ExplanationOfBenefit
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.
Columns
Header row
# |
path |
type |
required |
description |
0 |
resourceType |
string |
* |
Resource type identifier. Must be string "ExplanationOfBenefit" |
1 |
|
integer |
* |
Number of subrows |
2 |
id |
string |
* |
Logical id of this artifact |
3 |
status |
code |
|
active | cancelled | draft | entered-in-error |
|
type |
CodeableConcept |
|
Category or discipline |
|
type.coding |
Coding |
|
Code defined by a terminology system |
4 |
type.coding.system |
uri |
|
Identity of the terminology system |
5 |
type.coding.version |
string |
|
Version of the system - if relevant |
6 |
type.coding.code |
code |
|
Symbol in syntax defined by the system |
7 |
type.coding.display |
string |
|
Representation defined by the system |
8 |
type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
9 |
type.text |
string |
|
Plain text representation of the concept |
|
subType |
CodeableConcept |
|
More granular claim type |
|
subType.coding |
Coding |
|
Code defined by a terminology system |
10 |
subType.coding.system |
uri |
|
Identity of the terminology system |
11 |
subType.coding.version |
string |
|
Version of the system - if relevant |
12 |
subType.coding.code |
code |
|
Symbol in syntax defined by the system |
13 |
subType.coding.display |
string |
|
Representation defined by the system |
14 |
subType.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
15 |
subType.text |
string |
|
Plain text representation of the concept |
16 |
use |
code |
|
claim | preauthorization | predetermination |
|
patient |
Reference |
|
The recipient of the products and services |
17 |
patient.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
18 |
patient.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
patient.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
19 |
patient.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
patient.identifier.type |
CodeableConcept |
|
Description of identifier |
|
patient.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
20 |
patient.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
21 |
patient.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
22 |
patient.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
23 |
patient.identifier.type.coding.display |
string |
|
Representation defined by the system |
24 |
patient.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
25 |
patient.identifier.type.text |
string |
|
Plain text representation of the concept |
26 |
patient.identifier.system |
uri |
|
The namespace for the identifier value |
27 |
patient.identifier.value |
string |
|
The value that is unique |
|
patient.identifier.period |
Period |
|
Time period when id is/was valid for use |
28 |
patient.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
29 |
patient.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
30 |
patient.display |
string |
|
Text alternative for the resource |
|
billablePeriod |
Period |
|
Relevant time frame for the claim |
31 |
billablePeriod.start |
dateTime |
|
Starting time with inclusive boundary |
32 |
billablePeriod.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
33 |
created |
dateTime |
|
Response creation date |
|
enterer |
Reference |
|
Author of the claim |
34 |
enterer.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
35 |
enterer.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
enterer.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
36 |
enterer.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
enterer.identifier.type |
CodeableConcept |
|
Description of identifier |
|
enterer.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
37 |
enterer.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
38 |
enterer.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
39 |
enterer.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
40 |
enterer.identifier.type.coding.display |
string |
|
Representation defined by the system |
41 |
enterer.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
42 |
enterer.identifier.type.text |
string |
|
Plain text representation of the concept |
43 |
enterer.identifier.system |
uri |
|
The namespace for the identifier value |
44 |
enterer.identifier.value |
string |
|
The value that is unique |
|
enterer.identifier.period |
Period |
|
Time period when id is/was valid for use |
45 |
enterer.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
46 |
enterer.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
47 |
enterer.display |
string |
|
Text alternative for the resource |
|
insurer |
Reference |
|
Party responsible for reimbursement |
48 |
insurer.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
49 |
insurer.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
insurer.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
50 |
insurer.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
insurer.identifier.type |
CodeableConcept |
|
Description of identifier |
|
insurer.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
51 |
insurer.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
52 |
insurer.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
53 |
insurer.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
54 |
insurer.identifier.type.coding.display |
string |
|
Representation defined by the system |
55 |
insurer.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
56 |
insurer.identifier.type.text |
string |
|
Plain text representation of the concept |
57 |
insurer.identifier.system |
uri |
|
The namespace for the identifier value |
58 |
insurer.identifier.value |
string |
|
The value that is unique |
|
insurer.identifier.period |
Period |
|
Time period when id is/was valid for use |
59 |
insurer.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
60 |
insurer.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
61 |
insurer.display |
string |
|
Text alternative for the resource |
|
provider |
Reference |
|
Party responsible for the claim |
62 |
provider.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
63 |
provider.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
provider.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
64 |
provider.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
provider.identifier.type |
CodeableConcept |
|
Description of identifier |
|
provider.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
65 |
provider.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
66 |
provider.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
67 |
provider.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
68 |
provider.identifier.type.coding.display |
string |
|
Representation defined by the system |
69 |
provider.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
70 |
provider.identifier.type.text |
string |
|
Plain text representation of the concept |
71 |
provider.identifier.system |
uri |
|
The namespace for the identifier value |
72 |
provider.identifier.value |
string |
|
The value that is unique |
|
provider.identifier.period |
Period |
|
Time period when id is/was valid for use |
73 |
provider.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
74 |
provider.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
75 |
provider.display |
string |
|
Text alternative for the resource |
|
priority |
CodeableConcept |
|
Desired processing urgency |
|
priority.coding |
Coding |
|
Code defined by a terminology system |
76 |
priority.coding.system |
uri |
|
Identity of the terminology system |
77 |
priority.coding.version |
string |
|
Version of the system - if relevant |
78 |
priority.coding.code |
code |
|
Symbol in syntax defined by the system |
79 |
priority.coding.display |
string |
|
Representation defined by the system |
80 |
priority.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
81 |
priority.text |
string |
|
Plain text representation of the concept |
|
fundsReserveRequested |
CodeableConcept |
|
For whom to reserve funds |
|
fundsReserveRequested.coding |
Coding |
|
Code defined by a terminology system |
82 |
fundsReserveRequested.coding.system |
uri |
|
Identity of the terminology system |
83 |
fundsReserveRequested.coding.version |
string |
|
Version of the system - if relevant |
84 |
fundsReserveRequested.coding.code |
code |
|
Symbol in syntax defined by the system |
85 |
fundsReserveRequested.coding.display |
string |
|
Representation defined by the system |
86 |
fundsReserveRequested.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
87 |
fundsReserveRequested.text |
string |
|
Plain text representation of the concept |
|
fundsReserve |
CodeableConcept |
|
Funds reserved status |
|
fundsReserve.coding |
Coding |
|
Code defined by a terminology system |
88 |
fundsReserve.coding.system |
uri |
|
Identity of the terminology system |
89 |
fundsReserve.coding.version |
string |
|
Version of the system - if relevant |
90 |
fundsReserve.coding.code |
code |
|
Symbol in syntax defined by the system |
91 |
fundsReserve.coding.display |
string |
|
Representation defined by the system |
92 |
fundsReserve.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
93 |
fundsReserve.text |
string |
|
Plain text representation of the concept |
|
prescription |
Reference |
|
Prescription authorizing services or products |
94 |
prescription.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
95 |
prescription.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
prescription.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
96 |
prescription.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
prescription.identifier.type |
CodeableConcept |
|
Description of identifier |
|
prescription.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
97 |
prescription.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
98 |
prescription.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
99 |
prescription.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
100 |
prescription.identifier.type.coding.display |
string |
|
Representation defined by the system |
101 |
prescription.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
102 |
prescription.identifier.type.text |
string |
|
Plain text representation of the concept |
103 |
prescription.identifier.system |
uri |
|
The namespace for the identifier value |
104 |
prescription.identifier.value |
string |
|
The value that is unique |
|
prescription.identifier.period |
Period |
|
Time period when id is/was valid for use |
105 |
prescription.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
106 |
prescription.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
107 |
prescription.display |
string |
|
Text alternative for the resource |
|
originalPrescription |
Reference |
|
Original prescription if superceded by fulfiller |
108 |
originalPrescription.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
109 |
originalPrescription.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
originalPrescription.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
110 |
originalPrescription.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
originalPrescription.identifier.type |
CodeableConcept |
|
Description of identifier |
|
originalPrescription.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
111 |
originalPrescription.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
112 |
originalPrescription.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
113 |
originalPrescription.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
114 |
originalPrescription.identifier.type.coding.display |
string |
|
Representation defined by the system |
115 |
originalPrescription.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
116 |
originalPrescription.identifier.type.text |
string |
|
Plain text representation of the concept |
117 |
originalPrescription.identifier.system |
uri |
|
The namespace for the identifier value |
118 |
originalPrescription.identifier.value |
string |
|
The value that is unique |
|
originalPrescription.identifier.period |
Period |
|
Time period when id is/was valid for use |
119 |
originalPrescription.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
120 |
originalPrescription.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
121 |
originalPrescription.display |
string |
|
Text alternative for the resource |
|
payee |
|
|
Recipient of benefits payable |
|
payee.type |
CodeableConcept |
|
Category of recipient |
|
payee.type.coding |
Coding |
|
Code defined by a terminology system |
122 |
payee.type.coding.system |
uri |
|
Identity of the terminology system |
123 |
payee.type.coding.version |
string |
|
Version of the system - if relevant |
124 |
payee.type.coding.code |
code |
|
Symbol in syntax defined by the system |
125 |
payee.type.coding.display |
string |
|
Representation defined by the system |
126 |
payee.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
127 |
payee.type.text |
string |
|
Plain text representation of the concept |
|
payee.party |
Reference |
|
Recipient reference |
128 |
payee.party.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
129 |
payee.party.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
payee.party.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
130 |
payee.party.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
payee.party.identifier.type |
CodeableConcept |
|
Description of identifier |
|
payee.party.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
131 |
payee.party.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
132 |
payee.party.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
133 |
payee.party.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
134 |
payee.party.identifier.type.coding.display |
string |
|
Representation defined by the system |
135 |
payee.party.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
136 |
payee.party.identifier.type.text |
string |
|
Plain text representation of the concept |
137 |
payee.party.identifier.system |
uri |
|
The namespace for the identifier value |
138 |
payee.party.identifier.value |
string |
|
The value that is unique |
|
payee.party.identifier.period |
Period |
|
Time period when id is/was valid for use |
139 |
payee.party.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
140 |
payee.party.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
141 |
payee.party.display |
string |
|
Text alternative for the resource |
|
referral |
Reference |
|
Treatment Referral |
142 |
referral.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
143 |
referral.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
referral.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
144 |
referral.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
referral.identifier.type |
CodeableConcept |
|
Description of identifier |
|
referral.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
145 |
referral.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
146 |
referral.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
147 |
referral.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
148 |
referral.identifier.type.coding.display |
string |
|
Representation defined by the system |
149 |
referral.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
150 |
referral.identifier.type.text |
string |
|
Plain text representation of the concept |
151 |
referral.identifier.system |
uri |
|
The namespace for the identifier value |
152 |
referral.identifier.value |
string |
|
