@medplum/fhirtypes 0.3.0

package/dist/ClaimResponse.d.ts

@@ -0,0 +1,1204 @@
+/*
+ * Generated by @medplum/generator
+ * Do not edit manually.
+ */
+
+import { Address } from './Address';
+import { Attachment } from './Attachment';
+import { Claim } from './Claim';
+import { CodeableConcept } from './CodeableConcept';
+import { CommunicationRequest } from './CommunicationRequest';
+import { Coverage } from './Coverage';
+import { Extension } from './Extension';
+import { Identifier } from './Identifier';
+import { Location } from './Location';
+import { Meta } from './Meta';
+import { Money } from './Money';
+import { Narrative } from './Narrative';
+import { Organization } from './Organization';
+import { Patient } from './Patient';
+import { Period } from './Period';
+import { Practitioner } from './Practitioner';
+import { PractitionerRole } from './PractitionerRole';
+import { Quantity } from './Quantity';
+import { Reference } from './Reference';
+import { Resource } from './Resource';
+
+/**
+ * This resource provides the adjudication details from the processing of
+ * a Claim resource.
+ */
+export interface ClaimResponse {
+
+  /**
+   * This is a ClaimResponse resource
+   */
+  readonly resourceType: 'ClaimResponse';
+
+  /**
+   * The logical id of the resource, as used in the URL for the resource.
+   * Once assigned, this value never changes.
+   */
+  readonly id?: string;
+
+  /**
+   * 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.
+   */
+  readonly meta?: Meta;
+
+  /**
+   * 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.
+   */
+  readonly implicitRules?: string;
+
+  /**
+   * The base language in which the resource is written.
+   */
+  readonly language?: string;
+
+  /**
+   * 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.
+   */
+  readonly text?: Narrative;
+
+  /**
+   * 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.
+   */
+  readonly contained?: Resource[];
+
+  /**
+   * 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.
+   */
+  readonly extension?: Extension[];
+
+  /**
+   * 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).
+   */
+  readonly modifierExtension?: Extension[];
+
+  /**
+   * A unique identifier assigned to this claim response.
+   */
+  readonly identifier?: Identifier[];
+
+  /**
+   * The status of the resource instance.
+   */
+  readonly status?: string;
+
+  /**
+   * A finer grained suite of claim type codes which may convey additional
+   * information such as Inpatient vs Outpatient and/or a specialty
+   * service.
+   */
+  readonly type?: CodeableConcept;
+
+  /**
+   * A finer grained suite of claim type codes which may convey additional
+   * information such as Inpatient vs Outpatient and/or a specialty
+   * service.
+   */
+  readonly subType?: CodeableConcept;
+
+  /**
+   * A code to indicate whether the nature of the request is: to request
+   * adjudication of products and services previously rendered; or
+   * requesting authorization and adjudication for provision in the future;
+   * or requesting the non-binding adjudication of the listed products and
+   * services which could be provided in the future.
+   */
+  readonly use?: string;
+
+  /**
+   * The party to whom the professional services and/or products have been
+   * supplied or are being considered and for whom actual for facast
+   * reimbursement is sought.
+   */
+  readonly patient?: Reference<Patient>;
+
+  /**
+   * The date this resource was created.
+   */
+  readonly created?: string;
+
+  /**
+   * The party responsible for authorization, adjudication and
+   * reimbursement.
+   */
+  readonly insurer?: Reference<Organization>;
+
+  /**
+   * The provider which is responsible for the claim, predetermination or
+   * preauthorization.
+   */
+  readonly requestor?: Reference<Practitioner | PractitionerRole | Organization>;
+
+  /**
+   * Original request resource reference.
+   */
+  readonly request?: Reference<Claim>;
+
+  /**
+   * The outcome of the claim, predetermination, or preauthorization
+   * processing.
+   */
+  readonly outcome?: string;
+
+  /**
+   * A human readable description of the status of the adjudication.
+   */
+  readonly disposition?: string;
+
+  /**
+   * Reference from the Insurer which is used in later communications which
+   * refers to this adjudication.
