> ## Documentation Index > Fetch the complete documentation index at: https://docs.metriport.com/llms.txt > Use this file to discover all available pages before exploring further. # ClaimResponse > This resource provides the adjudication details from the processing of a Claim resource. ## Properties | Name | Required | Type | Description | | --------------------- | -------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------ | | identifier | No | [Identifier](/medical-api/fhir/data-types/identifier)\[] | Business Identifier for a claim response | | status | Yes | code | active / cancelled / draft / entered-in-error | | type | Yes | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept) | More granular claim type | | subType | No | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept) | More granular claim type | | use | Yes | code | claim / preauthorization / predetermination | | patient | Yes | Reference\<[Patient](/medical-api/fhir/resources/patient)> | The recipient of the products and services | | created | Yes | dateTime | Response creation date | | insurer | Yes | Reference\<[Organization](/medical-api/fhir/resources/organization)> | Party responsible for reimbursement | | requestor | No | Reference\<[Practitioner](/medical-api/fhir/resources/practitioner) / [PractitionerRole](/medical-api/fhir/resources/practitionerrole) / [Organization](/medical-api/fhir/resources/organization)> | Party responsible for the claim | | request | No | Reference\<[Claim](/medical-api/fhir/resources/claim)> | Id of resource triggering adjudication | | outcome | Yes | code | queued / complete / error / partial | | disposition | No | string | Disposition Message | | preAuthRef | No | string | Preauthorization reference | | preAuthPeriod | No | [Period](/medical-api/fhir/data-types/period) | Preauthorization reference effective period | | payeeType | No | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept) | Party to be paid any benefits payable | | item | No | ClaimResponseItem | Adjudication for claim line items | | - id | No | string | Unique id for inter-element referencing | | - extension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Additional content defined by implementations | | - modifierExtension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Extensions that cannot be ignored even if unrecognized | | - itemSequence | Yes | positiveInt | Claim item instance identifier | | - noteNumber | No | positiveInt\[] | Applicable note numbers | | - adjudication | Yes | ClaimResponseItemAdjudication | Adjudication details | | - id | No | string | Unique id for inter-element referencing | | - extension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Additional content defined by implementations | | - modifierExtension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Extensions that cannot be ignored even if unrecognized | | - category | Yes | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept) | Type of adjudication information | | - reason | No | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept) | Explanation of adjudication outcome | | - amount | No | [Money](/medical-api/fhir/data-types/money) | Monetary amount | | - value | No | decimal | Non-monetary value | | - detail | No | ClaimResponseItemDetail | Adjudication for claim details | | - id | No | string | Unique id for inter-element referencing | | - extension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Additional content defined by implementations | | - modifierExtension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Extensions that cannot be ignored even if unrecognized | | - detailSequence | Yes | positiveInt | Claim detail instance identifier | | - noteNumber | No | positiveInt\[] | Applicable note numbers | | - adjudication | Yes | \[] | Detail level adjudication details | | - subDetail | No | ClaimResponseItemDetailSubDetail | Adjudication for claim sub-details | | - id | No | string | Unique id for inter-element referencing | | - extension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Additional content defined by implementations | | - modifierExtension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Extensions that cannot be ignored even if unrecognized | | - subDetailSequence | Yes | positiveInt | Claim sub-detail instance identifier | | - noteNumber | No | positiveInt\[] | Applicable note numbers | | - adjudication | No | \[] | Subdetail level adjudication details | | addItem | No | ClaimResponseAddItem | Insurer added line items | | - id | No | string | Unique id for inter-element referencing | | - extension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Additional content defined by implementations | | - modifierExtension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Extensions that cannot be ignored even if unrecognized | | - itemSequence | No | positiveInt\[] | Item sequence number | | - detailSequence | No | positiveInt\[] | Detail sequence number | | - subdetailSequence | No | positiveInt\[] | Subdetail sequence number | | - provider | No | Reference\<[Practitioner](/medical-api/fhir/resources/practitioner) / [PractitionerRole](/medical-api/fhir/resources/practitionerrole) / [Organization](/medical-api/fhir/resources/organization)>\[] | Authorized providers | | - productOrService | Yes | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept) | Billing, service, product, or drug code | | - modifier | No | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept)\[] | Service/Product billing modifiers | | - programCode | No | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept)\[] | Program the product or service is provided under | | - serviced\[x] | No | date, [Period](/medical-api/fhir/data-types/period) | Date or dates of service or product delivery | | - location\[x] | No | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept), [Address](/medical-api/fhir/data-types/address), Reference\<[Location](/medical-api/fhir/resources/location)> | Place of service or where product was supplied | | - quantity | No | [Quantity](/medical-api/fhir/data-types/quantity) | Count of products or services | | - unitPrice | No | [Money](/medical-api/fhir/data-types/money) | Fee, charge or cost per item | | - factor | No | decimal | Price scaling factor | | - net | No | [Money](/medical-api/fhir/data-types/money) | Total item cost | | - bodySite | No | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept) | Anatomical location | | - subSite | No | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept)\[] | Anatomical sub-location | | - noteNumber | No | positiveInt\[] | Applicable note numbers | | - adjudication | Yes | \[] | Added items adjudication | | - detail | No | ClaimResponseAddItemDetail | Insurer added line details | | - id | No | string | Unique id for inter-element referencing | | - extension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Additional content defined by implementations | | - modifierExtension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Extensions that cannot be ignored even if unrecognized | | - productOrService | Yes | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept) | Billing, service, product, or drug code | | - modifier | No | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept)\[] | Service/Product billing modifiers | | - quantity | No | [Quantity](/medical-api/fhir/data-types/quantity) | Count of products or services | | - unitPrice | No | [Money](/medical-api/fhir/data-types/money) | Fee, charge or cost per item | | - factor | No | decimal | Price scaling factor | | - net | No | [Money](/medical-api/fhir/data-types/money) | Total item cost | | - noteNumber | No | positiveInt\[] | Applicable note numbers | | - adjudication | Yes | \[] | Added items detail adjudication | | - subDetail | No | ClaimResponseAddItemDetailSubDetail | Insurer added line items | | - id | No | string | Unique id for inter-element referencing | | - extension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Additional content defined by implementations | | - modifierExtension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Extensions that cannot be ignored even if unrecognized | | - productOrService | Yes | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept) | Billing, service, product, or drug code | | - modifier | No | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept)\[] | Service/Product billing modifiers | | - quantity | No | [Quantity](/medical-api/fhir/data-types/quantity) | Count of products or services | | - unitPrice | No | [Money](/medical-api/fhir/data-types/money) | Fee, charge or cost per item | | - factor | No | decimal | Price scaling factor | | - net | No | [Money](/medical-api/fhir/data-types/money) | Total item cost | | - noteNumber | No | positiveInt\[] | Applicable note numbers | | - adjudication | Yes | \[] | Added items detail adjudication | | adjudication | No | \[] | Header-level adjudication | | total | No | ClaimResponseTotal | Adjudication totals | | - id | No | string | Unique id for inter-element referencing | | - extension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Additional content defined by implementations | | - modifierExtension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Extensions that cannot be ignored even if unrecognized | | - category | Yes | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept) | Type of adjudication information | | - amount | Yes | [Money](/medical-api/fhir/data-types/money) | Financial total for the category | | payment | No | ClaimResponsePayment | Payment Details | | - id | No | string | Unique id for inter-element referencing | | - extension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Additional content defined by implementations | | - modifierExtension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Extensions that cannot be ignored even if unrecognized | | - type | Yes | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept) | Partial or complete payment | | - adjustment | No | [Money](/medical-api/fhir/data-types/money) | Payment adjustment for non-claim issues | | - adjustmentReason | No | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept) | Explanation for the adjustment | | - date | No | date | Expected date of payment | | - amount | Yes | [Money](/medical-api/fhir/data-types/money) | Payable amount after adjustment | | - identifier | No | [Identifier](/medical-api/fhir/data-types/identifier) | Business identifier for the payment | | fundsReserve | No | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept) | Funds reserved status | | formCode | No | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept) | Printed form identifier | | form | No | [Attachment](/medical-api/fhir/data-types/attachment) | Printed reference or actual form | | processNote | No | ClaimResponseProcessNote | Note concerning adjudication | | - id | No | string | Unique id for inter-element referencing | | - extension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Additional content defined by implementations | | - modifierExtension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Extensions that cannot be ignored even if unrecognized | | - number | No | positiveInt | Note instance identifier | | - type | No | code | display / print / printoper | | - text | Yes | string | Note explanatory text | | - language | No | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept) | Language of the text | | communicationRequest | No | Reference\<[CommunicationRequest](/medical-api/fhir/resources/communicationrequest)>\[] | Request for additional information | | insurance | No | ClaimResponseInsurance | Patient insurance information | | - id | No | string | Unique id for inter-element referencing | | - extension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Additional content defined by implementations | | - modifierExtension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Extensions that cannot be ignored even if unrecognized | | - sequence | Yes | positiveInt | Insurance instance identifier | | - focal | Yes | boolean | Coverage to be used for adjudication | | - coverage | Yes | Reference\<[Coverage](/medical-api/fhir/resources/coverage)> | Insurance information | | - businessArrangement | No | string | Additional provider contract number | | - claimResponse | No | Reference\<[ClaimResponse](/medical-api/fhir/resources/claimresponse)> | Adjudication results | | error | No | ClaimResponseError | Processing errors | | - id | No | string | Unique id for inter-element referencing | | - extension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Additional content defined by implementations | | - modifierExtension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Extensions that cannot be ignored even if unrecognized | | - itemSequence | No | positiveInt | Item sequence number | | - detailSequence | No | positiveInt | Detail sequence number | | - subDetailSequence | No | positiveInt | Subdetail sequence number | | - code | Yes | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept) | Error code detailing processing issues | ## Search Parameters | Name | Type | Description | Expression | | ------------ | --------- | ---------------------------------------------- | -------------------------- | | created | date | The creation date | ClaimResponse.created | | disposition | string | The contents of the disposition message | ClaimResponse.disposition | | identifier | token | The identity of the ClaimResponse | ClaimResponse.identifier | | insurer | reference | The organization which generated this resource | ClaimResponse.insurer | | outcome | token | The processing outcome | ClaimResponse.outcome | | patient | reference | The subject of care | ClaimResponse.patient | | payment-date | date | The expected payment date | ClaimResponse.payment.date | | request | reference | The claim reference | ClaimResponse.request | | requestor | reference | The Provider of the claim | ClaimResponse.requestor | | status | token | The status of the ClaimResponse | ClaimResponse.status | | use | token | The type of claim | ClaimResponse.use | ## Inherited Properties | Name | Required | Type | Description | | ----------------- | -------- | ------------------------------------------------------ | ------------------------------------------------------ | | id | No | string | Logical id of this artifact | | meta | No | [Meta](/medical-api/fhir/data-types/meta) | Metadata about the resource | | implicitRules | No | uri | A set of rules under which this content was created | | language | No | code | Language of the resource content | | text | No | [Narrative](/medical-api/fhir/data-types/narrative) | Text summary of the resource, for human interpretation | | contained | No | Resource\[] | Contained, inline Resources | | extension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Additional content defined by implementations | | modifierExtension | No | [Extension](/medical-api/fhir/data-types/extension)\[] | Extensions that cannot be ignored | To view the FHIR specification for this resource, see [ClaimResponse](https://www.hl7.org/fhir/StructureDefinition/ClaimResponse).