Profile Comparison between http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional vs http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional

Left:C4BB ExplanationOfBenefit Inpatient Institutional (http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional)
Right:C4BB ExplanationOfBenefit Inpatient Institutional (http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional)

Messages

ErrorStructureDefinition.versionValues for version differ: '1.2.0' vs '2.0.0'
InformationStructureDefinition.dateValues for date differ: '2021-12-06T20:26:50+00:00' vs '2022-11-28T15:29:06+00:00'
WarningExplanationOfBenefit.identifier.typeElements differ in comments: 'Indicates that the claim identifier is that assigned by a payer for a claim received from a provider or subscriber. (183)' vs 'This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.'
WarningExplanationOfBenefit.identifier.typeElements differ in definition for mustSupport: 'true' vs 'false'
InformationExplanationOfBenefit.identifier.typeElement minimum cardinalities differ: '1' vs '0'
InformationExplanationOfBenefit.billablePeriod.startElement minimum cardinalities differ: '0' vs '1'
InformationExplanationOfBenefit.supportingInfoElement minimum cardinalities differ: '2' vs '1'
InformationExplanationOfBenefit.adjudicationElement minimum cardinalities differ: '0' vs '1'

Metadata

NameValueComments
.abstractfalse
    .baseDefinitionhttp://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit
      .copyright
        .date2021-12-06T20:26:50+00:002022-11-28T15:29:06+00:00
        • Values Differ
        .descriptionThe profile is used for Explanation of Benefits (EOBs) based on claims submitted by clinics, hospitals, skilled nursing facilities and other institutions for inpatient services, which may include the use of equipment and supplies, laboratory services, radiology services and other charges. Inpatient claims are submitted for services rendered at an institution as part of an overnight stay. The claims data is based on the institutional claim format UB-04, submission standards adopted by the Department of Health and Human Services.
          .experimental
            .fhirVersion4.0.1
              .jurisdiction
                ..jurisdiction[0]urn:iso:std:iso:3166#US
                  .kindresource
                    .nameC4BBExplanationOfBenefitInpatientInstitutional
                      .publisherHL7 Financial Management Working Group
                        .purpose
                          .statusactive
                            .titleC4BB ExplanationOfBenefit Inpatient Institutional
                              .typeExplanationOfBenefit
                                .urlhttp://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional
                                  .version1.2.02.0.0
                                  • Values Differ

                                  Structure

                                  NameL FlagsL Card.L TypeL Description & ConstraintsR FlagsR Card.L TypeL Description & ConstraintsCommentsdoco
                                  .. ExplanationOfBenefit C0..*C4BBExplanationOfBenefitExplanation of Benefit resource
                                  EOB-inst-pointoforigin: Where Admission Type and Point of Origin slices exist, if Type of Admission code is Newborn, Point of Origin must be from Point of Origin - Newborn CodeSystem or Type of Admission is not Newborn and Point of Origin must be from Point of Origin Nonnewborn CodeSystem.
                                  EOB-institutional-item-or-header-adjudication: Institutional EOB: Should have adjudication at the item or header level, but not both
                                  adjudication-has-amount-type-slice: If Adjudication is present, it must have at least one adjudicationamounttype slice
                                  C0..*C4BBExplanationOfBenefitExplanation of Benefit resource
                                  EOB-institutional-inpatient-meta-profile-version: Institutional Inpatient EOB: meta.profile with canonical and major.minor. version required.
                                  EOB-inst-pointoforigin: Where Admission Type and Point of Origin slices exist, if Type of Admission code is Newborn, Point of Origin must be from Point of Origin - Newborn CodeSystem or Type of Admission is not Newborn and Point of Origin must be from Point of Origin Nonnewborn CodeSystem.
                                  EOB-institutional-item-or-header-adjudication: Institutional EOB: Should have adjudication with adjudicationamounttype slice at the item or header level, but not both
                                    ... id Σ0..1stringLogical id of this artifactΣ0..1idLogical id of this artifact
                                      ... meta SΣ1..1MetaMetadata about the resourceSΣ1..1MetaMetadata about the resource
                                        .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                          .... Slices for extension 0..*ExtensionAdditional content defined by implementations
                                          Slice: Unordered, Open by value:url
                                          0..*ExtensionAdditional content defined by implementations
                                          Slice: Unordered, Open by value:url
                                            .... versionId Σ0..1idVersion specific identifierΣ0..1idVersion specific identifier
                                              .... lastUpdated SΣ1..1instantWhen the resource version last changedSΣ1..1instantWhen the resource version last changed
                                                .... source Σ0..1uriIdentifies where the resource comes fromΣ0..1uriIdentifies where the resource comes from
                                                  .... Slices for profile Σ1..*canonical(StructureDefinition)Profiles this resource claims to conform to
                                                  Slice: Unordered, Open by pattern:$this
                                                  Σ1..*canonical(StructureDefinition)Profiles this resource claims to conform to
                                                    .... security Σ0..*CodingSecurity Labels applied to this resource
                                                    Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


                                                    Σ0..*CodingSecurity Labels applied to this resource
                                                    Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


                                                      .... tag Σ0..*CodingTags applied to this resource
                                                      Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


                                                      Σ0..*CodingTags applied to this resource
                                                      Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


                                                        ... implicitRules ?!Σ0..1uriA set of rules under which this content was created?!Σ0..1uriA set of rules under which this content was created
                                                          ... language 0..1codeLanguage of the resource content
                                                          Binding: CommonLanguages (preferred): A human language.

                                                          Additional BindingsPurpose
                                                          AllLanguagesMax Binding
                                                          0..1codeLanguage of the resource content
                                                          Binding: CommonLanguages (preferred): A human language.

                                                          Additional BindingsPurpose
                                                          AllLanguagesMax Binding
                                                            ... text 0..1NarrativeText summary of the resource, for human interpretation0..1NarrativeText summary of the resource, for human interpretation
                                                              ... contained 0..*ResourceContained, inline Resources
                                                              0..*ResourceContained, inline Resources
                                                                ... extension 0..*ExtensionAdditional content defined by implementations
                                                                0..*ExtensionAdditional content defined by implementations
                                                                  ... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
                                                                  ?!0..*ExtensionExtensions that cannot be ignored
                                                                    ... identifier S1..*IdentifierBusiness Identifier for the resource
                                                                    S1..*IdentifierBusiness Identifier for the resource
                                                                    Slice: Unordered, Open by pattern:type
                                                                      .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                        .... Slices for extension 0..*ExtensionAdditional content defined by implementations
                                                                        Slice: Unordered, Open by value:url
                                                                        0..*ExtensionAdditional content defined by implementations
                                                                        Slice: Unordered, Open by value:url
                                                                          .... use ?!Σ0..1codeusual | official | temp | secondary | old (If known)
                                                                          Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

                                                                          ?!Σ0..1codeusual | official | temp | secondary | old (If known)
                                                                          Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