The value that is unique |
|
referral.identifier.period |
Period |
|
Time period when id is/was valid for use |
153 |
referral.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
154 |
referral.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
155 |
referral.display |
string |
|
Text alternative for the resource |
|
facility |
Reference |
|
Servicing Facility |
156 |
facility.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
157 |
facility.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
facility.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
158 |
facility.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
facility.identifier.type |
CodeableConcept |
|
Description of identifier |
|
facility.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
159 |
facility.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
160 |
facility.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
161 |
facility.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
162 |
facility.identifier.type.coding.display |
string |
|
Representation defined by the system |
163 |
facility.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
164 |
facility.identifier.type.text |
string |
|
Plain text representation of the concept |
165 |
facility.identifier.system |
uri |
|
The namespace for the identifier value |
166 |
facility.identifier.value |
string |
|
The value that is unique |
|
facility.identifier.period |
Period |
|
Time period when id is/was valid for use |
167 |
facility.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
168 |
facility.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
169 |
facility.display |
string |
|
Text alternative for the resource |
|
claim |
Reference |
|
Claim reference |
170 |
claim.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
171 |
claim.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
claim.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
172 |
claim.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
claim.identifier.type |
CodeableConcept |
|
Description of identifier |
|
claim.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
173 |
claim.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
174 |
claim.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
175 |
claim.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
176 |
claim.identifier.type.coding.display |
string |
|
Representation defined by the system |
177 |
claim.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
178 |
claim.identifier.type.text |
string |
|
Plain text representation of the concept |
179 |
claim.identifier.system |
uri |
|
The namespace for the identifier value |
180 |
claim.identifier.value |
string |
|
The value that is unique |
|
claim.identifier.period |
Period |
|
Time period when id is/was valid for use |
181 |
claim.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
182 |
claim.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
183 |
claim.display |
string |
|
Text alternative for the resource |
|
claimResponse |
Reference |
|
Claim response reference |
184 |
claimResponse.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
185 |
claimResponse.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
claimResponse.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
186 |
claimResponse.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
claimResponse.identifier.type |
CodeableConcept |
|
Description of identifier |
|
claimResponse.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
187 |
claimResponse.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
188 |
claimResponse.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
189 |
claimResponse.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
190 |
claimResponse.identifier.type.coding.display |
string |
|
Representation defined by the system |
191 |
claimResponse.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
192 |
claimResponse.identifier.type.text |
string |
|
Plain text representation of the concept |
193 |
claimResponse.identifier.system |
uri |
|
The namespace for the identifier value |
194 |
claimResponse.identifier.value |
string |
|
The value that is unique |
|
claimResponse.identifier.period |
Period |
|
Time period when id is/was valid for use |
195 |
claimResponse.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
196 |
claimResponse.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
197 |
claimResponse.display |
string |
|
Text alternative for the resource |
198 |
outcome |
code |
|
queued | complete | error | partial |
199 |
disposition |
string |
|
Disposition Message |
200 |
precedence |
positiveInt |
|
Precedence (primary, secondary, etc.) |
|
accident |
|
|
Details of the event |
201 |
accident.date |
date |
|
When the incident occurred |
|
accident.type |
CodeableConcept |
|
The nature of the accident |
|
accident.type.coding |
Coding |
|
Code defined by a terminology system |
202 |
accident.type.coding.system |
uri |
|
Identity of the terminology system |
203 |
accident.type.coding.version |
string |
|
Version of the system - if relevant |
204 |
accident.type.coding.code |
code |
|
Symbol in syntax defined by the system |
205 |
accident.type.coding.display |
string |
|
Representation defined by the system |
206 |
accident.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
207 |
accident.type.text |
string |
|
Plain text representation of the concept |
|
accident.location[x] |
|
|
Where the event occurred |
|
accident.locationAddress |
Address |
|
|
208 |
accident.locationAddress.use |
code |
|
home | work | temp | old | billing - purpose of this address |
209 |
accident.locationAddress.type |
code |
|
postal | physical | both |
210 |
accident.locationAddress.text |
string |
|
Text representation of the address |
211 |
accident.locationAddress.line |
string |
|
Street name, number, direction & P.O. Box etc. |
212 |
accident.locationAddress.city |
string |
|
Name of city, town etc. |
213 |
accident.locationAddress.district |
string |
|
District name (aka county) |
214 |
accident.locationAddress.state |
string |
|
Sub-unit of country (abbreviations ok) |
215 |
accident.locationAddress.postalCode |
string |
|
Postal code for area |
216 |
accident.locationAddress.country |
string |
|
Country (e.g. can be ISO 3166 2 or 3 letter code) |
|
accident.locationAddress.period |
Period |
|
Time period when address was/is in use |
217 |
accident.locationAddress.period.start |
dateTime |
|
Starting time with inclusive boundary |
218 |
accident.locationAddress.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
|
accident.locationReference |
Reference |
|
|
219 |
accident.locationReference.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
220 |
accident.locationReference.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
accident.locationReference.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
221 |
accident.locationReference.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
accident.locationReference.identifier.type |
CodeableConcept |
|
Description of identifier |
|
accident.locationReference.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
222 |
accident.locationReference.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
223 |
accident.locationReference.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
224 |
accident.locationReference.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
225 |
accident.locationReference.identifier.type.coding.display |
string |
|
Representation defined by the system |
226 |
accident.locationReference.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
227 |
accident.locationReference.identifier.type.text |
string |
|
Plain text representation of the concept |
228 |
accident.locationReference.identifier.system |
uri |
|
The namespace for the identifier value |
229 |
accident.locationReference.identifier.value |
string |
|
The value that is unique |
|
accident.locationReference.identifier.period |
Period |
|
Time period when id is/was valid for use |
230 |
accident.locationReference.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
231 |
accident.locationReference.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
232 |
accident.locationReference.display |
string |
|
Text alternative for the resource |
|
payment |
|
|
Payment Details |
|
payment.type |
CodeableConcept |
|
Partial or complete payment |
|
payment.type.coding |
Coding |
|
Code defined by a terminology system |
233 |
payment.type.coding.system |
uri |
|
Identity of the terminology system |
234 |
payment.type.coding.version |
string |
|
Version of the system - if relevant |
235 |
payment.type.coding.code |
code |
|
Symbol in syntax defined by the system |
236 |
payment.type.coding.display |
string |
|
Representation defined by the system |
237 |
payment.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
238 |
payment.type.text |
string |
|
Plain text representation of the concept |
|
payment.adjustment |
Money |
|
Payment adjustment for non-claim issues |
239 |
payment.adjustment.value |
decimal |
|
Numerical value (with implicit precision) |
240 |
payment.adjustment.currency |
code |
|
ISO 4217 Currency Code |
|
payment.adjustmentReason |
CodeableConcept |
|
Explanation for the variance |
|
payment.adjustmentReason.coding |
Coding |
|
Code defined by a terminology system |
241 |
payment.adjustmentReason.coding.system |
uri |
|
Identity of the terminology system |
242 |
payment.adjustmentReason.coding.version |
string |
|
Version of the system - if relevant |
243 |
payment.adjustmentReason.coding.code |
code |
|
Symbol in syntax defined by the system |
244 |
payment.adjustmentReason.coding.display |
string |
|
Representation defined by the system |
245 |
payment.adjustmentReason.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
246 |
payment.adjustmentReason.text |
string |
|
Plain text representation of the concept |
247 |
payment.date |
date |
|
Expected date of payment |
|
payment.amount |
Money |
|
Payable amount after adjustment |
248 |
payment.amount.value |
decimal |
|
Numerical value (with implicit precision) |
249 |
payment.amount.currency |
code |
|
ISO 4217 Currency Code |
|
payment.identifier |
Identifier |
|
Business identifier for the payment |
250 |
payment.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
payment.identifier.type |
CodeableConcept |
|
Description of identifier |
|
payment.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
251 |
payment.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
252 |
payment.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
253 |
payment.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
254 |
payment.identifier.type.coding.display |
string |
|
Representation defined by the system |
255 |
payment.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
256 |
payment.identifier.type.text |
string |
|
Plain text representation of the concept |
257 |
payment.identifier.system |
uri |
|
The namespace for the identifier value |
258 |
payment.identifier.value |
string |
|
The value that is unique |
|
payment.identifier.period |
Period |
|
Time period when id is/was valid for use |
259 |
payment.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
260 |
payment.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
|
formCode |
CodeableConcept |
|
Printed form identifier |
|
formCode.coding |
Coding |
|
Code defined by a terminology system |
261 |
formCode.coding.system |
uri |
|
Identity of the terminology system |
262 |
formCode.coding.version |
string |
|
Version of the system - if relevant |
263 |
formCode.coding.code |
code |
|
Symbol in syntax defined by the system |
264 |
formCode.coding.display |
string |
|
Representation defined by the system |
265 |
formCode.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
266 |
formCode.text |
string |
|
Plain text representation of the concept |
|
form |
Attachment |
|
Printed reference or actual form |
267 |
form.contentType |
code |
|
Mime type of the content, with charset etc. |
268 |
form.language |
code |
|
Human language of the content (BCP-47) |
269 |
form.data |
base64Binary |
|
Data inline, base64ed |
270 |
form.url |
url |
|
Uri where the data can be found |
271 |
form.size |
unsignedInt |
|
Number of bytes of content (if url provided) |
272 |
form.hash |
base64Binary |
|
Hash of the data (sha-1, base64ed) |
273 |
form.title |
string |
|
Label to display in place of the data |
274 |
form.creation |
dateTime |
|
Date attachment was first created |
|
benefitPeriod |
Period |
|
When the benefits are applicable |
275 |
benefitPeriod.start |
dateTime |
|
Starting time with inclusive boundary |
276 |
benefitPeriod.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
Row identifier
# |
path |
type |
required |
description |
0 |
|
string |
* |
Subrow identifier. Must be string "identifier" |
|
identifier |
Identifier |
|
Business Identifier for the resource |
1 |
identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
identifier.type |
CodeableConcept |
|
Description of identifier |
|
identifier.type.coding |
Coding |
|
Code defined by a terminology system |
2 |
identifier.type.coding.system |
uri |
|
Identity of the terminology system |
3 |
identifier.type.coding.version |
string |
|
Version of the system - if relevant |
4 |
identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
5 |
identifier.type.coding.display |
string |
|
Representation defined by the system |
6 |
identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
7 |
identifier.type.text |
string |
|
Plain text representation of the concept |
8 |
identifier.system |
uri |
|
The namespace for the identifier value |
9 |
identifier.value |
string |
|
The value that is unique |
|
identifier.period |
Period |
|
Time period when id is/was valid for use |
10 |
identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
11 |
identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
Row related
# |
path |
type |
required |
description |
0 |
|
string |
* |
Subrow identifier. Must be string "related" |
|
related |
|
|
Prior or corollary claims |
|
related.claim |
Reference |
|
Reference to the related claim |
1 |
related.claim.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
2 |
related.claim.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
related.claim.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
3 |
related.claim.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
related.claim.identifier.type |
CodeableConcept |
|
Description of identifier |
|
related.claim.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
4 |
related.claim.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
5 |
related.claim.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
6 |
related.claim.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
7 |
related.claim.identifier.type.coding.display |
string |
|
Representation defined by the system |
8 |
related.claim.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
9 |
related.claim.identifier.type.text |
string |
|
Plain text representation of the concept |
10 |
related.claim.identifier.system |
uri |
|
The namespace for the identifier value |
11 |
related.claim.identifier.value |
string |
|
The value that is unique |
|
related.claim.identifier.period |
Period |
|
Time period when id is/was valid for use |
12 |
related.claim.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
13 |
related.claim.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
