Termini

CodeSystemsConceptSystemsStructureDefinitionsValueSetsPackagesConflicts
StructureDefinitionsExplanationOfBenefit

http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit|5.0.0

This resource provides: the claim details; adjudication details from the processing of a Claim; and optionally account balance information, for informing the subscriber of the benefits provided.
StructureJSONDependenciesFHIRSchemaOther VersionsDependant (0)ElementsSummary
Base: http://hl7.org/fhir/StructureDefinition/DomainResource4.0.1, 5.0.0, 4.0.1
Type: ExplanationOfBenefit (a.k.a: http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit)
Type dependencies: 24
Elements
accident: BackboneElement
id: http://hl7.org/fhirpath/System.String
extension: Extension
modifierExtension: Extension
date: date
type: CodeableConcept
location[x]: Address,Reference
addItem: BackboneElement
request: Reference
modifier: CodeableConcept
revenue: CodeableConcept
adjudication:
productOrServiceEnd: CodeableConcept
traceNumber: Identifier
itemSequence: positiveInt
net: Money
detailSequence: positiveInt
tax: Money
productOrService: CodeableConcept
extension: Extension
programCode: CodeableConcept
factor: decimal
id: http://hl7.org/fhirpath/System.String
subDetailSequence: positiveInt
bodySite: BackboneElement
id: http://hl7.org/fhirpath/System.String
extension: Extension
modifierExtension: Extension
site: CodeableReference
subSite: CodeableConcept
serviced[x]: date,Period
quantity: Quantity
location[x]: CodeableConcept,Address,Reference
provider: Reference
noteNumber: positiveInt
patientPaid: Money
unitPrice: Money
modifierExtension: Extension
reviewOutcome:
detail: BackboneElement
modifier: CodeableConcept
revenue: CodeableConcept
adjudication:
productOrServiceEnd: CodeableConcept
traceNumber: Identifier
net: Money
tax: Money
productOrService: CodeableConcept
extension: Extension
factor: decimal
id: http://hl7.org/fhirpath/System.String
subDetail: BackboneElement
modifier: CodeableConcept
revenue: CodeableConcept
adjudication:
productOrServiceEnd: CodeableConcept
traceNumber: Identifier
net: Money
tax: Money
productOrService: CodeableConcept
extension: Extension
factor: decimal
id: http://hl7.org/fhirpath/System.String
quantity: Quantity
noteNumber: positiveInt
patientPaid: Money
unitPrice: Money
modifierExtension: Extension
reviewOutcome:
quantity: Quantity
noteNumber: positiveInt
patientPaid: Money
unitPrice: Money
modifierExtension: Extension
reviewOutcome:
adjudication:
benefitBalance: BackboneElement
description: string
category: CodeableConcept
unit: CodeableConcept
excluded: boolean
name: string
financial: BackboneElement
id: http://hl7.org/fhirpath/System.String
extension: Extension
modifierExtension: Extension
type: CodeableConcept
allowed[x]: unsignedInt,string,Money
used[x]: unsignedInt,Money
term: CodeableConcept
extension: Extension
id: http://hl7.org/fhirpath/System.String
network: CodeableConcept
modifierExtension: Extension
benefitPeriod: Period
billablePeriod: Period
careTeam: BackboneElement
role: CodeableConcept
specialty: CodeableConcept
responsible: boolean
extension: Extension
id: http://hl7.org/fhirpath/System.String
sequence: positiveInt
provider: Reference
modifierExtension: Extension
claim: Reference
claimResponse: Reference
contained: Resource
created: dateTime
decision: CodeableConcept
diagnosis: BackboneElement
id: http://hl7.org/fhirpath/System.String
extension: Extension
modifierExtension: Extension
sequence: positiveInt
diagnosis[x]: CodeableConcept,Reference
type: CodeableConcept
onAdmission: CodeableConcept
diagnosisRelatedGroup: CodeableConcept
disposition: string
encounter: Reference
enterer: Reference
event: BackboneElement
id: http://hl7.org/fhirpath/System.String
extension: Extension
modifierExtension: Extension
type: CodeableConcept
when[x]: dateTime,Period
extension: Extension
facility: Reference
form: Attachment
formCode: CodeableConcept
fundsReserve: CodeableConcept
fundsReserveRequested: CodeableConcept
id: http://hl7.org/fhirpath/System.String
identifier: Identifier
implicitRules: uri
insurance: BackboneElement
id: http://hl7.org/fhirpath/System.String
extension: Extension
modifierExtension: Extension
focal: boolean
