Extensions for Using Data Elements from FHIR R4 in FHIR R4B
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Extensions for Using Data Elements from FHIR R4 in FHIR R4B - Downloaded Version null See the Directory of published versions

ConceptMap: R4ExplanationOfBenefitElementMapToR4B

Official URL: http://hl7.org/fhir/uv/xver/ConceptMap/R4-ExplanationOfBenefit-element-map-to-R4B Version: 0.1.0
Standards status: Trial-use Maturity Level: 0 Computable Name: R4ExplanationOfBenefitElementMapToR4B

This ConceptMap represents cross-version mappings for elements from a FHIR R4 ExplanationOfBenefit to FHIR R4B.

Mapping from http://hl7.org/fhir/4.0 to http://hl7.org/fhir/4.3


Group 1 Mapping from http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit|4.0.1 to ExplanationOfBenefitversion: 4.3.0)

Source CodeRelationshipTarget CodeComment
ExplanationOfBenefit.meta (meta)is equivalent toExplanationOfBenefit.metaElement `ExplanationOfBenefit.meta` is mapped to FHIR R4B element `ExplanationOfBenefit.meta` as `Equivalent`.
ExplanationOfBenefit.implicitRules (implicitRules)is equivalent toExplanationOfBenefit.implicitRulesElement `ExplanationOfBenefit.implicitRules` is mapped to FHIR R4B element `ExplanationOfBenefit.implicitRules` as `Equivalent`. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
ExplanationOfBenefit.language (language)is equivalent toExplanationOfBenefit.languageElement `ExplanationOfBenefit.language` is mapped to FHIR R4B element `ExplanationOfBenefit.language` as `Equivalent`. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
ExplanationOfBenefit.text (text)is equivalent toExplanationOfBenefit.textElement `ExplanationOfBenefit.text` is mapped to FHIR R4B element `ExplanationOfBenefit.text` as `Equivalent`. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
ExplanationOfBenefit.contained (contained)is equivalent toExplanationOfBenefit.containedElement `ExplanationOfBenefit.contained` is mapped to FHIR R4B element `ExplanationOfBenefit.contained` as `Equivalent`. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
ExplanationOfBenefit.identifier (identifier)is equivalent toExplanationOfBenefit.identifierElement `ExplanationOfBenefit.identifier` is mapped to FHIR R4B element `ExplanationOfBenefit.identifier` as `Equivalent`.
ExplanationOfBenefit.status (status)is equivalent toExplanationOfBenefit.statusElement `ExplanationOfBenefit.status` is mapped to FHIR R4B element `ExplanationOfBenefit.status` as `Equivalent`. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
ExplanationOfBenefit.type (type)is equivalent toExplanationOfBenefit.typeElement `ExplanationOfBenefit.type` is mapped to FHIR R4B element `ExplanationOfBenefit.type` as `Equivalent`. The majority of jurisdictions use: oral, pharmacy, vision, professional and institutional, or variants on those terms, as the general styles of claims. The valueset is extensible to accommodate other jurisdictional requirements.
ExplanationOfBenefit.subType (subType)is equivalent toExplanationOfBenefit.subTypeElement `ExplanationOfBenefit.subType` is mapped to FHIR R4B element `ExplanationOfBenefit.subType` as `Equivalent`. This may contain the local bill type codes such as the US UB-04 bill type code.
ExplanationOfBenefit.use (use)is equivalent toExplanationOfBenefit.useElement `ExplanationOfBenefit.use` is mapped to FHIR R4B element `ExplanationOfBenefit.use` as `Equivalent`.
ExplanationOfBenefit.patient (patient)is equivalent toExplanationOfBenefit.patientElement `ExplanationOfBenefit.patient` is mapped to FHIR R4B element `ExplanationOfBenefit.patient` as `Equivalent`.
ExplanationOfBenefit.billablePeriod (billablePeriod)is equivalent toExplanationOfBenefit.billablePeriodElement `ExplanationOfBenefit.billablePeriod` is mapped to FHIR R4B element `ExplanationOfBenefit.billablePeriod` as `Equivalent`. Typically this would be today or in the past for a claim, and today or in the future for preauthorizations and prodeterminations. Typically line item dates of service should fall within the billing period if one is specified.
ExplanationOfBenefit.created (created)is equivalent toExplanationOfBenefit.createdElement `ExplanationOfBenefit.created` is mapped to FHIR R4B element `ExplanationOfBenefit.created` as `Equivalent`. This field is independent of the date of creation of the resource as it may reflect the creation date of a source document prior to digitization. Typically for claims all services must be completed as of this date.