                                                                            .... type SΣ1..1CodeableConceptDescription of identifier
                                                                            Binding: C4BBClaimIdentifierType (extensible)
                                                                            Σ0..1CodeableConceptDescription of identifier
                                                                            Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                                                            • Elements differ in comments: 'Indicates that the claim identifier is that assigned by a payer for a claim received from a provider or subscriber. (183)' vs 'This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.'
                                                                            • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                                            • Element minimum cardinalities differ: '1' vs '0'
                                                                            .... system Σ0..1uriThe namespace for the identifier value
                                                                            Example General: http://www.acme.com/identifiers/patient
                                                                            Σ0..1uriThe namespace for the identifier value
                                                                            Example General: http://www.acme.com/identifiers/patient
                                                                              .... value Σ0..1stringThe value that is unique
                                                                              Example General: 123456
                                                                              Σ0..1stringThe value that is unique
                                                                              Example General: 123456
                                                                                .... period Σ0..1PeriodTime period when id is/was valid for useΣ0..1PeriodTime period when id is/was valid for use
                                                                                  .... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)Σ0..1Reference(Organization)Organization that issued id (may be just text)
                                                                                    ... status ?!SΣ1..1codeactive | cancelled | draft | entered-in-error
                                                                                    Binding: ExplanationOfBenefitStatus (required): A code specifying the state of the resource instance.

                                                                                    ?!SΣ1..1codeactive | cancelled | draft | entered-in-error
                                                                                    Binding: ExplanationOfBenefitStatus (required): A code specifying the state of the resource instance.

                                                                                      ... type SΣ1..1CodeableConceptCategory or discipline
                                                                                      Binding: ClaimTypeCodes (required)
                                                                                      Required Pattern: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/claim-type","code":"institutional"}]}
                                                                                      SΣ1..1CodeableConceptCategory or discipline
                                                                                      Binding: ClaimTypeCodes (required)
                                                                                      Required Pattern: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/claim-type","code":"institutional"}]}
                                                                                        ... subType S1..1CodeableConceptMore granular claim type
                                                                                        Binding: C4BBInstitutionalClaimSubType (required)
                                                                                        Required Pattern: {"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBInstitutionalClaimSubType","code":"inpatient"}]}
                                                                                        S1..1CodeableConceptMore granular claim type
                                                                                        Binding: C4BB Institutional Claim SubType Value Set (required)
                                                                                        Required Pattern: {"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBInstitutionalClaimSubType","code":"inpatient"}]}
                                                                                          ... use SΣ1..1codeclaim | preauthorization | predetermination
                                                                                          Binding: Use (required): Complete, proposed, exploratory, other.


                                                                                          Required Pattern: claim
                                                                                          SΣ1..1codeclaim | preauthorization | predetermination
                                                                                          Binding: Use (required): Complete, proposed, exploratory, other.


                                                                                          Required Pattern: claim
                                                                                            ... patient SΣ1..1Reference(C4BB Patient)The recipient of the products and servicesSΣ1..1Reference(C4BB Patient)The recipient of the products and services
                                                                                              ... billablePeriod SΣ1..1PeriodRelevant time frame for the claimSΣ1..1PeriodRelevant time frame for the claim
                                                                                                .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                  .... Slices for extension 0..*ExtensionAdditional content defined by implementations
                                                                                                  Slice: Unordered, Open by value:url
                                                                                                  0..*ExtensionAdditional content defined by implementations
                                                                                                  Slice: Unordered, Open by value:url
                                                                                                    .... start SΣC0..1dateTimeStarting time with inclusive boundarySΣC1..1dateTimeStarting time with inclusive boundary
                                                                                                    • Element minimum cardinalities differ: '0' vs '1'
                                                                                                    .... end SΣC0..1dateTimeEnd time with inclusive boundary, if not ongoingSΣC0..1dateTimeEnd time with inclusive boundary, if not ongoing
                                                                                                      ... created SΣ1..1dateTimeResponse creation dateSΣ1..1dateTimeResponse creation date
                                                                                                        ... enterer 0..1Reference(Practitioner | PractitionerRole)Author of the claim0..1Reference(Practitioner | PractitionerRole)Author of the claim
                                                                                                          ... insurer SΣ1..1Reference(C4BB Organization)Party responsible for reimbursementSΣ1..1Reference(C4BB Organization)Party responsible for reimbursement
                                                                                                            ... provider SΣ1..1Reference(C4BB Organization)Party responsible for the claimSΣ1..1Reference(C4BB Organization)Party responsible for the claim
                                                                                                              ... priority 0..1CodeableConceptDesired processing urgency
                                                                                                              Binding: ProcessPriorityCodes (required)
                                                                                                              0..1CodeableConceptDesired processing urgency
                                                                                                              Binding: ProcessPriorityCodes (required)
                                                                                                                ... fundsReserveRequested 0..1CodeableConceptFor whom to reserve funds
                                                                                                                Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).

                                                                                                                0..1CodeableConceptFor whom to reserve funds
                                                                                                                Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).

                                                                                                                  ... fundsReserve 0..1CodeableConceptFunds reserved status
                                                                                                                  Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).

                                                                                                                  0..1CodeableConceptFunds reserved status
                                                                                                                  Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).

                                                                                                                    ... related S0..*BackboneElementPrior or corollary claims
                                                                                                                    S0..*BackboneElementPrior or corollary claims
                                                                                                                      .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                        .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                        0..*ExtensionAdditional content defined by implementations
                                                                                                                          .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                          ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                            .... claim 0..1Reference(Claim)Reference to the related claim0..1Reference(Claim)Reference to the related claim
                                                                                                                              .... relationship S1..1CodeableConceptHow the reference claim is related
                                                                                                                              Binding: C4BBRelatedClaimRelationshipCodes (required)
                                                                                                                              S1..1CodeableConceptHow the reference claim is related
                                                                                                                              Binding: C4BB Related Claim Relationship Codes Value Set (required)
                                                                                                                                .... reference S1..1IdentifierFile or case referenceS1..1IdentifierFile or case reference
                                                                                                                                  ... prescription 0..1Reference(MedicationRequest | VisionPrescription)Prescription authorizing services or products0..1Reference(MedicationRequest | VisionPrescription)Prescription authorizing services or products
                                                                                                                                    ... originalPrescription 0..1Reference(MedicationRequest)Original prescription if superceded by fulfiller0..1Reference(MedicationRequest)Original prescription if superceded by fulfiller
                                                                                                                                      ... payee SC0..1BackboneElementRecipient of benefits payableSC0..1BackboneElementRecipient of benefits payable
                                                                                                                                        .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                          .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                          0..*ExtensionAdditional content defined by implementations
                                                                                                                                            .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                            ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                              .... type S1..1CodeableConceptCategory of recipient
                                                                                                                                              Binding: C4BBPayeeType (required)
                                                                                                                                              S1..1CodeableConceptCategory of recipient
                                                                                                                                              Binding: C4BB Payee Type Value Set (required)
                                                                                                                                                .... party S0..1Reference(C4BB Organization | C4BB Patient | C4BB Practitioner)Recipient referenceS0..1Reference(C4BB Organization | C4BB Patient | C4BB Practitioner | C4BB RelatedPerson)Recipient reference
                                                                                                                                                  ... referral 0..1Reference(ServiceRequest)Treatment Referral0..1Reference(ServiceRequest)Treatment Referral
                                                                                                                                                    ... facility 0..1Reference(Location)Servicing Facility0..1Reference(Location)Servicing Facility
                                                                                                                                                      ... claim 0..1Reference(Claim)Claim reference0..1Reference(Claim)Claim reference
                                                                                                                                                        ... claimResponse 0..1Reference(ClaimResponse)Claim response reference0..1Reference(ClaimResponse)Claim response reference
                                                                                                                                                          ... outcome SΣ1..1codequeued | complete | error | partial
                                                                                                                                                          Binding: ClaimProcessingCodes (required): The result of the claim processing.

