C4BBExplanationOfBenefitProfessionalNonClinician

C4BB ExplanationOfBenefit Professional NonClinician

activeCARIN Blue Button2.2.0resource6 key elements

This profile is used for Explanation of Benefits (EOBs) based on claims submitted by physicians, suppliers and other non-institutional providers for professional and vision services. These services may be rendered in inpatient or outpatient, including office locations. The claims data is based on the professional claim form 1500, submission standards adopted by the Department of Health and Human Services as form CMS-1500. The profile has requirements for financial data.

Metadata

hl7.org/fhir
Canonical URL
http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Professional-NonClinician
ID
C4BB-ExplanationOfBenefit-Professional-NonClinician
Type
Base Definition
C4BB-ExplanationOfBenefit-Professional-NonClinician-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