ExplanationOfBenefit.enterer (enterer)is equivalent toExplanationOfBenefit.entererElement `ExplanationOfBenefit.enterer` is mapped to FHIR R4B element `ExplanationOfBenefit.enterer` as `Equivalent`.
ExplanationOfBenefit.insurer (insurer)is equivalent toExplanationOfBenefit.insurerElement `ExplanationOfBenefit.insurer` is mapped to FHIR R4B element `ExplanationOfBenefit.insurer` as `Equivalent`.
ExplanationOfBenefit.provider (provider)is equivalent toExplanationOfBenefit.providerElement `ExplanationOfBenefit.provider` is mapped to FHIR R4B element `ExplanationOfBenefit.provider` as `Equivalent`. Typically this field would be 1..1 where this party is responsible for the claim but not necessarily professionally responsible for the provision of the individual products and services listed below.
ExplanationOfBenefit.priority (priority)is equivalent toExplanationOfBenefit.priorityElement `ExplanationOfBenefit.priority` is mapped to FHIR R4B element `ExplanationOfBenefit.priority` as `Equivalent`. If a claim processor is unable to complete the processing as per the priority then they should generate and error and not process the request.
ExplanationOfBenefit.fundsReserveRequested (fundsReserveRequested)is equivalent toExplanationOfBenefit.fundsReserveRequestedElement `ExplanationOfBenefit.fundsReserveRequested` is mapped to FHIR R4B element `ExplanationOfBenefit.fundsReserveRequested` as `Equivalent`. This field is only used for preauthorizations.
ExplanationOfBenefit.fundsReserve (fundsReserve)is equivalent toExplanationOfBenefit.fundsReserveElement `ExplanationOfBenefit.fundsReserve` is mapped to FHIR R4B element `ExplanationOfBenefit.fundsReserve` as `Equivalent`. Fund would be release by a future claim quoting the preAuthRef of this response. Examples of values include: provider, patient, none.
ExplanationOfBenefit.related (related)maps to wider conceptExplanationOfBenefit.relatedElement `ExplanationOfBenefit.related` is mapped to FHIR R4B element `ExplanationOfBenefit.related` as `Equivalent`. For example, for the original treatment and follow-up exams.
ExplanationOfBenefit.related.claim (claim)is equivalent toExplanationOfBenefit.related.claimElement `ExplanationOfBenefit.related.claim` is mapped to FHIR R4B element `ExplanationOfBenefit.related.claim` as `Equivalent`.
ExplanationOfBenefit.related.relationship (relationship)is equivalent toExplanationOfBenefit.related.relationshipElement `ExplanationOfBenefit.related.relationship` is mapped to FHIR R4B element `ExplanationOfBenefit.related.relationship` as `Equivalent`. For example, prior claim or umbrella.
ExplanationOfBenefit.related.reference (reference)is equivalent toExplanationOfBenefit.related.referenceElement `ExplanationOfBenefit.related.reference` is mapped to FHIR R4B element `ExplanationOfBenefit.related.reference` as `Equivalent`. For example, Property/Casualty insurer claim number or Workers Compensation case number.
ExplanationOfBenefit.prescription (prescription)is equivalent toExplanationOfBenefit.prescriptionElement `ExplanationOfBenefit.prescription` is mapped to FHIR R4B element `ExplanationOfBenefit.prescription` as `Equivalent`.
ExplanationOfBenefit.originalPrescription (originalPrescription)is equivalent toExplanationOfBenefit.originalPrescriptionElement `ExplanationOfBenefit.originalPrescription` is mapped to FHIR R4B element `ExplanationOfBenefit.originalPrescription` as `Equivalent`. For example, a physician may prescribe a medication which the pharmacy determines is contraindicated, or for which the patient has an intolerance, and therefor issues a new prescription for an alternate medication which has the same therapeutic intent. The prescription from the pharmacy becomes the 'prescription' and that from the physician becomes the 'original prescription'.
ExplanationOfBenefit.payee (payee)maps to wider conceptExplanationOfBenefit.payeeElement `ExplanationOfBenefit.payee` is mapped to FHIR R4B element `ExplanationOfBenefit.payee` as `Equivalent`. Often providers agree to receive the benefits payable to reduce the near-term costs to the patient. The insurer may decline to pay the provider and may choose to pay the subscriber instead.
ExplanationOfBenefit.payee.type (type)is equivalent toExplanationOfBenefit.payee.typeElement `ExplanationOfBenefit.payee.type` is mapped to FHIR R4B element `ExplanationOfBenefit.payee.type` as `Equivalent`.