14 |
related.claim.display |
string |
|
Text alternative for the resource |
|
related.relationship |
CodeableConcept |
|
How the reference claim is related |
|
related.relationship.coding |
Coding |
|
Code defined by a terminology system |
15 |
related.relationship.coding.system |
uri |
|
Identity of the terminology system |
16 |
related.relationship.coding.version |
string |
|
Version of the system - if relevant |
17 |
related.relationship.coding.code |
code |
|
Symbol in syntax defined by the system |
18 |
related.relationship.coding.display |
string |
|
Representation defined by the system |
19 |
related.relationship.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
20 |
related.relationship.text |
string |
|
Plain text representation of the concept |
|
related.reference |
Identifier |
|
File or case reference |
21 |
related.reference.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
related.reference.type |
CodeableConcept |
|
Description of identifier |
|
related.reference.type.coding |
Coding |
|
Code defined by a terminology system |
22 |
related.reference.type.coding.system |
uri |
|
Identity of the terminology system |
23 |
related.reference.type.coding.version |
string |
|
Version of the system - if relevant |
24 |
related.reference.type.coding.code |
code |
|
Symbol in syntax defined by the system |
25 |
related.reference.type.coding.display |
string |
|
Representation defined by the system |
26 |
related.reference.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
27 |
related.reference.type.text |
string |
|
Plain text representation of the concept |
28 |
related.reference.system |
uri |
|
The namespace for the identifier value |
29 |
related.reference.value |
string |
|
The value that is unique |
|
related.reference.period |
Period |
|
Time period when id is/was valid for use |
30 |
related.reference.period.start |
dateTime |
|
Starting time with inclusive boundary |
31 |
related.reference.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
Row preAuthRef
# |
path |
type |
required |
description |
0 |
|
string |
* |
Subrow identifier. Must be string "preAuthRef" |
1 |
preAuthRef |
string |
|
Preauthorization reference |
Row preAuthRefPeriod
# |
path |
type |
required |
description |
0 |
|
string |
* |
Subrow identifier. Must be string "preAuthRefPeriod" |
|
preAuthRefPeriod |
Period |
|
Preauthorization in-effect period |
1 |
preAuthRefPeriod.start |
dateTime |
|
Starting time with inclusive boundary |
2 |
preAuthRefPeriod.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
Row careTeam
# |
path |
type |
required |
description |
0 |
|
string |
* |
Subrow identifier. Must be string "careTeam" |
|
careTeam |
|
|
Care Team members |
1 |
careTeam.sequence |
positiveInt |
|
Order of care team |
|
careTeam.provider |
Reference |
|
Practitioner or organization |
2 |
careTeam.provider.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
3 |
careTeam.provider.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
careTeam.provider.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
4 |
careTeam.provider.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
careTeam.provider.identifier.type |
CodeableConcept |
|
Description of identifier |
|
careTeam.provider.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
5 |
careTeam.provider.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
6 |
careTeam.provider.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
7 |
careTeam.provider.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
8 |
careTeam.provider.identifier.type.coding.display |
string |
|
Representation defined by the system |
9 |
careTeam.provider.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
10 |
careTeam.provider.identifier.type.text |
string |
|
Plain text representation of the concept |
11 |
careTeam.provider.identifier.system |
uri |
|
The namespace for the identifier value |
12 |
careTeam.provider.identifier.value |
string |
|
The value that is unique |
|
careTeam.provider.identifier.period |
Period |
|
Time period when id is/was valid for use |
13 |
careTeam.provider.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
14 |
careTeam.provider.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
15 |
careTeam.provider.display |
string |
|
Text alternative for the resource |
16 |
careTeam.responsible |
boolean |
|
Indicator of the lead practitioner |
|
careTeam.role |
CodeableConcept |
|
Function within the team |
|
careTeam.role.coding |
Coding |
|
Code defined by a terminology system |
17 |
careTeam.role.coding.system |
uri |
|
Identity of the terminology system |
18 |
careTeam.role.coding.version |
string |
|
Version of the system - if relevant |
19 |
careTeam.role.coding.code |
code |
|
Symbol in syntax defined by the system |
20 |
careTeam.role.coding.display |
string |
|
Representation defined by the system |
21 |
careTeam.role.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
22 |
careTeam.role.text |
string |
|
Plain text representation of the concept |
|
careTeam.qualification |
CodeableConcept |
|
Practitioner credential or specialization |
|
careTeam.qualification.coding |
Coding |
|
Code defined by a terminology system |
23 |
careTeam.qualification.coding.system |
uri |
|
Identity of the terminology system |
24 |
careTeam.qualification.coding.version |
string |
|
Version of the system - if relevant |
25 |
careTeam.qualification.coding.code |
code |
|
Symbol in syntax defined by the system |
26 |
careTeam.qualification.coding.display |
string |
|
Representation defined by the system |
27 |
careTeam.qualification.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
28 |
careTeam.qualification.text |
string |
|
Plain text representation of the concept |
Row supportingInfo
# |
path |
type |
required |
description |
0 |
|
string |
* |
Subrow identifier. Must be string "supportingInfo" |
|
supportingInfo |
|
|
Supporting information |
1 |
supportingInfo.sequence |
positiveInt |
|
Information instance identifier |
|
supportingInfo.category |
CodeableConcept |
|
Classification of the supplied information |
|
supportingInfo.category.coding |
Coding |
|
Code defined by a terminology system |
2 |
supportingInfo.category.coding.system |
uri |
|
Identity of the terminology system |
3 |
supportingInfo.category.coding.version |
string |
|
Version of the system - if relevant |
4 |
supportingInfo.category.coding.code |
code |
|
Symbol in syntax defined by the system |
5 |
supportingInfo.category.coding.display |
string |
|
Representation defined by the system |
6 |
supportingInfo.category.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
7 |
supportingInfo.category.text |
string |
|
Plain text representation of the concept |
|
supportingInfo.code |
CodeableConcept |
|
Type of information |
|
supportingInfo.code.coding |
Coding |
|
Code defined by a terminology system |
8 |
supportingInfo.code.coding.system |
uri |
|
Identity of the terminology system |
9 |
supportingInfo.code.coding.version |
string |
|
Version of the system - if relevant |
10 |
supportingInfo.code.coding.code |
code |
|
Symbol in syntax defined by the system |
11 |
supportingInfo.code.coding.display |
string |
|
Representation defined by the system |
12 |
supportingInfo.code.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
13 |
supportingInfo.code.text |
string |
|
Plain text representation of the concept |
|
supportingInfo.timing[x] |
|
|
When it occurred |
14 |
supportingInfo.timingDate |
date |
|
|
|
supportingInfo.timingPeriod |
Period |
|
|
15 |
supportingInfo.timingPeriod.start |
dateTime |
|
Starting time with inclusive boundary |
16 |
supportingInfo.timingPeriod.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
|
supportingInfo.value[x] |
|
|
Data to be provided |
17 |
supportingInfo.valueBoolean |
boolean |
|
|
18 |
supportingInfo.valueString |
string |
|
|
|
supportingInfo.valueQuantity |
Quantity |
|
|
19 |
supportingInfo.valueQuantity.value |
decimal |
|
Numerical value (with implicit precision) |
20 |
supportingInfo.valueQuantity.comparator |
code |
|
< | <= | >= | > - how to understand the value |
21 |
supportingInfo.valueQuantity.unit |
string |
|
Unit representation |
22 |
supportingInfo.valueQuantity.system |
uri |
|
System that defines coded unit form |
23 |
supportingInfo.valueQuantity.code |
code |
|
Coded form of the unit |
|
supportingInfo.valueAttachment |
Attachment |
|
|
24 |
supportingInfo.valueAttachment.contentType |
code |
|
Mime type of the content, with charset etc. |
25 |
supportingInfo.valueAttachment.language |
code |
|
Human language of the content (BCP-47) |
26 |
supportingInfo.valueAttachment.data |
base64Binary |
|
Data inline, base64ed |
27 |
supportingInfo.valueAttachment.url |
url |
|
Uri where the data can be found |
28 |
supportingInfo.valueAttachment.size |
unsignedInt |
|
Number of bytes of content (if url provided) |
29 |
supportingInfo.valueAttachment.hash |
base64Binary |
|
Hash of the data (sha-1, base64ed) |
30 |
supportingInfo.valueAttachment.title |
string |
|
Label to display in place of the data |
31 |
supportingInfo.valueAttachment.creation |
dateTime |
|
Date attachment was first created |
|
supportingInfo.valueReference |
Reference |
|
|
32 |
supportingInfo.valueReference.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
33 |
supportingInfo.valueReference.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
supportingInfo.valueReference.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
34 |
supportingInfo.valueReference.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
supportingInfo.valueReference.identifier.type |
CodeableConcept |
|
Description of identifier |
|
supportingInfo.valueReference.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
35 |
supportingInfo.valueReference.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
36 |
supportingInfo.valueReference.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
37 |
supportingInfo.valueReference.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
38 |
supportingInfo.valueReference.identifier.type.coding.display |
string |
|
Representation defined by the system |
39 |
supportingInfo.valueReference.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
40 |
supportingInfo.valueReference.identifier.type.text |
string |
|
Plain text representation of the concept |
41 |
supportingInfo.valueReference.identifier.system |
uri |
|
The namespace for the identifier value |
42 |
supportingInfo.valueReference.identifier.value |
string |
|
The value that is unique |
|
supportingInfo.valueReference.identifier.period |
Period |
|
Time period when id is/was valid for use |
43 |
supportingInfo.valueReference.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
44 |
supportingInfo.valueReference.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
45 |
supportingInfo.valueReference.display |
string |
|
Text alternative for the resource |
|
supportingInfo.reason |
Coding |
|
Explanation for the information |
46 |
supportingInfo.reason.system |
uri |
|
Identity of the terminology system |
47 |
supportingInfo.reason.version |
string |
|
Version of the system - if relevant |
48 |
supportingInfo.reason.code |
code |
|
Symbol in syntax defined by the system |
49 |
supportingInfo.reason.display |
string |
|
Representation defined by the system |
50 |
supportingInfo.reason.userSelected |
boolean |
|
If this coding was chosen directly by the user |
Row diagnosis
# |
path |
type |
required |
description |
0 |
|
string |
* |
Subrow identifier. Must be string "diagnosis" |
|
diagnosis |
|
|
Pertinent diagnosis information |
1 |
diagnosis.sequence |
positiveInt |
|
Diagnosis instance identifier |
|
diagnosis.diagnosis[x] |
|
|
Nature of illness or problem |
|
diagnosis.diagnosisCodeableConcept |
CodeableConcept |
|
|
|
diagnosis.diagnosisCodeableConcept.coding |
Coding |
|
Code defined by a terminology system |
2 |
diagnosis.diagnosisCodeableConcept.coding.system |
uri |
|
Identity of the terminology system |
3 |
diagnosis.diagnosisCodeableConcept.coding.version |
string |
|
Version of the system - if relevant |
4 |
diagnosis.diagnosisCodeableConcept.coding.code |
code |
|
Symbol in syntax defined by the system |
5 |
diagnosis.diagnosisCodeableConcept.coding.display |
string |
|
Representation defined by the system |
6 |
diagnosis.diagnosisCodeableConcept.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
7 |
diagnosis.diagnosisCodeableConcept.text |
string |
|
Plain text representation of the concept |
|
diagnosis.diagnosisReference |
Reference |
|
|
8 |
diagnosis.diagnosisReference.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
9 |
diagnosis.diagnosisReference.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
diagnosis.diagnosisReference.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
10 |
diagnosis.diagnosisReference.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
diagnosis.diagnosisReference.identifier.type |
CodeableConcept |
|
Description of identifier |
|
diagnosis.diagnosisReference.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
11 |
diagnosis.diagnosisReference.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
12 |
diagnosis.diagnosisReference.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
13 |
diagnosis.diagnosisReference.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
14 |
diagnosis.diagnosisReference.identifier.type.coding.display |
string |
|
Representation defined by the system |
15 |
diagnosis.diagnosisReference.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
16 |
diagnosis.diagnosisReference.identifier.type.text |
string |
|
Plain text representation of the concept |
17 |
diagnosis.diagnosisReference.identifier.system |
uri |
|
The namespace for the identifier value |
18 |
diagnosis.diagnosisReference.identifier.value |
string |
|
The value that is unique |
|
diagnosis.diagnosisReference.identifier.period |
Period |
|
Time period when id is/was valid for use |
19 |
diagnosis.diagnosisReference.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
20 |
diagnosis.diagnosisReference.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
21 |
diagnosis.diagnosisReference.display |
string |
|
Text alternative for the resource |
|
diagnosis.type |
CodeableConcept |
|
Timing or nature of the diagnosis |
|
diagnosis.type.coding |
Coding |
|
Code defined by a terminology system |
22 |
diagnosis.type.coding.system |
uri |
|
Identity of the terminology system |
23 |
diagnosis.type.coding.version |
string |
|
Version of the system - if relevant |
24 |
diagnosis.type.coding.code |
code |
|
Symbol in syntax defined by the system |
25 |
diagnosis.type.coding.display |
string |
|
Representation defined by the system |
26 |
diagnosis.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
27 |
diagnosis.type.text |
string |
|
Plain text representation of the concept |
|
diagnosis.onAdmission |
CodeableConcept |
|
Present on admission |
|
diagnosis.onAdmission.coding |
Coding |
|
Code defined by a terminology system |
28 |
diagnosis.onAdmission.coding.system |
uri |
|
Identity of the terminology system |
29 |
diagnosis.onAdmission.coding.version |
string |
|
Version of the system - if relevant |
30 |
diagnosis.onAdmission.coding.code |
code |
|
Symbol in syntax defined by the system |
31 |
diagnosis.onAdmission.coding.display |
string |
|
Representation defined by the system |
32 |
diagnosis.onAdmission.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
