| /** |
| */ |
| package org.hl7.fhir; |
| |
| import org.eclipse.emf.common.util.EList; |
| |
| /** |
| * <!-- begin-user-doc --> |
| * A representation of the model object '<em><b>Explanation Of Benefit Detail</b></em>'. |
| * <!-- end-user-doc --> |
| * |
| * <!-- begin-model-doc --> |
| * This resource provides: the claim details; adjudication details from the processing of a Claim; and optionally account balance information, for informing the subscriber of the benefits provided. |
| * <!-- end-model-doc --> |
| * |
| * <p> |
| * The following features are supported: |
| * </p> |
| * <ul> |
| * <li>{@link org.hl7.fhir.ExplanationOfBenefitDetail#getSequence <em>Sequence</em>}</li> |
| * <li>{@link org.hl7.fhir.ExplanationOfBenefitDetail#getRevenue <em>Revenue</em>}</li> |
| * <li>{@link org.hl7.fhir.ExplanationOfBenefitDetail#getCategory <em>Category</em>}</li> |
| * <li>{@link org.hl7.fhir.ExplanationOfBenefitDetail#getProductOrService <em>Product Or Service</em>}</li> |
| * <li>{@link org.hl7.fhir.ExplanationOfBenefitDetail#getModifier <em>Modifier</em>}</li> |
| * <li>{@link org.hl7.fhir.ExplanationOfBenefitDetail#getProgramCode <em>Program Code</em>}</li> |
| * <li>{@link org.hl7.fhir.ExplanationOfBenefitDetail#getQuantity <em>Quantity</em>}</li> |
| * <li>{@link org.hl7.fhir.ExplanationOfBenefitDetail#getUnitPrice <em>Unit Price</em>}</li> |
| * <li>{@link org.hl7.fhir.ExplanationOfBenefitDetail#getFactor <em>Factor</em>}</li> |
| * <li>{@link org.hl7.fhir.ExplanationOfBenefitDetail#getNet <em>Net</em>}</li> |
| * <li>{@link org.hl7.fhir.ExplanationOfBenefitDetail#getUdi <em>Udi</em>}</li> |
| * <li>{@link org.hl7.fhir.ExplanationOfBenefitDetail#getNoteNumber <em>Note Number</em>}</li> |
| * <li>{@link org.hl7.fhir.ExplanationOfBenefitDetail#getAdjudication <em>Adjudication</em>}</li> |
| * <li>{@link org.hl7.fhir.ExplanationOfBenefitDetail#getSubDetail <em>Sub Detail</em>}</li> |
| * </ul> |
| * |
| * @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitDetail() |
| * @model extendedMetaData="name='ExplanationOfBenefit.Detail' kind='elementOnly'" |
| * @generated |
| */ |
| public interface ExplanationOfBenefitDetail extends BackboneElement { |
| /** |
| * Returns the value of the '<em><b>Sequence</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Sequence</em>' containment reference. |
| * @see #setSequence(PositiveInt) |
| * @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitDetail_Sequence() |
| * @model containment="true" required="true" |
| * extendedMetaData="kind='element' name='sequence' namespace='##targetNamespace'" |
| * @generated |
| */ |
| PositiveInt getSequence(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitDetail#getSequence <em>Sequence</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Sequence</em>' containment reference. |
| * @see #getSequence() |
| * @generated |
| */ |
| void setSequence(PositiveInt value); |
| |
| /** |
| * Returns the value of the '<em><b>Revenue</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * The type of revenue or cost center providing the product and/or service. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Revenue</em>' containment reference. |
| * @see #setRevenue(CodeableConcept) |
| * @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitDetail_Revenue() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='revenue' namespace='##targetNamespace'" |
| * @generated |
| */ |
| CodeableConcept getRevenue(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitDetail#getRevenue <em>Revenue</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Revenue</em>' containment reference. |
| * @see #getRevenue() |
| * @generated |
| */ |
| void setRevenue(CodeableConcept value); |
| |
| /** |
| * Returns the value of the '<em><b>Category</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * Code to identify the general type of benefits under which products and services are provided. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Category</em>' containment reference. |
| * @see #setCategory(CodeableConcept) |
| * @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitDetail_Category() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='category' namespace='##targetNamespace'" |
| * @generated |
| */ |
| CodeableConcept getCategory(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitDetail#getCategory <em>Category</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Category</em>' containment reference. |
| * @see #getCategory() |
| * @generated |
| */ |
| void setCategory(CodeableConcept value); |
| |
| /** |
| * Returns the value of the '<em><b>Product Or Service</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * 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. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Product Or Service</em>' containment reference. |
| * @see #setProductOrService(CodeableConcept) |
| * @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitDetail_ProductOrService() |
| * @model containment="true" required="true" |
| * extendedMetaData="kind='element' name='productOrService' namespace='##targetNamespace'" |
| * @generated |
| */ |
| CodeableConcept getProductOrService(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitDetail#getProductOrService <em>Product Or Service</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Product Or Service</em>' containment reference. |
| * @see #getProductOrService() |
| * @generated |
| */ |
| void setProductOrService(CodeableConcept value); |
| |
| /** |
| * Returns the value of the '<em><b>Modifier</b></em>' containment reference list. |
| * The list contents are of type {@link org.hl7.fhir.CodeableConcept}. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * Item typification or modifiers codes to convey additional context for the product or service. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Modifier</em>' containment reference list. |
| * @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitDetail_Modifier() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='modifier' namespace='##targetNamespace'" |
| * @generated |
| */ |
| EList<CodeableConcept> getModifier(); |
| |
| /** |