ExplanationOfBenefit.payee.party (party)is equivalent toExplanationOfBenefit.payee.partyElement `ExplanationOfBenefit.payee.party` is mapped to FHIR R4B element `ExplanationOfBenefit.payee.party` as `Equivalent`. Not required if the payee is 'subscriber' or 'provider'.
ExplanationOfBenefit.referral (referral)is equivalent toExplanationOfBenefit.referralElement `ExplanationOfBenefit.referral` is mapped to FHIR R4B element `ExplanationOfBenefit.referral` as `Equivalent`. The referral resource which lists the date, practitioner, reason and other supporting information.
ExplanationOfBenefit.facility (facility)is equivalent toExplanationOfBenefit.facilityElement `ExplanationOfBenefit.facility` is mapped to FHIR R4B element `ExplanationOfBenefit.facility` as `Equivalent`.
ExplanationOfBenefit.claim (claim)is equivalent toExplanationOfBenefit.claimElement `ExplanationOfBenefit.claim` is mapped to FHIR R4B element `ExplanationOfBenefit.claim` as `Equivalent`.
ExplanationOfBenefit.claimResponse (claimResponse)is equivalent toExplanationOfBenefit.claimResponseElement `ExplanationOfBenefit.claimResponse` is mapped to FHIR R4B element `ExplanationOfBenefit.claimResponse` as `Equivalent`.
ExplanationOfBenefit.outcome (outcome)is equivalent toExplanationOfBenefit.outcomeElement `ExplanationOfBenefit.outcome` is mapped to FHIR R4B element `ExplanationOfBenefit.outcome` as `Equivalent`. The resource may be used to indicate that: the request has been held (queued) for processing; that it has been processed and errors found (error); that no errors were found and that some of the adjudication has been undertaken (partial) or that all of the adjudication has been undertaken (complete).
ExplanationOfBenefit.disposition (disposition)is equivalent toExplanationOfBenefit.dispositionElement `ExplanationOfBenefit.disposition` is mapped to FHIR R4B element `ExplanationOfBenefit.disposition` as `Equivalent`.
ExplanationOfBenefit.preAuthRef (preAuthRef)is equivalent toExplanationOfBenefit.preAuthRefElement `ExplanationOfBenefit.preAuthRef` is mapped to FHIR R4B element `ExplanationOfBenefit.preAuthRef` as `Equivalent`. This value is only present on preauthorization adjudications.
ExplanationOfBenefit.preAuthRefPeriod (preAuthRefPeriod)is equivalent toExplanationOfBenefit.preAuthRefPeriodElement `ExplanationOfBenefit.preAuthRefPeriod` is mapped to FHIR R4B element `ExplanationOfBenefit.preAuthRefPeriod` as `Equivalent`. This value is only present on preauthorization adjudications.
ExplanationOfBenefit.careTeam (careTeam)maps to wider conceptExplanationOfBenefit.careTeamElement `ExplanationOfBenefit.careTeam` is mapped to FHIR R4B element `ExplanationOfBenefit.careTeam` as `Equivalent`.
ExplanationOfBenefit.careTeam.sequence (sequence)is equivalent toExplanationOfBenefit.careTeam.sequenceElement `ExplanationOfBenefit.careTeam.sequence` is mapped to FHIR R4B element `ExplanationOfBenefit.careTeam.sequence` as `Equivalent`.
ExplanationOfBenefit.careTeam.provider (provider)is equivalent toExplanationOfBenefit.careTeam.providerElement `ExplanationOfBenefit.careTeam.provider` is mapped to FHIR R4B element `ExplanationOfBenefit.careTeam.provider` as `Equivalent`.
ExplanationOfBenefit.careTeam.responsible (responsible)is equivalent toExplanationOfBenefit.careTeam.responsibleElement `ExplanationOfBenefit.careTeam.responsible` is mapped to FHIR R4B element `ExplanationOfBenefit.careTeam.responsible` as `Equivalent`. Responsible might not be required when there is only a single provider listed.
ExplanationOfBenefit.careTeam.role (role)is equivalent toExplanationOfBenefit.careTeam.roleElement `ExplanationOfBenefit.careTeam.role` is mapped to FHIR R4B element `ExplanationOfBenefit.careTeam.role` as `Equivalent`. Role might not be required when there is only a single provider listed.
ExplanationOfBenefit.careTeam.qualification (qualification)is equivalent toExplanationOfBenefit.careTeam.qualificationElement `ExplanationOfBenefit.careTeam.qualification` is mapped to FHIR R4B element `ExplanationOfBenefit.careTeam.qualification` as `Equivalent`.
