Draft2.16.840.1.113883.4.642.4.1171 - Adjudication Value Codes - FHIR: http://terminology.hl7.org/CodeSystem/adjudication
| Level/ Type | Code | Display Name | Code System | Code System Version | Designations | Description |
|---|---|---|---|---|---|---|
| 0‑L | submitted | Submitted Amount | Adjudication Value Codes | 2019-10-30T00:00:00 |  Preferred: Submitted Amount | The total submitted amount for the claim or group or line item. |
| 0‑L | copay | CoPay | Adjudication Value Codes | 2019-10-30T00:00:00 | Preferred: CoPay | Patient Co-Payment |
| 0‑L | eligible | Eligible Amount | Adjudication Value Codes | 2019-10-30T00:00:00 | Preferred: Eligible Amount | Amount of the change which is considered for adjudication. |
| 0‑L | deductible | Deductible | Adjudication Value Codes | 2019-10-30T00:00:00 | Preferred: Deductible | Amount deducted from the eligible amount prior to adjudication. |
| 0‑L | unallocdeduct | Unallocated Deductible | Adjudication Value Codes | 2019-10-30T00:00:00 | Preferred: Unallocated Deductible | The amount of deductible which could not allocated to other line items. |
| 0‑L | eligpercent | Eligible % | Adjudication Value Codes | 2019-10-30T00:00:00 | Preferred: Eligible % | Eligible Percentage. |
| 0‑L | tax | Tax | Adjudication Value Codes | 2019-10-30T00:00:00 | Preferred: Tax | The amount of tax. |
| 0‑L | benefit | Benefit Amount | Adjudication Value Codes | 2019-10-30T00:00:00 | Preferred: Benefit Amount | Amount payable under the coverage |