33 |
diagnosis.onAdmission.text |
string |
|
Plain text representation of the concept |
|
diagnosis.packageCode |
CodeableConcept |
|
Package billing code |
|
diagnosis.packageCode.coding |
Coding |
|
Code defined by a terminology system |
34 |
diagnosis.packageCode.coding.system |
uri |
|
Identity of the terminology system |
35 |
diagnosis.packageCode.coding.version |
string |
|
Version of the system - if relevant |
36 |
diagnosis.packageCode.coding.code |
code |
|
Symbol in syntax defined by the system |
37 |
diagnosis.packageCode.coding.display |
string |
|
Representation defined by the system |
38 |
diagnosis.packageCode.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
39 |
diagnosis.packageCode.text |
string |
|
Plain text representation of the concept |
Row procedure
# |
path |
type |
required |
description |
0 |
|
string |
* |
Subrow identifier. Must be string "procedure" |
|
procedure |
|
|
Clinical procedures performed |
1 |
procedure.sequence |
positiveInt |
|
Procedure instance identifier |
|
procedure.type |
CodeableConcept |
|
Category of Procedure |
|
procedure.type.coding |
Coding |
|
Code defined by a terminology system |
2 |
procedure.type.coding.system |
uri |
|
Identity of the terminology system |
3 |
procedure.type.coding.version |
string |
|
Version of the system - if relevant |
4 |
procedure.type.coding.code |
code |
|
Symbol in syntax defined by the system |
5 |
procedure.type.coding.display |
string |
|
Representation defined by the system |
6 |
procedure.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
7 |
procedure.type.text |
string |
|
Plain text representation of the concept |
8 |
procedure.date |
dateTime |
|
When the procedure was performed |
|
procedure.procedure[x] |
|
|
Specific clinical procedure |
|
procedure.procedureCodeableConcept |
CodeableConcept |
|
|
|
procedure.procedureCodeableConcept.coding |
Coding |
|
Code defined by a terminology system |
9 |
procedure.procedureCodeableConcept.coding.system |
uri |
|
Identity of the terminology system |
10 |
procedure.procedureCodeableConcept.coding.version |
string |
|
Version of the system - if relevant |
11 |
procedure.procedureCodeableConcept.coding.code |
code |
|
Symbol in syntax defined by the system |
12 |
procedure.procedureCodeableConcept.coding.display |
string |
|
Representation defined by the system |
13 |
procedure.procedureCodeableConcept.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
14 |
procedure.procedureCodeableConcept.text |
string |
|
Plain text representation of the concept |
|
procedure.procedureReference |
Reference |
|
|
15 |
procedure.procedureReference.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
16 |
procedure.procedureReference.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
procedure.procedureReference.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
17 |
procedure.procedureReference.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
procedure.procedureReference.identifier.type |
CodeableConcept |
|
Description of identifier |
|
procedure.procedureReference.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
18 |
procedure.procedureReference.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
19 |
procedure.procedureReference.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
20 |
procedure.procedureReference.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
21 |
procedure.procedureReference.identifier.type.coding.display |
string |
|
Representation defined by the system |
22 |
procedure.procedureReference.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
23 |
procedure.procedureReference.identifier.type.text |
string |
|
Plain text representation of the concept |
24 |
procedure.procedureReference.identifier.system |
uri |
|
The namespace for the identifier value |
25 |
procedure.procedureReference.identifier.value |
string |
|
The value that is unique |
|
procedure.procedureReference.identifier.period |
Period |
|
Time period when id is/was valid for use |
26 |
procedure.procedureReference.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
27 |
procedure.procedureReference.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
28 |
procedure.procedureReference.display |
string |
|
Text alternative for the resource |
|
procedure.udi |
Reference |
|
Unique device identifier |
29 |
procedure.udi.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
30 |
procedure.udi.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
procedure.udi.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
31 |
procedure.udi.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
procedure.udi.identifier.type |
CodeableConcept |
|
Description of identifier |
|
procedure.udi.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
32 |
procedure.udi.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
33 |
procedure.udi.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
34 |
procedure.udi.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
35 |
procedure.udi.identifier.type.coding.display |
string |
|
Representation defined by the system |
36 |
procedure.udi.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
37 |
procedure.udi.identifier.type.text |
string |
|
Plain text representation of the concept |
38 |
procedure.udi.identifier.system |
uri |
|
The namespace for the identifier value |
39 |
procedure.udi.identifier.value |
string |
|
The value that is unique |
|
procedure.udi.identifier.period |
Period |
|
Time period when id is/was valid for use |
40 |
procedure.udi.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
41 |
procedure.udi.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
42 |
procedure.udi.display |
string |
|
Text alternative for the resource |
Row insurance
# |
path |
type |
required |
description |
0 |
|
string |
* |
Subrow identifier. Must be string "insurance" |
|
insurance |
|
|
Patient insurance information |
1 |
insurance.focal |
boolean |
|
Coverage to be used for adjudication |
|
insurance.coverage |
Reference |
|
Insurance information |
2 |
insurance.coverage.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
3 |
insurance.coverage.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
insurance.coverage.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
4 |
insurance.coverage.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
insurance.coverage.identifier.type |
CodeableConcept |
|
Description of identifier |
|
insurance.coverage.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
5 |
insurance.coverage.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
6 |
insurance.coverage.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
7 |
insurance.coverage.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
8 |
insurance.coverage.identifier.type.coding.display |
string |
|
Representation defined by the system |
9 |
insurance.coverage.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
10 |
insurance.coverage.identifier.type.text |
string |
|
Plain text representation of the concept |
11 |
insurance.coverage.identifier.system |
uri |
|
The namespace for the identifier value |
12 |
insurance.coverage.identifier.value |
string |
|
The value that is unique |
|
insurance.coverage.identifier.period |
Period |
|
Time period when id is/was valid for use |
13 |
insurance.coverage.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
14 |
insurance.coverage.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
15 |
insurance.coverage.display |
string |
|
Text alternative for the resource |
16 |
insurance.preAuthRef |
string |
|
Prior authorization reference number |
Row item
# |
path |
type |
required |
description |
0 |
|
string |
* |
Subrow identifier. Must be string "item" |
|
item |
|
|
Product or service provided |
1 |
item.sequence |
positiveInt |
|
Item instance identifier |
2 |
item.careTeamSequence |
positiveInt |
|
Applicable care team members |
3 |
item.diagnosisSequence |
positiveInt |
|
Applicable diagnoses |
4 |
item.procedureSequence |
positiveInt |
|
Applicable procedures |
5 |
item.informationSequence |
positiveInt |
|
Applicable exception and supporting information |
|
item.revenue |
CodeableConcept |
|
Revenue or cost center code |
|
item.revenue.coding |
Coding |
|
Code defined by a terminology system |
6 |
item.revenue.coding.system |
uri |
|
Identity of the terminology system |
7 |
item.revenue.coding.version |
string |
|
Version of the system - if relevant |
8 |
item.revenue.coding.code |
code |
|
Symbol in syntax defined by the system |
9 |
item.revenue.coding.display |
string |
|
Representation defined by the system |
10 |
item.revenue.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
11 |
item.revenue.text |
string |
|
Plain text representation of the concept |
|
item.category |
CodeableConcept |
|
Benefit classification |
|
item.category.coding |
Coding |
|
Code defined by a terminology system |
12 |
item.category.coding.system |
uri |
|
Identity of the terminology system |
13 |
item.category.coding.version |
string |
|
Version of the system - if relevant |
14 |
item.category.coding.code |
code |
|
Symbol in syntax defined by the system |
15 |
item.category.coding.display |
string |
|
Representation defined by the system |
16 |
item.category.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
17 |
item.category.text |
string |
|
Plain text representation of the concept |
|
item.productOrService |
CodeableConcept |
|
Billing, service, product, or drug code |
|
item.productOrService.coding |
Coding |
|
Code defined by a terminology system |
18 |
item.productOrService.coding.system |
uri |
|
Identity of the terminology system |
19 |
item.productOrService.coding.version |
string |
|
Version of the system - if relevant |
20 |
item.productOrService.coding.code |
code |
|
Symbol in syntax defined by the system |
21 |
item.productOrService.coding.display |
string |
|
Representation defined by the system |
22 |
item.productOrService.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
23 |
item.productOrService.text |
string |
|
Plain text representation of the concept |
|
item.modifier |
CodeableConcept |
|
Product or service billing modifiers |
|
item.modifier.coding |
Coding |
|
Code defined by a terminology system |
24 |
item.modifier.coding.system |
uri |
|
Identity of the terminology system |
25 |
item.modifier.coding.version |
string |
|
Version of the system - if relevant |
26 |
item.modifier.coding.code |
code |
|
Symbol in syntax defined by the system |
27 |
item.modifier.coding.display |
string |
|
Representation defined by the system |
28 |
item.modifier.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
29 |
item.modifier.text |
string |
|
Plain text representation of the concept |
|
item.programCode |
CodeableConcept |
|
Program the product or service is provided under |
|
item.programCode.coding |
Coding |
|
Code defined by a terminology system |
30 |
item.programCode.coding.system |
uri |
|
Identity of the terminology system |
31 |
item.programCode.coding.version |
string |
|
Version of the system - if relevant |
32 |
item.programCode.coding.code |
code |
|
Symbol in syntax defined by the system |
33 |
item.programCode.coding.display |
string |
|
Representation defined by the system |
34 |
item.programCode.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
35 |
item.programCode.text |
string |
|
Plain text representation of the concept |
|
item.serviced[x] |
|
|
Date or dates of service or product delivery |
36 |
item.servicedDate |
date |
|
|
|
item.servicedPeriod |
Period |
|
|
37 |
item.servicedPeriod.start |
dateTime |
|
Starting time with inclusive boundary |
38 |
item.servicedPeriod.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
|
item.location[x] |
|
|
Place of service or where product was supplied |
|
item.locationCodeableConcept |
CodeableConcept |
|
|
|
item.locationCodeableConcept.coding |
Coding |
|
Code defined by a terminology system |
39 |
item.locationCodeableConcept.coding.system |
uri |
|
Identity of the terminology system |
40 |
item.locationCodeableConcept.coding.version |
string |
|
Version of the system - if relevant |
41 |
item.locationCodeableConcept.coding.code |
code |
|
Symbol in syntax defined by the system |
42 |
item.locationCodeableConcept.coding.display |
string |
|
Representation defined by the system |
43 |
item.locationCodeableConcept.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
44 |
item.locationCodeableConcept.text |
string |
|
Plain text representation of the concept |
|
item.locationAddress |
Address |
|
|
45 |
item.locationAddress.use |
code |
|
home | work | temp | old | billing - purpose of this address |
46 |
item.locationAddress.type |
code |
|
postal | physical | both |
47 |
item.locationAddress.text |
string |
|
Text representation of the address |
48 |
item.locationAddress.line |
string |
|
Street name, number, direction & P.O. Box etc. |
49 |
item.locationAddress.city |
string |
|
Name of city, town etc. |
50 |
item.locationAddress.district |
string |
|
District name (aka county) |
51 |
item.locationAddress.state |
string |
|
Sub-unit of country (abbreviations ok) |
52 |
item.locationAddress.postalCode |
string |
|
Postal code for area |
53 |
item.locationAddress.country |
string |
|
Country (e.g. can be ISO 3166 2 or 3 letter code) |
|
item.locationAddress.period |
Period |
|
Time period when address was/is in use |
54 |
item.locationAddress.period.start |
dateTime |
|
Starting time with inclusive boundary |
55 |
item.locationAddress.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
|
item.locationReference |
Reference |
|
|
56 |
item.locationReference.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
57 |
item.locationReference.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
item.locationReference.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
58 |
item.locationReference.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
item.locationReference.identifier.type |
CodeableConcept |
|
Description of identifier |
|
item.locationReference.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
59 |
item.locationReference.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
60 |
item.locationReference.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
61 |
item.locationReference.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
62 |
item.locationReference.identifier.type.coding.display |
string |
|
Representation defined by the system |
63 |
item.locationReference.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
64 |
item.locationReference.identifier.type.text |
string |
|
Plain text representation of the concept |
65 |
item.locationReference.identifier.system |
uri |
|
The namespace for the identifier value |
66 |
item.locationReference.identifier.value |
string |
|
The value that is unique |
|
item.locationReference.identifier.period |
Period |
|
Time period when id is/was valid for use |
67 |
item.locationReference.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
68 |
item.locationReference.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
69 |
item.locationReference.display |
string |
|
Text alternative for the resource |
|
item.quantity |
Quantity |
|
Count of products or services |
70 |
item.quantity.value |
decimal |
|
Numerical value (with implicit precision) |
71 |
item.quantity.unit |
string |
|
Unit representation |
72 |
item.quantity.system |
uri |
|
System that defines coded unit form |