+   */
+  readonly preAuthRef?: string;
+
+  /**
+   * The time frame during which this authorization is effective.
+   */
+  readonly preAuthPeriod?: Period;
+
+  /**
+   * Type of Party to be reimbursed: subscriber, provider, other.
+   */
+  readonly payeeType?: CodeableConcept;
+
+  /**
+   * A claim line. Either a simple (a product or service) or a 'group' of
+   * details which can also be a simple items or groups of sub-details.
+   */
+  readonly item?: ClaimResponseItem[];
+
+  /**
+   * The first-tier service adjudications for payor added product or
+   * service lines.
+   */
+  readonly addItem?: ClaimResponseAddItem[];
+
+  /**
+   * The adjudication results which are presented at the header level
+   * rather than at the line-item or add-item levels.
+   */
+  readonly adjudication?: ClaimResponseItemAdjudication[];
+
+  /**
+   * Categorized monetary totals for the adjudication.
+   */
+  readonly total?: ClaimResponseTotal[];
+
+  /**
+   * Payment details for the adjudication of the claim.
+   */
+  readonly payment?: ClaimResponsePayment;
+
+  /**
+   * A code, used only on a response to a preauthorization, to indicate
+   * whether the benefits payable have been reserved and for whom.
+   */
+  readonly fundsReserve?: CodeableConcept;
+
+  /**
+   * A code for the form to be used for printing the content.
+   */
+  readonly formCode?: CodeableConcept;
+
+  /**
+   * The actual form, by reference or inclusion, for printing the content
+   * or an EOB.
+   */
+  readonly form?: Attachment;
+
+  /**
+   * A note that describes or explains adjudication results in a human
+   * readable form.
+   */
+  readonly processNote?: ClaimResponseProcessNote[];
+
+  /**
+   * Request for additional supporting or authorizing information.
+   */
+  readonly communicationRequest?: Reference<CommunicationRequest>[];
+
+  /**
+   * Financial instruments for reimbursement for the health care products
+   * and services specified on the claim.
+   */
+  readonly insurance?: ClaimResponseInsurance[];
+
+  /**
+   * Errors encountered during the processing of the adjudication.
+   */
+  readonly error?: ClaimResponseError[];
+}
+
+/**
+ * The first-tier service adjudications for payor added product or
+ * service lines.
+ */
+export interface ClaimResponseAddItem {
+
+  /**
+   * Unique id for the element within a resource (for internal references).
+   * This may be any string value that does not contain spaces.
+   */
+  readonly id?: string;
+
+  /**
+   * 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.
+   */
+  readonly extension?: Extension[];
+
+  /**
+   * 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).
+   */
+  readonly modifierExtension?: Extension[];
+
+  /**
+   * Claim items which this service line is intended to replace.
+   */
+  readonly itemSequence?: number[];
+
+  /**
+   * The sequence number of the details within the claim item which this
+   * line is intended to replace.
+   */
+  readonly detailSequence?: number[];
+
+  /**
+   * The sequence number of the sub-details within the details within the
+   * claim item which this line is intended to replace.
+   */
+  readonly subdetailSequence?: number[];
+
+  /**
+   * The providers who are authorized for the services rendered to the
+   * patient.
+   */
+  readonly provider?: Reference<Practitioner | PractitionerRole | Organization>[];
+
+  /**
+   * When the value is a group code then this item collects a set of
+   * related claim details, otherwise this contains the product, service,
+   * drug or other billing code for the item.
+   */
+  readonly productOrService?: CodeableConcept;
+
+  /**
+   * Item typification or modifiers codes to convey additional context for
+   * the product or service.
+   */
+  readonly modifier?: CodeableConcept[];
+
+  /**
+   * Identifies the program under which this may be recovered.
+   */
+  readonly programCode?: CodeableConcept[];
+
+  /**
+   * The date or dates when the service or product was supplied, performed
+   * or completed.