ExplanationOfBenefit.supportingInfo (supportingInfo)maps to wider conceptExplanationOfBenefit.supportingInfoElement `ExplanationOfBenefit.supportingInfo` is mapped to FHIR R4B element `ExplanationOfBenefit.supportingInfo` as `Equivalent`. Often there are multiple jurisdiction specific valuesets which are required.
ExplanationOfBenefit.supportingInfo.sequence (sequence)is equivalent toExplanationOfBenefit.supportingInfo.sequenceElement `ExplanationOfBenefit.supportingInfo.sequence` is mapped to FHIR R4B element `ExplanationOfBenefit.supportingInfo.sequence` as `Equivalent`.
ExplanationOfBenefit.supportingInfo.category (category)is equivalent toExplanationOfBenefit.supportingInfo.categoryElement `ExplanationOfBenefit.supportingInfo.category` is mapped to FHIR R4B element `ExplanationOfBenefit.supportingInfo.category` as `Equivalent`. This may contain a category for the local bill type codes.
ExplanationOfBenefit.supportingInfo.code (code)is equivalent toExplanationOfBenefit.supportingInfo.codeElement `ExplanationOfBenefit.supportingInfo.code` is mapped to FHIR R4B element `ExplanationOfBenefit.supportingInfo.code` as `Equivalent`. This may contain the local bill type codes such as the US UB-04 bill type code.
ExplanationOfBenefit.supportingInfo.timing[x] (timing[x])is equivalent toExplanationOfBenefit.supportingInfo.timing[x]Element `ExplanationOfBenefit.supportingInfo.timing[x]` is mapped to FHIR R4B element `ExplanationOfBenefit.supportingInfo.timing[x]` as `Equivalent`. The target context `ExplanationOfBenefit.supportingInfo.timing[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `ExplanationOfBenefit.supportingInfo`.
ExplanationOfBenefit.supportingInfo.value[x] (value[x])is equivalent toExplanationOfBenefit.supportingInfo.value[x]Element `ExplanationOfBenefit.supportingInfo.value[x]` is mapped to FHIR R4B element `ExplanationOfBenefit.supportingInfo.value[x]` as `Equivalent`. The target context `ExplanationOfBenefit.supportingInfo.value[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `ExplanationOfBenefit.supportingInfo`. Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident.
ExplanationOfBenefit.supportingInfo.reason (reason)is equivalent toExplanationOfBenefit.supportingInfo.reasonElement `ExplanationOfBenefit.supportingInfo.reason` is mapped to FHIR R4B element `ExplanationOfBenefit.supportingInfo.reason` as `Equivalent`. For example: the reason for the additional stay, or why a tooth is missing.
ExplanationOfBenefit.diagnosis (diagnosis)maps to wider conceptExplanationOfBenefit.diagnosisElement `ExplanationOfBenefit.diagnosis` is mapped to FHIR R4B element `ExplanationOfBenefit.diagnosis` as `Equivalent`.
ExplanationOfBenefit.diagnosis.sequence (sequence)is equivalent toExplanationOfBenefit.diagnosis.sequenceElement `ExplanationOfBenefit.diagnosis.sequence` is mapped to FHIR R4B element `ExplanationOfBenefit.diagnosis.sequence` as `Equivalent`. Diagnosis are presented in list order to their expected importance: primary, secondary, etc.
ExplanationOfBenefit.diagnosis.diagnosis[x] (diagnosis[x])is equivalent toExplanationOfBenefit.diagnosis.diagnosis[x]Element `ExplanationOfBenefit.diagnosis.diagnosis[x]` is mapped to FHIR R4B element `ExplanationOfBenefit.diagnosis.diagnosis[x]` as `Equivalent`. The target context `ExplanationOfBenefit.diagnosis.diagnosis[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `ExplanationOfBenefit.diagnosis`.
ExplanationOfBenefit.diagnosis.type (type)is equivalent toExplanationOfBenefit.diagnosis.typeElement `ExplanationOfBenefit.diagnosis.type` is mapped to FHIR R4B element `ExplanationOfBenefit.diagnosis.type` as `Equivalent`. For example: admitting, primary, secondary, discharge.
ExplanationOfBenefit.diagnosis.onAdmission (onAdmission)is equivalent toExplanationOfBenefit.diagnosis.onAdmissionElement `ExplanationOfBenefit.diagnosis.onAdmission` is mapped to FHIR R4B element `ExplanationOfBenefit.diagnosis.onAdmission` as `Equivalent`.
