From Daniel Venton:

Can you explain how the type element has 2 coding elements?

. type SΣ 1..1 CodeableConcept Specifies the type of claim. (e.g., inpatient insitutional, outpatient institutional, physician, etc.) (16)
Binding: ClaimTypeCodes (required)
Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
.... text 0..1 string Plain text representation of the concept
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding SΣ 1..1 Coding Code defined by a terminology system