+   */
+  readonly servicedDate?: string;
+
+  /**
+   * The date or dates when the service or product was supplied, performed
+   * or completed.
+   */
+  readonly servicedPeriod?: Period;
+
+  /**
+   * Where the product or service was provided.
+   */
+  readonly locationCodeableConcept?: CodeableConcept;
+
+  /**
+   * Where the product or service was provided.
+   */
+  readonly locationAddress?: Address;
+
+  /**
+   * Where the product or service was provided.
+   */
+  readonly locationReference?: Reference<Location>;
+
+  /**
+   * The number of repetitions of a service or product.
+   */
+  readonly quantity?: Quantity;
+
+  /**
+   * If the item is not a group then this is the fee for the product or
+   * service, otherwise this is the total of the fees for the details of
+   * the group.
+   */
+  readonly unitPrice?: Money;
+
+  /**
+   * A real number that represents a multiplier used in determining the
+   * overall value of services delivered and/or goods received. The concept
+   * of a Factor allows for a discount or surcharge multiplier to be
+   * applied to a monetary amount.
+   */
+  readonly factor?: number;
+
+  /**
+   * The quantity times the unit price for an additional service or product
+   * or charge.
+   */
+  readonly net?: Money;
+
+  /**
+   * Physical service site on the patient (limb, tooth, etc.).
+   */
+  readonly bodySite?: CodeableConcept;
+
+  /**
+   * A region or surface of the bodySite, e.g. limb region or tooth
+   * surface(s).
+   */
+  readonly subSite?: CodeableConcept[];
+
+  /**
+   * The numbers associated with notes below which apply to the
+   * adjudication of this item.
+   */
+  readonly noteNumber?: number[];
+
+  /**
+   * The adjudication results.
+   */
+  readonly adjudication?: ClaimResponseItemAdjudication[];
+
+  /**
+   * The second-tier service adjudications for payor added services.
+   */
+  readonly detail?: ClaimResponseAddItemDetail[];
+}
+
+/**
+ * The second-tier service adjudications for payor added services.
+ */
+export interface ClaimResponseAddItemDetail {
+
+  /**
+   * Unique id for the element within a resource (for internal references).
+   * This may be any string value that does not contain spaces.
+   */
+  readonly id?: string;
+
+  /**
+   * 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.
+   */
+  readonly extension?: Extension[];
+
+  /**
+   * 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).
+   */
+  readonly modifierExtension?: Extension[];
+
+  /**
+   * When the value is a group code then this item collects a set of
+   * related claim details, otherwise this contains the product, service,
+   * drug or other billing code for the item.
+   */
+  readonly productOrService?: CodeableConcept;
+
+  /**
+   * Item typification or modifiers codes to convey additional context for
+   * the product or service.
+   */
+  readonly modifier?: CodeableConcept[];
+
+  /**
+   * The number of repetitions of a service or product.
+   */
+  readonly quantity?: Quantity;
+
+  /**
+   * If the item is not a group then this is the fee for the product or
+   * service, otherwise this is the total of the fees for the details of
+   * the group.
+   */
+  readonly unitPrice?: Money;
+
+  /**
+   * A real number that represents a multiplier used in determining the
+   * overall value of services delivered and/or goods received. The concept
+   * of a Factor allows for a discount or surcharge multiplier to be
+   * applied to a monetary amount.
+   */
+  readonly factor?: number;
+
+  /**
+   * The quantity times the unit price for an additional service or product
+   * or charge.
+   */
+  readonly net?: Money;
+
+  /**
+   * The numbers associated with notes below which apply to the
+   * adjudication of this item.
+   */
+  readonly noteNumber?: number[];
+
+  /**
+   * The adjudication results.
+   */
+  readonly adjudication?: ClaimResponseItemAdjudication[];
+
+  /**
+   * The third-tier service adjudications for payor added services.
+   */
+  readonly subDetail?: ClaimResponseAddItemDetailSubDetail[];
+}
+
+/**
+ * The third-tier service adjudications for payor added services.