ExplanationOfBenefit.diagnosis.packageCode (packageCode)is equivalent toExplanationOfBenefit.diagnosis.packageCodeElement `ExplanationOfBenefit.diagnosis.packageCode` is mapped to FHIR R4B element `ExplanationOfBenefit.diagnosis.packageCode` as `Equivalent`. For example, DRG (Diagnosis Related Group) or a bundled billing code. A patient may have a diagnosis of a Myocardio-infarction and a DRG for HeartAttack would assigned. The Claim item (and possible subsequent claims) would refer to the DRG for those line items that were for services related to the heart attack event.
ExplanationOfBenefit.procedure (procedure)maps to wider conceptExplanationOfBenefit.procedureElement `ExplanationOfBenefit.procedure` is mapped to FHIR R4B element `ExplanationOfBenefit.procedure` as `Equivalent`.
ExplanationOfBenefit.procedure.sequence (sequence)is equivalent toExplanationOfBenefit.procedure.sequenceElement `ExplanationOfBenefit.procedure.sequence` is mapped to FHIR R4B element `ExplanationOfBenefit.procedure.sequence` as `Equivalent`.
ExplanationOfBenefit.procedure.type (type)is equivalent toExplanationOfBenefit.procedure.typeElement `ExplanationOfBenefit.procedure.type` is mapped to FHIR R4B element `ExplanationOfBenefit.procedure.type` as `Equivalent`.
ExplanationOfBenefit.procedure.date (date)is equivalent toExplanationOfBenefit.procedure.dateElement `ExplanationOfBenefit.procedure.date` is mapped to FHIR R4B element `ExplanationOfBenefit.procedure.date` as `Equivalent`.
ExplanationOfBenefit.procedure.procedure[x] (procedure[x])is equivalent toExplanationOfBenefit.procedure.procedure[x]Element `ExplanationOfBenefit.procedure.procedure[x]` is mapped to FHIR R4B element `ExplanationOfBenefit.procedure.procedure[x]` as `Equivalent`. The target context `ExplanationOfBenefit.procedure.procedure[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `ExplanationOfBenefit.procedure`.
ExplanationOfBenefit.procedure.udi (udi)is equivalent toExplanationOfBenefit.procedure.udiElement `ExplanationOfBenefit.procedure.udi` is mapped to FHIR R4B element `ExplanationOfBenefit.procedure.udi` as `Equivalent`.
ExplanationOfBenefit.precedence (precedence)is equivalent toExplanationOfBenefit.precedenceElement `ExplanationOfBenefit.precedence` is mapped to FHIR R4B element `ExplanationOfBenefit.precedence` as `Equivalent`.
ExplanationOfBenefit.insurance (insurance)maps to wider conceptExplanationOfBenefit.insuranceElement `ExplanationOfBenefit.insurance` is mapped to FHIR R4B element `ExplanationOfBenefit.insurance` as `Equivalent`. All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'Coverage.subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim.
ExplanationOfBenefit.insurance.focal (focal)is equivalent toExplanationOfBenefit.insurance.focalElement `ExplanationOfBenefit.insurance.focal` is mapped to FHIR R4B element `ExplanationOfBenefit.insurance.focal` as `Equivalent`. A patient may (will) have multiple insurance policies which provide reimbursement for healthcare services and products. For example, a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for adjudicating this claim. Other claims would be created to request adjudication against the other listed policies.
ExplanationOfBenefit.insurance.coverage (coverage)is equivalent toExplanationOfBenefit.insurance.coverageElement `ExplanationOfBenefit.insurance.coverage` is mapped to FHIR R4B element `ExplanationOfBenefit.insurance.coverage` as `Equivalent`.
ExplanationOfBenefit.insurance.preAuthRef (preAuthRef)is equivalent toExplanationOfBenefit.insurance.preAuthRefElement `ExplanationOfBenefit.insurance.preAuthRef` is mapped to FHIR R4B element `ExplanationOfBenefit.insurance.preAuthRef` as `Equivalent`. This value is an alphanumeric string that may be provided over the phone, via text, via paper, or within a ClaimResponse resource and is not a FHIR Identifier.
ExplanationOfBenefit.accident (accident)maps to wider conceptExplanationOfBenefit.accidentElement `ExplanationOfBenefit.accident` is mapped to FHIR R4B element `ExplanationOfBenefit.accident` as `Equivalent`.
ExplanationOfBenefit.accident.date (date)is equivalent toExplanationOfBenefit.accident.dateElement `ExplanationOfBenefit.accident.date` is mapped to FHIR R4B element `ExplanationOfBenefit.accident.date` as `Equivalent`. The date of the accident has to precede the dates of the products and services but within a reasonable timeframe.
