http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit|4.0.1

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.
element_idtypes
ExplanationOfBenefit
ExplanationOfBenefit.identifier
ExplanationOfBenefit.status
ExplanationOfBenefit.type
ExplanationOfBenefit.subType
ExplanationOfBenefit.use
ExplanationOfBenefit.patient
ExplanationOfBenefit.billablePeriod
ExplanationOfBenefit.created
ExplanationOfBenefit.enterer
ExplanationOfBenefit.insurer
ExplanationOfBenefit.provider
ExplanationOfBenefit.priority
ExplanationOfBenefit.fundsReserveRequested
ExplanationOfBenefit.fundsReserve
ExplanationOfBenefit.related
ExplanationOfBenefit.related.claim
ExplanationOfBenefit.related.relationship
ExplanationOfBenefit.related.reference
ExplanationOfBenefit.prescription
ExplanationOfBenefit.originalPrescription
ExplanationOfBenefit.payee
ExplanationOfBenefit.payee.type
ExplanationOfBenefit.payee.party
ExplanationOfBenefit.referral
ExplanationOfBenefit.facility
ExplanationOfBenefit.claim
ExplanationOfBenefit.claimResponse
ExplanationOfBenefit.outcome
ExplanationOfBenefit.disposition
ExplanationOfBenefit.preAuthRef
ExplanationOfBenefit.preAuthRefPeriod
ExplanationOfBenefit.careTeam
ExplanationOfBenefit.careTeam.sequence
ExplanationOfBenefit.careTeam.provider
ExplanationOfBenefit.careTeam.responsible
ExplanationOfBenefit.careTeam.role
ExplanationOfBenefit.careTeam.qualification
ExplanationOfBenefit.supportingInfo
ExplanationOfBenefit.supportingInfo.sequence
ExplanationOfBenefit.supportingInfo.category
ExplanationOfBenefit.supportingInfo.code
ExplanationOfBenefit.supportingInfo.timing[x]
ExplanationOfBenefit.supportingInfo.value[x]
ExplanationOfBenefit.supportingInfo.reason
ExplanationOfBenefit.diagnosis
ExplanationOfBenefit.diagnosis.sequence
ExplanationOfBenefit.diagnosis.diagnosis[x]
ExplanationOfBenefit.diagnosis.type
ExplanationOfBenefit.diagnosis.onAdmission
ExplanationOfBenefit.diagnosis.packageCode
ExplanationOfBenefit.procedure
ExplanationOfBenefit.procedure.sequence
ExplanationOfBenefit.procedure.type
ExplanationOfBenefit.procedure.date
ExplanationOfBenefit.procedure.procedure[x]
ExplanationOfBenefit.procedure.udi
ExplanationOfBenefit.precedence
ExplanationOfBenefit.insurance
ExplanationOfBenefit.insurance.focal
ExplanationOfBenefit.insurance.coverage
ExplanationOfBenefit.insurance.preAuthRef
ExplanationOfBenefit.accident
ExplanationOfBenefit.accident.date
ExplanationOfBenefit.accident.type
ExplanationOfBenefit.accident.location[x]
ExplanationOfBenefit.item
ExplanationOfBenefit.item.sequence
ExplanationOfBenefit.item.careTeamSequence
ExplanationOfBenefit.item.diagnosisSequence
ExplanationOfBenefit.item.procedureSequence
ExplanationOfBenefit.item.informationSequence
ExplanationOfBenefit.item.revenue
ExplanationOfBenefit.item.category
ExplanationOfBenefit.item.productOrService
ExplanationOfBenefit.item.modifier
ExplanationOfBenefit.item.programCode
ExplanationOfBenefit.item.serviced[x]
ExplanationOfBenefit.item.location[x]
ExplanationOfBenefit.item.quantity
ExplanationOfBenefit.item.unitPrice
ExplanationOfBenefit.item.factor
ExplanationOfBenefit.item.net
ExplanationOfBenefit.item.udi
ExplanationOfBenefit.item.bodySite
ExplanationOfBenefit.item.subSite
ExplanationOfBenefit.item.encounter
ExplanationOfBenefit.item.noteNumber
ExplanationOfBenefit.item.adjudication
ExplanationOfBenefit.item.adjudication.category
ExplanationOfBenefit.item.adjudication.reason
ExplanationOfBenefit.item.adjudication.amount
ExplanationOfBenefit.item.adjudication.value
ExplanationOfBenefit.item.detail
ExplanationOfBenefit.item.detail.sequence
ExplanationOfBenefit.item.detail.revenue