+ */
+export interface ClaimResponseAddItemDetailSubDetail {
+
+  /**
+   * Unique id for the element within a resource (for internal references).
+   * This may be any string value that does not contain spaces.
+   */
+  readonly id?: string;
+
+  /**
+   * 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.
+   */
+  readonly extension?: Extension[];
+
+  /**
+   * 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).
+   */
+  readonly modifierExtension?: Extension[];
+
+  /**
+   * When the value is a group code then this item collects a set of
+   * related claim details, otherwise this contains the product, service,
+   * drug or other billing code for the item.
+   */
+  readonly productOrService?: CodeableConcept;
+
+  /**
+   * Item typification or modifiers codes to convey additional context for
+   * the product or service.
+   */
+  readonly modifier?: CodeableConcept[];
+
+  /**
+   * The number of repetitions of a service or product.
+   */
+  readonly quantity?: Quantity;
+
+  /**
+   * If the item is not a group then this is the fee for the product or
+   * service, otherwise this is the total of the fees for the details of
+   * the group.
+   */
+  readonly unitPrice?: Money;
+
+  /**
+   * A real number that represents a multiplier used in determining the
+   * overall value of services delivered and/or goods received. The concept
+   * of a Factor allows for a discount or surcharge multiplier to be
+   * applied to a monetary amount.
+   */
+  readonly factor?: number;
+
+  /**
+   * The quantity times the unit price for an additional service or product
+   * or charge.
+   */
+  readonly net?: Money;
+
+  /**
+   * The numbers associated with notes below which apply to the
+   * adjudication of this item.
+   */
+  readonly noteNumber?: number[];
+
+  /**
+   * The adjudication results.
+   */
+  readonly adjudication?: ClaimResponseItemAdjudication[];
+}
+
+/**
+ * Errors encountered during the processing of the adjudication.
+ */
+export interface ClaimResponseError {
+
+  /**
+   * Unique id for the element within a resource (for internal references).
+   * This may be any string value that does not contain spaces.
+   */
+  readonly id?: string;
+
+  /**
+   * 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.
+   */
+  readonly extension?: Extension[];
+
+  /**
+   * 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).
+   */
+  readonly modifierExtension?: Extension[];
+
+  /**
+   * The sequence number of the line item submitted which contains the
+   * error. This value is omitted when the error occurs outside of the item
+   * structure.
+   */
+  readonly itemSequence?: number;
+
+  /**
+   * The sequence number of the detail within the line item submitted which
+   * contains the error. This value is omitted when the error occurs
+   * outside of the item structure.
+   */
+  readonly detailSequence?: number;
+
+  /**
+   * The sequence number of the sub-detail within the detail within the
+   * line item submitted which contains the error. This value is omitted
+   * when the error occurs outside of the item structure.
+   */
+  readonly subDetailSequence?: number;
+
+  /**
+   * An error code, from a specified code system, which details why the
+   * claim could not be adjudicated.
+   */
+  readonly code?: CodeableConcept;
+}
+
+/**
+ * Financial instruments for reimbursement for the health care products
+ * and services specified on the claim.
+ */
+export interface ClaimResponseInsurance {
+
+  /**
+   * Unique id for the element within a resource (for internal references).
+   * This may be any string value that does not contain spaces.
+   */
+  readonly id?: string;
+
+  /**
+   * 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.
+   */
+  readonly extension?: Extension[];
+
+  /**
+   * 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).
+   */
+  readonly modifierExtension?: Extension[];
+
+  /**
+   * A number to uniquely identify insurance entries and provide a sequence
+   * of coverages to convey coordination of benefit order.
+   */
+  readonly sequence?: number;
+
+  /**
+   * A flag to indicate that this Coverage is to be used for adjudication
+   * of this claim when set to true.
+   */
+  readonly focal?: boolean;
+
+  /**
+   * Reference to the insurance card level information contained in the
+   * Coverage resource. The coverage issuing insurer will use these details
+   * to locate the patient's actual coverage within the insurer's
+   * information system.
