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ExplanationOfBenefit

PropertyValue
Publisher
NameExplanationOfBenefit
URLhttp://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit
Statusdraft
Description
Abstractfalse

Structure

PathCardinalityTypeDescription
ExplanationOfBenefit0..*ExplanationOfBenefitThis 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.
ExplanationOfBenefit.id0..1http://hl7.org/fhirpath/System.StringThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
ExplanationOfBenefit.meta0..1MetaThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
ExplanationOfBenefit.implicitRules0..1uriA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
ExplanationOfBenefit.language0..1codeThe base language in which the resource is written.
ExplanationOfBenefit.text0..1NarrativeA human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
ExplanationOfBenefit.contained0..*ResourceThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
ExplanationOfBenefit.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.identifier0..*IdentifierA unique identifier assigned to this explanation of benefit.
ExplanationOfBenefit.status1..1codeThe status of the resource instance.
ExplanationOfBenefit.type1..1CodeableConceptThe category of claim, e.g. oral, pharmacy, vision, institutional, professional.
ExplanationOfBenefit.subType0..1CodeableConceptA finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.
ExplanationOfBenefit.use1..1codeA code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.
ExplanationOfBenefit.patient1..1ReferenceThe party to whom the professional services and/or products have been supplied or are being considered and for whom actual for forecast reimbursement is sought.
ExplanationOfBenefit.billablePeriod0..1PeriodThe period for which charges are being submitted.
ExplanationOfBenefit.created1..1dateTimeThe date this resource was created.
ExplanationOfBenefit.enterer0..1ReferenceIndividual who created the claim, predetermination or preauthorization.
ExplanationOfBenefit.insurer1..1ReferenceThe party responsible for authorization, adjudication and reimbursement.
ExplanationOfBenefit.provider1..1ReferenceThe provider which is responsible for the claim, predetermination or preauthorization.
ExplanationOfBenefit.priority0..1CodeableConceptThe provider-required urgency of processing the request. Typical values include: stat, routine deferred.
ExplanationOfBenefit.fundsReserveRequested0..1CodeableConceptA code to indicate whether and for whom funds are to be reserved for future claims.
ExplanationOfBenefit.fundsReserve0..1CodeableConceptA code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom.
ExplanationOfBenefit.related0..*BackboneElementOther claims which are related to this claim such as prior submissions or claims for related services or for the same event.
ExplanationOfBenefit.related.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
ExplanationOfBenefit.related.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.related.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.related.claim0..1ReferenceReference to a related claim.
ExplanationOfBenefit.related.relationship0..1CodeableConceptA code to convey how the claims are related.
ExplanationOfBenefit.related.reference0..1IdentifierAn alternate organizational reference to the case or file to which this particular claim pertains.
ExplanationOfBenefit.prescription0..1ReferencePrescription to support the dispensing of pharmacy, device or vision products.
ExplanationOfBenefit.originalPrescription0..1ReferenceOriginal prescription which has been superseded by this prescription to support the dispensing of pharmacy services, medications or products.
ExplanationOfBenefit.payee0..1BackboneElementThe party to be reimbursed for cost of the products and services according to the terms of the policy.
ExplanationOfBenefit.payee.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
ExplanationOfBenefit.payee.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.payee.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.payee.type0..1CodeableConceptType of Party to be reimbursed: Subscriber, provider, other.
ExplanationOfBenefit.payee.party0..1ReferenceReference to the individual or organization to whom any payment will be made.
ExplanationOfBenefit.referral0..1ReferenceA reference to a referral resource.
ExplanationOfBenefit.facility0..1ReferenceFacility where the services were provided.
ExplanationOfBenefit.claim0..1ReferenceThe business identifier for the instance of the adjudication request: claim predetermination or preauthorization.
ExplanationOfBenefit.claimResponse0..1ReferenceThe business identifier for the instance of the adjudication response: claim, predetermination or preauthorization response.
ExplanationOfBenefit.outcome1..1codeThe outcome of the claim, predetermination, or preauthorization processing.
ExplanationOfBenefit.disposition0..1stringA human readable description of the status of the adjudication.
ExplanationOfBenefit.preAuthRef0..*stringReference from the Insurer which is used in later communications which refers to this adjudication.
ExplanationOfBenefit.preAuthRefPeriod0..*PeriodThe timeframe during which the supplied preauthorization reference may be quoted on claims to obtain the adjudication as provided.
ExplanationOfBenefit.careTeam0..*BackboneElementThe members of the team who provided the products and services.