                                                                                                                                                          SΣ1..1codequeued | complete | error | partial
                                                                                                                                                          Binding: ClaimProcessingCodes (required): The result of the claim processing.

                                                                                                                                                            ... disposition 0..1stringDisposition Message0..1stringDisposition Message
                                                                                                                                                              ... preAuthRef 0..*stringPreauthorization reference
                                                                                                                                                              0..*stringPreauthorization reference
                                                                                                                                                                ... preAuthRefPeriod 0..*PeriodPreauthorization in-effect period
                                                                                                                                                                0..*PeriodPreauthorization in-effect period
                                                                                                                                                                  ... careTeam SC0..*BackboneElementCare Team members
                                                                                                                                                                  EOB-inst-careTeam-practitioner: Institutional EOB: Careteam roles refer to a practitioner
                                                                                                                                                                  EOB-inst-careTeam-organization: Institutional EOB: Careteam roles refer to an organization
                                                                                                                                                                  SC0..*BackboneElementCare Team members
                                                                                                                                                                  EOB-inst-careTeam-practitioner: Institutional EOB: Careteam roles refer to a practitioner
                                                                                                                                                                  EOB-inst-careTeam-organization: Institutional EOB: Careteam roles refer to an organization
                                                                                                                                                                    .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                      .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                      0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                        .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                        ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                          .... sequence 1..1positiveIntOrder of care team1..1positiveIntOrder of care team
                                                                                                                                                                            .... provider S1..1Reference(C4BB Organization | C4BB Practitioner)Practitioner or organizationS1..1Reference(C4BB Organization | C4BB Practitioner)Practitioner or organization
                                                                                                                                                                              .... responsible 0..1booleanIndicator of the lead practitioner0..1booleanIndicator of the lead practitioner
                                                                                                                                                                                .... role S1..1CodeableConceptFunction within the team
                                                                                                                                                                                Binding: C4BBClaimInstitutionalCareTeamRole (required)
                                                                                                                                                                                S1..1CodeableConceptFunction within the team
                                                                                                                                                                                Binding: C4BB Claim Institutional Care Team Role Value Set (required)
                                                                                                                                                                                  .... qualification 0..1CodeableConceptPractitioner credential or specialization
                                                                                                                                                                                  Binding: ExampleProviderQualificationCodes (example): Provider professional qualifications.

                                                                                                                                                                                  0..1CodeableConceptPractitioner credential or specialization
                                                                                                                                                                                  Binding: ExampleProviderQualificationCodes (example): Provider professional qualifications.

                                                                                                                                                                                    ... Slices for supportingInfo S2..*BackboneElementSupporting information
                                                                                                                                                                                    Slice: Unordered, Open by pattern:category
                                                                                                                                                                                    S1..*BackboneElementSupporting information
                                                                                                                                                                                    Slice: Unordered, Open by pattern:category
                                                                                                                                                                                    • Element minimum cardinalities differ: '2' vs '1'
                                                                                                                                                                                    .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                      .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                      0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                        .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                        ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                          .... sequence 1..1positiveIntInformation instance identifier1..1positiveIntInformation instance identifier
                                                                                                                                                                                            .... category 1..1CodeableConceptClassification of the supplied information
                                                                                                                                                                                            Binding: C4BBSupportingInfoType (extensible)
                                                                                                                                                                                            1..1CodeableConceptClassification of the supplied information
                                                                                                                                                                                            Binding: C4BB SupportingInfo Type Value Set (extensible)
                                                                                                                                                                                              .... code 0..1CodeableConceptType of information
                                                                                                                                                                                              Binding: ExceptionCodes (example): The valuset used for additional information codes.

                                                                                                                                                                                              0..1CodeableConceptType of information
                                                                                                                                                                                              Binding: ExceptionCodes (example): The valuset used for additional information codes.

                                                                                                                                                                                                .... timing[x] 0..1date, PeriodWhen it occurred0..1date, PeriodWhen it occurred
                                                                                                                                                                                                  .... value[x] 0..1boolean, string, Quantity, Attachment, Reference(Resource)Data to be provided0..1boolean, string, Quantity, Attachment, Reference(Resource)Data to be provided
                                                                                                                                                                                                    .... reason 0..1CodingExplanation for the information
                                                                                                                                                                                                    Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

                                                                                                                                                                                                    0..1CodingExplanation for the information
                                                                                                                                                                                                    Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

                                                                                                                                                                                                      ... diagnosis S1..*BackboneElementPertinent diagnosis information
                                                                                                                                                                                                      S1..*BackboneElementPertinent diagnosis information
                                                                                                                                                                                                        .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                          .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                          0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                            .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                            ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                              .... sequence 1..1positiveIntDiagnosis instance identifier1..1positiveIntDiagnosis instance identifier
                                                                                                                                                                                                                .... diagnosis[x] S1..1CodeableConceptNature of illness or problem
                                                                                                                                                                                                                Binding: CDCICD910CMDiagnosisCodes (required)
                                                                                                                                                                                                                S1..1CodeableConceptNature of illness or problem
                                                                                                                                                                                                                Binding: Diagnosis Codes - International Classification of Diseases, Clinical Modification (ICD-9-CM, ICD-10-CM) Value Set (required)
                                                                                                                                                                                                                  .... type S1..1CodeableConceptTiming or nature of the diagnosis
                                                                                                                                                                                                                  Binding: C4BBClaimInpatientInstitutionalDiagnosisType (required)
                                                                                                                                                                                                                  S1..1CodeableConceptTiming or nature of the diagnosis
                                                                                                                                                                                                                  Binding: C4BB Claim Inpatient Institutional Diagnosis Type Value Set (required)
                                                                                                                                                                                                                    .... onAdmission S0..1CodeableConceptPresent on admission
                                                                                                                                                                                                                    Binding: AHANUBCPresentOnAdmission (required)
                                                                                                                                                                                                                    S0..1CodeableConceptPresent on admission
                                                                                                                                                                                                                    Binding: NUBC Present On Admission Indicator Codes Value Set (required)
                                                                                                                                                                                                                      .... packageCode 0..1CodeableConceptPackage billing code
                                                                                                                                                                                                                      Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.