ExplanationOfBenefit.accident.type (type)is equivalent toExplanationOfBenefit.accident.typeElement `ExplanationOfBenefit.accident.type` is mapped to FHIR R4B element `ExplanationOfBenefit.accident.type` as `Equivalent`.
ExplanationOfBenefit.accident.location[x] (location[x])is equivalent toExplanationOfBenefit.accident.location[x]Element `ExplanationOfBenefit.accident.location[x]` is mapped to FHIR R4B element `ExplanationOfBenefit.accident.location[x]` as `Equivalent`. The target context `ExplanationOfBenefit.accident.location[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `ExplanationOfBenefit.accident`.
ExplanationOfBenefit.item (item)maps to wider conceptExplanationOfBenefit.itemElement `ExplanationOfBenefit.item` is mapped to FHIR R4B element `ExplanationOfBenefit.item` as `Equivalent`.
ExplanationOfBenefit.item.sequence (sequence)is equivalent toExplanationOfBenefit.item.sequenceElement `ExplanationOfBenefit.item.sequence` is mapped to FHIR R4B element `ExplanationOfBenefit.item.sequence` as `Equivalent`.
ExplanationOfBenefit.item.careTeamSequence (careTeamSequence)is equivalent toExplanationOfBenefit.item.careTeamSequenceElement `ExplanationOfBenefit.item.careTeamSequence` is mapped to FHIR R4B element `ExplanationOfBenefit.item.careTeamSequence` as `Equivalent`.
ExplanationOfBenefit.item.diagnosisSequence (diagnosisSequence)is equivalent toExplanationOfBenefit.item.diagnosisSequenceElement `ExplanationOfBenefit.item.diagnosisSequence` is mapped to FHIR R4B element `ExplanationOfBenefit.item.diagnosisSequence` as `Equivalent`.
ExplanationOfBenefit.item.procedureSequence (procedureSequence)is equivalent toExplanationOfBenefit.item.procedureSequenceElement `ExplanationOfBenefit.item.procedureSequence` is mapped to FHIR R4B element `ExplanationOfBenefit.item.procedureSequence` as `Equivalent`.
ExplanationOfBenefit.item.informationSequence (informationSequence)is equivalent toExplanationOfBenefit.item.informationSequenceElement `ExplanationOfBenefit.item.informationSequence` is mapped to FHIR R4B element `ExplanationOfBenefit.item.informationSequence` as `Equivalent`.
ExplanationOfBenefit.item.revenue (revenue)is equivalent toExplanationOfBenefit.item.revenueElement `ExplanationOfBenefit.item.revenue` is mapped to FHIR R4B element `ExplanationOfBenefit.item.revenue` as `Equivalent`.
ExplanationOfBenefit.item.category (category)is equivalent toExplanationOfBenefit.item.categoryElement `ExplanationOfBenefit.item.category` is mapped to FHIR R4B element `ExplanationOfBenefit.item.category` as `Equivalent`. Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.
ExplanationOfBenefit.item.productOrService (productOrService)is equivalent toExplanationOfBenefit.item.productOrServiceElement `ExplanationOfBenefit.item.productOrService` is mapped to FHIR R4B element `ExplanationOfBenefit.item.productOrService` as `Equivalent`. If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.
ExplanationOfBenefit.item.modifier (modifier)is equivalent toExplanationOfBenefit.item.modifierElement `ExplanationOfBenefit.item.modifier` is mapped to FHIR R4B element `ExplanationOfBenefit.item.modifier` as `Equivalent`. For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.
ExplanationOfBenefit.item.programCode (programCode)is equivalent toExplanationOfBenefit.item.programCodeElement `ExplanationOfBenefit.item.programCode` is mapped to FHIR R4B element `ExplanationOfBenefit.item.programCode` as `Equivalent`. For example: Neonatal program, child dental program or drug users recovery program.
ExplanationOfBenefit.item.serviced[x] (serviced[x])is equivalent toExplanationOfBenefit.item.serviced[x]Element `ExplanationOfBenefit.item.serviced[x]` is mapped to FHIR R4B element `ExplanationOfBenefit.item.serviced[x]` as `Equivalent`. The target context `ExplanationOfBenefit.item.serviced[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `ExplanationOfBenefit.item`.
ExplanationOfBenefit.item.location[x] (location[x])is equivalent toExplanationOfBenefit.item.location[x]Element `ExplanationOfBenefit.item.location[x]` is mapped to FHIR R4B element `ExplanationOfBenefit.item.location[x]` as `Equivalent`. The target context `ExplanationOfBenefit.item.location[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `ExplanationOfBenefit.item`.