73 |
item.quantity.code |
code |
|
Coded form of the unit |
|
item.unitPrice |
Money |
|
Fee, charge or cost per item |
74 |
item.unitPrice.value |
decimal |
|
Numerical value (with implicit precision) |
75 |
item.unitPrice.currency |
code |
|
ISO 4217 Currency Code |
76 |
item.factor |
decimal |
|
Price scaling factor |
|
item.net |
Money |
|
Total item cost |
77 |
item.net.value |
decimal |
|
Numerical value (with implicit precision) |
78 |
item.net.currency |
code |
|
ISO 4217 Currency Code |
|
item.udi |
Reference |
|
Unique device identifier |
79 |
item.udi.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
80 |
item.udi.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
item.udi.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
81 |
item.udi.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
item.udi.identifier.type |
CodeableConcept |
|
Description of identifier |
|
item.udi.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
82 |
item.udi.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
83 |
item.udi.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
84 |
item.udi.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
85 |
item.udi.identifier.type.coding.display |
string |
|
Representation defined by the system |
86 |
item.udi.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
87 |
item.udi.identifier.type.text |
string |
|
Plain text representation of the concept |
88 |
item.udi.identifier.system |
uri |
|
The namespace for the identifier value |
89 |
item.udi.identifier.value |
string |
|
The value that is unique |
|
item.udi.identifier.period |
Period |
|
Time period when id is/was valid for use |
90 |
item.udi.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
91 |
item.udi.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
92 |
item.udi.display |
string |
|
Text alternative for the resource |
|
item.bodySite |
CodeableConcept |
|
Anatomical location |
|
item.bodySite.coding |
Coding |
|
Code defined by a terminology system |
93 |
item.bodySite.coding.system |
uri |
|
Identity of the terminology system |
94 |
item.bodySite.coding.version |
string |
|
Version of the system - if relevant |
95 |
item.bodySite.coding.code |
code |
|
Symbol in syntax defined by the system |
96 |
item.bodySite.coding.display |
string |
|
Representation defined by the system |
97 |
item.bodySite.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
98 |
item.bodySite.text |
string |
|
Plain text representation of the concept |
|
item.subSite |
CodeableConcept |
|
Anatomical sub-location |
|
item.subSite.coding |
Coding |
|
Code defined by a terminology system |
99 |
item.subSite.coding.system |
uri |
|
Identity of the terminology system |
100 |
item.subSite.coding.version |
string |
|
Version of the system - if relevant |
101 |
item.subSite.coding.code |
code |
|
Symbol in syntax defined by the system |
102 |
item.subSite.coding.display |
string |
|
Representation defined by the system |
103 |
item.subSite.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
104 |
item.subSite.text |
string |
|
Plain text representation of the concept |
|
item.encounter |
Reference |
|
Encounters related to this billed item |
105 |
item.encounter.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
106 |
item.encounter.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
item.encounter.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
107 |
item.encounter.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
item.encounter.identifier.type |
CodeableConcept |
|
Description of identifier |
|
item.encounter.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
108 |
item.encounter.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
109 |
item.encounter.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
110 |
item.encounter.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
111 |
item.encounter.identifier.type.coding.display |
string |
|
Representation defined by the system |
112 |
item.encounter.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
113 |
item.encounter.identifier.type.text |
string |
|
Plain text representation of the concept |
114 |
item.encounter.identifier.system |
uri |
|
The namespace for the identifier value |
115 |
item.encounter.identifier.value |
string |
|
The value that is unique |
|
item.encounter.identifier.period |
Period |
|
Time period when id is/was valid for use |
116 |
item.encounter.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
117 |
item.encounter.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
118 |
item.encounter.display |
string |
|
Text alternative for the resource |
119 |
item.noteNumber |
positiveInt |
|
Applicable note numbers |
|
item.adjudication |
|
|
Adjudication details |
|
item.adjudication.category |
CodeableConcept |
|
Type of adjudication information |
|
item.adjudication.category.coding |
Coding |
|
Code defined by a terminology system |
120 |
item.adjudication.category.coding.system |
uri |
|
Identity of the terminology system |
121 |
item.adjudication.category.coding.version |
string |
|
Version of the system - if relevant |
122 |
item.adjudication.category.coding.code |
code |
|
Symbol in syntax defined by the system |
123 |
item.adjudication.category.coding.display |
string |
|
Representation defined by the system |
124 |
item.adjudication.category.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
125 |
item.adjudication.category.text |
string |
|
Plain text representation of the concept |
|
item.adjudication.reason |
CodeableConcept |
|
Explanation of adjudication outcome |
|
item.adjudication.reason.coding |
Coding |
|
Code defined by a terminology system |
126 |
item.adjudication.reason.coding.system |
uri |
|
Identity of the terminology system |
127 |
item.adjudication.reason.coding.version |
string |
|
Version of the system - if relevant |
128 |
item.adjudication.reason.coding.code |
code |
|
Symbol in syntax defined by the system |
129 |
item.adjudication.reason.coding.display |
string |
|
Representation defined by the system |
130 |
item.adjudication.reason.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
131 |
item.adjudication.reason.text |
string |
|
Plain text representation of the concept |
|
item.adjudication.amount |
Money |
|
Monetary amount |
132 |
item.adjudication.amount.value |
decimal |
|
Numerical value (with implicit precision) |
133 |
item.adjudication.amount.currency |
code |
|
ISO 4217 Currency Code |
134 |
item.adjudication.value |
decimal |
|
Non-monitary value |
|
item.detail |
|
|
Additional items |
135 |
item.detail.sequence |
positiveInt |
|
Product or service provided |
|
item.detail.revenue |
CodeableConcept |
|
Revenue or cost center code |
|
item.detail.revenue.coding |
Coding |
|
Code defined by a terminology system |
136 |
item.detail.revenue.coding.system |
uri |
|
Identity of the terminology system |
137 |
item.detail.revenue.coding.version |
string |
|
Version of the system - if relevant |
138 |
item.detail.revenue.coding.code |
code |
|
Symbol in syntax defined by the system |
139 |
item.detail.revenue.coding.display |
string |
|
Representation defined by the system |
140 |
item.detail.revenue.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
141 |
item.detail.revenue.text |
string |
|
Plain text representation of the concept |
|
item.detail.category |
CodeableConcept |
|
Benefit classification |
|
item.detail.category.coding |
Coding |
|
Code defined by a terminology system |
142 |
item.detail.category.coding.system |
uri |
|
Identity of the terminology system |
143 |
item.detail.category.coding.version |
string |
|
Version of the system - if relevant |
144 |
item.detail.category.coding.code |
code |
|
Symbol in syntax defined by the system |
145 |
item.detail.category.coding.display |
string |
|
Representation defined by the system |
146 |
item.detail.category.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
147 |
item.detail.category.text |
string |
|
Plain text representation of the concept |
|
item.detail.productOrService |
CodeableConcept |
|
Billing, service, product, or drug code |
|
item.detail.productOrService.coding |
Coding |
|
Code defined by a terminology system |
148 |
item.detail.productOrService.coding.system |
uri |
|
Identity of the terminology system |
149 |
item.detail.productOrService.coding.version |
string |
|
Version of the system - if relevant |
150 |
item.detail.productOrService.coding.code |
code |
|
Symbol in syntax defined by the system |
151 |
item.detail.productOrService.coding.display |
string |
|
Representation defined by the system |
152 |
item.detail.productOrService.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
153 |
item.detail.productOrService.text |
string |
|
Plain text representation of the concept |
|
item.detail.modifier |
CodeableConcept |
|
Service/Product billing modifiers |
|
item.detail.modifier.coding |
Coding |
|
Code defined by a terminology system |
154 |
item.detail.modifier.coding.system |
uri |
|
Identity of the terminology system |
155 |
item.detail.modifier.coding.version |
string |
|
Version of the system - if relevant |
156 |
item.detail.modifier.coding.code |
code |
|
Symbol in syntax defined by the system |
157 |
item.detail.modifier.coding.display |
string |
|
Representation defined by the system |
158 |
item.detail.modifier.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
159 |
item.detail.modifier.text |
string |
|
Plain text representation of the concept |
|
item.detail.programCode |
CodeableConcept |
|
Program the product or service is provided under |
|
item.detail.programCode.coding |
Coding |
|
Code defined by a terminology system |
160 |
item.detail.programCode.coding.system |
uri |
|
Identity of the terminology system |
161 |
item.detail.programCode.coding.version |
string |
|
Version of the system - if relevant |
162 |
item.detail.programCode.coding.code |
code |
|
Symbol in syntax defined by the system |
163 |
item.detail.programCode.coding.display |
string |
|
Representation defined by the system |
164 |
item.detail.programCode.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
165 |
item.detail.programCode.text |
string |
|
Plain text representation of the concept |
|
item.detail.quantity |
Quantity |
|
Count of products or services |
166 |
item.detail.quantity.value |
decimal |
|
Numerical value (with implicit precision) |
167 |
item.detail.quantity.unit |
string |
|
Unit representation |
168 |
item.detail.quantity.system |
uri |
|
System that defines coded unit form |
169 |
item.detail.quantity.code |
code |
|
Coded form of the unit |
|
item.detail.unitPrice |
Money |
|
Fee, charge or cost per item |
170 |
item.detail.unitPrice.value |
decimal |
|
Numerical value (with implicit precision) |
171 |
item.detail.unitPrice.currency |
code |
|
ISO 4217 Currency Code |
172 |
item.detail.factor |
decimal |
|
Price scaling factor |
|
item.detail.net |
Money |
|
Total item cost |
173 |
item.detail.net.value |
decimal |
|
Numerical value (with implicit precision) |
174 |
item.detail.net.currency |
code |
|
ISO 4217 Currency Code |
|
item.detail.udi |
Reference |
|
Unique device identifier |
175 |
item.detail.udi.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
176 |
item.detail.udi.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
item.detail.udi.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
177 |
item.detail.udi.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
item.detail.udi.identifier.type |
CodeableConcept |
|
Description of identifier |
|
item.detail.udi.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
178 |
item.detail.udi.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
179 |
item.detail.udi.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
180 |
item.detail.udi.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
181 |
item.detail.udi.identifier.type.coding.display |
string |
|
Representation defined by the system |
182 |
item.detail.udi.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
183 |
item.detail.udi.identifier.type.text |
string |
|
Plain text representation of the concept |
184 |
item.detail.udi.identifier.system |
uri |
|
The namespace for the identifier value |
185 |
item.detail.udi.identifier.value |
string |
|
The value that is unique |
|
item.detail.udi.identifier.period |
Period |
|
Time period when id is/was valid for use |
186 |
item.detail.udi.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
187 |
item.detail.udi.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
188 |
item.detail.udi.display |
string |
|
Text alternative for the resource |
189 |
item.detail.noteNumber |
positiveInt |
|
Applicable note numbers |
|
item.detail.adjudication |
|
|
Detail level adjudication details |
|
item.detail.adjudication.category |
CodeableConcept |
|
Type of adjudication information |
|
item.detail.adjudication.category.coding |
Coding |
|
Code defined by a terminology system |
190 |
item.detail.adjudication.category.coding.system |
uri |
|
Identity of the terminology system |
191 |
item.detail.adjudication.category.coding.version |
string |
|
Version of the system - if relevant |
192 |
item.detail.adjudication.category.coding.code |
code |
|
Symbol in syntax defined by the system |
193 |
item.detail.adjudication.category.coding.display |
string |
|
Representation defined by the system |
194 |
item.detail.adjudication.category.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
195 |
item.detail.adjudication.category.text |
string |
|
Plain text representation of the concept |
|
item.detail.adjudication.reason |
CodeableConcept |
|
Explanation of adjudication outcome |
|
item.detail.adjudication.reason.coding |
Coding |
|
Code defined by a terminology system |
196 |
item.detail.adjudication.reason.coding.system |
uri |
|
Identity of the terminology system |
197 |
item.detail.adjudication.reason.coding.version |
string |
|
Version of the system - if relevant |
198 |
item.detail.adjudication.reason.coding.code |
code |
|
Symbol in syntax defined by the system |
199 |
item.detail.adjudication.reason.coding.display |
string |
|
Representation defined by the system |
200 |
item.detail.adjudication.reason.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
201 |
item.detail.adjudication.reason.text |
string |
|
Plain text representation of the concept |
|
item.detail.adjudication.amount |
Money |
|
Monetary amount |
202 |
item.detail.adjudication.amount.value |
decimal |
|
Numerical value (with implicit precision) |
203 |
item.detail.adjudication.amount.currency |
code |
|
ISO 4217 Currency Code |
204 |
item.detail.adjudication.value |
decimal |
|
Non-monitary value |
|
item.detail.subDetail |
|
|
Additional items |
205 |
item.detail.subDetail.sequence |
positiveInt |
|
Product or service provided |
|
item.detail.subDetail.revenue |
CodeableConcept |
|
Revenue or cost center code |
|
item.detail.subDetail.revenue.coding |
Coding |
|
Code defined by a terminology system |
206 |
item.detail.subDetail.revenue.coding.system |
uri |
|
Identity of the terminology system |
207 |
item.detail.subDetail.revenue.coding.version |
string |
|
Version of the system - if relevant |
208 |
item.detail.subDetail.revenue.coding.code |
code |
|
Symbol in syntax defined by the system |
209 |
item.detail.subDetail.revenue.coding.display |
string |
|
Representation defined by the system |
210 |
item.detail.subDetail.revenue.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