                                                                                                                                                                                                                      0..1CodeableConceptPackage billing code
                                                                                                                                                                                                                      Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.

                                                                                                                                                                                                                        ... procedure S0..*BackboneElementClinical procedures performed
                                                                                                                                                                                                                        S0..*BackboneElementClinical procedures performed
                                                                                                                                                                                                                          .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                            .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                            0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                              .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                              ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                .... sequence 1..1positiveIntProcedure instance identifier1..1positiveIntProcedure instance identifier
                                                                                                                                                                                                                                  .... type S1..1CodeableConceptCategory of Procedure
                                                                                                                                                                                                                                  Binding: C4BBClaimProcedureType (required)
                                                                                                                                                                                                                                  S1..1CodeableConceptCategory of Procedure
                                                                                                                                                                                                                                  Binding: C4BB Claim Procedure Type Value Set (required)
                                                                                                                                                                                                                                    .... date S0..1dateTimeWhen the procedure was performedS0..1dateTimeWhen the procedure was performed
                                                                                                                                                                                                                                      .... procedure[x] S1..1CodeableConceptSpecific clinical procedure
                                                                                                                                                                                                                                      Binding: CMSICD910PCSProcedureCodes (required)
                                                                                                                                                                                                                                      S1..1CodeableConceptSpecific clinical procedure
                                                                                                                                                                                                                                      Binding: Procedure Codes - International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) - ICD-10 Procedure Value Set (required)
                                                                                                                                                                                                                                        .... udi 0..*Reference(Device)Unique device identifier
                                                                                                                                                                                                                                        0..*Reference(Device)Unique device identifier
                                                                                                                                                                                                                                          ... precedence 0..1positiveIntPrecedence (primary, secondary, etc.)0..1positiveIntPrecedence (primary, secondary, etc.)
                                                                                                                                                                                                                                            ... insurance SΣC1..*BackboneElementPatient insurance information
                                                                                                                                                                                                                                            SΣC1..*BackboneElementPatient insurance information
                                                                                                                                                                                                                                              .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                  .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                  ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                    .... focal SΣ1..1booleanCoverage to be used for adjudicationSΣ1..1booleanCoverage to be used for adjudication
                                                                                                                                                                                                                                                      .... coverage SΣ1..1Reference(C4BB Coverage)Insurance informationSΣ1..1Reference(C4BB Coverage)Insurance information
                                                                                                                                                                                                                                                        .... preAuthRef 0..*stringPrior authorization reference number
                                                                                                                                                                                                                                                        0..*stringPrior authorization reference number
                                                                                                                                                                                                                                                          ... accident 0..1BackboneElementDetails of the event0..1BackboneElementDetails of the event
                                                                                                                                                                                                                                                            .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                              .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                              0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                  .... date 0..1dateWhen the incident occurred0..1dateWhen the incident occurred
                                                                                                                                                                                                                                                                    .... type 0..1CodeableConceptThe nature of the accident
                                                                                                                                                                                                                                                                    Binding: V3 Value SetActIncidentCode (extensible): Type of accident: work place, auto, etc.

                                                                                                                                                                                                                                                                    0..1CodeableConceptThe nature of the accident
                                                                                                                                                                                                                                                                    Binding: ActIncidentCode (extensible): Type of accident: work place, auto, etc.

                                                                                                                                                                                                                                                                      .... location[x] 0..1Address, Reference(Location)Where the event occurred0..1Address, Reference(Location)Where the event occurred
                                                                                                                                                                                                                                                                        ... item SC1..*BackboneElementProduct or service provided
                                                                                                                                                                                                                                                                        adjudication-has-amount-type-slice: If Adjudication is present, it must have at least one adjudicationamounttype slice
                                                                                                                                                                                                                                                                        SC1..*BackboneElementProduct or service provided
                                                                                                                                                                                                                                                                        adjudication-has-amount-type-slice: If Adjudication is present, it must have at least one adjudicationamounttype slice
                                                                                                                                                                                                                                                                          .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                            .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                            0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                              .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                              ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                .... sequence S1..1positiveIntItem instance identifierS1..1positiveIntItem instance identifier
                                                                                                                                                                                                                                                                                  .... careTeamSequence 0..*positiveIntApplicable care team members
                                                                                                                                                                                                                                                                                  0..*positiveIntApplicable care team members
                                                                                                                                                                                                                                                                                    .... diagnosisSequence 0..*positiveIntApplicable diagnoses
                                                                                                                                                                                                                                                                                    0..*positiveIntApplicable diagnoses
                                                                                                                                                                                                                                                                                      .... procedureSequence 0..*positiveIntApplicable procedures
                                                                                                                                                                                                                                                                                      0..*positiveIntApplicable procedures
                                                                                                                                                                                                                                                                                        .... informationSequence 0..*positiveIntApplicable exception and supporting information
                                                                                                                                                                                                                                                                                        0..*positiveIntApplicable exception and supporting information
                                                                                                                                                                                                                                                                                          .... revenue S1..1CodeableConceptRevenue or cost center code
                                                                                                                                                                                                                                                                                          Binding: AHANUBCRevenueCodes (required)
                                                                                                                                                                                                                                                                                          S1..1CodeableConceptRevenue or cost center code
                                                                                                                                                                                                                                                                                          Binding: NUBC Revenue Codes Value Set (required)
                                                                                                                                                                                                                                                                                            .... category 0..1CodeableConceptBenefit classification
                                                                                                                                                                                                                                                                                            Binding: BenefitCategoryCodes (example): Benefit categories such as: oral, medical, vision, oral-basic etc.

                                                                                                                                                                                                                                                                                            0..1CodeableConceptBenefit classification
                                                                                                                                                                                                                                                                                            Binding: BenefitCategoryCodes (example): Benefit categories such as: oral, medical, vision, oral-basic etc.

                                                                                                                                                                                                                                                                                              .... productOrService S1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                                              Binding: C4BBEOBInstitutionalProcedureCodes (required)
                                                                                                                                                                                                                                                                                              S1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                                              Binding: Procedure Codes - AMA CPT - CMS HCPCS - CMS HIPPS Value Set (required)
                                                                                                                                                                                                                                                                                                .... modifier S0..*CodeableConceptProduct or service billing modifiers
                                                                                                                                                                                                                                                                                                Binding: AMACPTCMSHCPCSModifiers (required)
                                                                                                                                                                                                                                                                                                S0..*CodeableConceptProduct or service billing modifiers
                                                                                                                                                                                                                                                                                                Binding: Procedure Modifier Codes - AMA CPT - CMS HCPCS Value Set (required)
                                                                                                                                                                                                                                                                                                  .... programCode 0..*CodeableConceptProgram the product or service is provided under
                                                                                                                                                                                                                                                                                                  Binding: ExampleProgramReasonCodes (example): Program specific reason codes.