ExplanationOfBenefit.item.detail.category
ExplanationOfBenefit.item.detail.productOrService
ExplanationOfBenefit.item.detail.modifier
ExplanationOfBenefit.item.detail.programCode
ExplanationOfBenefit.item.detail.quantity
ExplanationOfBenefit.item.detail.unitPrice
ExplanationOfBenefit.item.detail.factor
ExplanationOfBenefit.item.detail.net
ExplanationOfBenefit.item.detail.udi
ExplanationOfBenefit.item.detail.noteNumber
ExplanationOfBenefit.item.detail.adjudication
ExplanationOfBenefit.item.detail.subDetail
ExplanationOfBenefit.item.detail.subDetail.sequence
ExplanationOfBenefit.item.detail.subDetail.revenue
ExplanationOfBenefit.item.detail.subDetail.category
ExplanationOfBenefit.item.detail.subDetail.productOrService
ExplanationOfBenefit.item.detail.subDetail.modifier
ExplanationOfBenefit.item.detail.subDetail.programCode
ExplanationOfBenefit.item.detail.subDetail.quantity
ExplanationOfBenefit.item.detail.subDetail.unitPrice
ExplanationOfBenefit.item.detail.subDetail.factor
ExplanationOfBenefit.item.detail.subDetail.net
ExplanationOfBenefit.item.detail.subDetail.udi
ExplanationOfBenefit.item.detail.subDetail.noteNumber
ExplanationOfBenefit.item.detail.subDetail.adjudication
ExplanationOfBenefit.addItem
ExplanationOfBenefit.addItem.itemSequence
ExplanationOfBenefit.addItem.detailSequence
ExplanationOfBenefit.addItem.subDetailSequence
ExplanationOfBenefit.addItem.provider
ExplanationOfBenefit.addItem.productOrService
ExplanationOfBenefit.addItem.modifier
ExplanationOfBenefit.addItem.programCode
ExplanationOfBenefit.addItem.serviced[x]
ExplanationOfBenefit.addItem.location[x]
ExplanationOfBenefit.addItem.quantity
ExplanationOfBenefit.addItem.unitPrice
ExplanationOfBenefit.addItem.factor
ExplanationOfBenefit.addItem.net
ExplanationOfBenefit.addItem.bodySite
ExplanationOfBenefit.addItem.subSite
ExplanationOfBenefit.addItem.noteNumber
ExplanationOfBenefit.addItem.adjudication
ExplanationOfBenefit.addItem.detail
ExplanationOfBenefit.addItem.detail.productOrService
ExplanationOfBenefit.addItem.detail.modifier
ExplanationOfBenefit.addItem.detail.quantity
ExplanationOfBenefit.addItem.detail.unitPrice
ExplanationOfBenefit.addItem.detail.factor
ExplanationOfBenefit.addItem.detail.net
ExplanationOfBenefit.addItem.detail.noteNumber
ExplanationOfBenefit.addItem.detail.adjudication
ExplanationOfBenefit.addItem.detail.subDetail
ExplanationOfBenefit.addItem.detail.subDetail.productOrService
ExplanationOfBenefit.addItem.detail.subDetail.modifier
ExplanationOfBenefit.addItem.detail.subDetail.quantity
ExplanationOfBenefit.addItem.detail.subDetail.unitPrice
ExplanationOfBenefit.addItem.detail.subDetail.factor
ExplanationOfBenefit.addItem.detail.subDetail.net
ExplanationOfBenefit.addItem.detail.subDetail.noteNumber
ExplanationOfBenefit.addItem.detail.subDetail.adjudication
ExplanationOfBenefit.adjudication
ExplanationOfBenefit.total
ExplanationOfBenefit.total.category
ExplanationOfBenefit.total.amount
ExplanationOfBenefit.payment
ExplanationOfBenefit.payment.type
ExplanationOfBenefit.payment.adjustment
ExplanationOfBenefit.payment.adjustmentReason
ExplanationOfBenefit.payment.date
ExplanationOfBenefit.payment.amount
ExplanationOfBenefit.payment.identifier
ExplanationOfBenefit.formCode
ExplanationOfBenefit.form
ExplanationOfBenefit.processNote
ExplanationOfBenefit.processNote.number
ExplanationOfBenefit.processNote.type
ExplanationOfBenefit.processNote.text
ExplanationOfBenefit.processNote.language
ExplanationOfBenefit.benefitPeriod
ExplanationOfBenefit.benefitBalance
ExplanationOfBenefit.benefitBalance.category
ExplanationOfBenefit.benefitBalance.excluded
