blob: 117504fe81214d336351441f1df066d877e2d6c3 [file] [log] [blame]
/**
*/
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 Item</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.ExplanationOfBenefitItem#getSequence <em>Sequence</em>}</li>
* <li>{@link org.hl7.fhir.ExplanationOfBenefitItem#getType <em>Type</em>}</li>
* <li>{@link org.hl7.fhir.ExplanationOfBenefitItem#getProvider <em>Provider</em>}</li>
* <li>{@link org.hl7.fhir.ExplanationOfBenefitItem#getDiagnosisLinkId <em>Diagnosis Link Id</em>}</li>
* <li>{@link org.hl7.fhir.ExplanationOfBenefitItem#getService <em>Service</em>}</li>
* <li>{@link org.hl7.fhir.ExplanationOfBenefitItem#getServicedDate <em>Serviced Date</em>}</li>
* <li>{@link org.hl7.fhir.ExplanationOfBenefitItem#getServicedPeriod <em>Serviced Period</em>}</li>
* <li>{@link org.hl7.fhir.ExplanationOfBenefitItem#getPlace <em>Place</em>}</li>
* <li>{@link org.hl7.fhir.ExplanationOfBenefitItem#getQuantity <em>Quantity</em>}</li>
* <li>{@link org.hl7.fhir.ExplanationOfBenefitItem#getUnitPrice <em>Unit Price</em>}</li>
* <li>{@link org.hl7.fhir.ExplanationOfBenefitItem#getFactor <em>Factor</em>}</li>
* <li>{@link org.hl7.fhir.ExplanationOfBenefitItem#getPoints <em>Points</em>}</li>
* <li>{@link org.hl7.fhir.ExplanationOfBenefitItem#getNet <em>Net</em>}</li>
* <li>{@link org.hl7.fhir.ExplanationOfBenefitItem#getUdi <em>Udi</em>}</li>
* <li>{@link org.hl7.fhir.ExplanationOfBenefitItem#getBodySite <em>Body Site</em>}</li>
* <li>{@link org.hl7.fhir.ExplanationOfBenefitItem#getSubSite <em>Sub Site</em>}</li>
* <li>{@link org.hl7.fhir.ExplanationOfBenefitItem#getModifier <em>Modifier</em>}</li>
* <li>{@link org.hl7.fhir.ExplanationOfBenefitItem#getNoteNumber <em>Note Number</em>}</li>
* <li>{@link org.hl7.fhir.ExplanationOfBenefitItem#getAdjudication <em>Adjudication</em>}</li>
* <li>{@link org.hl7.fhir.ExplanationOfBenefitItem#getDetail <em>Detail</em>}</li>
* <li>{@link org.hl7.fhir.ExplanationOfBenefitItem#getProsthesis <em>Prosthesis</em>}</li>
* </ul>
*
* @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitItem()
* @model extendedMetaData="name='ExplanationOfBenefit.Item' kind='elementOnly'"
* @generated
*/
public interface ExplanationOfBenefitItem extends BackboneElement {
/**
* Returns the value of the '<em><b>Sequence</b></em>' containment reference.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* <!-- begin-model-doc -->
* A service line number.
* <!-- end-model-doc -->
* @return the value of the '<em>Sequence</em>' containment reference.
* @see #setSequence(PositiveInt)
* @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitItem_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.ExplanationOfBenefitItem#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>Type</b></em>' containment reference.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* <!-- begin-model-doc -->
* The type of product or service.
* <!-- end-model-doc -->
* @return the value of the '<em>Type</em>' containment reference.
* @see #setType(Coding)
* @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitItem_Type()
* @model containment="true" required="true"
* extendedMetaData="kind='element' name='type' namespace='##targetNamespace'"
* @generated
*/
Coding getType();
/**
* Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitItem#getType <em>Type</em>}' containment reference.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* @param value the new value of the '<em>Type</em>' containment reference.
* @see #getType()
* @generated
*/
void setType(Coding value);
/**
* Returns the value of the '<em><b>Provider</b></em>' containment reference.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* <!-- begin-model-doc -->
* The practitioner who is responsible for the services rendered to the patient.
* <!-- end-model-doc -->
* @return the value of the '<em>Provider</em>' containment reference.
* @see #setProvider(Reference)
* @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitItem_Provider()
* @model containment="true"
* extendedMetaData="kind='element' name='provider' namespace='##targetNamespace'"
* @generated
*/
Reference getProvider();
/**
* Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitItem#getProvider <em>Provider</em>}' containment reference.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* @param value the new value of the '<em>Provider</em>' containment reference.
* @see #getProvider()
* @generated
*/
void setProvider(Reference value);
/**
* Returns the value of the '<em><b>Diagnosis Link Id</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 -->
* Diagnosis applicable for this service or product line.
* <!-- end-model-doc -->
* @return the value of the '<em>Diagnosis Link Id</em>' containment reference list.
