Change amounttype.amount from 'May' to 'Must' in item-level adjudication.  

The current IG states —

In the institutional EOBs:

   - must have either header or item-level adjudication

       - header-level adjudication, if present, must include an amounttype slice, and this must include a $ amount. (1..1 MS)

       - item-level adjudication, if present, must include an amounttype slice, and this may include a $ amount  (0..1 MS)

   - total is required, and must include an amounttype slice, and this must include a $ amount. (1..1 MS).  (like header-level adjudication)

In the pharmacy and Professional  EOB:
       - item-level adjudication is required, and  must include an amounttype slice, and this may * include a*$ amount  (0..1 MS)

       - total is required, and must include an amounttype slice, and this must include a $ amount. (1..1 MS).  (like header-level adjudication)

In all four profiles change the cardinality of item.amounttype from (0..1) to (1..1)