ExplanationOfBenefit.benefitBalance.name
ExplanationOfBenefit.benefitBalance.description
ExplanationOfBenefit.benefitBalance.network
ExplanationOfBenefit.benefitBalance.unit
ExplanationOfBenefit.benefitBalance.term
ExplanationOfBenefit.benefitBalance.financial
ExplanationOfBenefit.benefitBalance.financial.type
ExplanationOfBenefit.benefitBalance.financial.allowed[x]
ExplanationOfBenefit.benefitBalance.financial.used[x]
ExplanationOfBenefit
ExplanationOfBenefit.id
ExplanationOfBenefit.meta
ExplanationOfBenefit.implicitRules
ExplanationOfBenefit.language
ExplanationOfBenefit.text
ExplanationOfBenefit.contained
ExplanationOfBenefit.extension
ExplanationOfBenefit.modifierExtension
ExplanationOfBenefit.identifier
ExplanationOfBenefit.status
ExplanationOfBenefit.type
ExplanationOfBenefit.subType
ExplanationOfBenefit.use
ExplanationOfBenefit.patient
ExplanationOfBenefit.billablePeriod
ExplanationOfBenefit.created
ExplanationOfBenefit.enterer
ExplanationOfBenefit.insurer
ExplanationOfBenefit.provider
ExplanationOfBenefit.priority
ExplanationOfBenefit.fundsReserveRequested
ExplanationOfBenefit.fundsReserve
ExplanationOfBenefit.related
ExplanationOfBenefit.related.id
ExplanationOfBenefit.related.extension
ExplanationOfBenefit.related.modifierExtension
ExplanationOfBenefit.related.claim
ExplanationOfBenefit.related.relationship
ExplanationOfBenefit.related.reference
ExplanationOfBenefit.prescription
ExplanationOfBenefit.originalPrescription
ExplanationOfBenefit.payee
ExplanationOfBenefit.payee.id
ExplanationOfBenefit.payee.extension
ExplanationOfBenefit.payee.modifierExtension
ExplanationOfBenefit.payee.type
ExplanationOfBenefit.payee.party
ExplanationOfBenefit.referral
ExplanationOfBenefit.facility
ExplanationOfBenefit.claim
ExplanationOfBenefit.claimResponse
ExplanationOfBenefit.outcome
ExplanationOfBenefit.disposition
ExplanationOfBenefit.preAuthRef
ExplanationOfBenefit.preAuthRefPeriod
ExplanationOfBenefit.careTeam
ExplanationOfBenefit.careTeam.id
ExplanationOfBenefit.careTeam.extension
ExplanationOfBenefit.careTeam.modifierExtension
ExplanationOfBenefit.careTeam.sequence
ExplanationOfBenefit.careTeam.provider
ExplanationOfBenefit.careTeam.responsible
ExplanationOfBenefit.careTeam.role
ExplanationOfBenefit.careTeam.qualification
ExplanationOfBenefit.supportingInfo
ExplanationOfBenefit.supportingInfo.id
ExplanationOfBenefit.supportingInfo.extension
ExplanationOfBenefit.supportingInfo.modifierExtension
ExplanationOfBenefit.supportingInfo.sequence
ExplanationOfBenefit.supportingInfo.category
ExplanationOfBenefit.supportingInfo.code
ExplanationOfBenefit.supportingInfo.timing[x]
ExplanationOfBenefit.supportingInfo.value[x]
ExplanationOfBenefit.supportingInfo.reason
ExplanationOfBenefit.diagnosis
ExplanationOfBenefit.diagnosis.id
ExplanationOfBenefit.diagnosis.extension
ExplanationOfBenefit.diagnosis.modifierExtension
ExplanationOfBenefit.diagnosis.sequence
ExplanationOfBenefit.diagnosis.diagnosis[x]
ExplanationOfBenefit.diagnosis.type
ExplanationOfBenefit.diagnosis.onAdmission
ExplanationOfBenefit.diagnosis.packageCode
ExplanationOfBenefit.procedure
ExplanationOfBenefit.procedure.id
ExplanationOfBenefit.procedure.extension
ExplanationOfBenefit.procedure.modifierExtension
ExplanationOfBenefit.procedure.sequence
ExplanationOfBenefit.procedure.type
ExplanationOfBenefit.procedure.date
ExplanationOfBenefit.procedure.procedure[x]
ExplanationOfBenefit.procedure.udi
ExplanationOfBenefit.precedence
ExplanationOfBenefit.insurance
ExplanationOfBenefit.insurance.id
ExplanationOfBenefit.insurance.extension
ExplanationOfBenefit.insurance.modifierExtension