ExplanationOfBenefit.item.quantity (quantity)is equivalent toExplanationOfBenefit.item.quantityElement `ExplanationOfBenefit.item.quantity` is mapped to FHIR R4B element `ExplanationOfBenefit.item.quantity` as `Equivalent`.
ExplanationOfBenefit.item.unitPrice (unitPrice)is equivalent toExplanationOfBenefit.item.unitPriceElement `ExplanationOfBenefit.item.unitPrice` is mapped to FHIR R4B element `ExplanationOfBenefit.item.unitPrice` as `Equivalent`.
ExplanationOfBenefit.item.factor (factor)is equivalent toExplanationOfBenefit.item.factorElement `ExplanationOfBenefit.item.factor` is mapped to FHIR R4B element `ExplanationOfBenefit.item.factor` as `Equivalent`. To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).
ExplanationOfBenefit.item.net (net)is equivalent toExplanationOfBenefit.item.netElement `ExplanationOfBenefit.item.net` is mapped to FHIR R4B element `ExplanationOfBenefit.item.net` as `Equivalent`. For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.
ExplanationOfBenefit.item.udi (udi)is equivalent toExplanationOfBenefit.item.udiElement `ExplanationOfBenefit.item.udi` is mapped to FHIR R4B element `ExplanationOfBenefit.item.udi` as `Equivalent`.
ExplanationOfBenefit.item.bodySite (bodySite)is equivalent toExplanationOfBenefit.item.bodySiteElement `ExplanationOfBenefit.item.bodySite` is mapped to FHIR R4B element `ExplanationOfBenefit.item.bodySite` as `Equivalent`. For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.
ExplanationOfBenefit.item.subSite (subSite)is equivalent toExplanationOfBenefit.item.subSiteElement `ExplanationOfBenefit.item.subSite` is mapped to FHIR R4B element `ExplanationOfBenefit.item.subSite` as `Equivalent`.
ExplanationOfBenefit.item.encounter (encounter)is equivalent toExplanationOfBenefit.item.encounterElement `ExplanationOfBenefit.item.encounter` is mapped to FHIR R4B element `ExplanationOfBenefit.item.encounter` as `Equivalent`.
ExplanationOfBenefit.item.noteNumber (noteNumber)is equivalent toExplanationOfBenefit.item.noteNumberElement `ExplanationOfBenefit.item.noteNumber` is mapped to FHIR R4B element `ExplanationOfBenefit.item.noteNumber` as `Equivalent`.
ExplanationOfBenefit.item.adjudication (adjudication)maps to wider conceptExplanationOfBenefit.item.adjudicationElement `ExplanationOfBenefit.item.adjudication` is mapped to FHIR R4B element `ExplanationOfBenefit.item.adjudication` as `Equivalent`.
ExplanationOfBenefit.item.adjudication.category (category)is equivalent toExplanationOfBenefit.item.adjudication.categoryElement `ExplanationOfBenefit.item.adjudication.category` is mapped to FHIR R4B element `ExplanationOfBenefit.item.adjudication.category` as `Equivalent`. For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.
ExplanationOfBenefit.item.adjudication.reason (reason)is equivalent toExplanationOfBenefit.item.adjudication.reasonElement `ExplanationOfBenefit.item.adjudication.reason` is mapped to FHIR R4B element `ExplanationOfBenefit.item.adjudication.reason` as `Equivalent`. For example, may indicate that the funds for this benefit type have been exhausted.
ExplanationOfBenefit.item.adjudication.amount (amount)is equivalent toExplanationOfBenefit.item.adjudication.amountElement `ExplanationOfBenefit.item.adjudication.amount` is mapped to FHIR R4B element `ExplanationOfBenefit.item.adjudication.amount` as `Equivalent`. For example, amount submitted, eligible amount, co-payment, and benefit payable.
ExplanationOfBenefit.item.adjudication.value (value)is equivalent toExplanationOfBenefit.item.adjudication.valueElement `ExplanationOfBenefit.item.adjudication.value` is mapped to FHIR R4B element `ExplanationOfBenefit.item.adjudication.value` as `Equivalent`. For example: eligible percentage or co-payment percentage.
ExplanationOfBenefit.item.detail (detail)maps to wider conceptExplanationOfBenefit.item.detailElement `ExplanationOfBenefit.item.detail` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail` as `Equivalent`.
ExplanationOfBenefit.item.detail.sequence (sequence)is equivalent toExplanationOfBenefit.item.detail.sequenceElement `ExplanationOfBenefit.item.detail.sequence` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.sequence` as `Equivalent`.