211 |
item.detail.subDetail.revenue.text |
string |
|
Plain text representation of the concept |
|
item.detail.subDetail.category |
CodeableConcept |
|
Benefit classification |
|
item.detail.subDetail.category.coding |
Coding |
|
Code defined by a terminology system |
212 |
item.detail.subDetail.category.coding.system |
uri |
|
Identity of the terminology system |
213 |
item.detail.subDetail.category.coding.version |
string |
|
Version of the system - if relevant |
214 |
item.detail.subDetail.category.coding.code |
code |
|
Symbol in syntax defined by the system |
215 |
item.detail.subDetail.category.coding.display |
string |
|
Representation defined by the system |
216 |
item.detail.subDetail.category.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
217 |
item.detail.subDetail.category.text |
string |
|
Plain text representation of the concept |
|
item.detail.subDetail.productOrService |
CodeableConcept |
|
Billing, service, product, or drug code |
|
item.detail.subDetail.productOrService.coding |
Coding |
|
Code defined by a terminology system |
218 |
item.detail.subDetail.productOrService.coding.system |
uri |
|
Identity of the terminology system |
219 |
item.detail.subDetail.productOrService.coding.version |
string |
|
Version of the system - if relevant |
220 |
item.detail.subDetail.productOrService.coding.code |
code |
|
Symbol in syntax defined by the system |
221 |
item.detail.subDetail.productOrService.coding.display |
string |
|
Representation defined by the system |
222 |
item.detail.subDetail.productOrService.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
223 |
item.detail.subDetail.productOrService.text |
string |
|
Plain text representation of the concept |
|
item.detail.subDetail.modifier |
CodeableConcept |
|
Service/Product billing modifiers |
|
item.detail.subDetail.modifier.coding |
Coding |
|
Code defined by a terminology system |
224 |
item.detail.subDetail.modifier.coding.system |
uri |
|
Identity of the terminology system |
225 |
item.detail.subDetail.modifier.coding.version |
string |
|
Version of the system - if relevant |
226 |
item.detail.subDetail.modifier.coding.code |
code |
|
Symbol in syntax defined by the system |
227 |
item.detail.subDetail.modifier.coding.display |
string |
|
Representation defined by the system |
228 |
item.detail.subDetail.modifier.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
229 |
item.detail.subDetail.modifier.text |
string |
|
Plain text representation of the concept |
|
item.detail.subDetail.programCode |
CodeableConcept |
|
Program the product or service is provided under |
|
item.detail.subDetail.programCode.coding |
Coding |
|
Code defined by a terminology system |
230 |
item.detail.subDetail.programCode.coding.system |
uri |
|
Identity of the terminology system |
231 |
item.detail.subDetail.programCode.coding.version |
string |
|
Version of the system - if relevant |
232 |
item.detail.subDetail.programCode.coding.code |
code |
|
Symbol in syntax defined by the system |
233 |
item.detail.subDetail.programCode.coding.display |
string |
|
Representation defined by the system |
234 |
item.detail.subDetail.programCode.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
235 |
item.detail.subDetail.programCode.text |
string |
|
Plain text representation of the concept |
|
item.detail.subDetail.quantity |
Quantity |
|
Count of products or services |
236 |
item.detail.subDetail.quantity.value |
decimal |
|
Numerical value (with implicit precision) |
237 |
item.detail.subDetail.quantity.unit |
string |
|
Unit representation |
238 |
item.detail.subDetail.quantity.system |
uri |
|
System that defines coded unit form |
239 |
item.detail.subDetail.quantity.code |
code |
|
Coded form of the unit |
|
item.detail.subDetail.unitPrice |
Money |
|
Fee, charge or cost per item |
240 |
item.detail.subDetail.unitPrice.value |
decimal |
|
Numerical value (with implicit precision) |
241 |
item.detail.subDetail.unitPrice.currency |
code |
|
ISO 4217 Currency Code |
242 |
item.detail.subDetail.factor |
decimal |
|
Price scaling factor |
|
item.detail.subDetail.net |
Money |
|
Total item cost |
243 |
item.detail.subDetail.net.value |
decimal |
|
Numerical value (with implicit precision) |
244 |
item.detail.subDetail.net.currency |
code |
|
ISO 4217 Currency Code |
|
item.detail.subDetail.udi |
Reference |
|
Unique device identifier |
245 |
item.detail.subDetail.udi.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
246 |
item.detail.subDetail.udi.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
item.detail.subDetail.udi.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
247 |
item.detail.subDetail.udi.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
item.detail.subDetail.udi.identifier.type |
CodeableConcept |
|
Description of identifier |
|
item.detail.subDetail.udi.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
248 |
item.detail.subDetail.udi.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
249 |
item.detail.subDetail.udi.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
250 |
item.detail.subDetail.udi.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
251 |
item.detail.subDetail.udi.identifier.type.coding.display |
string |
|
Representation defined by the system |
252 |
item.detail.subDetail.udi.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
253 |
item.detail.subDetail.udi.identifier.type.text |
string |
|
Plain text representation of the concept |
254 |
item.detail.subDetail.udi.identifier.system |
uri |
|
The namespace for the identifier value |
255 |
item.detail.subDetail.udi.identifier.value |
string |
|
The value that is unique |
|
item.detail.subDetail.udi.identifier.period |
Period |
|
Time period when id is/was valid for use |
256 |
item.detail.subDetail.udi.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
257 |
item.detail.subDetail.udi.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
258 |
item.detail.subDetail.udi.display |
string |
|
Text alternative for the resource |
259 |
item.detail.subDetail.noteNumber |
positiveInt |
|
Applicable note numbers |
|
item.detail.subDetail.adjudication |
|
|
Subdetail level adjudication details |
|
item.detail.subDetail.adjudication.category |
CodeableConcept |
|
Type of adjudication information |
|
item.detail.subDetail.adjudication.category.coding |
Coding |
|
Code defined by a terminology system |
260 |
item.detail.subDetail.adjudication.category.coding.system |
uri |
|
Identity of the terminology system |
261 |
item.detail.subDetail.adjudication.category.coding.version |
string |
|
Version of the system - if relevant |
262 |
item.detail.subDetail.adjudication.category.coding.code |
code |
|
Symbol in syntax defined by the system |
263 |
item.detail.subDetail.adjudication.category.coding.display |
string |
|
Representation defined by the system |
264 |
item.detail.subDetail.adjudication.category.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
265 |
item.detail.subDetail.adjudication.category.text |
string |
|
Plain text representation of the concept |
|
item.detail.subDetail.adjudication.reason |
CodeableConcept |
|
Explanation of adjudication outcome |
|
item.detail.subDetail.adjudication.reason.coding |
Coding |
|
Code defined by a terminology system |
266 |
item.detail.subDetail.adjudication.reason.coding.system |
uri |
|
Identity of the terminology system |
267 |
item.detail.subDetail.adjudication.reason.coding.version |
string |
|
Version of the system - if relevant |
268 |
item.detail.subDetail.adjudication.reason.coding.code |
code |
|
Symbol in syntax defined by the system |
269 |
item.detail.subDetail.adjudication.reason.coding.display |
string |
|
Representation defined by the system |
270 |
item.detail.subDetail.adjudication.reason.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
271 |
item.detail.subDetail.adjudication.reason.text |
string |
|
Plain text representation of the concept |
|
item.detail.subDetail.adjudication.amount |
Money |
|
Monetary amount |
272 |
item.detail.subDetail.adjudication.amount.value |
decimal |
|
Numerical value (with implicit precision) |
273 |
item.detail.subDetail.adjudication.amount.currency |
code |
|
ISO 4217 Currency Code |
274 |
item.detail.subDetail.adjudication.value |
decimal |
|
Non-monitary value |
Row addItem
# |
path |
type |
required |
description |
0 |
|
string |
* |
Subrow identifier. Must be string "addItem" |
|
addItem |
|
|
Insurer added line items |
1 |
addItem.itemSequence |
positiveInt |
|
Item sequence number |
2 |
addItem.detailSequence |
positiveInt |
|
Detail sequence number |
3 |
addItem.subDetailSequence |
positiveInt |
|
Subdetail sequence number |
|
addItem.provider |
Reference |
|
Authorized providers |
4 |
addItem.provider.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
5 |
addItem.provider.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
addItem.provider.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
6 |
addItem.provider.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
addItem.provider.identifier.type |
CodeableConcept |
|
Description of identifier |
|
addItem.provider.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
7 |
addItem.provider.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
8 |
addItem.provider.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
9 |
addItem.provider.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
10 |
addItem.provider.identifier.type.coding.display |
string |
|
Representation defined by the system |
11 |
addItem.provider.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
12 |
addItem.provider.identifier.type.text |
string |
|
Plain text representation of the concept |
13 |
addItem.provider.identifier.system |
uri |
|
The namespace for the identifier value |
14 |
addItem.provider.identifier.value |
string |
|
The value that is unique |
|
addItem.provider.identifier.period |
Period |
|
Time period when id is/was valid for use |
15 |
addItem.provider.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
16 |
addItem.provider.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
17 |
addItem.provider.display |
string |
|
Text alternative for the resource |
|
addItem.productOrService |
CodeableConcept |
|
Billing, service, product, or drug code |
|
addItem.productOrService.coding |
Coding |
|
Code defined by a terminology system |
18 |
addItem.productOrService.coding.system |
uri |
|
Identity of the terminology system |
19 |
addItem.productOrService.coding.version |
string |
|
Version of the system - if relevant |
20 |
addItem.productOrService.coding.code |
code |
|
Symbol in syntax defined by the system |
21 |
addItem.productOrService.coding.display |
string |
|
Representation defined by the system |
22 |
addItem.productOrService.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
23 |
addItem.productOrService.text |
string |
|
Plain text representation of the concept |
|
addItem.modifier |
CodeableConcept |
|
Service/Product billing modifiers |
|
addItem.modifier.coding |
Coding |
|
Code defined by a terminology system |
24 |
addItem.modifier.coding.system |
uri |
|
Identity of the terminology system |
25 |
addItem.modifier.coding.version |
string |
|
Version of the system - if relevant |
26 |
addItem.modifier.coding.code |
code |
|
Symbol in syntax defined by the system |
27 |
addItem.modifier.coding.display |
string |
|
Representation defined by the system |
28 |
addItem.modifier.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
29 |
addItem.modifier.text |
string |
|
Plain text representation of the concept |
|
addItem.programCode |
CodeableConcept |
|
Program the product or service is provided under |
|
addItem.programCode.coding |
Coding |
|
Code defined by a terminology system |
30 |
addItem.programCode.coding.system |
uri |
|
Identity of the terminology system |
31 |
addItem.programCode.coding.version |
string |
|
Version of the system - if relevant |
32 |
addItem.programCode.coding.code |
code |
|
Symbol in syntax defined by the system |
33 |
addItem.programCode.coding.display |
string |
|
Representation defined by the system |
34 |
addItem.programCode.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
35 |
addItem.programCode.text |
string |
|
Plain text representation of the concept |
|
addItem.serviced[x] |
|
|
Date or dates of service or product delivery |
36 |
addItem.servicedDate |
date |
|
|
|
addItem.servicedPeriod |
Period |
|
|
37 |
addItem.servicedPeriod.start |
dateTime |
|
Starting time with inclusive boundary |
38 |
addItem.servicedPeriod.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
|
addItem.location[x] |
|
|
Place of service or where product was supplied |
|
addItem.locationCodeableConcept |
CodeableConcept |
|
|
|
addItem.locationCodeableConcept.coding |
Coding |
|
Code defined by a terminology system |
39 |
addItem.locationCodeableConcept.coding.system |
uri |
|
Identity of the terminology system |
40 |
addItem.locationCodeableConcept.coding.version |
string |
|
Version of the system - if relevant |
41 |
addItem.locationCodeableConcept.coding.code |
code |
|
Symbol in syntax defined by the system |
42 |
addItem.locationCodeableConcept.coding.display |
string |
|
Representation defined by the system |
43 |
addItem.locationCodeableConcept.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
44 |
addItem.locationCodeableConcept.text |
string |
|
Plain text representation of the concept |
|
addItem.locationAddress |
Address |
|
|
45 |
addItem.locationAddress.use |
code |
|
home | work | temp | old | billing - purpose of this address |
46 |
addItem.locationAddress.type |
code |
|
postal | physical | both |
47 |
addItem.locationAddress.text |
string |
|
Text representation of the address |
48 |
addItem.locationAddress.line |
string |
|
Street name, number, direction & P.O. Box etc. |
49 |
addItem.locationAddress.city |
string |
|
Name of city, town etc. |
50 |
addItem.locationAddress.district |
string |
|
District name (aka county) |
51 |
addItem.locationAddress.state |
string |
|
Sub-unit of country (abbreviations ok) |
52 |
addItem.locationAddress.postalCode |
string |
|
Postal code for area |
53 |
addItem.locationAddress.country |
string |
|
Country (e.g. can be ISO 3166 2 or 3 letter code) |
|
addItem.locationAddress.period |
Period |
|
Time period when address was/is in use |
54 |
addItem.locationAddress.period.start |
dateTime |
|
Starting time with inclusive boundary |
55 |
addItem.locationAddress.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
|
addItem.locationReference |
Reference |
|
|
56 |
addItem.locationReference.reference |
string |
|
Literal reference, Relative, internal or absolute URL |
57 |
addItem.locationReference.type |
uri |
|
Type the reference refers to (e.g. "Patient") |
|
addItem.locationReference.identifier |
Identifier |
|
Logical reference, when literal reference is not known |
58 |
addItem.locationReference.identifier.use |
code |
|
usual | official | temp | secondary | old (If known) |
|
addItem.locationReference.identifier.type |
CodeableConcept |
|
Description of identifier |
|
addItem.locationReference.identifier.type.coding |
Coding |
|
Code defined by a terminology system |
59 |
addItem.locationReference.identifier.type.coding.system |
uri |
|
Identity of the terminology system |
60 |
addItem.locationReference.identifier.type.coding.version |
string |
|
Version of the system - if relevant |
61 |
addItem.locationReference.identifier.type.coding.code |