ExplanationOfBenefit.insurance.focal
ExplanationOfBenefit.insurance.coverage
ExplanationOfBenefit.insurance.preAuthRef
ExplanationOfBenefit.accident
ExplanationOfBenefit.accident.id
ExplanationOfBenefit.accident.extension
ExplanationOfBenefit.accident.modifierExtension
ExplanationOfBenefit.accident.date
ExplanationOfBenefit.accident.type
ExplanationOfBenefit.accident.location[x]
ExplanationOfBenefit.item
ExplanationOfBenefit.item.id
ExplanationOfBenefit.item.extension
ExplanationOfBenefit.item.modifierExtension
ExplanationOfBenefit.item.sequence
ExplanationOfBenefit.item.careTeamSequence
ExplanationOfBenefit.item.diagnosisSequence
ExplanationOfBenefit.item.procedureSequence
ExplanationOfBenefit.item.informationSequence
ExplanationOfBenefit.item.revenue
ExplanationOfBenefit.item.category
ExplanationOfBenefit.item.productOrService
ExplanationOfBenefit.item.modifier
ExplanationOfBenefit.item.programCode
ExplanationOfBenefit.item.serviced[x]
ExplanationOfBenefit.item.location[x]
ExplanationOfBenefit.item.quantity
ExplanationOfBenefit.item.unitPrice
ExplanationOfBenefit.item.factor
ExplanationOfBenefit.item.net
ExplanationOfBenefit.item.udi
ExplanationOfBenefit.item.bodySite
ExplanationOfBenefit.item.subSite
ExplanationOfBenefit.item.encounter
ExplanationOfBenefit.item.noteNumber
ExplanationOfBenefit.item.adjudication
ExplanationOfBenefit.item.adjudication.id
ExplanationOfBenefit.item.adjudication.extension
ExplanationOfBenefit.item.adjudication.modifierExtension
ExplanationOfBenefit.item.adjudication.category
ExplanationOfBenefit.item.adjudication.reason
ExplanationOfBenefit.item.adjudication.amount
ExplanationOfBenefit.item.adjudication.value
ExplanationOfBenefit.item.detail
ExplanationOfBenefit.item.detail.id
ExplanationOfBenefit.item.detail.extension
ExplanationOfBenefit.item.detail.modifierExtension
ExplanationOfBenefit.item.detail.sequence
ExplanationOfBenefit.item.detail.revenue
ExplanationOfBenefit.item.detail.category
ExplanationOfBenefit.item.detail.productOrService
ExplanationOfBenefit.item.detail.modifier
ExplanationOfBenefit.item.detail.programCode
ExplanationOfBenefit.item.detail.quantity
ExplanationOfBenefit.item.detail.unitPrice
ExplanationOfBenefit.item.detail.factor
ExplanationOfBenefit.item.detail.net
ExplanationOfBenefit.item.detail.udi
ExplanationOfBenefit.item.detail.noteNumber
ExplanationOfBenefit.item.detail.adjudication
ExplanationOfBenefit.item.detail.subDetail
ExplanationOfBenefit.item.detail.subDetail.id
ExplanationOfBenefit.item.detail.subDetail.extension
ExplanationOfBenefit.item.detail.subDetail.modifierExtension
ExplanationOfBenefit.item.detail.subDetail.sequence
ExplanationOfBenefit.item.detail.subDetail.revenue
ExplanationOfBenefit.item.detail.subDetail.category
ExplanationOfBenefit.item.detail.subDetail.productOrService
ExplanationOfBenefit.item.detail.subDetail.modifier
ExplanationOfBenefit.item.detail.subDetail.programCode
ExplanationOfBenefit.item.detail.subDetail.quantity
ExplanationOfBenefit.item.detail.subDetail.unitPrice
ExplanationOfBenefit.item.detail.subDetail.factor
ExplanationOfBenefit.item.detail.subDetail.net
ExplanationOfBenefit.item.detail.subDetail.udi
ExplanationOfBenefit.item.detail.subDetail.noteNumber
ExplanationOfBenefit.item.detail.subDetail.adjudication
ExplanationOfBenefit.addItem
ExplanationOfBenefit.addItem.id
ExplanationOfBenefit.addItem.extension
ExplanationOfBenefit.addItem.modifierExtension
ExplanationOfBenefit.addItem.itemSequence
ExplanationOfBenefit.addItem.detailSequence
ExplanationOfBenefit.addItem.subDetailSequence
ExplanationOfBenefit.addItem.provider
