|f:EvidenceReport|f:EvidenceVariable|f:MedicinalProductDefinition|f:PackagedProductDefinition|f:AdministrableProductDefinition|f:Ingredient|f:ClinicalUseDefinition|f:RegulatedAuthorization|f:SubstanceDefinition|f:SubscriptionStatus|f:SubscriptionTopic) or not(parent::f:Citation|parent::f:Evidence|parent::f:EvidenceReport|parent::f:EvidenceVariable|parent::f:MedicinalProductDefinition|parent::f:PackagedProductDefinition|parent::f:AdministrableProductDefinition|parent::f:Ingredient|parent::f:ClinicalUseDefinition|parent::f:RegulatedAuthorization|parent::f:SubstanceDefinition|f:SubscriptionStatus|f:SubscriptionTopic)" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="Entity. Role, or Act" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.extension"> <path value="ClaimResponse.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="DomainResource.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.modifierExtension"> <path value="ClaimResponse.modifierExtension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Extensions that cannot be ignored" /> <definition value="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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment value="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." /> <requirements value="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](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="DomainResource.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mustSupport value="false" /> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.identifier"> <path value="ClaimResponse.identifier" /> <short value="Business Identifier for a claim response" /> <definition value="Berisi data ID lokal yang ditetapkan untuk respons klaim dengan tipe data Identifier." /> <requirements value="Allows claim responses to be distinguished and referenced." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.identifier" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Identifier" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" /> </mapping> <mapping> <identity value="rim" /> <map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" /> </mapping> <mapping> <identity value="servd" /> <map value="Identifier" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.identifier" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.identifier" /> </mapping> </element> <element id="ClaimResponse.status"> <path value="ClaimResponse.status" /> <short value="active | cancelled | draft | entered-in-error" /> <definition value="Berisi data status respon klaim dengan tipe data code, yang nilainya mengacu pada data terminologi Financial Resource Status Code." /> <comment value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid." /> <requirements value="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'." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.status" /> <min value="1" /> <max value="1" /> </base> <type> <code value="code" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="true" /> <isModifierReason value="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" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ClaimResponseStatus" /> </extension> <strength value="required" /> <description value="A code specifying the state of the resource instance." /> <valueSet value="http://hl7.org/fhir/ValueSet/fm-status|4.3.0" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.status" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.status" /> </mapping> </element> <element id="ClaimResponse.type"> <path value="ClaimResponse.type" /> <short value="More granular claim type" /> <definition value="Berisi data kategori klaim dengan tipe data CodeableConcept." /> <comment value="This may contain the local bill type codes, for example the US UB-04 bill type code or the CMS bill type." /> <requirements value="Some jurisdictions need a finer grained claim type for routing and adjudication." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.type" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ClaimType" /> </extension> <strength value="extensible" /> <description value="The type or discipline-style of the claim." /> <valueSet value="http://hl7.org/fhir/ValueSet/claim-type" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.class" /> </mapping> </element> <element id="ClaimResponse.type.id"> <path value="ClaimResponse.type.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.type.extension"> <path value="ClaimResponse.type.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.type.coding"> <path value="ClaimResponse.type.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data kategori klaim dengan tipe data Coding, yang nilainya mengacu pada data terminologi yang dapat diperluas yaitu Claim Type Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="ClaimResponse.type.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ClaimResponse.type.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="ClaimResponse.subType"> <path value="ClaimResponse.subType" /> <short value="More granular claim type" /> <definition value="A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service." /> <comment value="This may contain the local bill type codes, for example the US UB-04 bill type code or the CMS bill type." /> <requirements value="Some jurisdictions need a finer grained claim type for routing and adjudication." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.subType" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ClaimSubType" /> </extension> <strength value="example" /> <description value="A more granular claim typecode." /> <valueSet value="http://hl7.org/fhir/ValueSet/claim-subtype" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.class" /> </mapping> </element> <element id="ClaimResponse.use"> <path value="ClaimResponse.use" /> <short value="claim | preauthorization | predetermination" /> <definition value="Berisi data kode untuk menunjukkan apakah sifat dari permintaan tersebut adalah: untuk meminta keputusan atas produk dan layanan yang telah diberikan sebelumnya; atau meminta otorisasi dan ajudikasi untuk ketentuan di masa depan; atau meminta keputusan yang tidak mengikat atas produk dan layanan yang tercantum yang dapat disediakan di masa mendatang. Tipe data yang digunakan adalah code, yang nilainya mengacu pada data terminologi Use." /> <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" /> <requirements value="This element is required to understand the nature of the request for adjudication." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.use" /> <min value="1" /> <max value="1" /> </base> <type> <code value="code" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Use" /> </extension> <strength value="required" /> <description value="Claim, preauthorization, predetermination." /> <valueSet value="http://hl7.org/fhir/ValueSet/claim-use|4.3.0" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.class" /> </mapping> </element> <element id="ClaimResponse.patient"> <path value="ClaimResponse.patient" /> <short value="The recipient of the products and services" /> <definition value="Berisi data terkait pihak kepada siapa layanan dan/atau produk profesional telah disediakan atau sedang dipertimbangkan dan untuk siapa penggantian aktual atau prakiraan dimintakan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Patient." /> <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." /> <requirements value="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." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.patient" /> <min value="1" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.subject[x]" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.subject" /> </mapping> </element> <element id="ClaimResponse.created"> <path value="ClaimResponse.created" /> <short value="Response creation date" /> <definition value="Berisi data tanggal ketika respon klaim dibuat dengan tipe data dateTime, dengan format yang diperbolehkan YYYY, YYYY-MM, YYYY-MM-DD atau YYYY-MM-DDThh:mm:ss+zz:zz." /> <requirements value="Need to record a timestamp for use by both the recipient and the issuer." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.created" /> <min value="1" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.occurrence[x]" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.recorded" /> </mapping> </element> <element id="ClaimResponse.insurer"> <path value="ClaimResponse.insurer" /> <short value="Party responsible for reimbursement" /> <definition value="Berisi data pihak yang bertanggung jawab untuk otorisasi, ajudikasi dan penggantian dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Organization." /> <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." /> <requirements value="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." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.insurer" /> <min value="1" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.performer" /> </mapping> </element> <element id="ClaimResponse.requestor"> <path value="ClaimResponse.requestor" /> <short value="Party responsible for the claim" /> <definition value="Berisi data penyedia yang bertanggung jawab atas klaim, penentuan sebelumnya atau pra-otorisasi dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Practitioner | PractitionerRole | Organization." /> <comment value="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." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.requestor" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.source" /> </mapping> </element> <element id="ClaimResponse.request"> <path value="ClaimResponse.request" /> <short value="Id of resource triggering adjudication" /> <definition value="Berisi data referensi ke resource asli permintaan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Claim." /> <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.request" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Claim" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.basedOn" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.why[x]" /> </mapping> </element> <element id="ClaimResponse.outcome"> <path value="ClaimResponse.outcome" /> <short value="queued | complete | error | partial" /> <definition value="Berisi data hasil dari pemrosesan klaim, penentuan sebelumnya, atau praotorisasi dengan tipe data code, yang nilainya mengacu pada data terminologi Claim Processing Codes." /> <comment value="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 value="To advise the requestor of an overall processing outcome." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.outcome" /> <min value="1" /> <max value="1" /> </base> <type> <code value="code" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="RemittanceOutcome" /> </extension> <strength value="required" /> <description value="The result of the claim processing." /> <valueSet value="http://hl7.org/fhir/ValueSet/remittance-outcome|4.3.0" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.disposition"> <path value="ClaimResponse.disposition" /> <short value="Disposition Message" /> <definition value="Berisi data deskripsi status keputusan yang dapat dibaca manusia dengan tipe data string." /> <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" /> <requirements value="Provided for user display." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.disposition" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.note" /> </mapping> </element> <element id="ClaimResponse.preAuthRef"> <path value="ClaimResponse.preAuthRef" /> <short value="Preauthorization reference" /> <definition value="Berisi data referensi dari penanggung yang digunakan dalam komunikasi selanjutnya yang mengacu pada keputusan dengan tipe data string." /> <comment value="This value is only present on preauthorization adjudications." /> <requirements value="On subsequent claims, the insurer may require the provider to quote this value." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.preAuthRef" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.preAuthPeriod"> <path value="ClaimResponse.preAuthPeriod" /> <short value="Preauthorization reference effective period" /> <definition value="Berisi data jangka waktu selama otorisasi berlaku efektif dengan tipe data Period." /> <comment value="A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration)." /> <requirements value="To convey to the provider when the authorized products and services must be supplied for the authorized adjudication to apply." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.preAuthPeriod" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Period" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="per-1" /> <severity value="error" /> <human value="If present, start SHALL have a lower value than end" /> <expression value="start.hasValue().not() or end.hasValue().not() or (start <= end)" /> <xpath value="not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))" /> <source value="http://hl7.org/fhir/StructureDefinition/Period" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="DR" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]" /> </mapping> </element> <element id="ClaimResponse.payeeType"> <path value="ClaimResponse.payeeType" /> <short value="Party to be paid any benefits payable" /> <definition value="Berisi data jenis pihak yang akan diberikan ganti: pelanggan, penyedia, lainnya dengan tipe data CodeableConcept." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="Need to know who should receive payment with the most common situations being the Provider (assignment of benefits) or the Subscriber." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.payeeType" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="PayeeType" /> </extension> <strength value="example" /> <description value="A code for the party to be reimbursed." /> <valueSet value="http://hl7.org/fhir/ValueSet/payeetype" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="ClaimResponse.payeeType.id"> <path value="ClaimResponse.payeeType.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.payeeType.extension"> <path value="ClaimResponse.payeeType.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.payeeType.coding"> <path value="ClaimResponse.payeeType.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data jenis pihak yang akan diberikan ganti: pelanggan, penyedia, lainnya dengan tipe data Coding, yang nilainya dapat mengacu pada contoh data terminologi PayeeType." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="ClaimResponse.payeeType.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ClaimResponse.payeeType.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="ClaimResponse.item"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Item" /> </extension> <path value="ClaimResponse.item" /> <short value="Adjudication for claim line items" /> <definition value="Berisi data baris klaim. Baik produk atau layanan sederhana atau 'grup' detail yang masing-masing dapat berupa item sederhana atau grup sub-detail dengan tipe data BackboneElement." /> <requirements value="The adjudication for items provided on the claim." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.item" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.item.id"> <path value="ClaimResponse.item.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.item.extension"> <path value="ClaimResponse.item.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.item.modifierExtension"> <path value="ClaimResponse.item.modifierExtension" /> <short value="Extensions that cannot be ignored even if unrecognized" /> <definition value="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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment value="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." /> <requirements value="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](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.item.itemSequence"> <path value="ClaimResponse.item.itemSequence" /> <short value="Claim item instance identifier" /> <definition value="Berisi data nomor unik untuk mengidentifikasi entri item dengan tipe data positiveInt." /> <comment value="32 bit number; for values larger than this, use decimal" /> <requirements value="Necessary to provide a mechanism to link the adjudication result to the submitted claim item." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.item.itemSequence" /> <min value="1" /> <max value="1" /> </base> <type> <code value="positiveInt" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.item.noteNumber"> <path value="ClaimResponse.item.noteNumber" /> <short value="Applicable note numbers" /> <definition value="Berisi data angka-angka yang terkait dengan catatan yang ada di bawah yang berlaku untuk penilaian item dengan tipe data positiveInt." /> <comment value="32 bit number; for values larger than this, use decimal" /> <requirements value="Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.item.noteNumber" /> <min value="0" /> <max value="*" /> </base> <type> <code value="positiveInt" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.item.adjudication"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Adjudication" /> </extension> <path value="ClaimResponse.item.adjudication" /> <short value="Adjudication details" /> <definition value="Berisi data penilaian item. Jika item ini adalah grup maka nilai-nilai di sini adalah ringkasan dari penilaian detail item. Jika item ini adalah produk atau layanan sederhana maka ini adalah hasil dari penilaian item ini. Hasil ajudikasi menyampaikan penilaian penanggung terhadap hal yang diberikan dalam klaim berdasarkan ketentuan pertanggungan asuransi pasien." /> <requirements value="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 value="1" /> <max value="*" /> <base> <path value="ClaimResponse.item.adjudication" /> <min value="1" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.item.adjudication.id"> <path value="ClaimResponse.item.adjudication.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.item.adjudication.extension"> <path value="ClaimResponse.item.adjudication.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.item.adjudication.modifierExtension"> <path value="ClaimResponse.item.adjudication.modifierExtension" /> <short value="Extensions that cannot be ignored even if unrecognized" /> <definition value="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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment value="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." /> <requirements value="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](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.item.adjudication.category"> <path value="ClaimResponse.item.adjudication.category" /> <short value="Type of adjudication information" /> <definition value="Berisi data kode untuk menunjukkan jenis informasi catatan keputusan. Jenis informasi dapat mencakup nilai yang diajukan, nilai maksimum atau persentase yang diperbolehkan atau dapat dibayarkan berdasarkan program, jumlah yang: pasien bertanggung jawab secara agregat atau berkaitan dengan item ini; jumlah yang dibayarkan oleh pertanggungan lain; dan, manfaat yang dibayarkan untuk item ini. Tipe data yang digunakan adalah CodeableConcept." /> <comment value="For example codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc." /> <requirements value="Needed to enable understanding of the context of the other information in the adjudication." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.item.adjudication.category" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Adjudication" /> </extension> <strength value="example" /> <description value="The adjudication codes." /> <valueSet value="http://hl7.org/fhir/ValueSet/adjudication" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="ClaimResponse.item.adjudication.category.id"> <path value="ClaimResponse.item.adjudication.category.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.item.adjudication.category.extension"> <path value="ClaimResponse.item.adjudication.category.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.item.adjudication.category.coding"> <path value="ClaimResponse.item.adjudication.category.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data kode untuk menunjukkan jenis informasi catatan keputusan. Jenis informasi dapat mencakup nilai yang diajukan, nilai maksimum atau persentase yang diperbolehkan atau dapat dibayarkan berdasarkan program, jumlah yang: pasien bertanggung jawab secara agregat atau berkaitan dengan item ini; jumlah yang dibayarkan oleh pertanggungan lain; dan, manfaat yang dibayarkan untuk item ini. Tipe data yang digunakan adalah Coding, yang nilainya dapat mengacu pada contoh data terminologi Adjudication Value Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="ClaimResponse.item.adjudication.category.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ClaimResponse.item.adjudication.category.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="ClaimResponse.item.adjudication.reason"> <path value="ClaimResponse.item.adjudication.reason" /> <short value="Explanation of adjudication outcome" /> <definition value="Berisi data kode yang mendukung pemahaman hasil keputusan dan menjelaskan perbedaan dari jumlah yang diharapkan dengan tipe data CodeableConcept." /> <comment value="For example may indicate that the funds for this benefit type have been exhausted." /> <requirements value="To support understanding of variance from adjudication expectations." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.item.adjudication.reason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AdjudicationReason" /> </extension> <strength value="example" /> <description value="The adjudication reason codes." /> <valueSet value="http://hl7.org/fhir/ValueSet/adjudication-reason" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="ClaimResponse.item.adjudication.reason.id"> <path value="ClaimResponse.item.adjudication.reason.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.item.adjudication.reason.extension"> <path value="ClaimResponse.item.adjudication.reason.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.item.adjudication.reason.coding"> <path value="ClaimResponse.item.adjudication.reason.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data kode yang mendukung pemahaman hasil keputusan dan menjelaskan perbedaan dari jumlah yang diharapkan dengan tipe data Coding, yang nilainya dapat mengacu pada contoh data terminologi Adjudication Reason Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="ClaimResponse.item.adjudication.reason.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ClaimResponse.item.adjudication.reason.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="ClaimResponse.item.adjudication.amount"> <path value="ClaimResponse.item.adjudication.amount" /> <short value="Monetary amount" /> <definition value="Berisi data jumlah uang yang terkait dengan kategori keputusan dengan tipe data Money." /> <comment value="For example: amount submitted, eligible amount, co-payment, and benefit payable." /> <requirements value="Most adjuciation categories convey a monetary amount." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.item.adjudication.amount" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Money" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="MO" /> </mapping> </element> <element id="ClaimResponse.item.adjudication.value"> <path value="ClaimResponse.item.adjudication.value" /> <short value="Non-monetary value" /> <definition value="Berisi data nilai non-moneter yang terkait dengan kategori, beberapa kategori penilaian menyampaikan persentase atau nilai tetap, dapat berupa persentase yang memenuhi syarat atau persentase pembayaran bersama dengan tipe data decimal." /> <comment value="For example: eligible percentage or co-payment percentage." /> <requirements value="Some adjudication categories convey a percentage or a fixed value." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.item.adjudication.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.item.detail"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="ItemDetail" /> </extension> <path value="ClaimResponse.item.detail" /> <short value="Adjudication for claim details" /> <definition value="Berisi data detail klaim, baik yang sederhana (produk atau layanan) atau 'kelompok' sub-detail yang merupakan barang sederhana dengan tipe data BackboneElement." /> <requirements value="The adjudication for details provided on the claim." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.item.detail" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.item.detail.id"> <path value="ClaimResponse.item.detail.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.item.detail.extension"> <path value="ClaimResponse.item.detail.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.item.detail.modifierExtension"> <path value="ClaimResponse.item.detail.modifierExtension" /> <short value="Extensions that cannot be ignored even if unrecognized" /> <definition value="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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment value="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." /> <requirements value="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](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.item.detail.detailSequence"> <path value="ClaimResponse.item.detail.detailSequence" /> <short value="Claim detail instance identifier" /> <definition value="Berisi data nomor unik untuk mereferensikan entri detail klaim dengan tipe data positiveInt." /> <comment value="32 bit number; for values larger than this, use decimal" /> <requirements value="Necessary to provide a mechanism to link the adjudication result to the submitted claim detail." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.item.detail.detailSequence" /> <min value="1" /> <max value="1" /> </base> <type> <code value="positiveInt" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.item.detail.noteNumber"> <path value="ClaimResponse.item.detail.noteNumber" /> <short value="Applicable note numbers" /> <definition value="Berisi data angka-angka yang terkait dengan catatan di bawah yang berlaku untuk penilaian item dengan tipe data positiveInt." /> <comment value="32 bit number; for values larger than this, use decimal" /> <requirements value="Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.item.detail.noteNumber" /> <min value="0" /> <max value="*" /> </base> <type> <code value="positiveInt" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.item.detail.adjudication"> <path value="ClaimResponse.item.detail.adjudication" /> <short value="Detail level adjudication details" /> <definition value="Berisi data hasil keputusan dengan tipe data yang mengacu pada ClaimResponse.item.adjudication." /> <min value="1" /> <max value="*" /> <base> <path value="ClaimResponse.item.detail.adjudication" /> <min value="1" /> <max value="*" /> </base> <contentReference value="http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication" /> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> </element> <element id="ClaimResponse.item.detail.subDetail"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="SubDetail" /> </extension> <path value="ClaimResponse.item.detail.subDetail" /> <short value="Adjudication for claim sub-details" /> <definition value="Berisi data keputusan sub-detail dari produk atau layanan sederhana dengan tipe data BackboneElement." /> <requirements value="The adjudication for sub-details provided on the claim." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.item.detail.subDetail" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.item.detail.subDetail.id"> <path value="ClaimResponse.item.detail.subDetail.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.item.detail.subDetail.extension"> <path value="ClaimResponse.item.detail.subDetail.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.item.detail.subDetail.modifierExtension"> <path value="ClaimResponse.item.detail.subDetail.modifierExtension" /> <short value="Extensions that cannot be ignored even if unrecognized" /> <definition value="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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment value="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." /> <requirements value="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](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.item.detail.subDetail.subDetailSequence"> <path value="ClaimResponse.item.detail.subDetail.subDetailSequence" /> <short value="Claim sub-detail instance identifier" /> <definition value="Berisi data nomor unik untuk mereferensikan entri sub-detail klaim dengan tipe data positiveInt." /> <comment value="32 bit number; for values larger than this, use decimal" /> <requirements value="Necessary to provide a mechanism to link the adjudication result to the submitted claim sub-detail." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.item.detail.subDetail.subDetailSequence" /> <min value="1" /> <max value="1" /> </base> <type> <code value="positiveInt" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.item.detail.subDetail.noteNumber"> <path value="ClaimResponse.item.detail.subDetail.noteNumber" /> <short value="Applicable note numbers" /> <definition value="Berisi data angka-angka yang terkait dengan catatan di bawah yang berlaku untuk penilaian item dengan tipe data positiveInt." /> <comment value="32 bit number; for values larger than this, use decimal" /> <requirements value="Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.item.detail.subDetail.noteNumber" /> <min value="0" /> <max value="*" /> </base> <type> <code value="positiveInt" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.item.detail.subDetail.adjudication"> <path value="ClaimResponse.item.detail.subDetail.adjudication" /> <short value="Subdetail level adjudication details" /> <definition value="Berisi data hasil keputusan dengan tipe data yang mengacu pada ClaimResponse.item.adjudication." /> <min value="1" /> <max value="*" /> <base> <path value="ClaimResponse.item.detail.subDetail.adjudication" /> <min value="0" /> <max value="*" /> </base> <contentReference value="http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication" /> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> </element> <element id="ClaimResponse.addItem"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="AddedItem" /> </extension> <path value="ClaimResponse.addItem" /> <short value="Insurer added line items" /> <definition value="Berisi data keputusan layanan tingkat pertama untuk payor dapat menambahkan lini produk atau layanan. Penanggung dapat mendefinisikan kembali produk atau layanan yang disediakan atau dapat mengemas dan/atau menguraikan kelompok produk dan layanan. AddItems memungkinkan perusahaan asuransi untuk memberikan daftar item baris mereka dengan tautan ke item/detail/sub-detail yang dikirimkan. Dalam pra-otorisasi perusahaan asuransi dapat menggunakan struktur addItem untuk memberikan informasi tambahan tentang produk dan layanan resmi dengan tipe data BackboneElement." /> <requirements value="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 value="0" /> <max value="*" /> <base> <path value="ClaimResponse.addItem" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.id"> <path value="ClaimResponse.addItem.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.extension"> <path value="ClaimResponse.addItem.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.addItem.modifierExtension"> <path value="ClaimResponse.addItem.modifierExtension" /> <short value="Extensions that cannot be ignored even if unrecognized" /> <definition value="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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment value="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." /> <requirements value="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](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.addItem.itemSequence"> <path value="ClaimResponse.addItem.itemSequence" /> <short value="Item sequence number" /> <definition value="Berisi data klaim item yang ingin diganti oleh saluran layanan ini dengan tipe data positiveInt." /> <comment value="32 bit number; for values larger than this, use decimal" /> <requirements value="Provides references to the claim items." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.addItem.itemSequence" /> <min value="0" /> <max value="*" /> </base> <type> <code value="positiveInt" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.detailSequence"> <path value="ClaimResponse.addItem.detailSequence" /> <short value="Detail sequence number" /> <definition value="Berisi data nomor urut detail dalam item klaim yang ingin diganti oleh baris ini dengan tipe data positiveInt." /> <comment value="32 bit number; for values larger than this, use decimal" /> <requirements value="Provides references to the claim details within the claim item." