Uses the Component:AdjustmentReasonType
Reason that adjustment was made on request
Table 6.10. Fields and Components
| Name | Description | Occurrence | Type | Data Type | User Notes |
|---|---|---|---|---|---|
| AdjustedReasonCode |
Free form text of reason(s) Claim was adjusted | 0..1 | Field | udt:CodeType | |
| AdjustedAmount |
Difference between the submitted amount and the paid amount | 0..1 | Field | udt:AmountType | |
| Tax |
Amount of tax on Adjusted Amount | 0..* | Component | TaxType |
The XML Sample provided here is an approximation of the generated XML for this component. Not all of the fields are required for implementation.
Example 6.10. AdjustmentReason
<AdjustmentReason>
<AdjustedReasonCode>......</AdjustedReasonCode> [0..1]
<AdjustedAmount>......</AdjustedAmount> [0..1]
<Tax>......</Tax> [0..*]
</AdjustmentReason>