| id | String | No description |
| extension | [Extension] | No description |
| modifierExtension | [Extension] | No description |
| itemSequence | positiveInt | No description |
| _itemSequence | [ElementBase] | No description |
| detailSequence | positiveInt | No description |
| _detailSequence | [ElementBase] | No description |
| subdetailSequence | positiveInt | No description |
| _subdetailSequence | [ElementBase] | No description |
| provider | [Reference] | No description |
| productOrService | CodeableConcept! | No description |
| modifier | [CodeableConcept] | No description |
| programCode | [CodeableConcept] | No description |
| servicedDate | date | No description |
| _servicedDate | ElementBase | No description |
| servicedPeriod | Period | No description |
| locationCodeableConcept | CodeableConcept | No description |
| locationAddress | Address | No description |
| locationReference | Reference | No description |
| quantity | Quantity | No description |
| unitPrice | Money | No description |
| factor | decimal | No description |
| _factor | ElementBase | No description |
| net | Money | No description |
| bodySite | CodeableConcept | No description |
| subSite | [CodeableConcept] | No description |
| noteNumber | positiveInt | No description |
| _noteNumber | [ElementBase] | No description |
| adjudication | [ClaimResponseItemAdjudication]! | No description |
| detail | [ClaimResponseAddItemDetail] | No description |