Extensions for Using Data Elements from FHIR R4 in FHIR STU3
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Extensions for Using Data Elements from FHIR R4 in FHIR STU3 - Downloaded Version null See the Directory of published versions

Resource Profile: Profile_R4_ExplanationOfBenefit_R3 - Mappings

Page standards status: Trial-use Maturity Level: 0

Mappings for the profile-ExplanationOfBenefit resource profile.

Mappings to Structures in this Implementation Guide

No Mappings Found

Mappings to other Structures

No Mappings Found

Other Mappings

NameW5 MappingCanadian Dental Association eclaims standardHL7 v2 MappingRIM Mappingdoco
.. ExplanationOfBenefit
financial.other
  • Entity. Role
  • or Act
... id
... meta
... implicitRules
... language
... text
Act.text?
... contained
N/A
... Slices for extension
.... extension:use
.... extension:provider
.... extension:priority
.... extension:fundsReserveRequested
.... extension:fundsReserve
.... extension:preAuthRef
.... extension:preAuthRefPeriod
.... extension:adjudication
.... extension:total
.... extension:benefitPeriod
... modifierExtension
N/A
... identifier
id
... status
status
... type
class
... subType
class
... patient
who.focus
  • C06
  • C07
  • C08
  • C05
  • C04
... billablePeriod
when.done
... created
when.recorded
... enterer
who.author
.... id
n/a
.... Slices for extension
..... extension:enterer
.... reference
N/A
.... identifier
.identifier
.... display
N/A
... insurer
who.author
B02
... provider
who.source
B02
... organization
who.source
B02
... referral
who.cause
B05
.... id
n/a
.... Slices for extension
..... extension:referral
.... reference
N/A
.... identifier
.identifier
.... display
N/A
... facility
where
... claim
why
A02|G01
... claimResponse
A02|G01
... outcome
.... id
n/a
.... Slices for extension
..... extension:outcome
.... coding
  • C*E.1-8
  • C*E.10-22
  • union(.
  • ./translation)
.... text
C*E.9. But note many systems use C*E.2 for this
./originalText[mediaType/code="text/plain"]/data
... disposition
... related
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... claim
.... relationship
.... reference
... prescription
... originalPrescription
... payee
F02
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... type
.... resourceType
.... party
  • B03
  • B04
..... id
n/a
..... Slices for extension
...... extension:party
..... reference
N/A
..... identifier
.identifier
..... display
N/A
... information
.... id
n/a
.... Slices for extension
..... extension:value
.... modifierExtension
N/A
.... sequence
.... category
.... code
F23
.... timing[x]
F24
.... value[x]
.... reason
... careTeam
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... sequence
.... provider
who.actor
..... id
n/a
..... Slices for extension
...... extension:provider
..... reference
N/A
..... identifier
.identifier
..... display
N/A
.... responsible
.... role
.... qualification
... diagnosis
.... id
n/a
.... Slices for extension
..... extension:onAdmission
.... modifierExtension
N/A
.... sequence
.... diagnosis[x]
.... type
.... packageCode
... procedure
.... id
n/a
.... Slices for extension
..... extension:type
..... extension:udi
.... modifierExtension
N/A
.... sequence
.... date
.... procedure[x]
... precedence
... insurance
Coverage
.... id
n/a
.... Slices for extension
..... extension:focal
.... modifierExtension
N/A
.... coverage
.... preAuthRef
F03
... accident
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... date
F02
.... type
.... location[x]
... employmentImpacted
... hospitalization
... item
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... sequence
F07
.... careTeamLinkId
.... diagnosisLinkId
.... procedureLinkId
.... informationLinkId
.... revenue
.... category
.... service
F06
.... modifier
F16 (required field for Oral) and F05
.... programCode
.... serviced[x]
when.done
F09
.... location[x]
where
.... quantity
.... unitPrice
F12
.... factor
F13/F14
.... net
F13/F14
.... udi
.... bodySite
F10
.... subSite
F11
.... encounter
.... noteNumber
.... adjudication
..... id
n/a
..... extension
n/a
..... modifierExtension
N/A
..... category
..... reason
..... amount
..... value
.... detail
..... id
n/a
..... extension
n/a
..... modifierExtension
N/A
..... sequence
F07
..... type
..... revenue
..... category
..... service
F34/F35
..... modifier
F16 (required field for Oral) and F05
..... programCode
..... quantity
..... unitPrice
F13/F14
..... factor
F13/F14
..... net
F13/F14
..... udi
..... noteNumber
..... adjudication
..... subDetail
...... id
n/a
...... extension
n/a
...... modifierExtension
N/A
...... sequence
F07
...... type
...... revenue
...... category
...... service
F34/F35
...... modifier
F16 (required field for Oral) and F05
...... programCode
...... quantity
...... unitPrice
F13/F14
...... factor
F13/F14
...... net
F13/F14
...... udi
...... noteNumber
...... adjudication
... addItem
.... id
n/a
.... Slices for extension
..... extension:detailSequence
..... extension:subDetailSequence
..... extension:provider
..... extension:programCode
..... extension:serviced
..... extension:location
..... extension:quantity
..... extension:unitPrice
..... extension:factor
..... extension:bodySite
..... extension:subSite
.... modifierExtension
N/A
.... sequenceLinkId
.... revenue
.... category
F06
.... service
.... modifier
F16 (required field for Oral) and F05
.... fee
.... noteNumber
.... adjudication
.... detail
..... id
n/a
..... Slices for extension
...... extension:quantity
...... extension:unitPrice
...... extension:factor
...... extension:subDetail
...... extension:adjudication
..... modifierExtension
N/A
..... revenue
..... category
F06
..... service
..... modifier
F16 (required field for Oral) and F05
..... fee
..... noteNumber
..... adjudication
... totalCost
... unallocDeductable
... totalBenefit
... payment
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... type
.... adjustment
.... adjustmentReason
.... date
.... amount
.... identifier
  • G01
  • B.23
... form
G42
.... id
n/a
.... Slices for extension
..... extension:form
.... coding
  • C*E.1-8
  • C*E.10-22
  • union(.
  • ./translation)
.... text
C*E.9. But note many systems use C*E.2 for this
./originalText[mediaType/code="text/plain"]/data
... processNote
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... number
.... type
.... text
G32
.... language
... benefitBalance
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... category
.... subCategory
.... excluded
.... name
.... description
.... network
.... unit
.... term
.... financial
..... id
n/a
..... extension
n/a
..... modifierExtension
N/A
..... type
..... allowed[x]
..... used[x]

doco Documentation for this format