| CARINBBExplanationOfBenefitOutpatientFacility |
| ExplanationOfBenefit | Entity. Role, or Act |
| text | Act.text? |
| contained | N/A |
| extension | N/A |
| modifierExtension | N/A |
| related | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| payee | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| careTeam | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| supportingInfo | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| supportingInfo (placeOfServiceCode) | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| supportingInfo (patientDischargeStatusCode) | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| supportingInfo (sourceInpatientAdmissionTypeCode) | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| supportingInfo (sourceInpatientAdmissionCode) | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| supportingInfo (frequencyCode) | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| supportingInfo (serviceClassificationCode) | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| supportingInfo (facilityTypeCode) | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| supportingInfo (claimReceivedDate) | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| supportingInfo (referringProviderNetworkStatus) | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| supportingInfo (billingProviderNetworkStatus) | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| diagnosis | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| procedure | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| insurance | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| insurance (primaryinsurance) | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| insurance (secondaryinsurance) | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| accident | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| item | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| adjudication | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| detail | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| subDetail | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| addItem | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| detail | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| subDetail | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| total | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| payment | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| processNote | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| benefitBalance | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |
| financial | |
| id | n/a |
| extension | n/a |
| modifierExtension | N/A |