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.addItem.detailSequence" /> <min value="0" /> <max value="*" /> </base> <type> <code value="positiveInt" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.subdetailSequence"> <path value="ClaimResponse.addItem.subdetailSequence" /> <short value="Subdetail sequence number" /> <definition value="Berisi data nomor urut sub-detail dalam detail pada item klaim yang dimaksudkan untuk diganti oleh baris ini dengan tipe data positiveInt." /> <comment value="32 bit number; for values larger than this, use decimal" /> <requirements value="Provides references to the claim sub-details within the claim detail." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.addItem.subdetailSequence" /> <min value="0" /> <max value="*" /> </base> <type> <code value="positiveInt" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.provider"> <path value="ClaimResponse.addItem.provider" /> <short value="Authorized providers" /> <definition value="Berisi data penyedia yang berwenang untuk layanan yang diberikan kepada pasien. dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Practitioner | PractitionerRole | Organization." /> <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." /> <requirements value="Insurer may provide authorization specifically to a restricted set of providers rather than an open authorization." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.addItem.provider" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.source" /> </mapping> </element> <element id="ClaimResponse.addItem.productOrService"> <path value="ClaimResponse.addItem.productOrService" /> <short value="Billing, service, product, or drug code" /> <definition value="Berisi data jika nilainya adalah kode grup maka item ini mengumpulkan serangkaian detail klaim terkait dan jika tidak maka berisi produk, layanan, obat, atau kode tagihan lainnya untuk item tersebut dengan tipe data CodeableConcept." /> <comment value="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 value="Necessary to state what was provided or done." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.addItem.productOrService" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ServiceProduct" /> </extension> <strength value="example" /> <description value="Allowable service and product codes." /> <valueSet value="http://hl7.org/fhir/ValueSet/service-uscls" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="ClaimResponse.addItem.productOrService.id"> <path value="ClaimResponse.addItem.productOrService.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.productOrService.extension"> <path value="ClaimResponse.addItem.productOrService.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.addItem.productOrService.coding"> <path value="ClaimResponse.addItem.productOrService.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data jika nilainya adalah kode grup maka item ini mengumpulkan serangkaian detail klaim terkait dan jika tidak maka berisi produk, layanan, obat, atau kode tagihan lainnya untuk item tersebut dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi USCLS Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="ClaimResponse.addItem.productOrService.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ClaimResponse.addItem.productOrService.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="ClaimResponse.addItem.modifier"> <path value="ClaimResponse.addItem.modifier" /> <short value="Service/Product billing modifiers" /> <definition value="Berisi data kode tipifikasi atau pengubah item untuk menyampaikan konteks tambahan untuk produk atau layanan dengan tipe data CodeableConcept." /> <comment value="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 value="To support inclusion of the item for adjudication or to charge an elevated fee." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.addItem.modifier" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Modifiers" /> </extension> <strength value="example" /> <description value="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 value="http://hl7.org/fhir/ValueSet/claim-modifiers" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="rim" /> <map value="24.C, 24.D mods" /> </mapping> </element> <element id="ClaimResponse.addItem.modifier.id"> <path value="ClaimResponse.addItem.modifier.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.modifier.extension"> <path value="ClaimResponse.addItem.modifier.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.addItem.modifier.coding"> <path value="ClaimResponse.addItem.modifier.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data kode tipifikasi atau pengubah item untuk menyampaikan konteks tambahan untuk produk atau layanan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Modifier types Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="ClaimResponse.addItem.modifier.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ClaimResponse.addItem.modifier.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="ClaimResponse.addItem.programCode"> <path value="ClaimResponse.addItem.programCode" /> <short value="Program the product or service is provided under" /> <definition value="Berisi data untuk mengidentifikasi program yang memungkinkan pemulihan dengan tipe data CodeableConcept." /> <comment value="For example: Neonatal program, child dental program or drug users recovery program." /> <requirements value="Commonly used in in the identification of publicly provided program focused on population segments or disease classifications." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.addItem.programCode" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ProgramCode" /> </extension> <strength value="example" /> <description value="Program specific reason codes." /> <valueSet value="http://hl7.org/fhir/ValueSet/ex-program-code" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="rim" /> <map value="24.H" /> </mapping> </element> <element id="ClaimResponse.addItem.programCode.id"> <path value="ClaimResponse.addItem.programCode.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.programCode.extension"> <path value="ClaimResponse.addItem.programCode.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.addItem.programCode.coding"> <path value="ClaimResponse.addItem.programCode.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data untuk mengidentifikasi program yang memungkinkan pemulihan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Example Program Reason Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="ClaimResponse.addItem.programCode.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ClaimResponse.addItem.programCode.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="ClaimResponse.addItem.serviced[x]"> <path value="ClaimResponse.addItem.serviced[x]" /> <short value="Date or dates of service or product delivery" /> <definition value="Berisi data tanggal atau tanggal ketika layanan atau produk dipasok, dilaksanakan, atau diselesaikan." /> <requirements value="Needed to determine whether the service or product was provided during the term of the insurance coverage." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.addItem.serviced[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="date" /> </type> <type> <code value="Period" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.done[x]" /> </mapping> <mapping> <identity value="rim" /> <map value="24.A" /> </mapping> </element> <element id="ClaimResponse.addItem.location[x]"> <path value="ClaimResponse.addItem.location[x]" /> <short value="Place of service or where product was supplied" /> <definition value="Berisi data lokasi produk atau layanan disediakan." /> <requirements value="The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.addItem.location[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <type> <code value="Address" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ServicePlace" /> </extension> <strength value="example" /> <description value="Place of service: pharmacy, school, prison, etc." /> <valueSet value="http://hl7.org/fhir/ValueSet/service-place" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.where[x]" /> </mapping> <mapping> <identity value="rim" /> <map value="24.B" /> </mapping> </element> <element id="ClaimResponse.addItem.quantity"> <path value="ClaimResponse.addItem.quantity" /> <short value="Count of products or services" /> <definition value="Berisi data jumlah pengulangan layanan atau produk dengan tipe data SimpleQuantity." /> <comment value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator." /> <requirements value="Required when the product or service code does not convey the quantity provided." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.addItem.quantity" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="qty-3" /> <severity value="error" /> <human value="If a code for the unit is present, the system SHALL also be present" /> <expression value="code.empty() or system.exists()" /> <xpath value="not(exists(f:code)) or exists(f:system)" /> <source value="http://hl7.org/fhir/StructureDefinition/Quantity" /> </constraint> <constraint> <key value="sqty-1" /> <severity value="error" /> <human value="The comparator is not used on a SimpleQuantity" /> <expression value="comparator.empty()" /> <xpath value="not(exists(f:comparator))" /> <source value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="SN (see also Range) or CQ" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ, IVL<PQ>, MO, CO, depending on the values" /> </mapping> <mapping> <identity value="rim" /> <map value="24.G" /> </mapping> </element> <element id="ClaimResponse.addItem.unitPrice"> <path value="ClaimResponse.addItem.unitPrice" /> <short value="Fee, charge or cost per item" /> <definition value="Berisi data jika item tersebut bukan grup maka ini adalah biaya untuk produk atau layanan, jika tidak, ini adalah total biaya untuk perincian grup dengan tipe data Money." /> <requirements value="The amount charged to the patient by the provider for a single unit." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.addItem.unitPrice" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Money" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="MO" /> </mapping> </element> <element id="ClaimResponse.addItem.factor"> <path value="ClaimResponse.addItem.factor" /> <short value="Price scaling factor" /> <definition value="Berisi data bilangan real yang mewakili pengali yang digunakan dalam menentukan nilai keseluruhan dari layanan yang diberikan dan/atau barang yang diterima. Konsep Faktor memungkinkan pengganda diskon atau biaya tambahan untuk diterapkan pada jumlah uang dengan tipe data decimal." /> <comment value="To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)." /> <requirements value="When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.addItem.factor" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.net"> <path value="ClaimResponse.addItem.net" /> <short value="Total item cost" /> <definition value="Berisi data kuantitas dikalikan harga satuan untuk layanan atau produk atau biaya tambahan dengan tipe data Money." /> <comment value="For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied." /> <requirements value="Provides the total amount claimed for the group (if a grouper) or the line item." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.addItem.net" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Money" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="MO" /> </mapping> <mapping> <identity value="rim" /> <map value="24.F" /> </mapping> </element> <element id="ClaimResponse.addItem.bodySite"> <path value="ClaimResponse.addItem.bodySite" /> <short value="Anatomical location" /> <definition value="Berisi data lokasi pelayanan fisik pada pasien (tungkai, gigi, dan lainnya) dengan tipe data CodeableConcept." /> <comment value="For example: Providing a tooth code allows an insurer to identify a provider performing a filling on a tooth that was previously removed." /> <requirements value="Allows insurer to validate specific procedures." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.addItem.bodySite" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="OralSites" /> </extension> <strength value="example" /> <description value="The code for the teeth, quadrant, sextant and arch." /> <valueSet value="http://hl7.org/fhir/ValueSet/tooth" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="ClaimResponse.addItem.bodySite.id"> <path value="ClaimResponse.addItem.bodySite.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.bodySite.extension"> <path value="ClaimResponse.addItem.bodySite.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.addItem.bodySite.coding"> <path value="ClaimResponse.addItem.bodySite.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data lokasi pelayanan fisik pada pasien (tungkai, gigi, dan lainnya) dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Oral Site Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="ClaimResponse.addItem.bodySite.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ClaimResponse.addItem.bodySite.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="ClaimResponse.addItem.subSite"> <path value="ClaimResponse.addItem.subSite" /> <short value="Anatomical sub-location" /> <definition value="Berisi data wilayah atau permukaan bodySite, seperti daerah anggota gerak atau permukaan gigi dengan tipe data CodeableConcept." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="Allows insurer to validate specific procedures." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.addItem.subSite" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Surface" /> </extension> <strength value="example" /> <description value="The code for the tooth surface and surface combinations." /> <valueSet value="http://hl7.org/fhir/ValueSet/surface" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="ClaimResponse.addItem.subSite.id"> <path value="ClaimResponse.addItem.subSite.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.subSite.extension"> <path value="ClaimResponse.addItem.subSite.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.addItem.subSite.coding"> <path value="ClaimResponse.addItem.subSite.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data wilayah atau permukaan bodySite, seperti daerah anggota gerak atau permukaan gigi dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Surface Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="ClaimResponse.addItem.subSite.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ClaimResponse.addItem.subSite.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="ClaimResponse.addItem.noteNumber"> <path value="ClaimResponse.addItem.noteNumber" /> <short value="Applicable note numbers" /> <definition value="Berisi data angka-angka yang terkait dengan catatan yang ada di bawah yang berlaku untuk penilaian item dengan tipe data positiveInt." /> <comment value="32 bit number; for values larger than this, use decimal" /> <requirements value="Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.addItem.noteNumber" /> <min value="0" /> <max value="*" /> </base> <type> <code value="positiveInt" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.adjudication"> <path value="ClaimResponse.addItem.adjudication" /> <short value="Added items adjudication" /> <definition value="Berisi data hasil keputusan dengan tipe data yang mengacu pada ClaimResponse.item.adjudication." /> <min value="1" /> <max value="*" /> <base> <path value="ClaimResponse.addItem.adjudication" /> <min value="1" /> <max value="*" /> </base> <contentReference value="http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication" /> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> </element> <element id="ClaimResponse.addItem.detail"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="AddedItemDetail" /> </extension> <path value="ClaimResponse.addItem.detail" /> <short value="Insurer added line details" /> <definition value="Berisi data keputusan layanan tingkat kedua untuk pembayar menambahkan layanan dengan tipe data BackboneElement." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.addItem.detail" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.id"> <path value="ClaimResponse.addItem.detail.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.extension"> <path value="ClaimResponse.addItem.detail.