Release 4 4B

This page is part of the FHIR Specification (v4.0.1: R4 (v4.3.0: R4B - Mixed Normative and STU ) in it's permanent home (it will always be available at this URL). ). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R4B R4

Financial Management Work Group Maturity Level : 2   Trial Use Compartments : Patient , Practitioner

Dependency Graph for ClaimResponse FMM level 2

Name Card. Type Dependency Analysis
. . ClaimResponse DomainResource
. . . identifier 0..* Identifier
. . . status 1..1 code
. . . type 1..1 CodeableConcept
. . . subType 0..1 CodeableConcept
. . . use 1..1 code
. . . patient 1..1 Reference ( Patient )
. . . created 1..1 dateTime
. . . insurer 1..1 Reference ( Organization )
. . . requestor 0..1 Reference ( Practitioner | PractitionerRole | Organization )
. . . request 0..1 Reference ( Claim )
. . . outcome 1..1 code
. . . disposition 0..1 string
. . . preAuthRef 0..1 string
. . . preAuthPeriod 0..1 Period
. . . payeeType 0..1 CodeableConcept
. . . item 0..* BackboneElement
. . . . itemSequence 1..1 positiveInt
. . . . noteNumber 0..* positiveInt
. . . . adjudication 1..* BackboneElement
. . . . . category 1..1 CodeableConcept
. . . . . reason 0..1 CodeableConcept
. . . . . amount 0..1 Money
. . . . . value 0..1 decimal
. . . . detail 0..* BackboneElement
. . . . . detailSequence 1..1 positiveInt
. . . . . noteNumber 0..* positiveInt
. . . . . adjudication 1..* see adjudication
. . . . . subDetail 0..* BackboneElement
. . . . . . subDetailSequence 1..1 positiveInt
. . . . . . noteNumber 0..* positiveInt
. . . . . . adjudication 0..* see adjudication
. . . addItem 0..* BackboneElement
. . . . itemSequence 0..* positiveInt
. . . . detailSequence 0..* positiveInt
. . . . subdetailSequence 0..* positiveInt
. . . . provider 0..* Reference ( Practitioner | PractitionerRole | Organization )
. . . . productOrService 1..1 CodeableConcept
. . . . modifier 0..* CodeableConcept
. . . . programCode 0..* CodeableConcept
. . . . serviced[x] 0..1
. . . . . servicedDate date
. . . . . servicedPeriod Period
. . . . location[x] 0..1
. . . . . locationCodeableConcept CodeableConcept
. . . . . locationAddress Address
. . . . . locationReference Reference ( Location
. . . . quantity 0..1 SimpleQuantity
. . . . unitPrice 0..1 Money
. . . . factor 0..1 decimal
. . . . net 0..1 Money
. . . . bodySite 0..1 CodeableConcept
. . . . subSite 0..* CodeableConcept
. . . . noteNumber 0..* positiveInt
. . . . adjudication 1..* see adjudication
. . . . detail 0..* BackboneElement
. . . . . productOrService 1..1 CodeableConcept
. . . . . modifier 0..* CodeableConcept
. . . . . quantity 0..1 SimpleQuantity
. . . . . unitPrice 0..1 Money
. . . . . factor 0..1 decimal
. . . . . net 0..1 Money
. . . . . noteNumber 0..* positiveInt
. . . . . adjudication 1..* see adjudication
. . . . . subDetail 0..* BackboneElement
. . . . . . productOrService 1..1 CodeableConcept
. . . . . . modifier 0..* CodeableConcept
. . . . . . quantity 0..1 SimpleQuantity
. . . . . . unitPrice 0..1 Money
. . . . . . factor 0..1 decimal
. . . . . . net 0..1 Money
. . . . . . noteNumber 0..* positiveInt
. . . . . . adjudication 1..* see adjudication
. . . adjudication 0..* see adjudication
. . . total 0..* BackboneElement
. . . . category 1..1 CodeableConcept
. . . . amount 1..1 Money
. . . payment 0..1 BackboneElement
. . . . type 1..1 CodeableConcept
. . . . adjustment 0..1 Money
. . . . adjustmentReason 0..1 CodeableConcept
. . . . date 0..1 date
. . . . amount 1..1 Money
. . . . identifier 0..1 Identifier
. . . fundsReserve 0..1 CodeableConcept
. . . formCode 0..1 CodeableConcept
. . . form 0..1 Attachment
. . . processNote 0..* BackboneElement
. . . . number 0..1 positiveInt
. . . . type 0..1 code
. . . . text 1..1 string
. . . . language 0..1 CodeableConcept
. . . communicationRequest 0..* Reference ( CommunicationRequest )
. . . insurance 0..* BackboneElement
. . . . sequence 1..1 positiveInt
. . . . focal 1..1 boolean
. . . . coverage 1..1 Reference ( Coverage )
. . . . businessArrangement 0..1 string
. . . . claimResponse 0..1 Reference ( ClaimResponse )
. . . error 0..* BackboneElement
. . . . itemSequence 0..1 positiveInt
. . . . detailSequence 0..1 positiveInt
. . . . subDetailSequence 0..1 positiveInt
. . . . code 1..1 CodeableConcept