ExplanationOfBenefit.addItem.productOrService
ExplanationOfBenefit.addItem.modifier
ExplanationOfBenefit.addItem.programCode
ExplanationOfBenefit.addItem.serviced[x]
ExplanationOfBenefit.addItem.location[x]
ExplanationOfBenefit.addItem.quantity
ExplanationOfBenefit.addItem.unitPrice
ExplanationOfBenefit.addItem.factor
ExplanationOfBenefit.addItem.net
ExplanationOfBenefit.addItem.bodySite
ExplanationOfBenefit.addItem.subSite
ExplanationOfBenefit.addItem.noteNumber
ExplanationOfBenefit.addItem.adjudication
ExplanationOfBenefit.addItem.detail
ExplanationOfBenefit.addItem.detail.id
ExplanationOfBenefit.addItem.detail.extension
ExplanationOfBenefit.addItem.detail.modifierExtension
ExplanationOfBenefit.addItem.detail.productOrService
ExplanationOfBenefit.addItem.detail.modifier
ExplanationOfBenefit.addItem.detail.quantity
ExplanationOfBenefit.addItem.detail.unitPrice
ExplanationOfBenefit.addItem.detail.factor
ExplanationOfBenefit.addItem.detail.net
ExplanationOfBenefit.addItem.detail.noteNumber
ExplanationOfBenefit.addItem.detail.adjudication
ExplanationOfBenefit.addItem.detail.subDetail
ExplanationOfBenefit.addItem.detail.subDetail.id
ExplanationOfBenefit.addItem.detail.subDetail.extension
ExplanationOfBenefit.addItem.detail.subDetail.modifierExtension
ExplanationOfBenefit.addItem.detail.subDetail.productOrService
ExplanationOfBenefit.addItem.detail.subDetail.modifier
ExplanationOfBenefit.addItem.detail.subDetail.quantity
ExplanationOfBenefit.addItem.detail.subDetail.unitPrice
ExplanationOfBenefit.addItem.detail.subDetail.factor
ExplanationOfBenefit.addItem.detail.subDetail.net
ExplanationOfBenefit.addItem.detail.subDetail.noteNumber
ExplanationOfBenefit.addItem.detail.subDetail.adjudication
ExplanationOfBenefit.adjudication
ExplanationOfBenefit.total
ExplanationOfBenefit.total.id
ExplanationOfBenefit.total.extension
ExplanationOfBenefit.total.modifierExtension
ExplanationOfBenefit.total.category
ExplanationOfBenefit.total.amount
ExplanationOfBenefit.payment
ExplanationOfBenefit.payment.id
ExplanationOfBenefit.payment.extension
ExplanationOfBenefit.payment.modifierExtension
ExplanationOfBenefit.payment.type
ExplanationOfBenefit.payment.adjustment
ExplanationOfBenefit.payment.adjustmentReason
ExplanationOfBenefit.payment.date
ExplanationOfBenefit.payment.amount
ExplanationOfBenefit.payment.identifier
ExplanationOfBenefit.formCode
ExplanationOfBenefit.form
ExplanationOfBenefit.processNote
ExplanationOfBenefit.processNote.id
ExplanationOfBenefit.processNote.extension
ExplanationOfBenefit.processNote.modifierExtension
ExplanationOfBenefit.processNote.number
ExplanationOfBenefit.processNote.type
ExplanationOfBenefit.processNote.text
ExplanationOfBenefit.processNote.language
ExplanationOfBenefit.benefitPeriod
ExplanationOfBenefit.benefitBalance
ExplanationOfBenefit.benefitBalance.id
ExplanationOfBenefit.benefitBalance.extension
ExplanationOfBenefit.benefitBalance.modifierExtension
ExplanationOfBenefit.benefitBalance.category
ExplanationOfBenefit.benefitBalance.excluded
ExplanationOfBenefit.benefitBalance.name
ExplanationOfBenefit.benefitBalance.description
ExplanationOfBenefit.benefitBalance.network
ExplanationOfBenefit.benefitBalance.unit
ExplanationOfBenefit.benefitBalance.term
ExplanationOfBenefit.benefitBalance.financial
ExplanationOfBenefit.benefitBalance.financial.id
ExplanationOfBenefit.benefitBalance.financial.extension
ExplanationOfBenefit.benefitBalance.financial.modifierExtension
ExplanationOfBenefit.benefitBalance.financial.type
ExplanationOfBenefit.benefitBalance.financial.allowed[x]
ExplanationOfBenefit.benefitBalance.financial.used[x]