code |
|
Symbol in syntax defined by the system |
62 |
addItem.locationReference.identifier.type.coding.display |
string |
|
Representation defined by the system |
63 |
addItem.locationReference.identifier.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
64 |
addItem.locationReference.identifier.type.text |
string |
|
Plain text representation of the concept |
65 |
addItem.locationReference.identifier.system |
uri |
|
The namespace for the identifier value |
66 |
addItem.locationReference.identifier.value |
string |
|
The value that is unique |
|
addItem.locationReference.identifier.period |
Period |
|
Time period when id is/was valid for use |
67 |
addItem.locationReference.identifier.period.start |
dateTime |
|
Starting time with inclusive boundary |
68 |
addItem.locationReference.identifier.period.end |
dateTime |
|
End time with inclusive boundary, if not ongoing |
69 |
addItem.locationReference.display |
string |
|
Text alternative for the resource |
|
addItem.quantity |
Quantity |
|
Count of products or services |
70 |
addItem.quantity.value |
decimal |
|
Numerical value (with implicit precision) |
71 |
addItem.quantity.unit |
string |
|
Unit representation |
72 |
addItem.quantity.system |
uri |
|
System that defines coded unit form |
73 |
addItem.quantity.code |
code |
|
Coded form of the unit |
|
addItem.unitPrice |
Money |
|
Fee, charge or cost per item |
74 |
addItem.unitPrice.value |
decimal |
|
Numerical value (with implicit precision) |
75 |
addItem.unitPrice.currency |
code |
|
ISO 4217 Currency Code |
76 |
addItem.factor |
decimal |
|
Price scaling factor |
|
addItem.net |
Money |
|
Total item cost |
77 |
addItem.net.value |
decimal |
|
Numerical value (with implicit precision) |
78 |
addItem.net.currency |
code |
|
ISO 4217 Currency Code |
|
addItem.bodySite |
CodeableConcept |
|
Anatomical location |
|
addItem.bodySite.coding |
Coding |
|
Code defined by a terminology system |
79 |
addItem.bodySite.coding.system |
uri |
|
Identity of the terminology system |
80 |
addItem.bodySite.coding.version |
string |
|
Version of the system - if relevant |
81 |
addItem.bodySite.coding.code |
code |
|
Symbol in syntax defined by the system |
82 |
addItem.bodySite.coding.display |
string |
|
Representation defined by the system |
83 |
addItem.bodySite.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
84 |
addItem.bodySite.text |
string |
|
Plain text representation of the concept |
|
addItem.subSite |
CodeableConcept |
|
Anatomical sub-location |
|
addItem.subSite.coding |
Coding |
|
Code defined by a terminology system |
85 |
addItem.subSite.coding.system |
uri |
|
Identity of the terminology system |
86 |
addItem.subSite.coding.version |
string |
|
Version of the system - if relevant |
87 |
addItem.subSite.coding.code |
code |
|
Symbol in syntax defined by the system |
88 |
addItem.subSite.coding.display |
string |
|
Representation defined by the system |
89 |
addItem.subSite.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
90 |
addItem.subSite.text |
string |
|
Plain text representation of the concept |
91 |
addItem.noteNumber |
positiveInt |
|
Applicable note numbers |
|
addItem.adjudication |
|
|
Added items adjudication |
|
addItem.adjudication.category |
CodeableConcept |
|
Type of adjudication information |
|
addItem.adjudication.category.coding |
Coding |
|
Code defined by a terminology system |
92 |
addItem.adjudication.category.coding.system |
uri |
|
Identity of the terminology system |
93 |
addItem.adjudication.category.coding.version |
string |
|
Version of the system - if relevant |
94 |
addItem.adjudication.category.coding.code |
code |
|
Symbol in syntax defined by the system |
95 |
addItem.adjudication.category.coding.display |
string |
|
Representation defined by the system |
96 |
addItem.adjudication.category.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
97 |
addItem.adjudication.category.text |
string |
|
Plain text representation of the concept |
|
addItem.adjudication.reason |
CodeableConcept |
|
Explanation of adjudication outcome |
|
addItem.adjudication.reason.coding |
Coding |
|
Code defined by a terminology system |
98 |
addItem.adjudication.reason.coding.system |
uri |
|
Identity of the terminology system |
99 |
addItem.adjudication.reason.coding.version |
string |
|
Version of the system - if relevant |
100 |
addItem.adjudication.reason.coding.code |
code |
|
Symbol in syntax defined by the system |
101 |
addItem.adjudication.reason.coding.display |
string |
|
Representation defined by the system |
102 |
addItem.adjudication.reason.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
103 |
addItem.adjudication.reason.text |
string |
|
Plain text representation of the concept |
|
addItem.adjudication.amount |
Money |
|
Monetary amount |
104 |
addItem.adjudication.amount.value |
decimal |
|
Numerical value (with implicit precision) |
105 |
addItem.adjudication.amount.currency |
code |
|
ISO 4217 Currency Code |
106 |
addItem.adjudication.value |
decimal |
|
Non-monitary value |
|
addItem.detail |
|
|
Insurer added line items |
|
addItem.detail.productOrService |
CodeableConcept |
|
Billing, service, product, or drug code |
|
addItem.detail.productOrService.coding |
Coding |
|
Code defined by a terminology system |
107 |
addItem.detail.productOrService.coding.system |
uri |
|
Identity of the terminology system |
108 |
addItem.detail.productOrService.coding.version |
string |
|
Version of the system - if relevant |
109 |
addItem.detail.productOrService.coding.code |
code |
|
Symbol in syntax defined by the system |
110 |
addItem.detail.productOrService.coding.display |
string |
|
Representation defined by the system |
111 |
addItem.detail.productOrService.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
112 |
addItem.detail.productOrService.text |
string |
|
Plain text representation of the concept |
|
addItem.detail.modifier |
CodeableConcept |
|
Service/Product billing modifiers |
|
addItem.detail.modifier.coding |
Coding |
|
Code defined by a terminology system |
113 |
addItem.detail.modifier.coding.system |
uri |
|
Identity of the terminology system |
114 |
addItem.detail.modifier.coding.version |
string |
|
Version of the system - if relevant |
115 |
addItem.detail.modifier.coding.code |
code |
|
Symbol in syntax defined by the system |
116 |
addItem.detail.modifier.coding.display |
string |
|
Representation defined by the system |
117 |
addItem.detail.modifier.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
118 |
addItem.detail.modifier.text |
string |
|
Plain text representation of the concept |
|
addItem.detail.quantity |
Quantity |
|
Count of products or services |
119 |
addItem.detail.quantity.value |
decimal |
|
Numerical value (with implicit precision) |
120 |
addItem.detail.quantity.unit |
string |
|
Unit representation |
121 |
addItem.detail.quantity.system |
uri |
|
System that defines coded unit form |
122 |
addItem.detail.quantity.code |
code |
|
Coded form of the unit |
|
addItem.detail.unitPrice |
Money |
|
Fee, charge or cost per item |
123 |
addItem.detail.unitPrice.value |
decimal |
|
Numerical value (with implicit precision) |
124 |
addItem.detail.unitPrice.currency |
code |
|
ISO 4217 Currency Code |
125 |
addItem.detail.factor |
decimal |
|
Price scaling factor |
|
addItem.detail.net |
Money |
|
Total item cost |
126 |
addItem.detail.net.value |
decimal |
|
Numerical value (with implicit precision) |
127 |
addItem.detail.net.currency |
code |
|
ISO 4217 Currency Code |
128 |
addItem.detail.noteNumber |
positiveInt |
|
Applicable note numbers |
|
addItem.detail.adjudication |
|
|
Added items adjudication |
|
addItem.detail.adjudication.category |
CodeableConcept |
|
Type of adjudication information |
|
addItem.detail.adjudication.category.coding |
Coding |
|
Code defined by a terminology system |
129 |
addItem.detail.adjudication.category.coding.system |
uri |
|
Identity of the terminology system |
130 |
addItem.detail.adjudication.category.coding.version |
string |
|
Version of the system - if relevant |
131 |
addItem.detail.adjudication.category.coding.code |
code |
|
Symbol in syntax defined by the system |
132 |
addItem.detail.adjudication.category.coding.display |
string |
|
Representation defined by the system |
133 |
addItem.detail.adjudication.category.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
134 |
addItem.detail.adjudication.category.text |
string |
|
Plain text representation of the concept |
|
addItem.detail.adjudication.reason |
CodeableConcept |
|
Explanation of adjudication outcome |
|
addItem.detail.adjudication.reason.coding |
Coding |
|
Code defined by a terminology system |
135 |
addItem.detail.adjudication.reason.coding.system |
uri |
|
Identity of the terminology system |
136 |
addItem.detail.adjudication.reason.coding.version |
string |
|
Version of the system - if relevant |
137 |
addItem.detail.adjudication.reason.coding.code |
code |
|
Symbol in syntax defined by the system |
138 |
addItem.detail.adjudication.reason.coding.display |
string |
|
Representation defined by the system |
139 |
addItem.detail.adjudication.reason.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
140 |
addItem.detail.adjudication.reason.text |
string |
|
Plain text representation of the concept |
|
addItem.detail.adjudication.amount |
Money |
|
Monetary amount |
141 |
addItem.detail.adjudication.amount.value |
decimal |
|
Numerical value (with implicit precision) |
142 |
addItem.detail.adjudication.amount.currency |
code |
|
ISO 4217 Currency Code |
143 |
addItem.detail.adjudication.value |
decimal |
|
Non-monitary value |
|
addItem.detail.subDetail |
|
|
Insurer added line items |
|
addItem.detail.subDetail.productOrService |
CodeableConcept |
|
Billing, service, product, or drug code |
|
addItem.detail.subDetail.productOrService.coding |
Coding |
|
Code defined by a terminology system |
144 |
addItem.detail.subDetail.productOrService.coding.system |
uri |
|
Identity of the terminology system |
145 |
addItem.detail.subDetail.productOrService.coding.version |
string |
|
Version of the system - if relevant |
146 |
addItem.detail.subDetail.productOrService.coding.code |
code |
|
Symbol in syntax defined by the system |
147 |
addItem.detail.subDetail.productOrService.coding.display |
string |
|
Representation defined by the system |
148 |
addItem.detail.subDetail.productOrService.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
149 |
addItem.detail.subDetail.productOrService.text |
string |
|
Plain text representation of the concept |
|
addItem.detail.subDetail.modifier |
CodeableConcept |
|
Service/Product billing modifiers |
|
addItem.detail.subDetail.modifier.coding |
Coding |
|
Code defined by a terminology system |
150 |
addItem.detail.subDetail.modifier.coding.system |
uri |
|
Identity of the terminology system |
151 |
addItem.detail.subDetail.modifier.coding.version |
string |
|
Version of the system - if relevant |
152 |
addItem.detail.subDetail.modifier.coding.code |
code |
|
Symbol in syntax defined by the system |
153 |
addItem.detail.subDetail.modifier.coding.display |
string |
|
Representation defined by the system |
154 |
addItem.detail.subDetail.modifier.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
155 |
addItem.detail.subDetail.modifier.text |
string |
|
Plain text representation of the concept |
|
addItem.detail.subDetail.quantity |
Quantity |
|
Count of products or services |
156 |
addItem.detail.subDetail.quantity.value |
decimal |
|
Numerical value (with implicit precision) |
157 |
addItem.detail.subDetail.quantity.unit |
string |
|
Unit representation |
158 |
addItem.detail.subDetail.quantity.system |
uri |
|
System that defines coded unit form |
159 |
addItem.detail.subDetail.quantity.code |
code |
|
Coded form of the unit |
|
addItem.detail.subDetail.unitPrice |
Money |
|
Fee, charge or cost per item |
160 |
addItem.detail.subDetail.unitPrice.value |
decimal |
|
Numerical value (with implicit precision) |
161 |
addItem.detail.subDetail.unitPrice.currency |
code |
|
ISO 4217 Currency Code |
162 |
addItem.detail.subDetail.factor |
decimal |
|
Price scaling factor |
|
addItem.detail.subDetail.net |
Money |
|
Total item cost |
163 |
addItem.detail.subDetail.net.value |
decimal |
|
Numerical value (with implicit precision) |
164 |
addItem.detail.subDetail.net.currency |
code |
|
ISO 4217 Currency Code |
165 |
addItem.detail.subDetail.noteNumber |
positiveInt |
|
Applicable note numbers |
|
addItem.detail.subDetail.adjudication |
|
|
Added items adjudication |
|
addItem.detail.subDetail.adjudication.category |
CodeableConcept |
|
Type of adjudication information |
|
addItem.detail.subDetail.adjudication.category.coding |
Coding |
|
Code defined by a terminology system |
166 |
addItem.detail.subDetail.adjudication.category.coding.system |
uri |
|
Identity of the terminology system |
167 |
addItem.detail.subDetail.adjudication.category.coding.version |
string |
|
Version of the system - if relevant |
168 |
addItem.detail.subDetail.adjudication.category.coding.code |
code |
|
Symbol in syntax defined by the system |
169 |
addItem.detail.subDetail.adjudication.category.coding.display |
string |
|
Representation defined by the system |
170 |
addItem.detail.subDetail.adjudication.category.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
171 |
addItem.detail.subDetail.adjudication.category.text |
string |
|
Plain text representation of the concept |
|
addItem.detail.subDetail.adjudication.reason |
CodeableConcept |
|
Explanation of adjudication outcome |
|
addItem.detail.subDetail.adjudication.reason.coding |
Coding |
|
Code defined by a terminology system |
172 |
addItem.detail.subDetail.adjudication.reason.coding.system |
uri |
|
Identity of the terminology system |
173 |
addItem.detail.subDetail.adjudication.reason.coding.version |
string |
|
Version of the system - if relevant |
174 |
addItem.detail.subDetail.adjudication.reason.coding.code |
code |
|
Symbol in syntax defined by the system |
175 |
addItem.detail.subDetail.adjudication.reason.coding.display |
string |
|
Representation defined by the system |
176 |
addItem.detail.subDetail.adjudication.reason.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
177 |
addItem.detail.subDetail.adjudication.reason.text |
string |
|
Plain text representation of the concept |
|
addItem.detail.subDetail.adjudication.amount |
Money |
|
Monetary amount |
178 |
addItem.detail.subDetail.adjudication.amount.value |
decimal |
|
Numerical value (with implicit precision) |
179 |
addItem.detail.subDetail.adjudication.amount.currency |
code |
|
ISO 4217 Currency Code |
180 |
addItem.detail.subDetail.adjudication.value |
decimal |
|
Non-monitary value |
Row adjudication
# |
path |
type |
required |
description |
0 |
|
string |
* |
Subrow identifier. Must be string "adjudication" |
|
adjudication |
|
|
Header-level adjudication |
|
adjudication.category |
CodeableConcept |
|
Type of adjudication information |
|
adjudication.category.coding |
Coding |
|
Code defined by a terminology system |
1 |
adjudication.category.coding.system |
uri |
|
Identity of the terminology system |
2 |
adjudication.category.coding.version |
string |
|
Version of the system - if relevant |
3 |
adjudication.category.coding.code |
code |
|
Symbol in syntax defined by the system |
4 |
adjudication.category.coding.display |
string |
|
Representation defined by the system |
5 |