+   */
+  readonly coverage?: Reference<Coverage>;
+
+  /**
+   * A business agreement number established between the provider and the
+   * insurer for special business processing purposes.
+   */
+  readonly businessArrangement?: string;
+
+  /**
+   * The result of the adjudication of the line items for the Coverage
+   * specified in this insurance.
+   */
+  readonly claimResponse?: Reference<ClaimResponse>;
+}
+
+/**
+ * A claim line. Either a simple (a product or service) or a 'group' of
+ * details which can also be a simple items or groups of sub-details.
+ */
+export interface ClaimResponseItem {
+
+  /**
+   * Unique id for the element within a resource (for internal references).
+   * This may be any string value that does not contain spaces.
+   */
+  readonly id?: string;
+
+  /**
+   * 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.
+   */
+  readonly extension?: Extension[];
+
+  /**
+   * 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).
+   */
+  readonly modifierExtension?: Extension[];
+
+  /**
+   * A number to uniquely reference the claim item entries.
+   */
+  readonly itemSequence?: number;
+
+  /**
+   * The numbers associated with notes below which apply to the
+   * adjudication of this item.
+   */
+  readonly noteNumber?: number[];
+
+  /**
+   * If this item is a group then the values here are a summary of the
+   * adjudication of the detail items. If this item is a simple product or
+   * service then this is the result of the adjudication of this item.
+   */
+  readonly adjudication?: ClaimResponseItemAdjudication[];
+
+  /**
+   * A claim detail. Either a simple (a product or service) or a 'group' of
+   * sub-details which are simple items.
+   */
+  readonly detail?: ClaimResponseItemDetail[];
+}
+
+/**
+ * If this item is a group then the values here are a summary of the
+ * adjudication of the detail items. If this item is a simple product or
+ * service then this is the result of the adjudication of this item.
+ */
+export interface ClaimResponseItemAdjudication {
+
+  /**
+   * Unique id for the element within a resource (for internal references).
+   * This may be any string value that does not contain spaces.
+   */
+  readonly id?: string;
+
+  /**
+   * 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.
+   */
+  readonly extension?: Extension[];
+
+  /**
+   * 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).
+   */
+  readonly modifierExtension?: Extension[];
+
+  /**
+   * A code to indicate the information type of this adjudication record.
+   * Information types may include the value submitted, maximum values or
+   * percentages allowed or payable under the plan, amounts that: the
+   * patient is responsible for in aggregate or pertaining to this item;
+   * amounts paid by other coverages; and, the benefit payable for this
+   * item.
+   */
+  readonly category?: CodeableConcept;
+
+  /**
+   * A code supporting the understanding of the adjudication result and
+   * explaining variance from expected amount.
+   */
+  readonly reason?: CodeableConcept;
+
+  /**
+   * Monetary amount associated with the category.
+   */
+  readonly amount?: Money;
+
+  /**
+   * A non-monetary value associated with the category. Mutually exclusive
+   * to the amount element above.
+   */
+  readonly value?: number;
+}
+
+/**
+ * A claim detail. Either a simple (a product or service) or a 'group' of
+ * sub-details which are simple items.
+ */
+export interface ClaimResponseItemDetail {
+
+  /**
+   * Unique id for the element within a resource (for internal references).
+   * This may be any string value that does not contain spaces.
+   */
+  readonly id?: string;
+
+  /**
+   * 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.
+   */
+  readonly extension?: Extension[];
+
+  /**
+   * 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).
+   */
+  readonly modifierExtension?: Extension[];
+
+  /**
+   * A number to uniquely reference the claim detail entry.
+   */
+  readonly detailSequence?: number;
+
+  /**
+   * The numbers associated with notes below which apply to the
+   * adjudication of this item.
+   */
+  readonly noteNumber?: number[];
+
+  /**
+   * The adjudication results.
+   */
+  readonly adjudication?: ClaimResponseItemAdjudication[];
+
+  /**
+   * A sub-detail adjudication of a simple product or service.
