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Source1

{
  "resourceType": "CodeSystem",
  "id": "adjudication",
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-ballot-status",
      "valueString": "Informative"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 1
    },
    {
      "extension": [
        {
          "url": "packageId",
          "valueId": "hl7.fhir.uv.xver-r3.r4b"
        },
        {
          "url": "version",
          "valueString": "0.0.1-snapshot-2"
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/package-source"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "fm"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode": "informative",
      "_valueCode": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical": "http://hl7.org/fhir/3.0/ImplementationGuide/hl7.fhir.uv.xver-r3.r4b"
          }
        ]
      }
    }
  ],
  "url": "http://hl7.org/fhir/adjudication",
  "version": "3.0.2",
  "name": "Adjudication Value Codes",
  "status": "draft",
  "experimental": true,
  "date": "2025-09-13T15:45:17-04:00",
  "publisher": "Financial Management",
  "contact": [
    {
      "name": "Financial Management",
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/fm"
        }
      ]
    }
  ],
  "description": "This value set includes a smattering of Adjudication Value codes which includes codes to indicate the amounts eligible under the plan, the amount of benefit, copays etc.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001",
          "display": "World"
        }
      ]
    }
  ],
  "copyright": "This is an example set.",
  "caseSensitive": true,
  "valueSet": "http://hl7.org/fhir/ValueSet/adjudication|4.3.0",
  "content": "complete",
  "concept": [
    {
      "code": "total",
      "display": "Total",
      "definition": "Total submitted"
    },
    {
      "code": "copay",
      "display": "CoPay",
      "definition": "Patient Co-Payment"
    },
    {
      "code": "eligible",
      "display": "Eligible Amount",
      "definition": "Amount of the change which is considered for adjudication"
    },
    {
      "code": "deductible",
      "display": "Deductable",
      "definition": "Amount deducted from the eligible amount prior to adjudication"
    },
    {
      "code": "eligpercent",
      "display": "Eligible %",
      "definition": "Eligible Percentage"
    },
    {
      "code": "tax",
      "display": "Emergency Department",
      "definition": "Emergency Department"
    },
    {
      "code": "benefit",
      "display": "Benefit Amount",
      "definition": "Amount payable under the coverage"
    }
  ]
}