adjudication.category.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
6 |
adjudication.category.text |
string |
|
Plain text representation of the concept |
|
adjudication.reason |
CodeableConcept |
|
Explanation of adjudication outcome |
|
adjudication.reason.coding |
Coding |
|
Code defined by a terminology system |
7 |
adjudication.reason.coding.system |
uri |
|
Identity of the terminology system |
8 |
adjudication.reason.coding.version |
string |
|
Version of the system - if relevant |
9 |
adjudication.reason.coding.code |
code |
|
Symbol in syntax defined by the system |
10 |
adjudication.reason.coding.display |
string |
|
Representation defined by the system |
11 |
adjudication.reason.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
12 |
adjudication.reason.text |
string |
|
Plain text representation of the concept |
|
adjudication.amount |
Money |
|
Monetary amount |
13 |
adjudication.amount.value |
decimal |
|
Numerical value (with implicit precision) |
14 |
adjudication.amount.currency |
code |
|
ISO 4217 Currency Code |
15 |
adjudication.value |
decimal |
|
Non-monitary value |
Row total
# |
path |
type |
required |
description |
0 |
|
string |
* |
Subrow identifier. Must be string "total" |
|
total |
|
|
Adjudication totals |
|
total.category |
CodeableConcept |
|
Type of adjudication information |
|
total.category.coding |
Coding |
|
Code defined by a terminology system |
1 |
total.category.coding.system |
uri |
|
Identity of the terminology system |
2 |
total.category.coding.version |
string |
|
Version of the system - if relevant |
3 |
total.category.coding.code |
code |
|
Symbol in syntax defined by the system |
4 |
total.category.coding.display |
string |
|
Representation defined by the system |
5 |
total.category.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
6 |
total.category.text |
string |
|
Plain text representation of the concept |
|
total.amount |
Money |
|
Financial total for the category |
7 |
total.amount.value |
decimal |
|
Numerical value (with implicit precision) |
8 |
total.amount.currency |
code |
|
ISO 4217 Currency Code |
Row processNote
# |
path |
type |
required |
description |
0 |
|
string |
* |
Subrow identifier. Must be string "processNote" |
|
processNote |
|
|
Note concerning adjudication |
1 |
processNote.number |
positiveInt |
|
Note instance identifier |
2 |
processNote.type |
code |
|
display | print | printoper |
3 |
processNote.text |
string |
|
Note explanatory text |
|
processNote.language |
CodeableConcept |
|
Language of the text |
|
processNote.language.coding |
Coding |
|
Code defined by a terminology system |
4 |
processNote.language.coding.system |
uri |
|
Identity of the terminology system |
5 |
processNote.language.coding.version |
string |
|
Version of the system - if relevant |
6 |
processNote.language.coding.code |
code |
|
Symbol in syntax defined by the system |
7 |
processNote.language.coding.display |
string |
|
Representation defined by the system |
8 |
processNote.language.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
9 |
processNote.language.text |
string |
|
Plain text representation of the concept |
Row benefitBalance
# |
path |
type |
required |
description |
0 |
|
string |
* |
Subrow identifier. Must be string "benefitBalance" |
|
benefitBalance |
|
|
Balance by Benefit Category |
|
benefitBalance.category |
CodeableConcept |
|
Benefit classification |
|
benefitBalance.category.coding |
Coding |
|
Code defined by a terminology system |
1 |
benefitBalance.category.coding.system |
uri |
|
Identity of the terminology system |
2 |
benefitBalance.category.coding.version |
string |
|
Version of the system - if relevant |
3 |
benefitBalance.category.coding.code |
code |
|
Symbol in syntax defined by the system |
4 |
benefitBalance.category.coding.display |
string |
|
Representation defined by the system |
5 |
benefitBalance.category.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
6 |
benefitBalance.category.text |
string |
|
Plain text representation of the concept |
7 |
benefitBalance.excluded |
boolean |
|
Excluded from the plan |
8 |
benefitBalance.name |
string |
|
Short name for the benefit |
9 |
benefitBalance.description |
string |
|
Description of the benefit or services covered |
|
benefitBalance.network |
CodeableConcept |
|
In or out of network |
|
benefitBalance.network.coding |
Coding |
|
Code defined by a terminology system |
10 |
benefitBalance.network.coding.system |
uri |
|
Identity of the terminology system |
11 |
benefitBalance.network.coding.version |
string |
|
Version of the system - if relevant |
12 |
benefitBalance.network.coding.code |
code |
|
Symbol in syntax defined by the system |
13 |
benefitBalance.network.coding.display |
string |
|
Representation defined by the system |
14 |
benefitBalance.network.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
15 |
benefitBalance.network.text |
string |
|
Plain text representation of the concept |
|
benefitBalance.unit |
CodeableConcept |
|
Individual or family |
|
benefitBalance.unit.coding |
Coding |
|
Code defined by a terminology system |
16 |
benefitBalance.unit.coding.system |
uri |
|
Identity of the terminology system |
17 |
benefitBalance.unit.coding.version |
string |
|
Version of the system - if relevant |
18 |
benefitBalance.unit.coding.code |
code |
|
Symbol in syntax defined by the system |
19 |
benefitBalance.unit.coding.display |
string |
|
Representation defined by the system |
20 |
benefitBalance.unit.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
21 |
benefitBalance.unit.text |
string |
|
Plain text representation of the concept |
|
benefitBalance.term |
CodeableConcept |
|
Annual or lifetime |
|
benefitBalance.term.coding |
Coding |
|
Code defined by a terminology system |
22 |
benefitBalance.term.coding.system |
uri |
|
Identity of the terminology system |
23 |
benefitBalance.term.coding.version |
string |
|
Version of the system - if relevant |
24 |
benefitBalance.term.coding.code |
code |
|
Symbol in syntax defined by the system |
25 |
benefitBalance.term.coding.display |
string |
|
Representation defined by the system |
26 |
benefitBalance.term.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
27 |
benefitBalance.term.text |
string |
|
Plain text representation of the concept |
|
benefitBalance.financial |
|
|
Benefit Summary |
|
benefitBalance.financial.type |
CodeableConcept |
|
Benefit classification |
|
benefitBalance.financial.type.coding |
Coding |
|
Code defined by a terminology system |
28 |
benefitBalance.financial.type.coding.system |
uri |
|
Identity of the terminology system |
29 |
benefitBalance.financial.type.coding.version |
string |
|
Version of the system - if relevant |
30 |
benefitBalance.financial.type.coding.code |
code |
|
Symbol in syntax defined by the system |
31 |
benefitBalance.financial.type.coding.display |
string |
|
Representation defined by the system |
32 |
benefitBalance.financial.type.coding.userSelected |
boolean |
|
If this coding was chosen directly by the user |
33 |
benefitBalance.financial.type.text |
string |
|
Plain text representation of the concept |
|
benefitBalance.financial.allowed[x] |
|
|
Benefits allowed |
34 |
benefitBalance.financial.allowedUnsignedInt |
unsignedInt |
|
|
35 |
benefitBalance.financial.allowedString |
string |
|
|
|
benefitBalance.financial.allowedMoney |
Money |
|
|
36 |
benefitBalance.financial.allowedMoney.value |
decimal |
|
Numerical value (with implicit precision) |
37 |
benefitBalance.financial.allowedMoney.currency |
code |
|
ISO 4217 Currency Code |
|
benefitBalance.financial.used[x] |
|
|
Benefits used |
38 |
benefitBalance.financial.usedUnsignedInt |
unsignedInt |
|
|
|
benefitBalance.financial.usedMoney |
Money |
|
|
39 |
benefitBalance.financial.usedMoney.value |
decimal |
|
Numerical value (with implicit precision) |
40 |
benefitBalance.financial.usedMoney.currency |
code |
|
ISO 4217 Currency Code |
Examples
Example #1
Input CSV
ExplanationOfBenefit,9,"EB3501","active","http://terminology.hl7.org/CodeSystem/claim-type",,"oral",,,,"http://terminology.hl7.org/CodeSystem/ex-claimsubtype",,"emergency",,,,"claim","Patient/pat1",,,,,,,,,,,,,,"2014-02-01","2014-03-01","2014-08-16","Practitioner/1",,,,,,,,,,,,,,"Organization/2",,,,,,,,,,,,,,"Organization/2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MedicationRequest/medrx002",,,,,,,,,,,,,,"MedicationRequest/medrx0301",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Location/1",,,,,,,,,,,,,,"Claim/100150",,,,,,,,,,,,,,"ClaimResponse/R3500",,,,,,,,,,,,,,"error","Could not process.",2,"2014-02-14","http://terminology.hl7.org/CodeSystem/v3-ActCode",,"SPT",,,,,,,,,,,,,,,"Location/ph",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"http://terminology.hl7.org/CodeSystem/forms-codes",,"2",,,,,,,,,,,,,
identifier,,,,,,,,"http://www.BenefitsInc.com/fhir/explanationofbenefit","error-1",,
related,,,,,,,,,,,,,,,,,,,,,,,,,,,,"http://www.BenefitsInc.com/case-number","23-56Tu-XX-47-20150M14",,
supportingInfo,1,"http://terminology.hl7.org/CodeSystem/claiminformationcategory",,"employmentimpacted",,,,,,,,,,,"2014-02-14","2014-02-28",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
supportingInfo,2,"http://terminology.hl7.org/CodeSystem/claiminformationcategory",,"hospitalized",,,,,,,,,,,"2014-02-14","2014-02-16",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
procedure,1,,,,,,,"2014-02-14","http://hl7.org/fhir/sid/ex-icd-10-procedures",,"123001",,,,,,,,,,,,,,,,,,"Device/example",,,,,,,,,,,,,
insurance,true,"Coverage/9876B1",,,,,,,,,,,,,,
total,,,"submitted",,,,2478.57,"USD"
total,,,"benefit",,,,0,"USD"
processNote,1,"display","Invalid claim","urn:ietf:bcp:47",,"en-CA",,,
Resulting resource
{
"resourceType": "ExplanationOfBenefit",
"id": "EB3501",
"identifier": [
{
"system": "http://www.BenefitsInc.com/fhir/explanationofbenefit",
"value": "error-1"
}
],
"status": "active",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "oral"
}
]
},
"subType": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/ex-claimsubtype",
"code": "emergency"
}
]
},
"use": "claim",
"patient": {
"reference": "Patient/pat1"
},
"billablePeriod": {
"start": "2014-02-01",
"end": "2014-03-01"
},
"created": "2014-08-16",
"enterer": {
"reference": "Practitioner/1"
},
"insurer": {
"reference": "Organization/2"
},
"provider": {
"reference": "Organization/2"
},
"related": [
{
"reference": {
"system": "http://www.BenefitsInc.com/case-number",
"value": "23-56Tu-XX-47-20150M14"
}
}
],
"prescription": {
"reference": "MedicationRequest/medrx002"
},
"originalPrescription": {
"reference": "MedicationRequest/medrx0301"
},
"facility": {
"reference": "Location/1"
},
"claim": {
"reference": "Claim/100150"
},
"claimResponse": {
"reference": "ClaimResponse/R3500"
},
"outcome": "error",
"disposition": "Could not process.",
"supportingInfo": [
{
"sequence": 1,
"category": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "employmentimpacted"
}
]
},
"timingPeriod": {
"start": "2014-02-14",
"end": "2014-02-28"
}
},
{
"sequence": 2,
"category": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "hospitalized"
}
]
},
"timingPeriod": {
"start": "2014-02-14",
"end": "2014-02-16"
}
}
],
"procedure": [
{
"sequence": 1,
"date": "2014-02-14",
"procedureCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/sid/ex-icd-10-procedures",
"code": "123001"
}
]
},
"udi": [
{
"reference": "Device/example"
}
]
}
],
"precedence": 2,
"insurance": [
{
"focal": true,
"coverage": {
"reference": "Coverage/9876B1"
}
}
],
"accident": {
"date": "2014-02-14",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "SPT"
}
]
},
"locationReference": {
"reference": "Location/ph"
}
},
"total": [
{
"category": {
"coding": [
{
"code": "submitted"
}
]
},
"amount": {
"value": 2478.57,
"currency": "USD"
}
},
{
"category": {
"coding": [
{
"code": "benefit"
}
]
},
"amount": {
"value": 0,
"currency": "USD"
}
}
],
"formCode": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/forms-codes",
"code": "2"
}
]
},
"processNote": [
{
"number": 1,
"type": "display",
"text": "Invalid claim",
"language": {
"coding": [
{
"system": "urn:ietf:bcp:47",
"code": "en-CA"
}
]
}
}
]
}
Example #2
Input CSV
ExplanationOfBenefit,7,"EB3500","active","http://terminology.hl7.org/CodeSystem/claim-type",,"oral",,,,,,,,,,"claim","Patient/pat1",,,,,,,,,,,,,,,,"2014-08-16","Practitioner/1",,,,,,,,,,,,,,"Organization/3",,,,,,,,,,,,,,"Practitioner/1",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"http://terminology.hl7.org/CodeSystem/payeetype",,"provider",,,,"Organization/2",,,,,,,,,,,,,,,,,,,,,,,,,,,,"Location/1",,,,,,,,,,,,,,"Claim/100150",,,,,,,,,,,,,,"ClaimResponse/R3500",,,,,,,,,,,,,,"complete","Claim settled as per contract.",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
identifier,,,,,,,,"http://www.BenefitsInc.com/fhir/explanationofbenefit","987654321",,
careTeam,1,"Practitioner/example",,,,,,,,,,,,,,,,,,,,,,,,,,
insurance,true,"Coverage/9876B1",,,,,,,,,,,,,,
item,1,1,,,,,,,,,,,,,,,,"http://terminology.hl7.org/CodeSystem/ex-USCLS",,"1205",,,,,,,,,,,,,,,,"2014-08-16",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,135.57,"USD",,135.57,"USD","Device/example",,,,,,,,,,,,,,,,,,,,,,,,,,"Encounter/example",,,,,,,,,,,,,,,,,"eligible",,,,,,,,,,120,"USD",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
item,2,1,,,,,,,,,,,,,,,,,,"group",,,,,,,,,,,,,,,,"2014-08-16",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,200,"USD",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"benefit",,,,,,,,,,180,"USD",,1,,,,,,,,,,,,,,,"group",,,,,,,,,,,,,,,,,,,,,,,200,"USD","Device/example",,,,,,,,,,,,,,,,,"benefit",,,,,,,,,,180,"USD",,1,,,,,,,,,,,,,"http://terminology.hl7.org/CodeSystem/ex-USCLS",,"1205",,,,,,,,,,,,,,,,,,,,200,"USD",,200,"USD","Device/example",,,,,,,,,,,,,,,,,"eligible",,,,,,,,,,200,"USD",
total,,,"submitted",,,,135.57,"USD"
total,,,"benefit",,,,96,"USD"
Resulting resource
{
"resourceType": "ExplanationOfBenefit",
"id": "EB3500",
"identifier": [
{
"system": "http://www.BenefitsInc.com/fhir/explanationofbenefit",
"value": "987654321"
}
],
"status": "active",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "oral"
}
]
},
"use": "claim",
"patient": {
"reference": "Patient/pat1"
},
"created": "2014-08-16",
"enterer": {
"reference": "Practitioner/1"
},
"insurer": {
"reference": "Organization/3"
},
"provider": {
"reference": "Practitioner/1"
},
"payee": {
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/payeetype",
"code": "provider"
}
]
},
"party": {
"reference": "Organization/2"
}
},
"facility": {
"reference": "Location/1"
},
"claim": {
"reference": "Claim/100150"
},
"claimResponse": {
"reference": "ClaimResponse/R3500"
},
"outcome": "complete",
"disposition": "Claim settled as per contract.",
"careTeam": [
{
"sequence": 1,
"provider": {
"reference": "Practitioner/example"
}
}
],
"insurance": [
{
"focal": true,
"coverage": {
"reference": "Coverage/9876B1"
}
}
],
"item": [
{
"sequence": 1,
"careTeamSequence": [
1
],
"productOrService": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/ex-USCLS",
"code": "1205"
}
]
},
"servicedDate": "2014-08-16",
"unitPrice": {
"value": 135.57,
"currency": "USD"
},
"net": {
"value": 135.57,
"currency": "USD"
},
"udi": [
{
"reference": "Device/example"
}
],
"encounter": [
{
"reference": "Encounter/example"
}
],
"adjudication": [
{
"category": {
"coding": [
{
"code": "eligible"
}
]
},
"amount": {
"value": 120,
"currency": "USD"
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}