                                                                                                                                                                                                                                                                                                  0..*CodeableConceptProgram the product or service is provided under
                                                                                                                                                                                                                                                                                                  Binding: ExampleProgramReasonCodes (example): Program specific reason codes.


                                                                                                                                                                                                                                                                                                    .... serviced[x] 0..1date, PeriodDate or dates of service or product delivery0..1date, PeriodDate or dates of service or product delivery
                                                                                                                                                                                                                                                                                                      .... location[x] 0..1CodeableConcept, Address, Reference(Location)Place of service or where product was supplied
                                                                                                                                                                                                                                                                                                      Binding: ExampleServicePlaceCodes (example): Place where the service is rendered.

                                                                                                                                                                                                                                                                                                      0..1CodeableConcept, Address, Reference(Location)Place of service or where product was supplied
                                                                                                                                                                                                                                                                                                      Binding: ExampleServicePlaceCodes (example): Place where the service is rendered.

                                                                                                                                                                                                                                                                                                        .... quantity S0..1SimpleQuantityCount of products or servicesS0..1SimpleQuantityCount of products or services
                                                                                                                                                                                                                                                                                                          .... unitPrice 0..1MoneyFee, charge or cost per item0..1MoneyFee, charge or cost per item
                                                                                                                                                                                                                                                                                                            .... factor 0..1decimalPrice scaling factor0..1decimalPrice scaling factor
                                                                                                                                                                                                                                                                                                              .... net 0..1MoneyTotal item cost0..1MoneyTotal item cost
                                                                                                                                                                                                                                                                                                                .... udi 0..*Reference(Device)Unique device identifier
                                                                                                                                                                                                                                                                                                                0..*Reference(Device)Unique device identifier
                                                                                                                                                                                                                                                                                                                  .... bodySite 0..1CodeableConceptAnatomical location
                                                                                                                                                                                                                                                                                                                  Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.

                                                                                                                                                                                                                                                                                                                  0..1CodeableConceptAnatomical location
                                                                                                                                                                                                                                                                                                                  Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.

                                                                                                                                                                                                                                                                                                                    .... subSite 0..*CodeableConceptAnatomical sub-location
                                                                                                                                                                                                                                                                                                                    Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.


                                                                                                                                                                                                                                                                                                                    0..*CodeableConceptAnatomical sub-location
                                                                                                                                                                                                                                                                                                                    Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.


                                                                                                                                                                                                                                                                                                                      .... encounter 0..*Reference(Encounter)Encounters related to this billed item
                                                                                                                                                                                                                                                                                                                      0..*Reference(Encounter)Encounters related to this billed item
                                                                                                                                                                                                                                                                                                                        .... noteNumber S0..*positiveIntApplicable note numbers
                                                                                                                                                                                                                                                                                                                        S0..*positiveIntApplicable note numbers
                                                                                                                                                                                                                                                                                                                          .... Slices for adjudication S0..*BackboneElementAdjudication details
                                                                                                                                                                                                                                                                                                                          Slice: Unordered, Open by pattern:category
                                                                                                                                                                                                                                                                                                                          S0..*BackboneElementAdjudication details
                                                                                                                                                                                                                                                                                                                          Slice: Unordered, Open by pattern:category
                                                                                                                                                                                                                                                                                                                            ..... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                                                                              ..... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                              0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                ..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                  ..... category S1..1CodeableConceptType of adjudication information
                                                                                                                                                                                                                                                                                                                                  Binding: C4BBAdjudicationCategoryDiscriminator (required)
                                                                                                                                                                                                                                                                                                                                  S1..1CodeableConceptType of adjudication information
                                                                                                                                                                                                                                                                                                                                  Binding: C4BB Adjudication Category Discriminator Value Set (extensible)
                                                                                                                                                                                                                                                                                                                                    ..... reason 0..1CodeableConceptExplanation of adjudication outcome
                                                                                                                                                                                                                                                                                                                                    Binding: AdjudicationReasonCodes (example): Adjudication reason codes.

                                                                                                                                                                                                                                                                                                                                    0..1CodeableConceptExplanation of adjudication outcome
                                                                                                                                                                                                                                                                                                                                    Binding: AdjudicationReasonCodes (example): Adjudication reason codes.

                                                                                                                                                                                                                                                                                                                                      ..... amount 0..1MoneyMonetary amount0..1MoneyMonetary amount
                                                                                                                                                                                                                                                                                                                                        ..... value 0..1decimalNon-monitary value0..1decimalNon-monitary value
                                                                                                                                                                                                                                                                                                                                          .... detail 0..*BackboneElementAdditional items
                                                                                                                                                                                                                                                                                                                                          0..*BackboneElementAdditional items
                                                                                                                                                                                                                                                                                                                                            ..... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                                                                                              ..... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                              0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                ..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                  ..... sequence 1..1positiveIntProduct or service provided1..1positiveIntProduct or service provided
                                                                                                                                                                                                                                                                                                                                                    ..... revenue 0..1CodeableConceptRevenue or cost center code
                                                                                                                                                                                                                                                                                                                                                    Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

                                                                                                                                                                                                                                                                                                                                                    0..1CodeableConceptRevenue or cost center code
                                                                                                                                                                                                                                                                                                                                                    Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

                                                                                                                                                                                                                                                                                                                                                      ..... category 0..1CodeableConceptBenefit classification
                                                                                                                                                                                                                                                                                                                                                      Binding: BenefitCategoryCodes (example): Benefit categories such as: oral, medical, vision, oral-basic etc.

                                                                                                                                                                                                                                                                                                                                                      0..1CodeableConceptBenefit classification
                                                                                                                                                                                                                                                                                                                                                      Binding: BenefitCategoryCodes (example): Benefit categories such as: oral, medical, vision, oral-basic etc.

                                                                                                                                                                                                                                                                                                                                                        ..... productOrService 1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                                                                                                        Binding: USCLSCodes (example): Allowable service and product codes.

                                                                                                                                                                                                                                                                                                                                                        1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                                                                                                        Binding: USCLSCodes (example): Allowable service and product codes.

                                                                                                                                                                                                                                                                                                                                                          ..... modifier 0..*CodeableConceptService/Product billing modifiers
                                                                                                                                                                                                                                                                                                                                                          Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.


                                                                                                                                                                                                                                                                                                                                                          0..*CodeableConceptService/Product billing modifiers
                                                                                                                                                                                                                                                                                                                                                          Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.


                                                                                                                                                                                                                                                                                                                                                            ..... programCode 0..*CodeableConceptProgram the product or service is provided under
                                                                                                                                                                                                                                                                                                                                                            Binding: ExampleProgramReasonCodes (example): Program specific reason codes.