ExplanationOfBenefit.careTeam.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
ExplanationOfBenefit.careTeam.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.careTeam.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.careTeam.sequence1..1positiveIntA number to uniquely identify care team entries.
ExplanationOfBenefit.careTeam.provider1..1ReferenceMember of the team who provided the product or service.
ExplanationOfBenefit.careTeam.responsible0..1booleanThe party who is billing and/or responsible for the claimed products or services.
ExplanationOfBenefit.careTeam.role0..1CodeableConceptThe lead, assisting or supervising practitioner and their discipline if a multidisciplinary team.
ExplanationOfBenefit.careTeam.qualification0..1CodeableConceptThe qualification of the practitioner which is applicable for this service.
ExplanationOfBenefit.supportingInfo0..*BackboneElementAdditional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
ExplanationOfBenefit.supportingInfo.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
ExplanationOfBenefit.supportingInfo.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.supportingInfo.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.supportingInfo.sequence1..1positiveIntA number to uniquely identify supporting information entries.
ExplanationOfBenefit.supportingInfo.category1..1CodeableConceptThe general class of the information supplied: information; exception; accident, employment; onset, etc.
ExplanationOfBenefit.supportingInfo.code0..1CodeableConceptSystem and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.
ExplanationOfBenefit.supportingInfo.timing[x]0..1dateThe date when or period to which this information refers.
ExplanationOfBenefit.supportingInfo.value[x]0..1booleanAdditional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
ExplanationOfBenefit.supportingInfo.reason0..1CodingProvides the reason in the situation where a reason code is required in addition to the content.
ExplanationOfBenefit.diagnosis0..*BackboneElementInformation about diagnoses relevant to the claim items.
ExplanationOfBenefit.diagnosis.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
ExplanationOfBenefit.diagnosis.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.diagnosis.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.diagnosis.sequence1..1positiveIntA number to uniquely identify diagnosis entries.
ExplanationOfBenefit.diagnosis.diagnosis[x]1..1CodeableConceptThe nature of illness or problem in a coded form or as a reference to an external defined Condition.
ExplanationOfBenefit.diagnosis.type0..*CodeableConceptWhen the condition was observed or the relative ranking.
ExplanationOfBenefit.diagnosis.onAdmission0..1CodeableConceptIndication of whether the diagnosis was present on admission to a facility.
ExplanationOfBenefit.diagnosis.packageCode0..1CodeableConceptA package billing code or bundle code used to group products and services to a particular health condition (such as heart attack) which is based on a predetermined grouping code system.
ExplanationOfBenefit.procedure0..*BackboneElementProcedures performed on the patient relevant to the billing items with the claim.
ExplanationOfBenefit.procedure.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
ExplanationOfBenefit.procedure.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.procedure.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.procedure.sequence1..1positiveIntA number to uniquely identify procedure entries.
ExplanationOfBenefit.procedure.type0..*CodeableConceptWhen the condition was observed or the relative ranking.
ExplanationOfBenefit.procedure.date0..1dateTimeDate and optionally time the procedure was performed.
ExplanationOfBenefit.procedure.procedure[x]1..1CodeableConceptThe code or reference to a Procedure resource which identifies the clinical intervention performed.
ExplanationOfBenefit.procedure.udi0..*ReferenceUnique Device Identifiers associated with this line item.
ExplanationOfBenefit.precedence0..1positiveIntThis indicates the relative order of a series of EOBs related to different coverages for the same suite of services.
ExplanationOfBenefit.insurance1..*BackboneElementFinancial instruments for reimbursement for the health care products and services specified on the claim.
ExplanationOfBenefit.insurance.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
ExplanationOfBenefit.insurance.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.insurance.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.insurance.focal1..1booleanA flag to indicate that this Coverage is to be used for adjudication of this claim when set to true.
ExplanationOfBenefit.insurance.coverage1..1ReferenceReference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system.
ExplanationOfBenefit.insurance.preAuthRef0..*stringReference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.
ExplanationOfBenefit.accident0..1BackboneElementDetails of a accident which resulted in injuries which required the products and services listed in the claim.
ExplanationOfBenefit.accident.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
ExplanationOfBenefit.accident.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.accident.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.accident.date0..1dateDate of an accident event related to the products and services contained in the claim.
ExplanationOfBenefit.accident.type0..1CodeableConceptThe type or context of the accident event for the purposes of selection of potential insurance coverages and determination of coordination between insurers.
ExplanationOfBenefit.accident.location[x]0..1AddressThe physical location of the accident event.
