C4BBExplanationOfBenefitPharmacy

C4BB ExplanationOfBenefit Pharmacy

activeCARIN Blue Button2.2.0resource6 key elements

This profile is used for Explanation of Benefits (EOBs) based on claims submitted by retail pharmacies. The claims data is based on submission standards adopted by the Department of Health and Human Services defined by NCPDP (National Council for Prescription Drug Program) The profile has requirements for financial data.

Metadata

hl7.org/fhir
Canonical URL
http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Pharmacy
ID
C4BB-ExplanationOfBenefit-Pharmacy
Type
Base Definition
C4BB-ExplanationOfBenefit-Pharmacy-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+
Line level adjudication type and amount
item.adjudication.amount
S1+
total
S1+
total.category
S
:adjudicationamounttype1..*
S1+
Total adjudication type and amount