+   */
+  readonly subDetail?: ClaimResponseItemDetailSubDetail[];
+}
+
+/**
+ * A sub-detail adjudication of a simple product or service.
+ */
+export interface ClaimResponseItemDetailSubDetail {
+
+  /**
+   * Unique id for the element within a resource (for internal references).
+   * This may be any string value that does not contain spaces.
+   */
+  readonly id?: string;
+
+  /**
+   * 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.
+   */
+  readonly extension?: Extension[];
+
+  /**
+   * 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).
+   */
+  readonly modifierExtension?: Extension[];
+
+  /**
+   * A number to uniquely reference the claim sub-detail entry.
+   */
+  readonly subDetailSequence?: number;
+
+  /**
+   * The numbers associated with notes below which apply to the
+   * adjudication of this item.
+   */
+  readonly noteNumber?: number[];
+
+  /**
+   * The adjudication results.
+   */
+  readonly adjudication?: ClaimResponseItemAdjudication[];
+}
+
+/**
+ * Payment details for the adjudication of the claim.
+ */
+export interface ClaimResponsePayment {
+
+  /**
+   * Unique id for the element within a resource (for internal references).
+   * This may be any string value that does not contain spaces.
+   */
+  readonly id?: string;
+
+  /**
+   * 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.
+   */
+  readonly extension?: Extension[];
+
+  /**
+   * 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).
+   */
+  readonly modifierExtension?: Extension[];
+
+  /**
+   * Whether this represents partial or complete payment of the benefits
+   * payable.
+   */
+  readonly type?: CodeableConcept;
+
+  /**
+   * Total amount of all adjustments to this payment included in this
+   * transaction which are not related to this claim's adjudication.
+   */
+  readonly adjustment?: Money;
+
+  /**
+   * Reason for the payment adjustment.
+   */
+  readonly adjustmentReason?: CodeableConcept;
+
+  /**
+   * Estimated date the payment will be issued or the actual issue date of
+   * payment.
+   */
+  readonly date?: string;
+
+  /**
+   * Benefits payable less any payment adjustment.
+   */
+  readonly amount?: Money;
+
+  /**
+   * Issuer's unique identifier for the payment instrument.
+   */
+  readonly identifier?: Identifier;
+}
+
+/**
+ * A note that describes or explains adjudication results in a human
+ * readable form.
+ */
+export interface ClaimResponseProcessNote {
+
+  /**
+   * Unique id for the element within a resource (for internal references).
+   * This may be any string value that does not contain spaces.
+   */
+  readonly id?: string;
+
+  /**
+   * 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.
+   */
+  readonly extension?: Extension[];
+
+  /**
+   * 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).
+   */
+  readonly modifierExtension?: Extension[];
+
+  /**
+   * A number to uniquely identify a note entry.
+   */
+  readonly number?: number;
+
+  /**
+   * The business purpose of the note text.
+   */
+  readonly type?: string;
+
+  /**
+   * The explanation or description associated with the processing.
+   */
+  readonly text?: string;
+
+  /**
+   * A code to define the language used in the text of the note.
+   */
+  readonly language?: CodeableConcept;
+}
+
+/**
+ * Categorized monetary totals for the adjudication.
+ */
+export interface ClaimResponseTotal {
+
+  /**
+   * Unique id for the element within a resource (for internal references).
+   * This may be any string value that does not contain spaces.
+   */
+  readonly id?: string;
+
+  /**
+   * 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.
+   */
+  readonly extension?: Extension[];
+
+  /**
+   * 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).
+   */
+  readonly modifierExtension?: Extension[];
+
+  /**
+   * A code to indicate the information type of this adjudication record.
+   * Information types may include: the value submitted, maximum values or
+   * percentages allowed or payable under the plan, amounts that the
+   * patient is responsible for in aggregate or pertaining to this item,
+   * amounts paid by other coverages, and the benefit payable for this
+   * item.
+   */
+  readonly category?: CodeableConcept;
+
+  /**
+   * Monetary total amount associated with the category.
+   */
+  readonly amount?: Money;
+}