* @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitItem_DiagnosisLinkId()
* @model containment="true"
* extendedMetaData="kind='element' name='diagnosisLinkId' namespace='##targetNamespace'"
* @generated
*/
EList<PositiveInt> getDiagnosisLinkId();
/**
* Returns the value of the '<em><b>Service</b></em>' containment reference.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* <!-- begin-model-doc -->
* If a grouping item then 'GROUP' otherwise it is a node therefore a code to indicate the Professional Service or Product supplied.
* <!-- end-model-doc -->
* @return the value of the '<em>Service</em>' containment reference.
* @see #setService(Coding)
* @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitItem_Service()
* @model containment="true" required="true"
* extendedMetaData="kind='element' name='service' namespace='##targetNamespace'"
* @generated
*/
Coding getService();
/**
* Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitItem#getService <em>Service</em>}' containment reference.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* @param value the new value of the '<em>Service</em>' containment reference.
* @see #getService()
* @generated
*/
void setService(Coding value);
/**
* Returns the value of the '<em><b>Serviced Date</b></em>' containment reference.
* <!-- begin-user-doc -->
* <p>
* If the meaning of the '<em>Serviced Date</em>' containment reference isn't clear,
* there really should be more of a description here...
* </p>
* <!-- end-user-doc -->
* @return the value of the '<em>Serviced Date</em>' containment reference.
* @see #setServicedDate(Date)
* @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitItem_ServicedDate()
* @model containment="true"
* extendedMetaData="kind='element' name='servicedDate' namespace='##targetNamespace'"
* @generated
*/
Date getServicedDate();
/**
* Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitItem#getServicedDate <em>Serviced Date</em>}' containment reference.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* @param value the new value of the '<em>Serviced Date</em>' containment reference.
* @see #getServicedDate()
* @generated
*/
void setServicedDate(Date value);
/**
* Returns the value of the '<em><b>Serviced Period</b></em>' containment reference.
* <!-- begin-user-doc -->
* <p>
* If the meaning of the '<em>Serviced Period</em>' containment reference isn't clear,
* there really should be more of a description here...
* </p>
* <!-- end-user-doc -->
* @return the value of the '<em>Serviced Period</em>' containment reference.
* @see #setServicedPeriod(Period)
* @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitItem_ServicedPeriod()
* @model containment="true"
* extendedMetaData="kind='element' name='servicedPeriod' namespace='##targetNamespace'"
* @generated
*/
Period getServicedPeriod();
/**
* Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitItem#getServicedPeriod <em>Serviced Period</em>}' containment reference.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* @param value the new value of the '<em>Serviced Period</em>' containment reference.
* @see #getServicedPeriod()
* @generated
*/
void setServicedPeriod(Period value);
/**
* Returns the value of the '<em><b>Place</b></em>' containment reference.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* <!-- begin-model-doc -->
* Where the service was provided.
* <!-- end-model-doc -->
* @return the value of the '<em>Place</em>' containment reference.
* @see #setPlace(Coding)
* @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitItem_Place()
* @model containment="true"
* extendedMetaData="kind='element' name='place' namespace='##targetNamespace'"
* @generated
*/
Coding getPlace();
/**
* Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitItem#getPlace <em>Place</em>}' containment reference.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* @param value the new value of the '<em>Place</em>' containment reference.
* @see #getPlace()
* @generated
*/
void setPlace(Coding value);
/**
* 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(SimpleQuantity)
* @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitItem_Quantity()
* @model containment="true"
* extendedMetaData="kind='element' name='quantity' namespace='##targetNamespace'"
* @generated
*/
SimpleQuantity getQuantity();
/**
* Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitItem#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(SimpleQuantity 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 a node then this is the fee for the product or service, otherwise this is the total of the fees for the children 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#getExplanationOfBenefitItem_UnitPrice()
* @model containment="true"
* extendedMetaData="kind='element' name='unitPrice' namespace='##targetNamespace'"
* @generated
*/
Money getUnitPrice();
/**
* Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitItem#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#getExplanationOfBenefitItem_Factor()
* @model containment="true"
* extendedMetaData="kind='element' name='factor' namespace='##targetNamespace'"
* @generated
*/
Decimal getFactor();
/**
* Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitItem#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>Points</b></em>' containment reference.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* <!-- begin-model-doc -->
* An amount that expresses the weighting (based on difficulty, cost and/or resource intensiveness) associated with the good or service delivered. The concept of Points allows for assignment of point values for services and/or goods, such that a monetary amount can be assigned to each point.
* <!-- end-model-doc -->
* @return the value of the '<em>Points</em>' containment reference.
* @see #setPoints(Decimal)
* @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitItem_Points()
* @model containment="true"
* extendedMetaData="kind='element' name='points' namespace='##targetNamespace'"
* @generated
*/
Decimal getPoints();
/**
* Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitItem#getPoints <em>Points</em>}' containment reference.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* @param value the new value of the '<em>Points</em>' containment reference.
* @see #getPoints()
* @generated
*/
void setPoints(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 addittional service or product or charge. For example, the formula: unit Quantity * unit Price (Cost per Point) * factor Number * points = net Amount. Quantity, factor and points are assumed to be 1 if not supplied.