ExplanationOfBenefit.item0..*BackboneElementA claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details.
ExplanationOfBenefit.item.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
ExplanationOfBenefit.item.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.item.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.item.sequence1..1positiveIntA number to uniquely identify item entries.
ExplanationOfBenefit.item.careTeamSequence0..*positiveIntCare team members related to this service or product.
ExplanationOfBenefit.item.diagnosisSequence0..*positiveIntDiagnoses applicable for this service or product.
ExplanationOfBenefit.item.procedureSequence0..*positiveIntProcedures applicable for this service or product.
ExplanationOfBenefit.item.informationSequence0..*positiveIntExceptions, special conditions and supporting information applicable for this service or product.
ExplanationOfBenefit.item.revenue0..1CodeableConceptThe type of revenue or cost center providing the product and/or service.
ExplanationOfBenefit.item.category0..1CodeableConceptCode to identify the general type of benefits under which products and services are provided.
ExplanationOfBenefit.item.productOrService1..1CodeableConceptWhen the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.
ExplanationOfBenefit.item.modifier0..*CodeableConceptItem typification or modifiers codes to convey additional context for the product or service.
ExplanationOfBenefit.item.programCode0..*CodeableConceptIdentifies the program under which this may be recovered.
ExplanationOfBenefit.item.serviced[x]0..1dateThe date or dates when the service or product was supplied, performed or completed.
ExplanationOfBenefit.item.location[x]0..1CodeableConceptWhere the product or service was provided.
ExplanationOfBenefit.item.quantity0..1QuantityThe number of repetitions of a service or product.
ExplanationOfBenefit.item.unitPrice0..1MoneyIf the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.
ExplanationOfBenefit.item.factor0..1decimalA real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.
ExplanationOfBenefit.item.net0..1MoneyThe quantity times the unit price for an additional service or product or charge.
ExplanationOfBenefit.item.udi0..*ReferenceUnique Device Identifiers associated with this line item.
ExplanationOfBenefit.item.bodySite0..1CodeableConceptPhysical service site on the patient (limb, tooth, etc.).
ExplanationOfBenefit.item.subSite0..*CodeableConceptA region or surface of the bodySite, e.g. limb region or tooth surface(s).
ExplanationOfBenefit.item.encounter0..*ReferenceA billed item may include goods or services provided in multiple encounters.
ExplanationOfBenefit.item.noteNumber0..*positiveIntThe numbers associated with notes below which apply to the adjudication of this item.
ExplanationOfBenefit.item.adjudication0..*BackboneElementIf this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item.
ExplanationOfBenefit.item.adjudication.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
ExplanationOfBenefit.item.adjudication.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.item.adjudication.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.item.adjudication.category1..1CodeableConceptA code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in-aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.
ExplanationOfBenefit.item.adjudication.reason0..1CodeableConceptA code supporting the understanding of the adjudication result and explaining variance from expected amount.
ExplanationOfBenefit.item.adjudication.amount0..1MoneyMonetary amount associated with the category.
ExplanationOfBenefit.item.adjudication.value0..1decimalA non-monetary value associated with the category. Mutually exclusive to the amount element above.
ExplanationOfBenefit.item.detail0..*BackboneElementSecond-tier of goods and services.
ExplanationOfBenefit.item.detail.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
ExplanationOfBenefit.item.detail.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.item.detail.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.item.detail.sequence1..1positiveIntA claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.
ExplanationOfBenefit.item.detail.revenue0..1CodeableConceptThe type of revenue or cost center providing the product and/or service.
ExplanationOfBenefit.item.detail.category0..1CodeableConceptCode to identify the general type of benefits under which products and services are provided.
ExplanationOfBenefit.item.detail.productOrService1..1CodeableConceptWhen the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.
ExplanationOfBenefit.item.detail.modifier0..*CodeableConceptItem typification or modifiers codes to convey additional context for the product or service.
ExplanationOfBenefit.item.detail.programCode0..*CodeableConceptIdentifies the program under which this may be recovered.
ExplanationOfBenefit.item.detail.quantity0..1QuantityThe number of repetitions of a service or product.
ExplanationOfBenefit.item.detail.unitPrice0..1MoneyIf the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.
ExplanationOfBenefit.item.detail.factor0..1decimalA real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.
ExplanationOfBenefit.item.detail.net0..1MoneyThe quantity times the unit price for an additional service or product or charge.
ExplanationOfBenefit.item.detail.udi0..*ReferenceUnique Device Identifiers associated with this line item.
