C4BBExplanationOfBenefitOral

C4BB ExplanationOfBenefit Oral

activeCARIN Blue Button2.2.0resource6 key elements

This profile is used for Explanation of Benefits (EOBs) based on claims submitted by providers of oral services including Dental, Denture and Hygiene. The ADA Dental Claim Form provides a common format for reporting dental services to a patient's dental benefit plan. The profile has requirements for financial data.

Metadata

hl7.org/fhir
Canonical URL
http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Oral
ID
C4BB-ExplanationOfBenefit-Oral
Type
Base Definition
C4BB-ExplanationOfBenefit-Oral-Basis
Derivation
constraint
Mandatory and Must-Support Elements

Elements with cardinality > 0 or marked as Must Support (S)

PathCard.TypeFlagsDescription
item.adjudication
1+
:adjudicationamounttype1..*
S1+
Amounts
item.adjudication.amount
S1+
total
S1+
total.category
S
:adjudicationamounttype1..*
S1+
Total adjudication type and amount