                                                                                                                                                                                                                                                                                                                                                            0..*CodeableConceptProgram the product or service is provided under
                                                                                                                                                                                                                                                                                                                                                            Binding: ExampleProgramReasonCodes (example): Program specific reason codes.


                                                                                                                                                                                                                                                                                                                                                              ..... quantity 0..1SimpleQuantityCount of products or services0..1SimpleQuantityCount of products or services
                                                                                                                                                                                                                                                                                                                                                                ..... unitPrice 0..1MoneyFee, charge or cost per item0..1MoneyFee, charge or cost per item
                                                                                                                                                                                                                                                                                                                                                                  ..... factor 0..1decimalPrice scaling factor0..1decimalPrice scaling factor
                                                                                                                                                                                                                                                                                                                                                                    ..... net 0..1MoneyTotal item cost0..1MoneyTotal item cost
                                                                                                                                                                                                                                                                                                                                                                      ..... udi 0..*Reference(Device)Unique device identifier
                                                                                                                                                                                                                                                                                                                                                                      0..*Reference(Device)Unique device identifier
                                                                                                                                                                                                                                                                                                                                                                        ..... noteNumber 0..*positiveIntApplicable note numbers
                                                                                                                                                                                                                                                                                                                                                                        0..*positiveIntApplicable note numbers
                                                                                                                                                                                                                                                                                                                                                                          ..... adjudication 0..*See adjudication (ExplanationOfBenefit)Detail level adjudication details
                                                                                                                                                                                                                                                                                                                                                                          0..*See adjudication (ExplanationOfBenefit)Detail level adjudication details
                                                                                                                                                                                                                                                                                                                                                                            ..... subDetail 0..*BackboneElementAdditional items
                                                                                                                                                                                                                                                                                                                                                                            0..*BackboneElementAdditional items
                                                                                                                                                                                                                                                                                                                                                                              ...... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                                                                                                                                ...... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                                                0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                                                  ...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                                                  ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                                                    ...... sequence 1..1positiveIntProduct or service provided1..1positiveIntProduct or service provided
                                                                                                                                                                                                                                                                                                                                                                                      ...... revenue 0..1CodeableConceptRevenue or cost center code
                                                                                                                                                                                                                                                                                                                                                                                      Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

                                                                                                                                                                                                                                                                                                                                                                                      0..1CodeableConceptRevenue or cost center code
                                                                                                                                                                                                                                                                                                                                                                                      Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

                                                                                                                                                                                                                                                                                                                                                                                        ...... category 0..1CodeableConceptBenefit classification
                                                                                                                                                                                                                                                                                                                                                                                        Binding: BenefitCategoryCodes (example): Benefit categories such as: oral, medical, vision, oral-basic etc.

                                                                                                                                                                                                                                                                                                                                                                                        0..1CodeableConceptBenefit classification
                                                                                                                                                                                                                                                                                                                                                                                        Binding: BenefitCategoryCodes (example): Benefit categories such as: oral, medical, vision, oral-basic etc.

                                                                                                                                                                                                                                                                                                                                                                                          ...... productOrService 1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                                                                                                                                          Binding: USCLSCodes (example): Allowable service and product codes.

                                                                                                                                                                                                                                                                                                                                                                                          1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                                                                                                                                          Binding: USCLSCodes (example): Allowable service and product codes.

                                                                                                                                                                                                                                                                                                                                                                                            ...... modifier 0..*CodeableConceptService/Product billing modifiers
                                                                                                                                                                                                                                                                                                                                                                                            Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.


                                                                                                                                                                                                                                                                                                                                                                                            0..*CodeableConceptService/Product billing modifiers
                                                                                                                                                                                                                                                                                                                                                                                            Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.


                                                                                                                                                                                                                                                                                                                                                                                              ...... programCode 0..*CodeableConceptProgram the product or service is provided under
                                                                                                                                                                                                                                                                                                                                                                                              Binding: ExampleProgramReasonCodes (example): Program specific reason codes.


                                                                                                                                                                                                                                                                                                                                                                                              0..*CodeableConceptProgram the product or service is provided under
                                                                                                                                                                                                                                                                                                                                                                                              Binding: ExampleProgramReasonCodes (example): Program specific reason codes.


                                                                                                                                                                                                                                                                                                                                                                                                ...... quantity 0..1SimpleQuantityCount of products or services0..1SimpleQuantityCount of products or services
                                                                                                                                                                                                                                                                                                                                                                                                  ...... unitPrice 0..1MoneyFee, charge or cost per item0..1MoneyFee, charge or cost per item
                                                                                                                                                                                                                                                                                                                                                                                                    ...... factor 0..1decimalPrice scaling factor0..1decimalPrice scaling factor
                                                                                                                                                                                                                                                                                                                                                                                                      ...... net 0..1MoneyTotal item cost0..1MoneyTotal item cost
                                                                                                                                                                                                                                                                                                                                                                                                        ...... udi 0..*Reference(Device)Unique device identifier
                                                                                                                                                                                                                                                                                                                                                                                                        0..*Reference(Device)Unique device identifier
                                                                                                                                                                                                                                                                                                                                                                                                          ...... noteNumber 0..*positiveIntApplicable note numbers
                                                                                                                                                                                                                                                                                                                                                                                                          0..*positiveIntApplicable note numbers
                                                                                                                                                                                                                                                                                                                                                                                                            ...... adjudication 0..*See adjudication (ExplanationOfBenefit)Subdetail level adjudication details
                                                                                                                                                                                                                                                                                                                                                                                                            0..*See adjudication (ExplanationOfBenefit)Subdetail level adjudication details
                                                                                                                                                                                                                                                                                                                                                                                                              ... addItem 0..*BackboneElementInsurer added line items
                                                                                                                                                                                                                                                                                                                                                                                                              0..*BackboneElementInsurer added line items
                                                                                                                                                                                                                                                                                                                                                                                                                .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                                                                                                                                                                  .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                                                                                  0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                                                                                    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                                                                                    ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                                                                                      .... itemSequence 0..*positiveIntItem sequence number
                                                                                                                                                                                                                                                                                                                                                                                                                      0..*positiveIntItem sequence number
                                                                                                                                                                                                                                                                                                                                                                                                                        .... detailSequence 0..*positiveIntDetail sequence number
                                                                                                                                                                                                                                                                                                                                                                                                                        0..*positiveIntDetail sequence number
                                                                                                                                                                                                                                                                                                                                                                                                                          .... subDetailSequence 0..*positiveIntSubdetail sequence number
                                                                                                                                                                                                                                                                                                                                                                                                                          0..*positiveIntSubdetail sequence number
                                                                                                                                                                                                                                                                                                                                                                                                                            .... provider 0..*Reference(Practitioner | PractitionerRole | Organization)Authorized providers
                                                                                                                                                                                                                                                                                                                                                                                                                            0..*Reference(Practitioner | PractitionerRole | Organization)Authorized providers
                                                                                                                                                                                                                                                                                                                                                                                                                              .... productOrService 1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                                                                                                                                                                              Binding: USCLSCodes (example): Allowable service and product codes.

