This page is part of the FHIR Specification (v5.0.0: R5 - STU ). This is the current published version. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2
13.10.9 Resource ExplanationOfBenefit - Mappings Mappings for the explanationofbenefit resource (see Mappings to Other Standards for further information & status).
ExplanationOfBenefit financial.other identifier FiveWs.identifier status FiveWs.status type FiveWs.class subType FiveWs.class use FiveWs.class patient FiveWs.subject[x] billablePeriod FiveWs.done[x] created FiveWs.recorded enterer FiveWs.author insurer FiveWs.author provider FiveWs.source referral FiveWs.cause facility FiveWs.where[x] claim FiveWs.why[x] provider FiveWs.actor serviced[x] FiveWs.done[x] location[x] FiveWs.where[x] provider FiveWs.source serviced[x] FiveWs.done[x] location[x] FiveWs.where[x]
ExplanationOfBenefit Event identifier Event.identifier status Event.status type Event.code patient Event.subject created Event.occurrence[x] enterer Event.performer.agent insurer Event.performer.agent facility Event.performer.location
ExplanationOfBenefit identifier traceNumber status type subType use patient billablePeriod created enterer insurer provider priority Request.priority fundsReserveRequested fundsReserve related claim relationship reference prescription originalPrescription event type when[x] payee type party referral encounter facility claim claimResponse outcome decision disposition preAuthRef preAuthRefPeriod diagnosisRelatedGroup careTeam sequence provider responsible role specialty supportingInfo sequence category code timing[x] value[x] reason diagnosis sequence diagnosis[x] type onAdmission procedure sequence type date procedure[x] udi precedence insurance Coverage focal coverage preAuthRef accident date type location[x] patientPaid item sequence careTeamSequence diagnosisSequence procedureSequence informationSequence traceNumber revenue category productOrService productOrServiceEnd request modifier programCode serviced[x] location[x] patientPaid quantity unitPrice factor tax net udi bodySite site subSite encounter noteNumber reviewOutcome decision reason preAuthRef preAuthPeriod adjudication category reason amount quantity detail sequence traceNumber revenue category productOrService productOrServiceEnd modifier programCode patientPaid quantity unitPrice factor tax net udi noteNumber reviewOutcome adjudication subDetail sequence traceNumber revenue category productOrService productOrServiceEnd modifier programCode patientPaid quantity unitPrice factor tax net udi noteNumber reviewOutcome adjudication addItem itemSequence detailSequence subDetailSequence traceNumber provider revenue productOrService productOrServiceEnd request modifier programCode serviced[x] location[x] patientPaid quantity unitPrice factor tax net bodySite site subSite noteNumber reviewOutcome adjudication detail traceNumber revenue productOrService productOrServiceEnd modifier patientPaid quantity unitPrice factor tax net noteNumber reviewOutcome adjudication subDetail traceNumber revenue productOrService productOrServiceEnd modifier patientPaid quantity unitPrice factor tax net noteNumber reviewOutcome adjudication adjudication total category amount payment type adjustment adjustmentReason date amount identifier formCode form processNote number type text language benefitPeriod benefitBalance category excluded name description network unit term financial type allowed[x] used[x]
Financial
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