* <!-- end-model-doc -->
* @return the value of the '<em>Net</em>' containment reference.
* @see #setNet(Money)
* @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitItem_Net()
* @model containment="true"
* extendedMetaData="kind='element' name='net' namespace='##targetNamespace'"
* @generated
*/
Money getNet();
/**
* Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitItem#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.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* <!-- begin-model-doc -->
* List of Unique Device Identifiers associated with this line item.
* <!-- end-model-doc -->
* @return the value of the '<em>Udi</em>' containment reference.
* @see #setUdi(Coding)
* @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitItem_Udi()
* @model containment="true"
* extendedMetaData="kind='element' name='udi' namespace='##targetNamespace'"
* @generated
*/
Coding getUdi();
/**
* Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitItem#getUdi <em>Udi</em>}' containment reference.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* @param value the new value of the '<em>Udi</em>' containment reference.
* @see #getUdi()
* @generated
*/
void setUdi(Coding value);
/**
* Returns the value of the '<em><b>Body Site</b></em>' containment reference.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* <!-- begin-model-doc -->
* Physical service site on the patient (limb, tooth, etc).
* <!-- end-model-doc -->
* @return the value of the '<em>Body Site</em>' containment reference.
* @see #setBodySite(Coding)
* @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitItem_BodySite()
* @model containment="true"
* extendedMetaData="kind='element' name='bodySite' namespace='##targetNamespace'"
* @generated
*/
Coding getBodySite();
/**
* Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitItem#getBodySite <em>Body Site</em>}' containment reference.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* @param value the new value of the '<em>Body Site</em>' containment reference.
* @see #getBodySite()
* @generated
*/
void setBodySite(Coding value);
/**
* Returns the value of the '<em><b>Sub Site</b></em>' containment reference list.
* The list contents are of type {@link org.hl7.fhir.Coding}.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* <!-- begin-model-doc -->
* A region or surface of the site, eg. limb region or tooth surface(s).
* <!-- end-model-doc -->
* @return the value of the '<em>Sub Site</em>' containment reference list.
* @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitItem_SubSite()
* @model containment="true"
* extendedMetaData="kind='element' name='subSite' namespace='##targetNamespace'"
* @generated
*/
EList<Coding> getSubSite();
/**
* Returns the value of the '<em><b>Modifier</b></em>' containment reference list.
* The list contents are of type {@link org.hl7.fhir.Coding}.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* <!-- begin-model-doc -->
* Item typification or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
* <!-- end-model-doc -->
* @return the value of the '<em>Modifier</em>' containment reference list.
* @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitItem_Modifier()
* @model containment="true"
* extendedMetaData="kind='element' name='modifier' namespace='##targetNamespace'"
* @generated
*/
EList<Coding> getModifier();
/**
* 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 -->
* A list of note references to the notes provided below.
* <!-- end-model-doc -->
* @return the value of the '<em>Note Number</em>' containment reference list.
* @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitItem_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 adjudications results.
* <!-- end-model-doc -->
* @return the value of the '<em>Adjudication</em>' containment reference list.
* @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitItem_Adjudication()
* @model containment="true"
* extendedMetaData="kind='element' name='adjudication' namespace='##targetNamespace'"
* @generated
*/
EList<ExplanationOfBenefitAdjudication> getAdjudication();
/**
* Returns the value of the '<em><b>Detail</b></em>' containment reference list.
* The list contents are of type {@link org.hl7.fhir.ExplanationOfBenefitDetail}.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* <!-- begin-model-doc -->
* Second tier of goods and services.
* <!-- end-model-doc -->
* @return the value of the '<em>Detail</em>' containment reference list.
* @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitItem_Detail()
* @model containment="true"
* extendedMetaData="kind='element' name='detail' namespace='##targetNamespace'"
* @generated
*/
EList<ExplanationOfBenefitDetail> getDetail();
/**
* Returns the value of the '<em><b>Prosthesis</b></em>' containment reference.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* <!-- begin-model-doc -->
* The materials and placement date of prior fixed prosthesis.
* <!-- end-model-doc -->
* @return the value of the '<em>Prosthesis</em>' containment reference.
* @see #setProsthesis(ExplanationOfBenefitProsthesis)
* @see org.hl7.fhir.FhirPackage#getExplanationOfBenefitItem_Prosthesis()
* @model containment="true"
* extendedMetaData="kind='element' name='prosthesis' namespace='##targetNamespace'"
* @generated
*/
ExplanationOfBenefitProsthesis getProsthesis();
/**
* Sets the value of the '{@link org.hl7.fhir.ExplanationOfBenefitItem#getProsthesis <em>Prosthesis</em>}' containment reference.
* <!-- begin-user-doc -->
* <!-- end-user-doc -->
* @param value the new value of the '<em>Prosthesis</em>' containment reference.
* @see #getProsthesis()
* @generated
*/
void setProsthesis(ExplanationOfBenefitProsthesis value);
} // ExplanationOfBenefitItem