ExplanationOfBenefit.item.detail.noteNumber0..*positiveIntThe numbers associated with notes below which apply to the adjudication of this item.
ExplanationOfBenefit.item.detail.adjudication0..*ExplanationOfBenefitThe adjudication results.
ExplanationOfBenefit.item.detail.subDetail0..*BackboneElementThird-tier of goods and services.
ExplanationOfBenefit.item.detail.subDetail.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
ExplanationOfBenefit.item.detail.subDetail.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.item.detail.subDetail.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.item.detail.subDetail.sequence1..1positiveIntA claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.
ExplanationOfBenefit.item.detail.subDetail.revenue0..1CodeableConceptThe type of revenue or cost center providing the product and/or service.
ExplanationOfBenefit.item.detail.subDetail.category0..1CodeableConceptCode to identify the general type of benefits under which products and services are provided.
ExplanationOfBenefit.item.detail.subDetail.productOrService1..1CodeableConceptWhen the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.
ExplanationOfBenefit.item.detail.subDetail.modifier0..*CodeableConceptItem typification or modifiers codes to convey additional context for the product or service.
ExplanationOfBenefit.item.detail.subDetail.programCode0..*CodeableConceptIdentifies the program under which this may be recovered.
ExplanationOfBenefit.item.detail.subDetail.quantity0..1QuantityThe number of repetitions of a service or product.
ExplanationOfBenefit.item.detail.subDetail.unitPrice0..1MoneyIf the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.
ExplanationOfBenefit.item.detail.subDetail.factor0..1decimalA real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.
ExplanationOfBenefit.item.detail.subDetail.net0..1MoneyThe quantity times the unit price for an additional service or product or charge.
ExplanationOfBenefit.item.detail.subDetail.udi0..*ReferenceUnique Device Identifiers associated with this line item.
ExplanationOfBenefit.item.detail.subDetail.noteNumber0..*positiveIntThe numbers associated with notes below which apply to the adjudication of this item.
ExplanationOfBenefit.item.detail.subDetail.adjudication0..*ExplanationOfBenefitThe adjudication results.
ExplanationOfBenefit.addItem0..*BackboneElementThe first-tier service adjudications for payor added product or service lines.
ExplanationOfBenefit.addItem.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
ExplanationOfBenefit.addItem.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.addItem.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.addItem.itemSequence0..*positiveIntClaim items which this service line is intended to replace.
ExplanationOfBenefit.addItem.detailSequence0..*positiveIntThe sequence number of the details within the claim item which this line is intended to replace.
ExplanationOfBenefit.addItem.subDetailSequence0..*positiveIntThe sequence number of the sub-details woithin the details within the claim item which this line is intended to replace.
ExplanationOfBenefit.addItem.provider0..*ReferenceThe providers who are authorized for the services rendered to the patient.
ExplanationOfBenefit.addItem.productOrService1..1CodeableConceptWhen the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.
ExplanationOfBenefit.addItem.modifier0..*CodeableConceptItem typification or modifiers codes to convey additional context for the product or service.
ExplanationOfBenefit.addItem.programCode0..*CodeableConceptIdentifies the program under which this may be recovered.
ExplanationOfBenefit.addItem.serviced[x]0..1dateThe date or dates when the service or product was supplied, performed or completed.
ExplanationOfBenefit.addItem.location[x]0..1CodeableConceptWhere the product or service was provided.
ExplanationOfBenefit.addItem.quantity0..1QuantityThe number of repetitions of a service or product.
ExplanationOfBenefit.addItem.unitPrice0..1MoneyIf the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.
ExplanationOfBenefit.addItem.factor0..1decimalA real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.
ExplanationOfBenefit.addItem.net0..1MoneyThe quantity times the unit price for an additional service or product or charge.
ExplanationOfBenefit.addItem.bodySite0..1CodeableConceptPhysical service site on the patient (limb, tooth, etc.).
ExplanationOfBenefit.addItem.subSite0..*CodeableConceptA region or surface of the bodySite, e.g. limb region or tooth surface(s).
ExplanationOfBenefit.addItem.noteNumber0..*positiveIntThe numbers associated with notes below which apply to the adjudication of this item.
ExplanationOfBenefit.addItem.adjudication0..*ExplanationOfBenefitThe adjudication results.
ExplanationOfBenefit.addItem.detail0..*BackboneElementThe second-tier service adjudications for payor added services.