| * Returns the value of the '<em><b>Program Code</b></em>' containment reference list. |
| * The list contents are of type {@link org.hl7.fhir.CodeableConcept}. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * Identifies the program under which this may be recovered. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Program Code</em>' containment reference list. |
| * @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitDetail_ProgramCode() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='programCode' namespace='##targetNamespace'" |
| * @generated |
| */ |
| EList<CodeableConcept> getProgramCode(); |
| |
| /** |
| * Returns the value of the '<em><b>Quantity</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * The number of repetitions of a service or product. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Quantity</em>' containment reference. |
| * @see #setQuantity(Quantity) |
| * @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitDetail_Quantity() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='quantity' namespace='##targetNamespace'" |
| * @generated |
| */ |
| Quantity getQuantity(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitDetail#getQuantity <em>Quantity</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Quantity</em>' containment reference. |
| * @see #getQuantity() |
| * @generated |
| */ |
| void setQuantity(Quantity value); |
| |
| /** |
| * Returns the value of the '<em><b>Unit Price</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * 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. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Unit Price</em>' containment reference. |
| * @see #setUnitPrice(Money) |
| * @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitDetail_UnitPrice() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='unitPrice' namespace='##targetNamespace'" |
| * @generated |
| */ |
| Money getUnitPrice(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitDetail#getUnitPrice <em>Unit Price</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Unit Price</em>' containment reference. |
| * @see #getUnitPrice() |
| * @generated |
| */ |
| void setUnitPrice(Money value); |
| |
| /** |
| * Returns the value of the '<em><b>Factor</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * 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. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Factor</em>' containment reference. |
| * @see #setFactor(Decimal) |
| * @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitDetail_Factor() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='factor' namespace='##targetNamespace'" |
| * @generated |
| */ |
| Decimal getFactor(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitDetail#getFactor <em>Factor</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Factor</em>' containment reference. |
| * @see #getFactor() |
| * @generated |
| */ |
| void setFactor(Decimal value); |
| |
| /** |
| * Returns the value of the '<em><b>Net</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * The quantity times the unit price for an additional service or product or charge. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Net</em>' containment reference. |
| * @see #setNet(Money) |
| * @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitDetail_Net() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='net' namespace='##targetNamespace'" |
| * @generated |
| */ |
| Money getNet(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitDetail#getNet <em>Net</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Net</em>' containment reference. |
| * @see #getNet() |
| * @generated |
| */ |
| void setNet(Money value); |
| |
| /** |
| * Returns the value of the '<em><b>Udi</b></em>' containment reference list. |
| * The list contents are of type {@link org.hl7.fhir.Reference}. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * Unique Device Identifiers associated with this line item. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Udi</em>' containment reference list. |
| * @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitDetail_Udi() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='udi' namespace='##targetNamespace'" |
| * @generated |
| */ |
| EList<Reference> getUdi(); |
| |
| /** |
| * Returns the value of the '<em><b>Note Number</b></em>' containment reference list. |
| * The list contents are of type {@link org.hl7.fhir.PositiveInt}. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * The numbers associated with notes below which apply to the adjudication of this item. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Note Number</em>' containment reference list. |
| * @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitDetail_NoteNumber() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='noteNumber' namespace='##targetNamespace'" |
| * @generated |
| */ |
| EList<PositiveInt> getNoteNumber(); |
| |
| /** |
| * Returns the value of the '<em><b>Adjudication</b></em>' containment reference list. |
| * The list contents are of type {@link org.hl7.fhir.ExplanationOfBenefitAdjudication}. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * The adjudication results. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Adjudication</em>' containment reference list. |
| * @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitDetail_Adjudication() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='adjudication' namespace='##targetNamespace'" |
| * @generated |
| */ |
| EList<ExplanationOfBenefitAdjudication> getAdjudication(); |
| |
| /** |
| * Returns the value of the '<em><b>Sub Detail</b></em>' containment reference list. |
| * The list contents are of type {@link org.hl7.fhir.ExplanationOfBenefitSubDetail}. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * Third-tier of goods and services. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Sub Detail</em>' containment reference list. |
| * @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitDetail_SubDetail() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='subDetail' namespace='##targetNamespace'" |
| * @generated |
| */ |
| EList<ExplanationOfBenefitSubDetail> getSubDetail(); |
| |
| } // ExplanationOfBenefitDetail |