                                                                                                                                                                                                                                                                                                                                                                                                                              1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                                                                                                                                                                              Binding: USCLSCodes (example): Allowable service and product codes.

                                                                                                                                                                                                                                                                                                                                                                                                                                .... modifier 0..*CodeableConceptService/Product billing modifiers
                                                                                                                                                                                                                                                                                                                                                                                                                                Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.


                                                                                                                                                                                                                                                                                                                                                                                                                                0..*CodeableConceptService/Product billing modifiers
                                                                                                                                                                                                                                                                                                                                                                                                                                Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.


                                                                                                                                                                                                                                                                                                                                                                                                                                  .... programCode 0..*CodeableConceptProgram the product or service is provided under
                                                                                                                                                                                                                                                                                                                                                                                                                                  Binding: ExampleProgramReasonCodes (example): Program specific reason codes.


                                                                                                                                                                                                                                                                                                                                                                                                                                  0..*CodeableConceptProgram the product or service is provided under
                                                                                                                                                                                                                                                                                                                                                                                                                                  Binding: ExampleProgramReasonCodes (example): Program specific reason codes.


                                                                                                                                                                                                                                                                                                                                                                                                                                    .... serviced[x] 0..1date, PeriodDate or dates of service or product delivery0..1date, PeriodDate or dates of service or product delivery
                                                                                                                                                                                                                                                                                                                                                                                                                                      .... location[x] 0..1CodeableConcept, Address, Reference(Location)Place of service or where product was supplied
                                                                                                                                                                                                                                                                                                                                                                                                                                      Binding: ExampleServicePlaceCodes (example): Place where the service is rendered.

                                                                                                                                                                                                                                                                                                                                                                                                                                      0..1CodeableConcept, Address, Reference(Location)Place of service or where product was supplied
                                                                                                                                                                                                                                                                                                                                                                                                                                      Binding: ExampleServicePlaceCodes (example): Place where the service is rendered.

                                                                                                                                                                                                                                                                                                                                                                                                                                        .... quantity 0..1SimpleQuantityCount of products or services0..1SimpleQuantityCount of products or services
                                                                                                                                                                                                                                                                                                                                                                                                                                          .... unitPrice 0..1MoneyFee, charge or cost per item0..1MoneyFee, charge or cost per item
                                                                                                                                                                                                                                                                                                                                                                                                                                            .... factor 0..1decimalPrice scaling factor0..1decimalPrice scaling factor
                                                                                                                                                                                                                                                                                                                                                                                                                                              .... net 0..1MoneyTotal item cost0..1MoneyTotal item cost
                                                                                                                                                                                                                                                                                                                                                                                                                                                .... bodySite 0..1CodeableConceptAnatomical location
                                                                                                                                                                                                                                                                                                                                                                                                                                                Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.

                                                                                                                                                                                                                                                                                                                                                                                                                                                0..1CodeableConceptAnatomical location
                                                                                                                                                                                                                                                                                                                                                                                                                                                Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.

                                                                                                                                                                                                                                                                                                                                                                                                                                                  .... subSite 0..*CodeableConceptAnatomical sub-location
                                                                                                                                                                                                                                                                                                                                                                                                                                                  Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.


                                                                                                                                                                                                                                                                                                                                                                                                                                                  0..*CodeableConceptAnatomical sub-location
                                                                                                                                                                                                                                                                                                                                                                                                                                                  Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.


                                                                                                                                                                                                                                                                                                                                                                                                                                                    .... noteNumber 0..*positiveIntApplicable note numbers
                                                                                                                                                                                                                                                                                                                                                                                                                                                    0..*positiveIntApplicable note numbers
                                                                                                                                                                                                                                                                                                                                                                                                                                                      .... adjudication 0..*See adjudication (ExplanationOfBenefit)Added items adjudication
                                                                                                                                                                                                                                                                                                                                                                                                                                                      0..*See adjudication (ExplanationOfBenefit)Added items adjudication
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... detail 0..*BackboneElementInsurer added line items
                                                                                                                                                                                                                                                                                                                                                                                                                                                        0..*BackboneElementInsurer added line items
                                                                                                                                                                                                                                                                                                                                                                                                                                                          ..... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                                                                                                                                                                                                            ..... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                                                                                                                            0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                                                                                                                              ..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                                                                                                                              ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                                                                                                                                ..... productOrService 1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                                                                                                                                                                                                                Binding: USCLSCodes (example): Allowable service and product codes.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                                                                                                                                                                                                                Binding: USCLSCodes (example): Allowable service and product codes.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                  ..... modifier 0..*CodeableConceptService/Product billing modifiers
                                                                                                                                                                                                                                                                                                                                                                                                                                                                  Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.


                                                                                                                                                                                                                                                                                                                                                                                                                                                                  0..*CodeableConceptService/Product billing modifiers
                                                                                                                                                                                                                                                                                                                                                                                                                                                                  Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.


                                                                                                                                                                                                                                                                                                                                                                                                                                                                    ..... quantity 0..1SimpleQuantityCount of products or services0..1SimpleQuantityCount of products or services
                                                                                                                                                                                                                                                                                                                                                                                                                                                                      ..... unitPrice 0..1MoneyFee, charge or cost per item0..1MoneyFee, charge or cost per item
                                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... factor 0..1decimalPrice scaling factor0..1decimalPrice scaling factor
                                                                                                                                                                                                                                                                                                                                                                                                                                                                          ..... net 0..1MoneyTotal item cost0..1MoneyTotal item cost
                                                                                                                                                                                                                                                                                                                                                                                                                                                                            ..... noteNumber 0..*positiveIntApplicable note numbers
                                                                                                                                                                                                                                                                                                                                                                                                                                                                            0..*positiveIntApplicable note numbers
                                                                                                                                                                                                                                                                                                                                                                                                                                                                              ..... adjudication 0..*See adjudication (ExplanationOfBenefit)Added items adjudication
                                                                                                                                                                                                                                                                                                                                                                                                                                                                              0..*See adjudication (ExplanationOfBenefit)Added items adjudication
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                ..... subDetail 0..*BackboneElementInsurer added line items
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                0..*BackboneElementInsurer added line items
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  ...... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    ...... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      ...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... productOrService 1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Binding: USCLSCodes (example): Allowable service and product codes.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Binding: USCLSCodes (example): Allowable service and product codes.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          ...... modifier 0..*CodeableConceptService/Product billing modifiers
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.


                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          0..*CodeableConceptService/Product billing modifiers
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.