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.modifierExtension"> <path value="ClaimResponse.addItem.detail.modifierExtension" /> <short value="Extensions that cannot be ignored even if unrecognized" /> <definition value="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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment value="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." /> <requirements value="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](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.productOrService"> <path value="ClaimResponse.addItem.detail.productOrService" /> <short value="Billing, service, product, or drug code" /> <definition value="Berisi data jika nilainya adalah kode grup maka item ini mengumpulkan serangkaian detail klaim terkait dan jika tidak maka berisi produk, layanan, obat, atau kode tagihan lainnya untuk item tersebut dengan tipe data CodeableConcept." /> <comment value="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 value="Necessary to state what was provided or done." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.addItem.detail.productOrService" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ServiceProduct" /> </extension> <strength value="example" /> <description value="Allowable service and product codes." /> <valueSet value="http://hl7.org/fhir/ValueSet/service-uscls" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.productOrService.id"> <path value="ClaimResponse.addItem.detail.productOrService.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.productOrService.extension"> <path value="ClaimResponse.addItem.detail.productOrService.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.productOrService.coding"> <path value="ClaimResponse.addItem.detail.productOrService.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data jika nilainya adalah kode grup maka item ini mengumpulkan serangkaian detail klaim terkait dan jika tidak maka berisi produk, layanan, obat, atau kode tagihan lainnya untuk item tersebut dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi USCLS Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.productOrService.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ClaimResponse.addItem.detail.productOrService.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.modifier"> <path value="ClaimResponse.addItem.detail.modifier" /> <short value="Service/Product billing modifiers" /> <definition value="Berisi data kode tipifikasi atau pengubah item untuk menyampaikan konteks tambahan untuk produk atau layanan dengan tipe data CodeableConcept." /> <comment value="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 value="To support inclusion of the item for adjudication or to charge an elevated fee." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.addItem.detail.modifier" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Modifiers" /> </extension> <strength value="example" /> <description value="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 value="http://hl7.org/fhir/ValueSet/claim-modifiers" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="rim" /> <map value="24.C, 24.D mods" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.modifier.id"> <path value="ClaimResponse.addItem.detail.modifier.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.modifier.extension"> <path value="ClaimResponse.addItem.detail.modifier.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.modifier.coding"> <path value="ClaimResponse.addItem.detail.modifier.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data kode tipifikasi atau pengubah item untuk menyampaikan konteks tambahan untuk produk atau layanan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Modifier types Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.modifier.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ClaimResponse.addItem.detail.modifier.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.quantity"> <path value="ClaimResponse.addItem.detail.quantity" /> <short value="Count of products or services" /> <definition value="Berisi data jumlah pengulangan layanan atau produk dengan tipe data SimpleQuantity." /> <comment value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator." /> <requirements value="Required when the product or service code does not convey the quantity provided." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.addItem.detail.quantity" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="qty-3" /> <severity value="error" /> <human value="If a code for the unit is present, the system SHALL also be present" /> <expression value="code.empty() or system.exists()" /> <xpath value="not(exists(f:code)) or exists(f:system)" /> <source value="http://hl7.org/fhir/StructureDefinition/Quantity" /> </constraint> <constraint> <key value="sqty-1" /> <severity value="error" /> <human value="The comparator is not used on a SimpleQuantity" /> <expression value="comparator.empty()" /> <xpath value="not(exists(f:comparator))" /> <source value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="SN (see also Range) or CQ" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ, IVL<PQ>, MO, CO, depending on the values" /> </mapping> <mapping> <identity value="rim" /> <map value="24.G" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.unitPrice"> <path value="ClaimResponse.addItem.detail.unitPrice" /> <short value="Fee, charge or cost per item" /> <definition value="Berisi data biaya di mana jika item yang tersebut bukan grup maka ini adalah biaya untuk produk atau layanan, jika tidak maka ini adalah total biaya untuk perincian grup dengan tipe data Money." /> <requirements value="The amount charged to the patient by the provider for a single unit." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.addItem.detail.unitPrice" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Money" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="MO" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.factor"> <path value="ClaimResponse.addItem.detail.factor" /> <short value="Price scaling factor" /> <definition value="Berisi data bilangan real yang mewakili pengali yang digunakan dalam menentukan nilai keseluruhan dari layanan yang diberikan dan/atau barang yang diterima. Konsep Faktor memungkinkan pengganda diskon atau biaya tambahan untuk diterapkan pada jumlah uang. Tipe data yang digunakan adalah decimal." /> <comment value="To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)." /> <requirements value="When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.addItem.detail.factor" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.net"> <path value="ClaimResponse.addItem.detail.net" /> <short value="Total item cost" /> <definition value="Berisi data kuantitas dikalikan harga satuan untuk layanan atau produk atau biaya tambahan dengan tipe data Money." /> <comment value="For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied." /> <requirements value="Provides the total amount claimed for the group (if a grouper) or the line item." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.addItem.detail.net" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Money" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="MO" /> </mapping> <mapping> <identity value="rim" /> <map value="24.F" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.noteNumber"> <path value="ClaimResponse.addItem.detail.noteNumber" /> <short value="Applicable note numbers" /> <definition value="Berisi data angka-angka yang terkait dengan catatan yang ada di bawah yang berlaku untuk penilaian item dengan tipe data positiveInt." /> <comment value="32 bit number; for values larger than this, use decimal" /> <requirements value="Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.addItem.detail.noteNumber" /> <min value="0" /> <max value="*" /> </base> <type> <code value="positiveInt" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.adjudication"> <path value="ClaimResponse.addItem.detail.adjudication" /> <short value="Added items detail adjudication" /> <definition value="Berisi data hasil keputusan dengan tipe data yang mengacu pada ClaimResponse.item.adjudication." /> <min value="1" /> <max value="*" /> <base> <path value="ClaimResponse.addItem.detail.adjudication" /> <min value="1" /> <max value="*" /> </base> <contentReference value="http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication" /> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> </element> <element id="ClaimResponse.addItem.detail.subDetail"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="AddedItemSubDetail" /> </extension> <path value="ClaimResponse.addItem.detail.subDetail" /> <short value="Insurer added line items" /> <definition value="Berisi data keputusan layanan tingkat ketiga untuk pembayar menambahkan layanan dengan tipe data BackboneElement." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.addItem.detail.subDetail" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.subDetail.id"> <path value="ClaimResponse.addItem.detail.subDetail.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.subDetail.extension"> <path value="ClaimResponse.addItem.detail.subDetail.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.subDetail.modifierExtension"> <path value="ClaimResponse.addItem.detail.subDetail.modifierExtension" /> <short value="Extensions that cannot be ignored even if unrecognized" /> <definition value="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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment value="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." /> <requirements value="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](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.subDetail.productOrService"> <path value="ClaimResponse.addItem.detail.subDetail.productOrService" /> <short value="Billing, service, product, or drug code" /> <definition value="Berisi data jika nilainya adalah kode grup maka item ini mengumpulkan serangkaian detail klaim terkait dan jika tidak maka berisi produk, layanan, obat, atau kode tagihan lainnya untuk item tersebut dengan tipe data CodeableConcept." /> <comment value="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 value="Necessary to state what was provided or done." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.addItem.detail.subDetail.productOrService" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ServiceProduct" /> </extension> <strength value="example" /> <description value="Allowable service and product codes." /> <valueSet value="http://hl7.org/fhir/ValueSet/service-uscls" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.subDetail.productOrService.id"> <path value="ClaimResponse.addItem.detail.subDetail.productOrService.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.subDetail.productOrService.extension"> <path value="ClaimResponse.addItem.detail.subDetail.productOrService.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.subDetail.productOrService.coding"> <path value="ClaimResponse.addItem.detail.subDetail.productOrService.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data jika nilainya adalah kode grup maka item ini mengumpulkan serangkaian detail klaim terkait dan jika tidak maka berisi produk, layanan, obat, atau kode tagihan lainnya untuk item tersebut dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi USCLS Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.subDetail.productOrService.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ClaimResponse.addItem.detail.subDetail.productOrService.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.subDetail.modifier"> <path value="ClaimResponse.addItem.detail.subDetail.modifier" /> <short value="Service/Product billing modifiers" /> <definition value="Berisi data kode tipifikasi atau pengubah item untuk menyampaikan konteks tambahan untuk produk atau layanan dengan tipe data CodeableConcept." /> <comment value="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 value="To support inclusion of the item for adjudication or to charge an elevated fee." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.addItem.detail.subDetail.modifier" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Modifiers" /> </extension> <strength value="example" /> <description value="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 value="http://hl7.org/fhir/ValueSet/claim-modifiers" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="rim" /> <map value="24.C, 24.D mods" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.subDetail.modifier.id"> <path value="ClaimResponse.addItem.detail.subDetail.modifier.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.subDetail.modifier.extension"> <path value="ClaimResponse.addItem.detail.subDetail.modifier.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.subDetail.modifier.coding"> <path value="ClaimResponse.addItem.detail.subDetail.modifier.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data kode tipifikasi atau pengubah item untuk menyampaikan konteks tambahan untuk produk atau layanan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Modifier types Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.subDetail.modifier.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ClaimResponse.addItem.detail.subDetail.modifier.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.subDetail.quantity"> <path value="ClaimResponse.addItem.detail.subDetail.quantity" /> <short value="Count of products or services" /> <definition value="Berisi data jumlah pengulangan layanan atau produk dengan tipe data SimpleQuantity." /> <comment value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator." /> <requirements value="Required when the product or service code does not convey the quantity provided." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.addItem.detail.subDetail.quantity" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="qty-3" /> <severity value="error" /> <human value="If a code for the unit is present, the system SHALL also be present" /> <expression value="code.empty() or system.exists()" /> <xpath value="not(exists(f:code)) or exists(f:system)" /> <source value="http://hl7.org/fhir/StructureDefinition/Quantity" /> </constraint> <constraint> <key value="sqty-1" /> <severity value="error" /> <human value="The comparator is not used on a SimpleQuantity" /> <expression value="comparator.empty()" /> <xpath value="not(exists(f:comparator))" /> <source value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="SN (see also Range) or CQ" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ, IVL<PQ>, MO, CO, depending on the values" /> </mapping> <mapping> <identity value="rim" /> <map value="24.G" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.subDetail.unitPrice"> <path value="ClaimResponse.addItem.detail.subDetail.unitPrice" /> <short value="Fee, charge or cost per item" /> <definition value="Berisi data biaya di mana jika item yang tersebut bukan grup maka ini adalah biaya untuk produk atau layanan, jika tidak maka ini adalah total biaya untuk perincian grup dengan tipe data Money." /> <requirements value="The amount charged to the patient by the provider for a single unit." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.addItem.detail.subDetail.unitPrice" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Money" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="MO" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.subDetail.factor"> <path value="ClaimResponse.addItem.detail.subDetail.factor" /> <short value="Price scaling factor" /> <definition value="Berisi data bilangan real yang mewakili pengali yang digunakan dalam menentukan nilai keseluruhan dari layanan yang diberikan dan/atau barang yang diterima. Konsep Faktor memungkinkan pengganda diskon atau biaya tambahan untuk diterapkan pada jumlah uang. Tipe data yang digunakan adalah decimal." /> <comment value="To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)." /> <requirements value="When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.addItem.detail.subDetail.factor" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.subDetail.net"> <path value="ClaimResponse.addItem.detail.subDetail.net" /> <short value="Total item cost" /> <definition value="Berisi data kuantitas dikalikan harga satuan untuk layanan atau produk atau biaya tambahan dengan tipe data Money." /> <comment value="For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied." /> <requirements value="Provides the total amount claimed for the group (if a grouper) or the line item." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.addItem.detail.subDetail.net" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Money" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="MO" /> </mapping> <mapping> <identity value="rim" /> <map value="24.F" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.subDetail.noteNumber"> <path value="ClaimResponse.addItem.detail.subDetail.noteNumber" /> <short value="Applicable note numbers" /> <definition value="Berisi data angka-angka yang terkait dengan catatan yang ada di bawah yang berlaku untuk penilaian item dengan tipe data positiveInt." /> <comment value="32 bit number; for values larger than this, use decimal" /> <requirements value="Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.addItem.detail.subDetail.noteNumber" /> <min value="0" /> <max value="*" /> </base> <type> <code value="positiveInt" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.addItem.detail.subDetail.adjudication"> <path value="ClaimResponse.addItem.detail.subDetail.adjudication" /> <short value="Added items detail adjudication" /> <definition value="Berisi data hasil ajudikasi dengan tipe data yang mengacu pada ClaimResponse.item.adjudication." /> <min value="1" /> <max value="*" /> <base> <path value="ClaimResponse.addItem.detail.subDetail.adjudication" /> <min value="1" /> <max value="*" /> </base> <contentReference value="http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication" /> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> </element> <element id="ClaimResponse.adjudication"> <path value="ClaimResponse.adjudication" /> <short value="Header-level adjudication" /> <definition value="The adjudication results which are presented at the header level rather than at the line-item or add-item levels." /> <requirements value="Some insurers will receive line-items but provide the adjudication only at a summary or header-level." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.adjudication" /> <min value="0" /> <max value="*" /> </base> <contentReference value="http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication" /> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> </element> <element id="ClaimResponse.total"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Total" /> </extension> <path value="ClaimResponse.total" /> <short value="Adjudication totals" /> <definition value="Berisi data total moneter yang dikategorikan untuk ajudikasi dengan tipe data Money." /> <comment value="Totals for amounts submitted, co-pays, benefits payable etc." /> <requirements value="To provide the requestor with financial totals by category for the adjudication." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.total" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.total.id"> <path value="ClaimResponse.total.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.total.extension"> <path value="ClaimResponse.total.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.total.modifierExtension"> <path value="ClaimResponse.total.modifierExtension" /> <short value="Extensions that cannot be ignored even if unrecognized" /> <definition value="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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment value="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." /> <requirements value="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](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.total.category"> <path value="ClaimResponse.total.category" /> <short value="Type of adjudication information" /> <definition value="Berisi data Kode untuk menunjukkan jenis informasi catatan ajudikasi ini. Jenis informasi dapat mencakup: nilai yang diajukan, nilai maksimum atau persentase yang diperbolehkan atau dibayarkan berdasarkan program, jumlah yang menjadi tanggung jawab pasien secara keseluruhan atau berkaitan dengan item ini, jumlah yang dibayarkan oleh pertanggungan lain, dan manfaat yang dibayarkan untuk item ini. Tipe data yang digunakan adalah CodeableConcept." /> <comment value="For example codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc." /> <requirements value="Needed to convey the type of total provided." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.total.category" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Adjudication" /> </extension> <strength value="example" /> <description value="The adjudication codes." /> <valueSet value="http://hl7.org/fhir/ValueSet/adjudication" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="ClaimResponse.total.category.id"> <path value="ClaimResponse.total.category.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.total.category.extension"> <path value="ClaimResponse.total.category.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.total.category.coding"> <path value="ClaimResponse.total.category.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data Kode untuk menunjukkan jenis informasi catatan ajudikasi ini. Jenis informasi dapat mencakup: nilai yang diajukan, nilai maksimum atau persentase yang diperbolehkan atau dibayarkan berdasarkan program, jumlah yang menjadi tanggung jawab pasien secara keseluruhan atau berkaitan dengan item ini, jumlah yang dibayarkan oleh pertanggungan lain, dan manfaat yang dibayarkan untuk item ini. Tipe data yang digunakan adalah Coding yang nilainya dapat mengacu pada contoh data terminologi Adjudication Value Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="ClaimResponse.total.category.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ClaimResponse.total.category.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="ClaimResponse.total.amount"> <path value="ClaimResponse.total.amount" /> <short value="Financial total for the category" /> <definition value="Berisi data jumlah total biaya yang terkait dengan kategori dengan tipe data Money." /> <requirements value="Needed to convey the total monetary amount." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.total.amount" /> <min value="1" /> <max value="1" /> </base> <type> <code value="Money" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="MO" /> </mapping> </element> <element id="ClaimResponse.payment"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Payment" /> </extension> <path value="ClaimResponse.payment" /> <short value="Payment Details" /> <definition value="Berisi data rincian pembayaran untuk ajudikasi klaim dengan tipe data BackboneElement." /> <requirements value="Needed to convey references to the financial instrument that has been used if payment has been made." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.payment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.payment.id"> <path value="ClaimResponse.payment.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.payment.extension"> <path value="ClaimResponse.payment.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.payment.modifierExtension"> <path value="ClaimResponse.payment.modifierExtension" /> <short value="Extensions that cannot be ignored even if unrecognized" /> <definition value="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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment value="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." /> <requirements value="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](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.payment.type"> <path value="ClaimResponse.payment.type" /> <short value="Partial or complete payment" /> <definition value="Berisi data jenis pembayaran untuk membedakan apakah merupakan pembayaran sebagian atau seluruhnya dari manfaat yang dibayarkan dengan tipe data CodeableConcept." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="To advise the requestor when the insurer believes all payments to have been completed." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.payment.type" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="PaymentType" /> </extension> <strength value="example" /> <description value="The type (partial, complete) of the payment." /> <valueSet value="http://hl7.org/fhir/ValueSet/ex-paymenttype" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="ClaimResponse.payment.type.id"> <path value="ClaimResponse.payment.type.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.payment.type.extension"> <path value="ClaimResponse.payment.type.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.payment.type.coding"> <path value="ClaimResponse.payment.type.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data jenis pembayaran untuk membedakan apakah merupakan pembayaran sebagian atau seluruhnya dari manfaat yang dibayarkan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Example Payment Type Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="ClaimResponse.payment.type.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ClaimResponse.payment.type.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="ClaimResponse.payment.adjustment"> <path value="ClaimResponse.payment.adjustment" /> <short value="Payment adjustment for non-claim issues" /> <definition value="Berisi data jumlah total dari semua penyesuaian untuk pembayaran yang termasuk dalam transaksi yang tidak terkait dengan ajudikasi klaim dengan tipe data Money." /> <comment value="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." /> <requirements value="To advise the requestor of adjustments applied to the payment." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.payment.adjustment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Money" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="MO" /> </mapping> </element> <element id="ClaimResponse.payment.adjustmentReason"> <path value="ClaimResponse.payment.adjustmentReason" /> <short value="Explanation for the adjustment" /> <definition value="Berisi data alasan penyesuaian pembayaran dengan tipe data CodeableConcept." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="Needed to clarify the monetary adjustment." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.payment.adjustmentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="PaymentAdjustmentReason" /> </extension> <strength value="example" /> <description value="Payment Adjustment reason codes." /> <valueSet value="http://hl7.org/fhir/ValueSet/payment-adjustment-reason" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="ClaimResponse.payment.date"> <path value="ClaimResponse.payment.date" /> <short value="Expected date of payment" /> <definition value="Berisi data perkiraan tanggal pembayaran akan dikeluarkan atau tanggal penerbitan pembayaran yang sebenarnya dengan tipe data date." /> <requirements value="To advise the payee when payment can be expected." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.payment.date" /> <min value="0" /> <max value="1" /> </base> <type> <code value="date" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.payment.amount"> <path value="ClaimResponse.payment.amount" /> <short value="Payable amount after adjustment" /> <definition value="Berisi data manfaat yang dibayarkan dikurangi penyesuaian pembayaran dengan tipe data Money." /> <requirements value="Needed to provide the actual payment amount." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.payment.amount" /> <min value="1" /> <max value="1" /> </base> <type> <code value="Money" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="MO" /> </mapping> </element> <element id="ClaimResponse.payment.identifier"> <path value="ClaimResponse.payment.identifier" /> <short value="Business identifier for the payment" /> <definition value="Berisi data pengidentifikasi unik penerbit untuk instrumen pembayaran dengan tipe data Identifier." /> <comment value="For example: EFT number or check number." /> <requirements value="Enable the receiver to reconcile when payment received." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.payment.identifier" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Identifier" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" /> </mapping> <mapping> <identity value="rim" /> <map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" /> </mapping> <mapping> <identity value="servd" /> <map value="Identifier" /> </mapping> </element> <element id="ClaimResponse.fundsReserve"> <path value="ClaimResponse.fundsReserve" /> <short value="Funds reserved status" /> <definition value="Berisi data sebuah kode, yang digunakan hanya sebagai tanggapan atas pra-otorisasi, untuk menunjukkan apakah tunjangan yang dibayarkan telah dipesan dan untuk siapa dengan tipe data CodeableConcept." /> <comment value="Fund would be release by a future claim quoting the preAuthRef of this response. Examples of values include: provider, patient, none." /> <requirements value="Needed to advise the submitting provider on whether the rquest for reservation of funds has been honored." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.fundsReserve" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="FundsReserve" /> </extension> <strength value="example" /> <description value="For whom funds are to be reserved: (Patient, Provider, None)." /> <valueSet value="http://hl7.org/fhir/ValueSet/fundsreserve" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="ClaimResponse.fundsReserve.id"> <path value="ClaimResponse.fundsReserve.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.fundsReserve.extension"> <path value="ClaimResponse.fundsReserve.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.fundsReserve.coding"> <path value="ClaimResponse.fundsReserve.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data sebuah kode, yang digunakan hanya sebagai tanggapan atas pra-otorisasi, untuk menunjukkan apakah tunjangan yang dibayarkan telah dipesan dan untuk siapa dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi FundsReserve." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="ClaimResponse.fundsReserve.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ClaimResponse.fundsReserve.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="ClaimResponse.formCode"> <path value="ClaimResponse.formCode" /> <short value="Printed form identifier" /> <definition value="Berisi data kode untuk formulir yang akan digunakan untuk mencetak konten dengan tipe data CodeableConcept." /> <comment value="May be needed to identify specific jurisdictional forms." /> <requirements value="Needed to specify the specific form used for producing output for this response." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.formCode" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Forms" /> </extension> <strength value="example" /> <description value="The forms codes." /> <valueSet value="http://hl7.org/fhir/ValueSet/forms" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="ClaimResponse.formCode.id"> <path value="ClaimResponse.formCode.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.formCode.extension"> <path value="ClaimResponse.formCode.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.formCode.coding"> <path value="ClaimResponse.formCode.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data kode untuk formulir yang akan digunakan untuk mencetak konten dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Forms." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="ClaimResponse.formCode.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ClaimResponse.formCode.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="ClaimResponse.form"> <path value="ClaimResponse.form" /> <short value="Printed reference or actual form" /> <definition value="Berisi data bentuk sebenarnya, dengan referensi atau penyertaan, untuk mencetak konten atau EOB dengan tipe data Attachment." /> <comment value="Needed to permit insurers to include the actual form." /> <requirements value="Needed to include the specific form used for producing output for this response." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.form" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Attachment" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="att-1" /> <severity value="error" /> <human value="If the Attachment has data, it SHALL have a contentType" /> <expression value="data.empty() or contentType.exists()" /> <xpath value="not(exists(f:data)) or exists(f:contentType)" /> <source value="http://hl7.org/fhir/StructureDefinition/Attachment" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="ED/RP" /> </mapping> <mapping> <identity value="rim" /> <map value="ED" /> </mapping> </element> <element id="ClaimResponse.processNote"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Note" /> </extension> <path value="ClaimResponse.processNote" /> <short value="Note concerning adjudication" /> <definition value="Berisi data catatan yang menggambarkan atau menjelaskan hasil ajudikasi dalam bentuk yang dapat dibaca manusia dengan tipe data BackboneElement." /> <requirements value="Provides the insurer specific textual explanations associated with the processing." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.processNote" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.processNote.id"> <path value="ClaimResponse.processNote.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.processNote.extension"> <path value="ClaimResponse.processNote.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.processNote.modifierExtension"> <path value="ClaimResponse.processNote.modifierExtension" /> <short value="Extensions that cannot be ignored even if unrecognized" /> <definition value="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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment value="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." /> <requirements value="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](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.processNote.number"> <path value="ClaimResponse.processNote.number" /> <short value="Note instance identifier" /> <definition value="Berisi data nomor unik untuk mengidentifikasi entri catatan dengan tipe data positiveInt." /> <comment value="32 bit number; for values larger than this, use decimal" /> <requirements value="Necessary to provide a mechanism to link from adjudications." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.processNote.number" /> <min value="0" /> <max value="1" /> </base> <type> <code value="positiveInt" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.processNote.type"> <path value="ClaimResponse.processNote.type" /> <short value="display | print | printoper" /> <definition value="Berisi data tujuan bisnis dari teks catatan dengan tipe data code yang nilainya mengacu pada data terminologi NoteType." /> <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" /> <requirements value="To convey the expectation for when the text is used." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.processNote.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="NoteType" /> </extension> <strength value="required" /> <description value="The presentation types of notes." /> <valueSet value="http://hl7.org/fhir/ValueSet/note-type|4.3.0" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.processNote.text"> <path value="ClaimResponse.processNote.text" /> <short value="Note explanatory text" /> <definition value="Berisi data penjelasan atau deskripsi yang terkait dengan pemrosesan dengan tipe data string." /> <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" /> <requirements value="Required to provide human readable explanation." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.processNote.text" /> <min value="1" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.processNote.language"> <path value="ClaimResponse.processNote.language" /> <short value="Language of the text" /> <definition value="Berisi data kode untuk menentukan bahasa yang digunakan dalam teks catatan dengan tipe data CodeableConcept yang nilainya lebih baik mengacu pada contoh data terminologi urn:ietf:bcp:47[Common Languages]." /> <comment value="Only required if the language is different from the resource language." /> <requirements value="Note text may vary from the resource defined language." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.processNote.language" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet"> <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Language" /> </extension> <strength value="preferred" /> <description value="IETF language tag" /> <valueSet value="http://hl7.org/fhir/ValueSet/languages" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="ClaimResponse.communicationRequest"> <path value="ClaimResponse.communicationRequest" /> <short value="Request for additional information" /> <definition value="Berisi data permintaan informasi pendukung atau otorisasi tambahan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource CommunicationRequest." /> <comment value="For example: professional reports, documents, images, clinical resources, or accident reports." /> <requirements value="Need to communicate insurer request for additional information required to support the adjudication." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.communicationRequest" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CommunicationRequest" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> </element> <element id="ClaimResponse.insurance"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Insurance" /> </extension> <path value="ClaimResponse.insurance" /> <short value="Patient insurance information" /> <definition value="Berisi data instrumen keuangan untuk penggantian produk dan layanan perawatan kesehatan yang ditentukan pada klaim. Semua pertanggungan asuransi untuk pasien yang mungkin berlaku untuk penggantian, dari produk dan layanan yang tercantum dalam klaim, biasanya diberikan dalam klaim untuk memungkinkan perusahaan asuransi mengkonfirmasi pemesanan pertanggungan asuransi relatif terhadap aturan 'koordinasi manfaat' setempat. Satu liputan (dan hanya satu) dengan 'focal=true' akan digunakan dalam putusan klaim ini. Cakupan muncul sebelum Cakupan fokus dalam daftar, dan di mana 'subrogasi = salah', harus memberikan referensi ke ClaimResponse berisi hasil ajudikasi dari klaim sebelumnya dengan tipe data BackboneElement." /> <comment value="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." /> <requirements value="At least one insurer is required for a claim to be a claim." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.insurance" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="Coverage" /> </mapping> </element> <element id="ClaimResponse.insurance.id"> <path value="ClaimResponse.insurance.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.insurance.extension"> <path value="ClaimResponse.insurance.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.insurance.modifierExtension"> <path value="ClaimResponse.insurance.modifierExtension" /> <short value="Extensions that cannot be ignored even if unrecognized" /> <definition value="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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment value="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." /> <requirements value="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](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.insurance.sequence"> <path value="ClaimResponse.insurance.sequence" /> <short value="Insurance instance identifier" /> <definition value="Berisi nomor unik untuk mengidentifikasi entri asuransi dan memberikan urutan pertanggungan untuk menyampaikan koordinasi urutan manfaat dengan tipe data positiveInt." /> <comment value="32 bit number; for values larger than this, use decimal" /> <requirements value="To maintain order of the coverages." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.insurance.sequence" /> <min value="1" /> <max value="1" /> </base> <type> <code value="positiveInt" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.insurance.focal"> <path value="ClaimResponse.insurance.focal" /> <short value="Coverage to be used for adjudication" /> <definition value="Berisi data penanda untuk menunjukkan bahwa cakupan yang tersebut akan digunakan untuk keputusan klaim bila disetel ke true dengan tipe data booelan." /> <comment value="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." /> <requirements value="To identify which coverage in the list is being used to adjudicate this claim." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.insurance.focal" /> <min value="1" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.insurance.coverage"> <path value="ClaimResponse.insurance.coverage" /> <short value="Insurance information" /> <definition value="Berisi data referensi ke informasi tingkat kartu asuransi yang terdapat pada resource Coverage. Perusahaan asuransi yang mengeluarkan pertanggungan akan menggunakan perincian ini untuk menemukan pertanggungan aktual pasien dalam sistem informasi perusahaan asuransi. Tipe data yang digunakan adalah Reference yang direferensikan ke data yang tersimpan di resource Coverage." /> <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." /> <requirements value="Required to allow the adjudicator to locate the correct policy and history within their information system." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.insurance.coverage" /> <min value="1" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Coverage" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> </element> <element id="ClaimResponse.insurance.businessArrangement"> <path value="ClaimResponse.insurance.businessArrangement" /> <short value="Additional provider contract number" /> <definition value="Berisi data nomor perjanjian bisnis yang dibuat antara penyedia dan perusahaan asuransi untuk tujuan pemrosesan bisnis khusus dengan tipe data string." /> <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" /> <requirements value="Providers may have multiple business arrangements with a given insurer and must supply the specific contract number for adjudication." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.insurance.businessArrangement" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.insurance.claimResponse"> <path value="ClaimResponse.insurance.claimResponse" /> <short value="Adjudication results" /> <definition value="Berisi data hasil ajudikasi item baris untuk pertanggungan yang ditentukan dalam asuransi dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource ClaimResponse." /> <comment value="Must not be specified when 'focal=true' for this insurance." /> <requirements value="An insurer need the adjudication results from prior insurers to determine the outstanding balance remaining by item for the items in the curent claim." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.insurance.claimResponse" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ClaimResponse" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> </element> <element id="ClaimResponse.error"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Error" /> </extension> <path value="ClaimResponse.error" /> <short value="Processing errors" /> <definition value="Berisi data kesalahan yang ditemui selama proses ajudikasi dengan tipe data BackboneElement." /> <comment value="If the request contains errors then an error element should be provided and no adjudication related sections (item, addItem, or payment) should be present." /> <requirements value="Need to communicate processing issues to the requestor." /> <min value="0" /> <max value="*" /> <base> <path value="ClaimResponse.error" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.error.id"> <path value="ClaimResponse.error.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.error.extension"> <path value="ClaimResponse.error.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.error.modifierExtension"> <path value="ClaimResponse.error.modifierExtension" /> <short value="Extensions that cannot be ignored even if unrecognized" /> <definition value="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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment value="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." /> <requirements value="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](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ClaimResponse.error.itemSequence"> <path value="ClaimResponse.error.itemSequence" /> <short value="Item sequence number" /> <definition value="Berisi data nomor urut item baris yang dikirimkan yang berisi kesalahan. Nilai ini dihilangkan ketika kesalahan terjadi di luar struktur item. Tipe data yang digunakan adalah positiveInt." /> <comment value="32 bit number; for values larger than this, use decimal" /> <requirements value="Provides references to the claim items." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.error.itemSequence" /> <min value="0" /> <max value="1" /> </base> <type> <code value="positiveInt" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.error.detailSequence"> <path value="ClaimResponse.error.detailSequence" /> <short value="Detail sequence number" /> <definition value="Berisi data nomor urut detail dalam item baris yang dikirimkan yang berisi kesalahan. Nilai ini dihilangkan ketika kesalahan terjadi di luar struktur item. Tipe data yang digunakan adalah positiveInt." /> <comment value="32 bit number; for values larger than this, use decimal" /> <requirements value="Provides references to the claim details within the claim item." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.error.detailSequence" /> <min value="0" /> <max value="1" /> </base> <type> <code value="positiveInt" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.error.subDetailSequence"> <path value="ClaimResponse.error.subDetailSequence" /> <short value="Subdetail sequence number" /> <definition value="Berisi data nomor urut sub-detail dalam detail dalam item baris yang dikirimkan yang berisi kesalahan. Nilai ini dihilangkan ketika kesalahan terjadi di luar struktur item. Tipe data yang digunakan adalah positiveInt." /> <comment value="32 bit number; for values larger than this, use decimal" /> <requirements value="Provides references to the claim sub-details within the claim detail." /> <min value="0" /> <max value="1" /> <base> <path value="ClaimResponse.error.subDetailSequence" /> <min value="0" /> <max value="1" /> </base> <type> <code value="positiveInt" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ClaimResponse.error.code"> <path value="ClaimResponse.error.code" /> <short value="Error code detailing processing issues" /> <definition value="Berisi data kode kesalahan, dari sistem kode tertentu, yang merinci mengapa klaim tidak dapat diajudikasi dengan tipe data CodeableConcept yang nilainya dapat mengacu pada contoh data terminologi AdjudicationError." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="Required to convey processing errors." /> <min value="1" /> <max value="1" /> <base> <path value="ClaimResponse.error.code" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AdjudicationError" /> </extension> <strength value="example" /> <description value="The adjudication error codes." /> <valueSet value="http://hl7.org/fhir/ValueSet/adjudication-error" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> </snapshot> <differential> <element id="ClaimResponse.identifier"> <path value="ClaimResponse.identifier" /> <definition value="Berisi data ID lokal yang ditetapkan untuk respons klaim dengan tipe data Identifier." /> <max value="1" /> </element> <element id="ClaimResponse.status"> <path value="ClaimResponse.status" /> <definition value="Berisi data status respon klaim dengan tipe data code, yang nilainya mengacu pada data terminologi Financial Resource Status Code." /> </element> <element id="ClaimResponse.type"> <path value="ClaimResponse.type" /> <definition value="Berisi data kategori klaim dengan tipe data CodeableConcept." /> </element> <element id="ClaimResponse.type.coding"> <path value="ClaimResponse.type.coding" /> <definition value="Berisi data kategori klaim dengan tipe data Coding, yang nilainya mengacu pada data terminologi yang dapat diperluas yaitu Claim Type Codes." /> </element> <element id="ClaimResponse.use"> <path value="ClaimResponse.use" /> <definition value="Berisi data kode untuk menunjukkan apakah sifat dari permintaan tersebut adalah: untuk meminta keputusan atas produk dan layanan yang telah diberikan sebelumnya; atau meminta otorisasi dan ajudikasi untuk ketentuan di masa depan; atau meminta keputusan yang tidak mengikat atas produk dan layanan yang tercantum yang dapat disediakan di masa mendatang. Tipe data yang digunakan adalah code, yang nilainya mengacu pada data terminologi Use." /> </element> <element id="ClaimResponse.patient"> <path value="ClaimResponse.patient" /> <definition value="Berisi data terkait pihak kepada siapa layanan dan/atau produk profesional telah disediakan atau sedang dipertimbangkan dan untuk siapa penggantian aktual atau prakiraan dimintakan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Patient." /> </element> <element id="ClaimResponse.created"> <path value="ClaimResponse.created" /> <definition value="Berisi data tanggal ketika respon klaim dibuat dengan tipe data dateTime, dengan format yang diperbolehkan YYYY, YYYY-MM, YYYY-MM-DD atau YYYY-MM-DDThh:mm:ss+zz:zz." /> </element> <element id="ClaimResponse.insurer"> <path value="ClaimResponse.insurer" /> <definition value="Berisi data pihak yang bertanggung jawab untuk otorisasi, ajudikasi dan penggantian dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Organization." /> </element> <element id="ClaimResponse.requestor"> <path value="ClaimResponse.requestor" /> <definition value="Berisi data penyedia yang bertanggung jawab atas klaim, penentuan sebelumnya atau pra-otorisasi dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Practitioner | PractitionerRole | Organization." /> </element> <element id="ClaimResponse.request"> <path value="ClaimResponse.request" /> <definition value="Berisi data referensi ke resource asli permintaan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Claim." /> </element> <element id="ClaimResponse.outcome"> <path value="ClaimResponse.outcome" /> <definition value="Berisi data hasil dari pemrosesan klaim, penentuan sebelumnya, atau praotorisasi dengan tipe data code, yang nilainya mengacu pada data terminologi Claim Processing Codes." /> </element> <element id="ClaimResponse.disposition"> <path value="ClaimResponse.disposition" /> <definition value="Berisi data deskripsi status keputusan yang dapat dibaca manusia dengan tipe data string." /> </element> <element id="ClaimResponse.preAuthRef"> <path value="ClaimResponse.preAuthRef" /> <definition value="Berisi data referensi dari penanggung yang digunakan dalam komunikasi selanjutnya yang mengacu pada keputusan dengan tipe data string." /> </element> <element id="ClaimResponse.preAuthPeriod"> <path value="ClaimResponse.preAuthPeriod" /> <definition value="Berisi data jangka waktu selama otorisasi berlaku efektif dengan tipe data Period." /> </element> <element id="ClaimResponse.payeeType"> <path value="ClaimResponse.payeeType" /> <definition value="Berisi data jenis pihak yang akan diberikan ganti: pelanggan, penyedia, lainnya dengan tipe data CodeableConcept." /> </element> <element id="ClaimResponse.payeeType.coding"> <path value="ClaimResponse.payeeType.coding" /> <definition value="Berisi data jenis pihak yang akan diberikan ganti: pelanggan, penyedia, lainnya dengan tipe data Coding, yang nilainya dapat mengacu pada contoh data terminologi PayeeType." /> </element> <element id="ClaimResponse.item"> <path value="ClaimResponse.item" /> <definition value="Berisi data baris klaim. Baik produk atau layanan sederhana atau 'grup' detail yang masing-masing dapat berupa item sederhana atau grup sub-detail dengan tipe data BackboneElement." /> </element> <element id="ClaimResponse.item.itemSequence"> <path value="ClaimResponse.item.itemSequence" /> <definition value="Berisi data nomor unik untuk mengidentifikasi entri item dengan tipe data positiveInt." /> </element> <element id="ClaimResponse.item.noteNumber"> <path value="ClaimResponse.item.noteNumber" /> <definition value="Berisi data angka-angka yang terkait dengan catatan yang ada di bawah yang berlaku untuk penilaian item dengan tipe data positiveInt." /> </element> <element id="ClaimResponse.item.adjudication"> <path value="ClaimResponse.item.adjudication" /> <definition value="Berisi data penilaian item. Jika item ini adalah grup maka nilai-nilai di sini adalah ringkasan dari penilaian detail item. Jika item ini adalah produk atau layanan sederhana maka ini adalah hasil dari penilaian item ini. Hasil ajudikasi menyampaikan penilaian penanggung terhadap hal yang diberikan dalam klaim berdasarkan ketentuan pertanggungan asuransi pasien." /> </element> <element id="ClaimResponse.item.adjudication.category"> <path value="ClaimResponse.item.adjudication.category" /> <definition value="Berisi data kode untuk menunjukkan jenis informasi catatan keputusan. Jenis informasi dapat mencakup nilai yang diajukan, nilai maksimum atau persentase yang diperbolehkan atau dapat dibayarkan berdasarkan program, jumlah yang: pasien bertanggung jawab secara agregat atau berkaitan dengan item ini; jumlah yang dibayarkan oleh pertanggungan lain; dan, manfaat yang dibayarkan untuk item ini. Tipe data yang digunakan adalah CodeableConcept." /> </element> <element id="ClaimResponse.item.adjudication.category.coding"> <path value="ClaimResponse.item.adjudication.category.coding" /> <definition value="Berisi data kode untuk menunjukkan jenis informasi catatan keputusan. Jenis informasi dapat mencakup nilai yang diajukan, nilai maksimum atau persentase yang diperbolehkan atau dapat dibayarkan berdasarkan program, jumlah yang: pasien bertanggung jawab secara agregat atau berkaitan dengan item ini; jumlah yang dibayarkan oleh pertanggungan lain; dan, manfaat yang dibayarkan untuk item ini. Tipe data yang digunakan adalah Coding, yang nilainya dapat mengacu pada contoh data terminologi Adjudication Value Codes." /> </element> <element id="ClaimResponse.item.adjudication.reason"> <path value="ClaimResponse.item.adjudication.reason" /> <definition value="Berisi data kode yang mendukung pemahaman hasil keputusan dan menjelaskan perbedaan dari jumlah yang diharapkan dengan tipe data CodeableConcept." /> </element> <element id="ClaimResponse.item.adjudication.reason.coding"> <path value="ClaimResponse.item.adjudication.reason.coding" /> <definition value="Berisi data kode yang mendukung pemahaman hasil keputusan dan menjelaskan perbedaan dari jumlah yang diharapkan dengan tipe data Coding, yang nilainya dapat mengacu pada contoh data terminologi Adjudication Reason Codes." /> </element> <element id="ClaimResponse.item.adjudication.amount"> <path value="ClaimResponse.item.adjudication.amount" /> <definition value="Berisi data jumlah uang yang terkait dengan kategori keputusan dengan tipe data Money." /> </element> <element id="ClaimResponse.item.adjudication.value"> <path value="ClaimResponse.item.adjudication.value" /> <definition value="Berisi data nilai non-moneter yang terkait dengan kategori, beberapa kategori penilaian menyampaikan persentase atau nilai tetap, dapat berupa persentase yang memenuhi syarat atau persentase pembayaran bersama dengan tipe data decimal." /> </element> <element id="ClaimResponse.item.detail"> <path value="ClaimResponse.item.detail" /> <definition value="Berisi data detail klaim, baik yang sederhana (produk atau layanan) atau 'kelompok' sub-detail yang merupakan barang sederhana dengan tipe data BackboneElement." /> </element> <element id="ClaimResponse.item.detail.detailSequence"> <path value="ClaimResponse.item.detail.detailSequence" /> <definition value="Berisi data nomor unik untuk mereferensikan entri detail klaim dengan tipe data positiveInt." /> </element> <element id="ClaimResponse.item.detail.noteNumber"> <path value="ClaimResponse.item.detail.noteNumber" /> <definition value="Berisi data angka-angka yang terkait dengan catatan di bawah yang berlaku untuk penilaian item dengan tipe data positiveInt." /> </element> <element id="ClaimResponse.item.detail.adjudication"> <path value="ClaimResponse.item.detail.adjudication" /> <definition value="Berisi data hasil keputusan dengan tipe data yang mengacu pada ClaimResponse.item.adjudication." /> </element> <element id="ClaimResponse.item.detail.subDetail"> <path value="ClaimResponse.item.detail.subDetail" /> <definition value="Berisi data keputusan sub-detail dari produk atau layanan sederhana dengan tipe data BackboneElement." /> </element> <element id="ClaimResponse.item.detail.subDetail.subDetailSequence"> <path value="ClaimResponse.item.detail.subDetail.subDetailSequence" /> <definition value="Berisi data nomor unik untuk mereferensikan entri sub-detail klaim dengan tipe data positiveInt." /> </element> <element id="ClaimResponse.item.detail.subDetail.noteNumber"> <path value="ClaimResponse.item.detail.subDetail.noteNumber" /> <definition value="Berisi data angka-angka yang terkait dengan catatan di bawah yang berlaku untuk penilaian item dengan tipe data positiveInt." /> </element> <element id="ClaimResponse.item.detail.subDetail.adjudication"> <path value="ClaimResponse.item.detail.subDetail.adjudication" /> <definition value="Berisi data hasil keputusan dengan tipe data yang mengacu pada ClaimResponse.item.adjudication." /> <min value="1" /> </element> <element id="ClaimResponse.addItem"> <path value="ClaimResponse.addItem" /> <definition value="Berisi data keputusan layanan tingkat pertama untuk payor dapat menambahkan lini produk atau layanan. Penanggung dapat mendefinisikan kembali produk atau layanan yang disediakan atau dapat mengemas dan/atau menguraikan kelompok produk dan layanan. AddItems memungkinkan perusahaan asuransi untuk memberikan daftar item baris mereka dengan tautan ke item/detail/sub-detail yang dikirimkan. Dalam pra-otorisasi perusahaan asuransi dapat menggunakan struktur addItem untuk memberikan informasi tambahan tentang produk dan layanan resmi dengan tipe data BackboneElement." /> </element> <element id="ClaimResponse.addItem.itemSequence"> <path value="ClaimResponse.addItem.itemSequence" /> <definition value="Berisi data klaim item yang ingin diganti oleh saluran layanan ini dengan tipe data positiveInt." /> </element> <element id="ClaimResponse.addItem.detailSequence"> <path value="ClaimResponse.addItem.detailSequence" /> <definition value="Berisi data nomor urut detail dalam item klaim yang ingin diganti oleh baris ini dengan tipe data positiveInt." /> </element> <element id="ClaimResponse.addItem.subdetailSequence"> <path value="ClaimResponse.addItem.subdetailSequence" /> <definition value="Berisi data nomor urut sub-detail dalam detail pada item klaim yang dimaksudkan untuk diganti oleh baris ini dengan tipe data positiveInt." /> </element> <element id="ClaimResponse.addItem.provider"> <path value="ClaimResponse.addItem.provider" /> <definition value="Berisi data penyedia yang berwenang untuk layanan yang diberikan kepada pasien. dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Practitioner | PractitionerRole | Organization." /> </element> <element id="ClaimResponse.addItem.productOrService"> <path value="ClaimResponse.addItem.productOrService" /> <definition value="Berisi data jika nilainya adalah kode grup maka item ini mengumpulkan serangkaian detail klaim terkait dan jika tidak maka berisi produk, layanan, obat, atau kode tagihan lainnya untuk item tersebut dengan tipe data CodeableConcept." /> </element> <element id="ClaimResponse.addItem.productOrService.coding"> <path value="ClaimResponse.addItem.productOrService.coding" /> <definition value="Berisi data jika nilainya adalah kode grup maka item ini mengumpulkan serangkaian detail klaim terkait dan jika tidak maka berisi produk, layanan, obat, atau kode tagihan lainnya untuk item tersebut dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi USCLS Codes." /> </element> <element id="ClaimResponse.addItem.modifier"> <path value="ClaimResponse.addItem.modifier" /> <definition value="Berisi data kode tipifikasi atau pengubah item untuk menyampaikan konteks tambahan untuk produk atau layanan dengan tipe data CodeableConcept." /> </element> <element id="ClaimResponse.addItem.modifier.coding"> <path value="ClaimResponse.addItem.modifier.coding" /> <definition value="Berisi data kode tipifikasi atau pengubah item untuk menyampaikan konteks tambahan untuk produk atau layanan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Modifier types Codes." /> </element> <element id="ClaimResponse.addItem.programCode"> <path value="ClaimResponse.addItem.programCode" /> <definition value="Berisi data untuk mengidentifikasi program yang memungkinkan pemulihan dengan tipe data CodeableConcept." /> </element> <element id="ClaimResponse.addItem.programCode.coding"> <path value="ClaimResponse.addItem.programCode.coding" /> <definition value="Berisi data untuk mengidentifikasi program yang memungkinkan pemulihan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Example Program Reason Codes." /> </element> <element id="ClaimResponse.addItem.serviced[x]"> <path value="ClaimResponse.addItem.serviced[x]" /> <definition value="Berisi data tanggal atau tanggal ketika layanan atau produk dipasok, dilaksanakan, atau diselesaikan." /> </element> <element id="ClaimResponse.addItem.location[x]"> <path value="ClaimResponse.addItem.location[x]" /> <definition value="Berisi data lokasi produk atau layanan disediakan." /> </element> <element id="ClaimResponse.addItem.quantity"> <path value="ClaimResponse.addItem.quantity" /> <definition value="Berisi data jumlah pengulangan layanan atau produk dengan tipe data SimpleQuantity." /> </element> <element id="ClaimResponse.addItem.unitPrice"> <path value="ClaimResponse.addItem.unitPrice" /> <definition value="Berisi data jika item tersebut bukan grup maka ini adalah biaya untuk produk atau layanan, jika tidak, ini adalah total biaya untuk perincian grup dengan tipe data Money." /> </element> <element id="ClaimResponse.addItem.factor"> <path value="ClaimResponse.addItem.factor" /> <definition value="Berisi data bilangan real yang mewakili pengali yang digunakan dalam menentukan nilai keseluruhan dari layanan yang diberikan dan/atau barang yang diterima. Konsep Faktor memungkinkan pengganda diskon atau biaya tambahan untuk diterapkan pada jumlah uang dengan tipe data decimal." /> </element> <element id="ClaimResponse.addItem.net"> <path value="ClaimResponse.addItem.net" /> <definition value="Berisi data kuantitas dikalikan harga satuan untuk layanan atau produk atau biaya tambahan dengan tipe data Money." /> </element> <element id="ClaimResponse.addItem.bodySite"> <path value="ClaimResponse.addItem.bodySite" /> <definition value="Berisi data lokasi pelayanan fisik pada pasien (tungkai, gigi, dan lainnya) dengan tipe data CodeableConcept." /> </element> <element id="ClaimResponse.addItem.bodySite.coding"> <path value="ClaimResponse.addItem.bodySite.coding" /> <definition value="Berisi data lokasi pelayanan fisik pada pasien (tungkai, gigi, dan lainnya) dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Oral Site Codes." /> </element> <element id="ClaimResponse.addItem.subSite"> <path value="ClaimResponse.addItem.subSite" /> <definition value="Berisi data wilayah atau permukaan bodySite, seperti daerah anggota gerak atau permukaan gigi dengan tipe data CodeableConcept." /> </element> <element id="ClaimResponse.addItem.subSite.coding"> <path value="ClaimResponse.addItem.subSite.coding" /> <definition value="Berisi data wilayah atau permukaan bodySite, seperti daerah anggota gerak atau permukaan gigi dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Surface Codes." /> </element> <element id="ClaimResponse.addItem.noteNumber"> <path value="ClaimResponse.addItem.noteNumber" /> <definition value="Berisi data angka-angka yang terkait dengan catatan yang ada di bawah yang berlaku untuk penilaian item dengan tipe data positiveInt." /> </element> <element id="ClaimResponse.addItem.adjudication"> <path value="ClaimResponse.addItem.adjudication" /> <definition value="Berisi data hasil keputusan dengan tipe data yang mengacu pada ClaimResponse.item.adjudication." /> </element> <element id="ClaimResponse.addItem.detail"> <path value="ClaimResponse.addItem.detail" /> <definition value="Berisi data keputusan layanan tingkat kedua untuk pembayar menambahkan layanan dengan tipe data BackboneElement." /> </element> <element id="ClaimResponse.addItem.detail.productOrService"> <path value="ClaimResponse.addItem.detail.productOrService" /> <definition value="Berisi data jika nilainya adalah kode grup maka item ini mengumpulkan serangkaian detail klaim terkait dan jika tidak maka berisi produk, layanan, obat, atau kode tagihan lainnya untuk item tersebut dengan tipe data CodeableConcept." /> </element> <element id="ClaimResponse.addItem.detail.productOrService.coding"> <path value="ClaimResponse.addItem.detail.productOrService.coding" /> <definition value="Berisi data jika nilainya adalah kode grup maka item ini mengumpulkan serangkaian detail klaim terkait dan jika tidak maka berisi produk, layanan, obat, atau kode tagihan lainnya untuk item tersebut dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi USCLS Codes." /> </element> <element id="ClaimResponse.addItem.detail.modifier"> <path value="ClaimResponse.addItem.detail.modifier" /> <definition value="Berisi data kode tipifikasi atau pengubah item untuk menyampaikan konteks tambahan untuk produk atau layanan dengan tipe data CodeableConcept." /> </element> <element