| id | String | No description |
| extension | [Extension] | No description |
| modifierExtension | [Extension] | No description |
| productOrService | CodeableConcept! | No description |
| modifier | [CodeableConcept] | No description |
| quantity | Quantity | No description |
| unitPrice | Money | No description |
| factor | decimal | No description |
| _factor | ElementBase | No description |
| net | Money | No description |
| noteNumber | positiveInt | No description |
| _noteNumber | [ElementBase] | No description |
| adjudication | [ExplanationOfBenefitItemAdjudication] | No description |
| subDetail | [ExplanationOfBenefitAddItemDetailSubDetail] | No description |