                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            ...... quantity 0..1SimpleQuantityCount of products or services0..1SimpleQuantityCount of products or services
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              ...... unitPrice 0..1MoneyFee, charge or cost per item0..1MoneyFee, charge or cost per item
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                ...... factor 0..1decimalPrice scaling factor0..1decimalPrice scaling factor
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  ...... net 0..1MoneyTotal item cost0..1MoneyTotal item cost
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    ...... noteNumber 0..*positiveIntApplicable note numbers
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    0..*positiveIntApplicable note numbers
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      ...... adjudication 0..*See adjudication (ExplanationOfBenefit)Added items adjudication
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      0..*See adjudication (ExplanationOfBenefit)Added items adjudication
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... Slices for adjudication S0..*BackboneElementHeader-level adjudication
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Slice: Unordered, Open by pattern:category
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        S1..*BackboneElementHeader-level adjudication
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Slice: Unordered, Open by pattern:category
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        • Element minimum cardinalities differ: '0' vs '1'
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              .... category S1..1CodeableConceptType of adjudication information
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              Binding: C4BBAdjudicationCategoryDiscriminator (required)
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              S1..1CodeableConceptType of adjudication information
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              Binding: C4BB Adjudication Category Discriminator Value Set (extensible)
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                .... reason 0..1CodeableConceptExplanation of adjudication outcome
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                Binding: AdjudicationReasonCodes (example): Adjudication reason codes.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                0..1CodeableConceptExplanation of adjudication outcome
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                Binding: AdjudicationReasonCodes (example): Adjudication reason codes.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  .... amount 0..1MoneyMonetary amount0..1MoneyMonetary amount
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    .... value 0..1decimalNon-monitary value0..1decimalNon-monitary value
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      ... Slices for total SΣ1..*BackboneElementAdjudication totals
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      Slice: Unordered, Open by pattern:category
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      SΣ1..*BackboneElementAdjudication totals
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      Slice: Unordered, Open by pattern:category
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              .... category SΣ1..1CodeableConceptType of adjudication information
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              Binding: C4BBTotalCategoryDiscriminator (extensible)
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              SΣ1..1CodeableConceptType of adjudication information
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              Binding: C4BB Total Category Discriminator Value Set (extensible)
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                .... amount Σ1..1MoneyFinancial total for the categoryΣ1..1MoneyFinancial total for the category
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  ... payment S0..1BackboneElementPayment DetailsS0..1BackboneElementPayment Details
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .... type S0..1CodeableConceptPartial or complete payment
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          Binding: C4BBPayerClaimPaymentStatusCode (required)
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          S0..1CodeableConceptPartial or complete payment
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          Binding: C4BB Payer Claim Payment Status Code Value Set (required)
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            .... adjustment 0..1MoneyPayment adjustment for non-claim issues0..1MoneyPayment adjustment for non-claim issues
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              .... adjustmentReason 0..1CodeableConceptExplanation for the variance
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              Binding: PaymentAdjustmentReasonCodes (example): Payment Adjustment reason codes.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              0..1CodeableConceptExplanation for the variance
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              Binding: PaymentAdjustmentReasonCodes (example): Payment Adjustment reason codes.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                .... date S0..1dateExpected date of paymentS0..1dateExpected date of payment
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  .... amount 0..1MoneyPayable amount after adjustment0..1MoneyPayable amount after adjustment
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    .... identifier 0..1IdentifierBusiness identifier for the payment0..1IdentifierBusiness identifier for the payment
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      ... formCode 0..1CodeableConceptPrinted form identifier
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      Binding: Form Codes (example): The forms codes.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      0..1CodeableConceptPrinted form identifier
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      Binding: Form Codes (example): The forms codes.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... form 0..1AttachmentPrinted reference or actual form0..1AttachmentPrinted reference or actual form
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          ... processNote S0..*BackboneElementNote concerning adjudication
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          S0..*BackboneElementNote concerning adjudication
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  .... number 0..1positiveIntNote instance identifier0..1positiveIntNote instance identifier
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    .... type 0..1codedisplay | print | printoper
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    Binding: NoteType (required): The presentation types of notes.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    0..1codedisplay | print | printoper
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    Binding: NoteType (required): The presentation types of notes.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      .... text S0..1stringNote explanatory textS0..1stringNote explanatory text
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... language 0..1CodeableConceptLanguage of the text
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Binding: CommonLanguages (preferred): A human language.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Additional BindingsPurpose
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        AllLanguagesMax Binding
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        0..1CodeableConceptLanguage of the text
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Binding: CommonLanguages (preferred): A human language.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Additional BindingsPurpose
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        AllLanguagesMax Binding
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          ... benefitPeriod 0..1PeriodWhen the benefits are applicable0..1PeriodWhen the benefits are applicable
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            ... benefitBalance 0..*BackboneElementBalance by Benefit Category
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            0..*BackboneElementBalance by Benefit Category
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    .... category 1..1CodeableConceptBenefit classification
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    Binding: BenefitCategoryCodes (example): Benefit categories such as: oral, medical, vision, oral-basic etc.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    1..1CodeableConceptBenefit classification
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    Binding: BenefitCategoryCodes (example): Benefit categories such as: oral, medical, vision, oral-basic etc.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      .... excluded 0..1booleanExcluded from the plan0..1booleanExcluded from the plan
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... name 0..1stringShort name for the benefit0..1stringShort name for the benefit
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .... description 0..1stringDescription of the benefit or services covered0..1stringDescription of the benefit or services covered
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            .... network 0..1CodeableConceptIn or out of network
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Binding: NetworkTypeCodes (example): Code to classify in or out of network services.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            0..1CodeableConceptIn or out of network
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Binding: NetworkTypeCodes (example): Code to classify in or out of network services.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              .... unit 0..1CodeableConceptIndividual or family
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              Binding: UnitTypeCodes (example): Unit covered/serviced - individual or family.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              0..1CodeableConceptIndividual or family
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              Binding: UnitTypeCodes (example): Unit covered/serviced - individual or family.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                .... term 0..1CodeableConceptAnnual or lifetime
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                Binding: BenefitTermCodes (example): Coverage unit - annual, lifetime.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                0..1CodeableConceptAnnual or lifetime
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                Binding: BenefitTermCodes (example): Coverage unit - annual, lifetime.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  .... financial 0..*BackboneElementBenefit Summary
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  0..*BackboneElementBenefit Summary
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    ..... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      ..... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          ..... type 1..1CodeableConceptBenefit classification
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          Binding: BenefitTypeCodes (example): Deductable, visits, co-pay, etc.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          1..1CodeableConceptBenefit classification
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          Binding: BenefitTypeCodes (example): Deductable, visits, co-pay, etc.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            ..... allowed[x] 0..1unsignedInt, string, MoneyBenefits allowed0..1unsignedInt, string, MoneyBenefits allowed
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              ..... used[x] 0..1unsignedInt, MoneyBenefits used0..1unsignedInt, MoneyBenefits used

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                doco Documentation for this format