ExplanationOfBenefit.addItem.detail.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
ExplanationOfBenefit.addItem.detail.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.addItem.detail.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.addItem.detail.productOrService1..1CodeableConceptWhen the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.
ExplanationOfBenefit.addItem.detail.modifier0..*CodeableConceptItem typification or modifiers codes to convey additional context for the product or service.
ExplanationOfBenefit.addItem.detail.quantity0..1QuantityThe number of repetitions of a service or product.
ExplanationOfBenefit.addItem.detail.unitPrice0..1MoneyIf the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.
ExplanationOfBenefit.addItem.detail.factor0..1decimalA real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.
ExplanationOfBenefit.addItem.detail.net0..1MoneyThe quantity times the unit price for an additional service or product or charge.
ExplanationOfBenefit.addItem.detail.noteNumber0..*positiveIntThe numbers associated with notes below which apply to the adjudication of this item.
ExplanationOfBenefit.addItem.detail.adjudication0..*ExplanationOfBenefitThe adjudication results.
ExplanationOfBenefit.addItem.detail.subDetail0..*BackboneElementThe third-tier service adjudications for payor added services.
ExplanationOfBenefit.addItem.detail.subDetail.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
ExplanationOfBenefit.addItem.detail.subDetail.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.addItem.detail.subDetail.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.addItem.detail.subDetail.productOrService1..1CodeableConceptWhen the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.
ExplanationOfBenefit.addItem.detail.subDetail.modifier0..*CodeableConceptItem typification or modifiers codes to convey additional context for the product or service.
ExplanationOfBenefit.addItem.detail.subDetail.quantity0..1QuantityThe number of repetitions of a service or product.
ExplanationOfBenefit.addItem.detail.subDetail.unitPrice0..1MoneyIf the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.
ExplanationOfBenefit.addItem.detail.subDetail.factor0..1decimalA real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.
ExplanationOfBenefit.addItem.detail.subDetail.net0..1MoneyThe quantity times the unit price for an additional service or product or charge.
ExplanationOfBenefit.addItem.detail.subDetail.noteNumber0..*positiveIntThe numbers associated with notes below which apply to the adjudication of this item.
ExplanationOfBenefit.addItem.detail.subDetail.adjudication0..*ExplanationOfBenefitThe adjudication results.
ExplanationOfBenefit.adjudication0..*ExplanationOfBenefitThe adjudication results which are presented at the header level rather than at the line-item or add-item levels.
ExplanationOfBenefit.total0..*BackboneElementCategorized monetary totals for the adjudication.
ExplanationOfBenefit.total.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
ExplanationOfBenefit.total.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.total.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.total.category1..1CodeableConceptA code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.
ExplanationOfBenefit.total.amount1..1MoneyMonetary total amount associated with the category.
ExplanationOfBenefit.payment0..1BackboneElementPayment details for the adjudication of the claim.
ExplanationOfBenefit.payment.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
ExplanationOfBenefit.payment.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.payment.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.payment.type0..1CodeableConceptWhether this represents partial or complete payment of the benefits payable.
ExplanationOfBenefit.payment.adjustment0..1MoneyTotal amount of all adjustments to this payment included in this transaction which are not related to this claim's adjudication.
ExplanationOfBenefit.payment.adjustmentReason0..1CodeableConceptReason for the payment adjustment.
ExplanationOfBenefit.payment.date0..1dateEstimated date the payment will be issued or the actual issue date of payment.
ExplanationOfBenefit.payment.amount0..1MoneyBenefits payable less any payment adjustment.
ExplanationOfBenefit.payment.identifier0..1IdentifierIssuer's unique identifier for the payment instrument.
ExplanationOfBenefit.formCode0..1CodeableConceptA code for the form to be used for printing the content.
ExplanationOfBenefit.form0..1AttachmentThe actual form, by reference or inclusion, for printing the content or an EOB.
ExplanationOfBenefit.processNote0..*BackboneElementA note that describes or explains adjudication results in a human readable form.
ExplanationOfBenefit.processNote.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
ExplanationOfBenefit.processNote.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.processNote.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.processNote.number0..1positiveIntA number to uniquely identify a note entry.
ExplanationOfBenefit.processNote.type0..1codeThe business purpose of the note text.
ExplanationOfBenefit.processNote.text0..1stringThe explanation or description associated with the processing.
ExplanationOfBenefit.processNote.language0..1CodeableConceptA code to define the language used in the text of the note.
ExplanationOfBenefit.benefitPeriod0..1PeriodThe term of the benefits documented in this response.