id="ClaimResponse.addItem.detail.modifier.coding"> <path value="ClaimResponse.addItem.detail.modifier.coding" /> <definition value="Berisi data kode tipifikasi atau pengubah item untuk menyampaikan konteks tambahan untuk produk atau layanan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Modifier types Codes." /> </element> <element id="ClaimResponse.addItem.detail.quantity"> <path value="ClaimResponse.addItem.detail.quantity" /> <definition value="Berisi data jumlah pengulangan layanan atau produk dengan tipe data SimpleQuantity." /> </element> <element id="ClaimResponse.addItem.detail.unitPrice"> <path value="ClaimResponse.addItem.detail.unitPrice" /> <definition value="Berisi data biaya di mana jika item yang tersebut bukan grup maka ini adalah biaya untuk produk atau layanan, jika tidak maka ini adalah total biaya untuk perincian grup dengan tipe data Money." /> </element> <element id="ClaimResponse.addItem.detail.factor"> <path value="ClaimResponse.addItem.detail.factor" /> <definition value="Berisi data bilangan real yang mewakili pengali yang digunakan dalam menentukan nilai keseluruhan dari layanan yang diberikan dan/atau barang yang diterima. Konsep Faktor memungkinkan pengganda diskon atau biaya tambahan untuk diterapkan pada jumlah uang. Tipe data yang digunakan adalah decimal." /> </element> <element id="ClaimResponse.addItem.detail.net"> <path value="ClaimResponse.addItem.detail.net" /> <definition value="Berisi data kuantitas dikalikan harga satuan untuk layanan atau produk atau biaya tambahan dengan tipe data Money." /> </element> <element id="ClaimResponse.addItem.detail.noteNumber"> <path value="ClaimResponse.addItem.detail.noteNumber" /> <definition value="Berisi data angka-angka yang terkait dengan catatan yang ada di bawah yang berlaku untuk penilaian item dengan tipe data positiveInt." /> </element> <element id="ClaimResponse.addItem.detail.adjudication"> <path value="ClaimResponse.addItem.detail.adjudication" /> <definition value="Berisi data hasil keputusan dengan tipe data yang mengacu pada ClaimResponse.item.adjudication." /> </element> <element id="ClaimResponse.addItem.detail.subDetail"> <path value="ClaimResponse.addItem.detail.subDetail" /> <definition value="Berisi data keputusan layanan tingkat ketiga untuk pembayar menambahkan layanan dengan tipe data BackboneElement." /> </element> <element id="ClaimResponse.addItem.detail.subDetail.productOrService"> <path value="ClaimResponse.addItem.detail.subDetail.productOrService" /> <definition value="Berisi data jika nilainya adalah kode grup maka item ini mengumpulkan serangkaian detail klaim terkait dan jika tidak maka berisi produk, layanan, obat, atau kode tagihan lainnya untuk item tersebut dengan tipe data CodeableConcept." /> </element> <element id="ClaimResponse.addItem.detail.subDetail.productOrService.coding"> <path value="ClaimResponse.addItem.detail.subDetail.productOrService.coding" /> <definition value="Berisi data jika nilainya adalah kode grup maka item ini mengumpulkan serangkaian detail klaim terkait dan jika tidak maka berisi produk, layanan, obat, atau kode tagihan lainnya untuk item tersebut dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi USCLS Codes." /> </element> <element id="ClaimResponse.addItem.detail.subDetail.modifier"> <path value="ClaimResponse.addItem.detail.subDetail.modifier" /> <definition value="Berisi data kode tipifikasi atau pengubah item untuk menyampaikan konteks tambahan untuk produk atau layanan dengan tipe data CodeableConcept." /> </element> <element id="ClaimResponse.addItem.detail.subDetail.modifier.coding"> <path value="ClaimResponse.addItem.detail.subDetail.modifier.coding" /> <definition value="Berisi data kode tipifikasi atau pengubah item untuk menyampaikan konteks tambahan untuk produk atau layanan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Modifier types Codes." /> </element> <element id="ClaimResponse.addItem.detail.subDetail.quantity"> <path value="ClaimResponse.addItem.detail.subDetail.quantity" /> <definition value="Berisi data jumlah pengulangan layanan atau produk dengan tipe data SimpleQuantity." /> </element> <element id="ClaimResponse.addItem.detail.subDetail.unitPrice"> <path value="ClaimResponse.addItem.detail.subDetail.unitPrice" /> <definition value="Berisi data biaya di mana jika item yang tersebut bukan grup maka ini adalah biaya untuk produk atau layanan, jika tidak maka ini adalah total biaya untuk perincian grup dengan tipe data Money." /> </element> <element id="ClaimResponse.addItem.detail.subDetail.factor"> <path value="ClaimResponse.addItem.detail.subDetail.factor" /> <definition value="Berisi data bilangan real yang mewakili pengali yang digunakan dalam menentukan nilai keseluruhan dari layanan yang diberikan dan/atau barang yang diterima. Konsep Faktor memungkinkan pengganda diskon atau biaya tambahan untuk diterapkan pada jumlah uang. Tipe data yang digunakan adalah decimal." /> </element> <element id="ClaimResponse.addItem.detail.subDetail.net"> <path value="ClaimResponse.addItem.detail.subDetail.net" /> <definition value="Berisi data kuantitas dikalikan harga satuan untuk layanan atau produk atau biaya tambahan dengan tipe data Money." /> </element> <element id="ClaimResponse.addItem.detail.subDetail.noteNumber"> <path value="ClaimResponse.addItem.detail.subDetail.noteNumber" /> <definition value="Berisi data angka-angka yang terkait dengan catatan yang ada di bawah yang berlaku untuk penilaian item dengan tipe data positiveInt." /> </element> <element id="ClaimResponse.addItem.detail.subDetail.adjudication"> <path value="ClaimResponse.addItem.detail.subDetail.adjudication" /> <definition value="Berisi data hasil ajudikasi dengan tipe data yang mengacu pada ClaimResponse.item.adjudication." /> </element> <element id="ClaimResponse.total"> <path value="ClaimResponse.total" /> <definition value="Berisi data total moneter yang dikategorikan untuk ajudikasi dengan tipe data Money." /> </element> <element id="ClaimResponse.total.category"> <path value="ClaimResponse.total.category" /> <definition value="Berisi data Kode untuk menunjukkan jenis informasi catatan ajudikasi ini. Jenis informasi dapat mencakup: nilai yang diajukan, nilai maksimum atau persentase yang diperbolehkan atau dibayarkan berdasarkan program, jumlah yang menjadi tanggung jawab pasien secara keseluruhan atau berkaitan dengan item ini, jumlah yang dibayarkan oleh pertanggungan lain, dan manfaat yang dibayarkan untuk item ini. Tipe data yang digunakan adalah CodeableConcept." /> </element> <element id="ClaimResponse.total.category.coding"> <path value="ClaimResponse.total.category.coding" /> <definition value="Berisi data Kode untuk menunjukkan jenis informasi catatan ajudikasi ini. Jenis informasi dapat mencakup: nilai yang diajukan, nilai maksimum atau persentase yang diperbolehkan atau dibayarkan berdasarkan program, jumlah yang menjadi tanggung jawab pasien secara keseluruhan atau berkaitan dengan item ini, jumlah yang dibayarkan oleh pertanggungan lain, dan manfaat yang dibayarkan untuk item ini. Tipe data yang digunakan adalah Coding yang nilainya dapat mengacu pada contoh data terminologi Adjudication Value Codes." /> </element> <element id="ClaimResponse.total.amount"> <path value="ClaimResponse.total.amount" /> <definition value="Berisi data jumlah total biaya yang terkait dengan kategori dengan tipe data Money." /> </element> <element id="ClaimResponse.payment"> <path value="ClaimResponse.payment" /> <definition value="Berisi data rincian pembayaran untuk ajudikasi klaim dengan tipe data BackboneElement." /> </element> <element id="ClaimResponse.payment.type"> <path value="ClaimResponse.payment.type" /> <definition value="Berisi data jenis pembayaran untuk membedakan apakah merupakan pembayaran sebagian atau seluruhnya dari manfaat yang dibayarkan dengan tipe data CodeableConcept." /> </element> <element id="ClaimResponse.payment.type.coding"> <path value="ClaimResponse.payment.type.coding" /> <definition value="Berisi data jenis pembayaran untuk membedakan apakah merupakan pembayaran sebagian atau seluruhnya dari manfaat yang dibayarkan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Example Payment Type Codes." /> </element> <element id="ClaimResponse.payment.adjustment"> <path value="ClaimResponse.payment.adjustment" /> <definition value="Berisi data jumlah total dari semua penyesuaian untuk pembayaran yang termasuk dalam transaksi yang tidak terkait dengan ajudikasi klaim dengan tipe data Money." /> </element> <element id="ClaimResponse.payment.adjustmentReason"> <path value="ClaimResponse.payment.adjustmentReason" /> <definition value="Berisi data alasan penyesuaian pembayaran dengan tipe data CodeableConcept." /> </element> <element id="ClaimResponse.payment.date"> <path value="ClaimResponse.payment.date" /> <definition value="Berisi data perkiraan tanggal pembayaran akan dikeluarkan atau tanggal penerbitan pembayaran yang sebenarnya dengan tipe data date." /> </element> <element id="ClaimResponse.payment.amount"> <path value="ClaimResponse.payment.amount" /> <definition value="Berisi data manfaat yang dibayarkan dikurangi penyesuaian pembayaran dengan tipe data Money." /> </element> <element id="ClaimResponse.payment.identifier"> <path value="ClaimResponse.payment.identifier" /> <definition value="Berisi data pengidentifikasi unik penerbit untuk instrumen pembayaran dengan tipe data Identifier." /> </element> <element id="ClaimResponse.fundsReserve"> <path value="ClaimResponse.fundsReserve" /> <definition value="Berisi data sebuah kode, yang digunakan hanya sebagai tanggapan atas pra-otorisasi, untuk menunjukkan apakah tunjangan yang dibayarkan telah dipesan dan untuk siapa dengan tipe data CodeableConcept." /> </element> <element id="ClaimResponse.fundsReserve.coding"> <path value="ClaimResponse.fundsReserve.coding" /> <definition value="Berisi data sebuah kode, yang digunakan hanya sebagai tanggapan atas pra-otorisasi, untuk menunjukkan apakah tunjangan yang dibayarkan telah dipesan dan untuk siapa dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi FundsReserve." /> </element> <element id="ClaimResponse.formCode"> <path value="ClaimResponse.formCode" /> <definition value="Berisi data kode untuk formulir yang akan digunakan untuk mencetak konten dengan tipe data CodeableConcept." /> </element> <element id="ClaimResponse.formCode.coding"> <path value="ClaimResponse.formCode.coding" /> <definition value="Berisi data kode untuk formulir yang akan digunakan untuk mencetak konten dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Forms." /> </element> <element id="ClaimResponse.form"> <path value="ClaimResponse.form" /> <definition value="Berisi data bentuk sebenarnya, dengan referensi atau penyertaan, untuk mencetak konten atau EOB dengan tipe data Attachment." /> </element> <element id="ClaimResponse.processNote"> <path value="ClaimResponse.processNote" /> <definition value="Berisi data catatan yang menggambarkan atau menjelaskan hasil ajudikasi dalam bentuk yang dapat dibaca manusia dengan tipe data BackboneElement." /> </element> <element id="ClaimResponse.processNote.number"> <path value="ClaimResponse.processNote.number" /> <definition value="Berisi data nomor unik untuk mengidentifikasi entri catatan dengan tipe data positiveInt." /> <min value="1" /> </element> <element id="ClaimResponse.processNote.type"> <path value="ClaimResponse.processNote.type" /> <definition value="Berisi data tujuan bisnis dari teks catatan dengan tipe data code yang nilainya mengacu pada data terminologi NoteType." /> </element> <element id="ClaimResponse.processNote.text"> <path value="ClaimResponse.processNote.text" /> <definition value="Berisi data penjelasan atau deskripsi yang terkait dengan pemrosesan dengan tipe data string." /> </element> <element id="ClaimResponse.processNote.language"> <path value="ClaimResponse.processNote.language" /> <definition value="Berisi data kode untuk menentukan bahasa yang digunakan dalam teks catatan dengan tipe data CodeableConcept yang nilainya lebih baik mengacu pada contoh data terminologi urn:ietf:bcp:47[Common Languages]." /> </element> <element id="ClaimResponse.communicationRequest"> <path value="ClaimResponse.communicationRequest" /> <definition value="Berisi data permintaan informasi pendukung atau otorisasi tambahan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource CommunicationRequest." /> </element> <element id="ClaimResponse.insurance"> <path value="ClaimResponse.insurance" /> <definition value="Berisi data instrumen keuangan untuk penggantian produk dan layanan perawatan kesehatan yang ditentukan pada klaim. Semua pertanggungan asuransi untuk pasien yang mungkin berlaku untuk penggantian, dari produk dan layanan yang tercantum dalam klaim, biasanya diberikan dalam klaim untuk memungkinkan perusahaan asuransi mengkonfirmasi pemesanan pertanggungan asuransi relatif terhadap aturan 'koordinasi manfaat' setempat. Satu liputan (dan hanya satu) dengan 'focal=true' akan digunakan dalam putusan klaim ini. Cakupan muncul sebelum Cakupan fokus dalam daftar, dan di mana 'subrogasi = salah', harus memberikan referensi ke ClaimResponse berisi hasil ajudikasi dari klaim sebelumnya dengan tipe data BackboneElement." /> </element> <element id="ClaimResponse.insurance.sequence"> <path value="ClaimResponse.insurance.sequence" /> <definition value="Berisi nomor unik untuk mengidentifikasi entri asuransi dan memberikan urutan pertanggungan untuk menyampaikan koordinasi urutan manfaat dengan tipe data positiveInt." /> </element> <element id="ClaimResponse.insurance.focal"> <path value="ClaimResponse.insurance.focal" /> <definition value="Berisi data penanda untuk menunjukkan bahwa cakupan yang tersebut akan digunakan untuk keputusan klaim bila disetel ke true dengan tipe data booelan." /> </element> <element id="ClaimResponse.insurance.coverage"> <path value="ClaimResponse.insurance.coverage" /> <definition value="Berisi data referensi ke informasi tingkat kartu asuransi yang terdapat pada resource Coverage. Perusahaan asuransi yang mengeluarkan pertanggungan akan menggunakan perincian ini untuk menemukan pertanggungan aktual pasien dalam sistem informasi perusahaan asuransi. Tipe data yang digunakan adalah Reference yang direferensikan ke data yang tersimpan di resource Coverage." /> </element> <element id="ClaimResponse.insurance.businessArrangement"> <path value="ClaimResponse.insurance.businessArrangement" /> <definition value="Berisi data nomor perjanjian bisnis yang dibuat antara penyedia dan perusahaan asuransi untuk tujuan pemrosesan bisnis khusus dengan tipe data string." /> </element> <element id="ClaimResponse.insurance.claimResponse"> <path value="ClaimResponse.insurance.claimResponse" /> <definition value="Berisi data hasil ajudikasi item baris untuk pertanggungan yang ditentukan dalam asuransi dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource ClaimResponse." /> </element> <element id="ClaimResponse.error"> <path value="ClaimResponse.error" /> <definition value="Berisi data kesalahan yang ditemui selama proses ajudikasi dengan tipe data BackboneElement." /> </element> <element id="ClaimResponse.error.itemSequence"> <path value="ClaimResponse.error.itemSequence" /> <definition value="Berisi data nomor urut item baris yang dikirimkan yang berisi kesalahan. Nilai ini dihilangkan ketika kesalahan terjadi di luar struktur item. Tipe data yang digunakan adalah positiveInt." /> </element> <element id="ClaimResponse.error.detailSequence"> <path value="ClaimResponse.error.detailSequence" /> <definition value="Berisi data nomor urut detail dalam item baris yang dikirimkan yang berisi kesalahan. Nilai ini dihilangkan ketika kesalahan terjadi di luar struktur item. Tipe data yang digunakan adalah positiveInt." /> </element> <element id="ClaimResponse.error.subDetailSequence"> <path value="ClaimResponse.error.subDetailSequence" /> <definition value="Berisi data nomor urut sub-detail dalam detail dalam item baris yang dikirimkan yang berisi kesalahan. Nilai ini dihilangkan ketika kesalahan terjadi di luar struktur item. Tipe data yang digunakan adalah positiveInt." /> </element> <element id="ClaimResponse.error.code"> <path value="ClaimResponse.error.code" /> <definition value="Berisi data kode kesalahan, dari sistem kode tertentu, yang merinci mengapa klaim tidak dapat diajudikasi dengan tipe data CodeableConcept yang nilainya dapat mengacu pada contoh data terminologi AdjudicationError." /> </element> </differential> </StructureDefinition>