--- :name: C4BB_EOB_Oral :class_name: C4bbExplanationofbenefitOralSequence :version: v2.0.0-dev-nonfinancial :reformatted_version: v200devnonfinancial :resource: ExplanationOfBenefit :conformance_expectation: SHALL :profile_url: http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Oral :profile_name: C4BB ExplanationOfBenefit Oral :profile_version: 2.0.0 :title: ExplanationOfBenefit Oral :short_description: Verify support for the server capabilities required by the C4BB ExplanationOfBenefit Oral. :interactions: - :code: search-type :expectation: SHALL - :code: read :expectation: SHALL - :code: vread :expectation: SHOULD :operations: [] :searches: - :names: - _id :expectation: SHALL :names_not_must_support_or_mandatory: [] :must_support_or_mandatory: true - :names: - patient :expectation: SHALL :names_not_must_support_or_mandatory: [] :must_support_or_mandatory: true - :names: - _lastUpdated :expectation: SHALL :names_not_must_support_or_mandatory: [] :must_support_or_mandatory: true - :names: - type :expectation: SHALL :names_not_must_support_or_mandatory: [] :must_support_or_mandatory: true - :names: - identifier :expectation: SHALL :names_not_must_support_or_mandatory: [] :must_support_or_mandatory: true - :names: - service-date :expectation: SHALL :names_not_must_support_or_mandatory: [] :must_support_or_mandatory: true - :names: - service-start-date :expectation: SHALL :names_not_must_support_or_mandatory: [] :must_support_or_mandatory: true - :names: - billable-period-start :expectation: SHALL :names_not_must_support_or_mandatory: [] :must_support_or_mandatory: true :search_definitions: :_id: :paths: - id :full_paths: - ExplanationOfBenefit.id :comparators: {} :values: [] :type: http://hl7.org/fhirpath/System.String :target_paths: - :path: id :target: [] :contains_multiple: false :patient: :paths: - patient :full_paths: - ExplanationOfBenefit.patient :comparators: {} :values: [] :type: Reference :target_paths: - :path: patient :target: - Patient :contains_multiple: false :_lastUpdated: :paths: - meta.lastUpdated :full_paths: - ExplanationOfBenefit.meta.lastUpdated :comparators: :eq: MAY :ne: MAY :gt: MAY :ge: MAY :lt: MAY :le: MAY :sa: MAY :eb: MAY :ap: MAY :values: [] :type: instant :target_paths: - :path: meta.lastUpdated :target: [] :contains_multiple: false :type: :paths: - type :full_paths: - ExplanationOfBenefit.type :comparators: {} :values: - oral :type: CodeableConcept :target_paths: - :path: type :target: [] :contains_multiple: false :identifier: :paths: - identifier :full_paths: - ExplanationOfBenefit.identifier :comparators: {} :values: [] :type: Identifier :target_paths: - :path: identifier :target: [] :contains_multiple: true :service-date: :paths: - billablePeriod - item.serviced :full_paths: - ExplanationOfBenefit.billablePeriod - ExplanationOfBenefit.item.serviced :comparators: :eq: MAY :ne: MAY :gt: MAY :ge: MAY :lt: MAY :le: MAY :sa: MAY :eb: MAY :ap: MAY :values: [] :type: Period :target_paths: - :path: billablePeriod :target: &1 [] - :path: item.serviced :target: *1 :contains_multiple: false :service-start-date: :paths: - billablePeriod.start - item.servicedDate - item.servicedPeriod.start :full_paths: - ExplanationOfBenefit.billablePeriod.start - ExplanationOfBenefit.item.servicedDate - ExplanationOfBenefit.item.servicedPeriod.start :comparators: :eq: MAY :ne: MAY :gt: MAY :ge: MAY :lt: MAY :le: MAY :sa: MAY :eb: MAY :ap: MAY :values: [] :type: dateTime :target_paths: - :path: billablePeriod.start :target: &2 [] - :path: item.servicedDate :target: *2 - :path: item.servicedPeriod.start :target: *2 :contains_multiple: false :billable-period-start: :paths: - billablePeriod.start :full_paths: - ExplanationOfBenefit.billablePeriod.start :comparators: :eq: MAY :ne: MAY :gt: MAY :ge: MAY :lt: MAY :le: MAY :sa: MAY :eb: MAY :ap: MAY :values: [] :type: dateTime :target_paths: - :path: billablePeriod.start :target: [] :contains_multiple: false :provider: :paths: - provider :full_paths: - ExplanationOfBenefit.provider :comparators: {} :values: [] :type: Reference :target_paths: - :path: provider :target: - Practitioner - Organization - PractitionerRole :contains_multiple: false :care-team: :paths: - careTeam.provider :full_paths: - ExplanationOfBenefit.careTeam.provider :comparators: {} :values: [] :type: Reference :target_paths: - :path: careTeam.provider :target: - Practitioner - Organization - PractitionerRole :contains_multiple: false :coverage: :paths: - insurance.coverage :full_paths: - ExplanationOfBenefit.insurance.coverage :comparators: {} :values: [] :type: Reference :target_paths: - :path: insurance.coverage :target: - Coverage :contains_multiple: false :insurer: :paths: - insurer :full_paths: - ExplanationOfBenefit.insurer :comparators: {} :values: [] :type: Reference :target_paths: - :path: insurer :target: - Organization :contains_multiple: false :payee: :paths: [] :full_paths: [] :values: [] :target_paths: [] :contains_multiple: false :*: :paths: [] :full_paths: [] :values: [] :target_paths: [] :contains_multiple: false :include_params: - ExplanationOfBenefit:patient - ExplanationOfBenefit:provider - ExplanationOfBenefit:care-team - ExplanationOfBenefit:coverage - ExplanationOfBenefit:insurer - ExplanationOfBenefit:payee - ExplanationOfBenefit:* :revincludes: [] :required_concepts: - type - priority - related.relationship - payee.type - careTeam.role - careTeam.qualification - supportingInfo.code - supportingInfo.code - diagnosis.diagnosisCodeableConcept - diagnosis.type - item.productOrService - item.modifier - item.locationCodeableConcept - item.bodySite - item.subSite - item.adjudication.reason - item.adjudication.reason - item.adjudication.category - adjudication.reason - adjudication.reason - adjudication.reason - total.category - payment.type :must_supports: :extensions: [] :slices: - :name: ExplanationOfBenefit.identifier:uniqueclaimid :path: identifier :discriminator: :type: patternCodeableConcept :path: type :code: uc :system: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType - :name: ExplanationOfBenefit.supportingInfo:clmrecvddate :path: supportingInfo :discriminator: :type: patternCodeableConcept :path: category :code: clmrecvddate :system: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType - :name: ExplanationOfBenefit.supportingInfo:servicefacility :path: supportingInfo :discriminator: :type: patternCodeableConcept :path: category :code: servicefacility :system: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType - :name: ExplanationOfBenefit.supportingInfo:orthodontics :path: supportingInfo :discriminator: :type: patternCodeableConcept :path: category :code: orthodontics :system: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType - :name: ExplanationOfBenefit.supportingInfo:prosthesis :path: supportingInfo :discriminator: :type: patternCodeableConcept :path: category :code: prosthesis :system: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType - :name: ExplanationOfBenefit.supportingInfo:additionalbodysite :path: supportingInfo :discriminator: :type: patternCodeableConcept :path: category :code: additionalbodysite :system: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType - :name: ExplanationOfBenefit.supportingInfo:missingtoothnumber :path: supportingInfo :discriminator: :type: patternCodeableConcept :path: category :code: missingtoothnumber :system: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType - :name: ExplanationOfBenefit.supportingInfo:medicalrecordnumber :path: supportingInfo :discriminator: :type: patternCodeableConcept :path: category :code: medicalrecordnumber :system: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType - :name: ExplanationOfBenefit.supportingInfo:patientaccountnumber :path: supportingInfo :discriminator: :type: patternCodeableConcept :path: category :code: patientaccountnumber :system: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType - :name: ExplanationOfBenefit.item.adjudication:adjustmentreason :path: item.adjudication :discriminator: :type: patternCodeableConcept :path: category :code: adjustmentreason :system: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator - :name: ExplanationOfBenefit.item.adjudication:benefitpaymentstatus :path: item.adjudication :discriminator: :type: patternCodeableConcept :path: category :code: benefitpaymentstatus :system: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator - :name: ExplanationOfBenefit.item.adjudication:allowedunits :path: item.adjudication :discriminator: :type: patternCodeableConcept :path: category :code: allowedunits :system: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator - :name: ExplanationOfBenefit.item.adjudication:adjudicationamounttype :path: item.adjudication :discriminator: :type: requiredBinding :path: category :values: - submitted - copay - eligible - deductible - benefit - coinsurance - noncovered - priorpayerpaid - paidbypatient - paidbypatientcash - paidbypatientother - paidtopatient - paidtoprovider - memberliability - discount - drugcost - :name: ExplanationOfBenefit.adjudication:billingnetworkstatus :path: adjudication :discriminator: :type: patternCodeableConcept :path: category :code: billingnetworkstatus :system: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator - :name: ExplanationOfBenefit.adjudication:renderingnetworkstatus :path: adjudication :discriminator: :type: patternCodeableConcept :path: category :code: renderingnetworkstatus :system: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator - :name: ExplanationOfBenefit.adjudication:benefitpaymentstatus :path: adjudication :discriminator: :type: patternCodeableConcept :path: category :code: benefitpaymentstatus :system: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator - :name: ExplanationOfBenefit.total:adjudicationamounttype :path: total :discriminator: :type: requiredBinding :path: category :values: - submitted - copay - eligible - deductible - benefit - coinsurance - noncovered - priorpayerpaid - paidbypatient - paidbypatientcash - paidbypatientother - paidtopatient - paidtoprovider - memberliability - discount - drugcost :elements: - :path: meta - :path: meta.lastUpdated - :path: identifier.value - :path: status - :path: type.coding.code :fixed_value: oral - :path: use - :path: patient :types: - Reference - :path: billablePeriod - :path: billablePeriod.start - :path: insurer :types: - Reference - :path: provider :types: - Reference - :path: related - :path: related.relationship - :path: related.reference - :path: payee - :path: payee.type - :path: payee.party :types: - Reference - :path: outcome - :path: careTeam - :path: careTeam.provider :types: - Reference - :path: careTeam.role - :path: careTeam.qualification - :path: supportingInfo - :path: supportingInfo.category.coding.code :fixed_value: clmrecvddate - :path: supportingInfo.timing[x] - :path: supportingInfo.category.coding.code :fixed_value: servicefacility - :path: supportingInfo.category.coding.code :fixed_value: orthodontics - :path: supportingInfo.category.coding.code :fixed_value: prosthesis - :path: supportingInfo.value[x] - :path: supportingInfo.sequence - :path: supportingInfo.category.coding.code :fixed_value: additionalbodysite - :path: supportingInfo.category.coding.code :fixed_value: missingtoothnumber - :path: supportingInfo.code - :path: diagnosis - :path: diagnosis.diagnosis[x] - :path: diagnosis.type - :path: insurance - :path: insurance.focal - :path: insurance.coverage :types: - Reference - :path: item - :path: item.sequence - :path: item.informationSequence - :path: item.productOrService - :path: item.modifier - :path: item.serviced[x] - :path: item.location[x] - :path: item.bodySite - :path: item.noteNumber - :path: item.adjudication - :path: item.adjudication.category.coding.code :fixed_value: adjustmentreason - :path: item.adjudication.category.coding.code :fixed_value: benefitpaymentstatus - :path: item.adjudication.reason - :path: item.adjudication.category.coding.code :fixed_value: allowedunits - :path: item.adjudication.category - :path: item.adjudication.amount - :path: adjudication - :path: adjudication.category - :path: adjudication.reason - :path: total - :path: total.category - :path: payment - :path: payment.type - :path: processNote :mandatory_elements: - ExplanationOfBenefit.meta - ExplanationOfBenefit.meta.lastUpdated - ExplanationOfBenefit.meta.profile - ExplanationOfBenefit.identifier - ExplanationOfBenefit.identifier.type - ExplanationOfBenefit.identifier.value - ExplanationOfBenefit.status - ExplanationOfBenefit.type - ExplanationOfBenefit.use - ExplanationOfBenefit.patient - ExplanationOfBenefit.billablePeriod - ExplanationOfBenefit.billablePeriod.start - ExplanationOfBenefit.created - ExplanationOfBenefit.insurer - ExplanationOfBenefit.provider - ExplanationOfBenefit.related.relationship - ExplanationOfBenefit.related.reference - ExplanationOfBenefit.payee.type - ExplanationOfBenefit.outcome - ExplanationOfBenefit.careTeam.sequence - ExplanationOfBenefit.careTeam.provider - ExplanationOfBenefit.careTeam.role - ExplanationOfBenefit.supportingInfo.sequence - ExplanationOfBenefit.supportingInfo.category - ExplanationOfBenefit.supportingInfo.timing[x] - ExplanationOfBenefit.supportingInfo.value[x] - ExplanationOfBenefit.supportingInfo.code - ExplanationOfBenefit.diagnosis.sequence - ExplanationOfBenefit.diagnosis.diagnosis[x] - ExplanationOfBenefit.diagnosis.type - ExplanationOfBenefit.procedure.sequence - ExplanationOfBenefit.procedure.procedure[x] - ExplanationOfBenefit.insurance - ExplanationOfBenefit.insurance.focal - ExplanationOfBenefit.insurance.coverage - ExplanationOfBenefit.item - ExplanationOfBenefit.item.sequence - ExplanationOfBenefit.item.productOrService - ExplanationOfBenefit.item.serviced[x] - ExplanationOfBenefit.item.location[x] - ExplanationOfBenefit.item.adjudication - ExplanationOfBenefit.item.adjudication.category - ExplanationOfBenefit.item.adjudication.reason - ExplanationOfBenefit.item.adjudication.amount - ExplanationOfBenefit.item.detail.sequence - ExplanationOfBenefit.item.detail.productOrService - ExplanationOfBenefit.item.detail.subDetail.sequence - ExplanationOfBenefit.item.detail.subDetail.productOrService - ExplanationOfBenefit.addItem.productOrService - ExplanationOfBenefit.addItem.detail.productOrService - ExplanationOfBenefit.addItem.detail.subDetail.productOrService - ExplanationOfBenefit.adjudication - ExplanationOfBenefit.adjudication.category - ExplanationOfBenefit.adjudication.reason - ExplanationOfBenefit.total - ExplanationOfBenefit.total.category - ExplanationOfBenefit.total.amount - ExplanationOfBenefit.benefitBalance.category - ExplanationOfBenefit.benefitBalance.financial.type :bindings: - :type: Coding :strength: extensible :system: http://hl7.org/fhir/ValueSet/security-labels :path: meta.security - :type: Coding :strength: example :system: http://hl7.org/fhir/ValueSet/common-tags :path: meta.tag - :type: code :strength: preferred :system: http://hl7.org/fhir/ValueSet/languages :path: language - :type: code :strength: required :system: http://hl7.org/fhir/ValueSet/identifier-use :path: identifier.use - :type: CodeableConcept :strength: extensible :system: http://hl7.org/fhir/ValueSet/identifier-type :path: identifier.type - :type: code :strength: required :system: http://hl7.org/fhir/ValueSet/identifier-use :path: identifier.use - :type: CodeableConcept :strength: extensible :system: http://hl7.org/fhir/ValueSet/identifier-type :path: identifier.type - :type: code :strength: required :system: http://hl7.org/fhir/ValueSet/explanationofbenefit-status :path: status - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/ValueSet/claim-type :path: type - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/claim-subtype :path: subType - :type: code :strength: required :system: http://hl7.org/fhir/ValueSet/claim-use :path: use - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/ValueSet/process-priority :path: priority - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/fundsreserve :path: fundsReserveRequested - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/fundsreserve :path: fundsReserve - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBRelatedClaimRelationshipCodes :path: related.relationship - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayeeType :path: payee.type - :type: code :strength: required :system: http://hl7.org/fhir/ValueSet/remittance-outcome :path: outcome - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimProfessionalAndNonClinicianCareTeamRole :path: careTeam.role - :type: CodeableConcept :strength: required :system: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.1066 :path: careTeam.qualification - :type: CodeableConcept :strength: extensible :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType :path: supportingInfo.category - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/claim-exception :path: supportingInfo.code - :type: Coding :strength: example :system: http://hl7.org/fhir/ValueSet/missing-tooth-reason :path: supportingInfo.reason - :type: CodeableConcept :strength: extensible :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType :path: supportingInfo.category - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/claim-exception :path: supportingInfo.code - :type: Coding :strength: example :system: http://hl7.org/fhir/ValueSet/missing-tooth-reason :path: supportingInfo.reason - :type: CodeableConcept :strength: extensible :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType :path: supportingInfo.category - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/claim-exception :path: supportingInfo.code - :type: Coding :strength: example :system: http://hl7.org/fhir/ValueSet/missing-tooth-reason :path: supportingInfo.reason - :type: CodeableConcept :strength: extensible :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType :path: supportingInfo.category - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/claim-exception :path: supportingInfo.code - :type: Coding :strength: example :system: http://hl7.org/fhir/ValueSet/missing-tooth-reason :path: supportingInfo.reason - :type: CodeableConcept :strength: extensible :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType :path: supportingInfo.category - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/claim-exception :path: supportingInfo.code - :type: Coding :strength: example :system: http://hl7.org/fhir/ValueSet/missing-tooth-reason :path: supportingInfo.reason - :type: CodeableConcept :strength: extensible :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType :path: supportingInfo.category - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/us/carin-bb/ValueSet/OralBodySite :path: supportingInfo.code - :type: Coding :strength: example :system: http://hl7.org/fhir/ValueSet/missing-tooth-reason :path: supportingInfo.reason - :type: CodeableConcept :strength: extensible :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType :path: supportingInfo.category - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/us/carin-bb/ValueSet/ADAUniversalNumberingSystem :path: supportingInfo.code - :type: Coding :strength: example :system: http://hl7.org/fhir/ValueSet/missing-tooth-reason :path: supportingInfo.reason - :type: CodeableConcept :strength: extensible :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType :path: supportingInfo.category - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/claim-exception :path: supportingInfo.code - :type: Coding :strength: example :system: http://hl7.org/fhir/ValueSet/missing-tooth-reason :path: supportingInfo.reason - :type: CodeableConcept :strength: extensible :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType :path: supportingInfo.category - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/claim-exception :path: supportingInfo.code - :type: Coding :strength: example :system: http://hl7.org/fhir/ValueSet/missing-tooth-reason :path: supportingInfo.reason - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/us/carin-bb/ValueSet/CDCICD910CMDiagnosisCodes :path: diagnosis.diagnosis - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimProfessionalAndNonClinicianDiagnosisType :path: diagnosis.type - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission :path: diagnosis.onAdmission - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup :path: diagnosis.packageCode - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/ex-procedure-type :path: procedure.type - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/icd-10-procedures :path: procedure.procedure - :type: CodeableConcept :strength: extensible :system: http://terminology.hl7.org/ValueSet/v3-ActIncidentCode :path: accident.type - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/ex-revenue-center :path: item.revenue - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/ex-benefitcategory :path: item.category - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/us/carin-bb/ValueSet/ADADentalProcedureCode :path: item.productOrService - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSModifiers :path: item.modifier - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/ex-program-code :path: item.programCode - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/service-place :path: item.location - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/us/carin-bb/ValueSet/CMSPlaceofServiceCodes :path: item.location - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/us/carin-bb/ValueSet/OralBodySite :path: item.bodySite - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSurfaceCodes :path: item.subSite - :type: CodeableConcept :strength: extensible :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudicationCategoryDiscriminator :path: item.adjudication.category - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/adjudication-reason :path: item.adjudication.reason - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/adjudication :path: item.adjudication.category - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/us/carin-bb/ValueSet/X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes :path: item.adjudication.reason - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/adjudication :path: item.adjudication.category - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerBenefitPaymentStatus :path: item.adjudication.reason - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/adjudication :path: item.adjudication.category - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/adjudication-reason :path: item.adjudication.reason - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication :path: item.adjudication.category - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/adjudication-reason :path: item.adjudication.reason - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/ex-revenue-center :path: item.detail.revenue - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/ex-benefitcategory :path: item.detail.category - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/service-uscls :path: item.detail.productOrService - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/claim-modifiers :path: item.detail.modifier - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/ex-program-code :path: item.detail.programCode - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/ex-revenue-center :path: item.detail.subDetail.revenue - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/ex-benefitcategory :path: item.detail.subDetail.category - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/service-uscls :path: item.detail.subDetail.productOrService - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/claim-modifiers :path: item.detail.subDetail.modifier - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/ex-program-code :path: item.detail.subDetail.programCode - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/service-uscls :path: addItem.productOrService - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/claim-modifiers :path: addItem.modifier - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/ex-program-code :path: addItem.programCode - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/service-place :path: addItem.location - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/tooth :path: addItem.bodySite - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/surface :path: addItem.subSite - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/service-uscls :path: addItem.detail.productOrService - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/claim-modifiers :path: addItem.detail.modifier - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/service-uscls :path: addItem.detail.subDetail.productOrService - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/claim-modifiers :path: addItem.detail.subDetail.modifier - :type: CodeableConcept :strength: extensible :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudicationCategoryDiscriminator :path: adjudication.category - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/adjudication-reason :path: adjudication.reason - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/adjudication :path: adjudication.category - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerProviderNetworkStatus :path: adjudication.reason - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/adjudication :path: adjudication.category - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerProviderNetworkStatus :path: adjudication.reason - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/adjudication :path: adjudication.category - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerBenefitPaymentStatus :path: adjudication.reason - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/adjudication :path: total.category - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication :path: total.category - :type: CodeableConcept :strength: required :system: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerClaimPaymentStatusCode :path: payment.type - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/payment-adjustment-reason :path: payment.adjustmentReason - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/forms :path: formCode - :type: code :strength: required :system: http://hl7.org/fhir/ValueSet/note-type :path: processNote.type - :type: CodeableConcept :strength: preferred :system: http://hl7.org/fhir/ValueSet/languages :path: processNote.language - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/ex-benefitcategory :path: benefitBalance.category - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/benefit-network :path: benefitBalance.network - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/benefit-unit :path: benefitBalance.unit - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/benefit-term :path: benefitBalance.term - :type: CodeableConcept :strength: example :system: http://hl7.org/fhir/ValueSet/benefit-type :path: benefitBalance.financial.type :references: - :path: ExplanationOfBenefit.identifier.assigner :profiles: - http://hl7.org/fhir/StructureDefinition/Organization - :path: ExplanationOfBenefit.identifier.assigner :profiles: - http://hl7.org/fhir/StructureDefinition/Organization - :path: ExplanationOfBenefit.patient :profiles: - http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Patient - :path: ExplanationOfBenefit.enterer :profiles: - http://hl7.org/fhir/StructureDefinition/Practitioner - http://hl7.org/fhir/StructureDefinition/PractitionerRole - :path: ExplanationOfBenefit.insurer :profiles: - http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization - :path: ExplanationOfBenefit.provider :profiles: - http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner - :path: ExplanationOfBenefit.related.claim :profiles: - http://hl7.org/fhir/StructureDefinition/Claim - :path: ExplanationOfBenefit.prescription :profiles: - http://hl7.org/fhir/StructureDefinition/MedicationRequest - http://hl7.org/fhir/StructureDefinition/VisionPrescription - :path: ExplanationOfBenefit.originalPrescription :profiles: - http://hl7.org/fhir/StructureDefinition/MedicationRequest - :path: ExplanationOfBenefit.payee.party :profiles: - http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization - http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Patient - http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner - http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-RelatedPerson - :path: ExplanationOfBenefit.referral :profiles: - http://hl7.org/fhir/StructureDefinition/ServiceRequest - :path: ExplanationOfBenefit.facility :profiles: - http://hl7.org/fhir/StructureDefinition/Location - :path: ExplanationOfBenefit.claim :profiles: - http://hl7.org/fhir/StructureDefinition/Claim - :path: ExplanationOfBenefit.claimResponse :profiles: - http://hl7.org/fhir/StructureDefinition/ClaimResponse - :path: ExplanationOfBenefit.careTeam.provider :profiles: - http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization - http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner - :path: ExplanationOfBenefit.supportingInfo.value[x] :profiles: - http://hl7.org/fhir/StructureDefinition/Resource - :path: ExplanationOfBenefit.supportingInfo.value[x] :profiles: - http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization - :path: ExplanationOfBenefit.procedure.udi :profiles: - http://hl7.org/fhir/StructureDefinition/Device - :path: ExplanationOfBenefit.insurance.coverage :profiles: - http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage - :path: ExplanationOfBenefit.item.udi :profiles: - http://hl7.org/fhir/StructureDefinition/Device - :path: ExplanationOfBenefit.item.encounter :profiles: - http://hl7.org/fhir/StructureDefinition/Encounter - :path: ExplanationOfBenefit.item.detail.udi :profiles: - http://hl7.org/fhir/StructureDefinition/Device - :path: ExplanationOfBenefit.item.detail.subDetail.udi :profiles: - http://hl7.org/fhir/StructureDefinition/Device - :path: ExplanationOfBenefit.addItem.provider :profiles: - http://hl7.org/fhir/StructureDefinition/Practitioner - http://hl7.org/fhir/StructureDefinition/PractitionerRole - http://hl7.org/fhir/StructureDefinition/Organization :tests: - :id: c4bb_v200devnonfinancial_eob_oral_patient_search_test :file_name: patient_search_test.rb - :id: c4bb_v200devnonfinancial_eob_oral__id_search_test :file_name: id_search_test.rb - :id: c4bb_v200devnonfinancial_eob_oral__lastUpdated_search_test :file_name: lastupdated_search_test.rb - :id: c4bb_v200devnonfinancial_eob_oral_type_search_test :file_name: type_search_test.rb - :id: c4bb_v200devnonfinancial_eob_oral_identifier_search_test :file_name: identifier_search_test.rb - :id: c4bb_v200devnonfinancial_eob_oral_service_date_search_test :file_name: service_date_search_test.rb - :id: c4bb_v200devnonfinancial_eob_oral_service_start_date_search_test :file_name: service_start_date_search_test.rb - :id: c4bb_v200devnonfinancial_eob_oral_billable_period_start_search_test :file_name: billable_period_start_search_test.rb - :id: c4bb_v200devnonfinancial_eob_oral_include_ExplanationOfBenefit_patient_search_test :file_name: incl_patient_search_test.rb - :id: c4bb_v200devnonfinancial_eob_oral_include_ExplanationOfBenefit_provider_search_test :file_name: incl_provider_search_test.rb - :id: c4bb_v200devnonfinancial_eob_oral_include_ExplanationOfBenefit_careteam_search_test :file_name: incl_careteam_search_test.rb - :id: c4bb_v200devnonfinancial_eob_oral_include_ExplanationOfBenefit_coverage_search_test :file_name: incl_coverage_search_test.rb - :id: c4bb_v200devnonfinancial_eob_oral_include_ExplanationOfBenefit_insurer_search_test :file_name: incl_insurer_search_test.rb - :id: c4bb_v200devnonfinancial_eob_oral_include_ExplanationOfBenefit_payee_search_test :file_name: incl_payee_search_test.rb - :id: c4bb_v200devnonfinancial_eob_oral_include_ExplanationOfBenefit_All_search_test :file_name: incl_all_search_test.rb - :id: c4bb_v200devnonfinancial_eob_oral_read_test :file_name: read_test.rb - :id: c4bb_v200devnonfinancial_eob_oral_validation_test :file_name: validation_test.rb - :id: c4bb_v200devnonfinancial_eob_oral_must_support_test :file_name: must_support_test.rb :id: c4bb_v200devnonfinancial_eob_oral :file_name: eob_oral_group.rb :delayed_references: - :path: insurer :resources: - Organization - :path: provider :resources: - Practitioner - :path: payee.party :resources: - Organization - Practitioner - RelatedPerson - :path: careTeam.provider :resources: - Organization - Practitioner - :path: supportingInfo.value[x] :resources: - Organization - :path: insurance.coverage :resources: - Coverage