ExplanationOfBenefit.benefitBalance0..*BackboneElementBalance by Benefit Category.
ExplanationOfBenefit.benefitBalance.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
ExplanationOfBenefit.benefitBalance.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.benefitBalance.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.benefitBalance.category1..1CodeableConceptCode to identify the general type of benefits under which products and services are provided.
ExplanationOfBenefit.benefitBalance.excluded0..1booleanTrue if the indicated class of service is excluded from the plan, missing or False indicates the product or service is included in the coverage.
ExplanationOfBenefit.benefitBalance.name0..1stringA short name or tag for the benefit.
ExplanationOfBenefit.benefitBalance.description0..1stringA richer description of the benefit or services covered.
ExplanationOfBenefit.benefitBalance.network0..1CodeableConceptIs a flag to indicate whether the benefits refer to in-network providers or out-of-network providers.
ExplanationOfBenefit.benefitBalance.unit0..1CodeableConceptIndicates if the benefits apply to an individual or to the family.
ExplanationOfBenefit.benefitBalance.term0..1CodeableConceptThe term or period of the values such as 'maximum lifetime benefit' or 'maximum annual visits'.
ExplanationOfBenefit.benefitBalance.financial0..*BackboneElementBenefits Used to date.
ExplanationOfBenefit.benefitBalance.financial.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
ExplanationOfBenefit.benefitBalance.financial.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
ExplanationOfBenefit.benefitBalance.financial.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
ExplanationOfBenefit.benefitBalance.financial.type1..1CodeableConceptClassification of benefit being provided.
ExplanationOfBenefit.benefitBalance.financial.allowed[x]0..1unsignedIntThe quantity of the benefit which is permitted under the coverage.
ExplanationOfBenefit.benefitBalance.financial.used[x]0..1unsignedIntThe quantity of the benefit which have been consumed to date.

Search Parameters

NameTypeDescriptionExpression
_textstringSearch on the narrative of the resource
_contentstringSearch on the entire content of the resource
_filtertokenFilter search parameter which supports a more sophisticated grammar for searching. See documentation for further details
_hasstringProvides limited support for reverse chaining - that is, selecting resources based on the properties of resources that refer to them (instead of chaining where resources can be selected based on the properties of resources that they refer to). See the FHIR search page for further documentation
_idtokenLogical id of this artifactResource.id
_lastUpdateddateWhen the resource version last changedResource.meta.lastUpdated
_liststringAll resources in nominated list (by id, Type/id, url or one of the magic List types)
_profileuriProfiles this resource claims to conform toResource.meta.profile
_querytokenA custom search profile that describes a specific defined query operation
_securitytokenSecurity Labels applied to this resourceResource.meta.security
_sourceuriIdentifies where the resource comes fromResource.meta.source
_tagtokenTags applied to this resourceResource.meta.tag
_textstringSearch on the narrative text (html) of the resource
_typetokenUsed when a search is performed in a context which doesn't limit the search to indicate which types are being searched. See the FHIR search page for further discussion
care-teamreferenceMember of the CareTeamExplanationOfBenefit.careTeam.provider
claimreferenceThe reference to the claimExplanationOfBenefit.claim
coveragereferenceThe plan under which the claim was adjudicatedExplanationOfBenefit.insurance.coverage
createddateThe creation date for the EOBExplanationOfBenefit.created
detail-udireferenceUDI associated with a line item detail product or serviceExplanationOfBenefit.item.detail.udi
dispositionstringThe contents of the disposition messageExplanationOfBenefit.disposition
encounterreferenceEncounters associated with a billed line itemExplanationOfBenefit.item.encounter
entererreferenceThe party responsible for the entry of the ClaimExplanationOfBenefit.enterer
facilityreferenceFacility responsible for the goods and servicesExplanationOfBenefit.facility
identifiertokenThe business identifier of the Explanation of BenefitExplanationOfBenefit.identifier
item-udireferenceUDI associated with a line item product or serviceExplanationOfBenefit.item.udi
patientreferenceThe reference to the patientExplanationOfBenefit.patient
payeereferenceThe party receiving any payment for the ClaimExplanationOfBenefit.payee.party
procedure-udireferenceUDI associated with a procedureExplanationOfBenefit.procedure.udi
providerreferenceThe reference to the providerExplanationOfBenefit.provider
statustokenStatus of the instanceExplanationOfBenefit.status
subdetail-udireferenceUDI associated with a line item detail subdetail product or serviceExplanationOfBenefit.item.detail.subDetail.udi