coverage: Reference
preAuthRef: string
insurer: Reference
item: BackboneElement
category: CodeableConcept
diagnosisSequence: positiveInt
procedureSequence: positiveInt
request: Reference
modifier: CodeableConcept
revenue: CodeableConcept
adjudication: BackboneElement
id: http://hl7.org/fhirpath/System.String
extension: Extension
modifierExtension: Extension
category: CodeableConcept
reason: CodeableConcept
amount: Money
quantity: Quantity
encounter: Reference
productOrServiceEnd: CodeableConcept
traceNumber: Identifier
net: Money
tax: Money
careTeamSequence: positiveInt
productOrService: CodeableConcept
extension: Extension
udi: Reference
informationSequence: positiveInt
programCode: CodeableConcept
factor: decimal
id: http://hl7.org/fhirpath/System.String
sequence: positiveInt
bodySite: BackboneElement
id: http://hl7.org/fhirpath/System.String
extension: Extension
modifierExtension: Extension
site: CodeableReference
subSite: CodeableConcept
serviced[x]: date,Period
quantity: Quantity
location[x]: CodeableConcept,Address,Reference
noteNumber: positiveInt
patientPaid: Money
unitPrice: Money
modifierExtension: Extension
reviewOutcome: BackboneElement
id: http://hl7.org/fhirpath/System.String
extension: Extension
modifierExtension: Extension
decision: CodeableConcept
reason: CodeableConcept
preAuthRef: string
preAuthPeriod: Period
detail: BackboneElement
category: CodeableConcept
modifier: CodeableConcept
revenue: CodeableConcept
adjudication:
productOrServiceEnd: CodeableConcept
traceNumber: Identifier
net: Money
tax: Money
productOrService: CodeableConcept
extension: Extension
udi: Reference
programCode: CodeableConcept
factor: decimal
id: http://hl7.org/fhirpath/System.String
sequence: positiveInt
subDetail: BackboneElement
category: CodeableConcept
modifier: CodeableConcept
revenue: CodeableConcept
adjudication:
productOrServiceEnd: CodeableConcept
traceNumber: Identifier
net: Money
tax: Money
productOrService: CodeableConcept
extension: Extension
udi: Reference
programCode: CodeableConcept
factor: decimal
id: http://hl7.org/fhirpath/System.String
sequence: positiveInt
quantity: Quantity
noteNumber: positiveInt
patientPaid: Money
unitPrice: Money
modifierExtension: Extension
reviewOutcome:
quantity: Quantity
noteNumber: positiveInt
patientPaid: Money
unitPrice: Money
modifierExtension: Extension
reviewOutcome:
language: code
meta: Meta
modifierExtension: Extension
originalPrescription: Reference
outcome: code
patient: Reference
patientPaid: Money
payee: BackboneElement
id: http://hl7.org/fhirpath/System.String
extension: Extension
modifierExtension: Extension
type: CodeableConcept
party: Reference
payment: BackboneElement
amount: Money
date: date
type: CodeableConcept
adjustment: Money
adjustmentReason: CodeableConcept
extension: Extension
id: http://hl7.org/fhirpath/System.String
identifier: Identifier
modifierExtension: Extension
preAuthRef: string
preAuthRefPeriod: Period
precedence: positiveInt
prescription: Reference
priority: CodeableConcept
procedure: BackboneElement
date: dateTime
type: CodeableConcept
extension: Extension
udi: Reference
id: http://hl7.org/fhirpath/System.String
sequence: positiveInt
procedure[x]: CodeableConcept,Reference
modifierExtension: Extension
processNote: BackboneElement
id: http://hl7.org/fhirpath/System.String
extension: Extension
modifierExtension: Extension
number: positiveInt
type: CodeableConcept
text: string
language: CodeableConcept
provider: Reference
referral: Reference
related: BackboneElement
id: http://hl7.org/fhirpath/System.String
extension: Extension
modifierExtension: Extension
claim: Reference
relationship: CodeableConcept
reference: Identifier
status: code
subType: CodeableConcept
supportingInfo: BackboneElement
category: CodeableConcept
value[x]: boolean,string,Quantity,Attachment,Reference,Identifier
reason: Coding
extension: Extension
id: http://hl7.org/fhirpath/System.String
sequence: positiveInt
code: CodeableConcept
timing[x]: date,Period
modifierExtension: Extension
text: Narrative
total: BackboneElement
id: http://hl7.org/fhirpath/System.String
extension: Extension
modifierExtension: Extension
category: CodeableConcept
amount: Money
traceNumber: Identifier
type: CodeableConcept
use: code