ExplanationOfBenefit.item.detail.revenue (revenue)is equivalent toExplanationOfBenefit.item.detail.revenueElement `ExplanationOfBenefit.item.detail.revenue` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.revenue` as `Equivalent`.
ExplanationOfBenefit.item.detail.category (category)is equivalent toExplanationOfBenefit.item.detail.categoryElement `ExplanationOfBenefit.item.detail.category` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.category` as `Equivalent`. Examples include: Medical Care, Periodontics, Renal Dialysis, Vision Coverage.
ExplanationOfBenefit.item.detail.productOrService (productOrService)is equivalent toExplanationOfBenefit.item.detail.productOrServiceElement `ExplanationOfBenefit.item.detail.productOrService` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.productOrService` as `Equivalent`. If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.
ExplanationOfBenefit.item.detail.modifier (modifier)is equivalent toExplanationOfBenefit.item.detail.modifierElement `ExplanationOfBenefit.item.detail.modifier` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.modifier` as `Equivalent`. For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.
ExplanationOfBenefit.item.detail.programCode (programCode)is equivalent toExplanationOfBenefit.item.detail.programCodeElement `ExplanationOfBenefit.item.detail.programCode` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.programCode` as `Equivalent`. For example: Neonatal program, child dental program or drug users recovery program.
ExplanationOfBenefit.item.detail.quantity (quantity)is equivalent toExplanationOfBenefit.item.detail.quantityElement `ExplanationOfBenefit.item.detail.quantity` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.quantity` as `Equivalent`.
ExplanationOfBenefit.item.detail.unitPrice (unitPrice)is equivalent toExplanationOfBenefit.item.detail.unitPriceElement `ExplanationOfBenefit.item.detail.unitPrice` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.unitPrice` as `Equivalent`.
ExplanationOfBenefit.item.detail.factor (factor)is equivalent toExplanationOfBenefit.item.detail.factorElement `ExplanationOfBenefit.item.detail.factor` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.factor` as `Equivalent`. To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).
ExplanationOfBenefit.item.detail.net (net)is equivalent toExplanationOfBenefit.item.detail.netElement `ExplanationOfBenefit.item.detail.net` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.net` as `Equivalent`. For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.
ExplanationOfBenefit.item.detail.udi (udi)is equivalent toExplanationOfBenefit.item.detail.udiElement `ExplanationOfBenefit.item.detail.udi` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.udi` as `Equivalent`.
ExplanationOfBenefit.item.detail.noteNumber (noteNumber)is equivalent toExplanationOfBenefit.item.detail.noteNumberElement `ExplanationOfBenefit.item.detail.noteNumber` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.noteNumber` as `Equivalent`.
ExplanationOfBenefit.item.detail.adjudication (adjudication)is equivalent toExplanationOfBenefit.item.detail.adjudicationElement `ExplanationOfBenefit.item.detail.adjudication` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.adjudication` as `Equivalent`.
ExplanationOfBenefit.item.detail.subDetail (subDetail)maps to wider conceptExplanationOfBenefit.item.detail.subDetailElement `ExplanationOfBenefit.item.detail.subDetail` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.subDetail` as `Equivalent`.
ExplanationOfBenefit.item.detail.subDetail.sequence (sequence)is equivalent toExplanationOfBenefit.item.detail.subDetail.sequenceElement `ExplanationOfBenefit.item.detail.subDetail.sequence` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.subDetail.sequence` as `Equivalent`.
ExplanationOfBenefit.item.detail.subDetail.revenue (revenue)is equivalent toExplanationOfBenefit.item.detail.subDetail.revenueElement `ExplanationOfBenefit.item.detail.subDetail.revenue` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.subDetail.revenue` as `Equivalent`.
ExplanationOfBenefit.item.detail.subDetail.category (category)is equivalent toExplanationOfBenefit.item.detail.subDetail.categoryElement `ExplanationOfBenefit.item.detail.subDetail.category` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.subDetail.category` as `Equivalent`. Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.
ExplanationOfBenefit.item.detail.subDetail.productOrService (productOrService)is equivalent toExplanationOfBenefit.item.detail.subDetail.productOrServiceElement `ExplanationOfBenefit.item.detail.subDetail.productOrService` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.subDetail.productOrService` as `Equivalent`. If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.
ExplanationOfBenefit.item.detail.subDetail.modifier (modifier)is equivalent toExplanationOfBenefit.item.detail.subDetail.modifierElement `ExplanationOfBenefit.item.detail.subDetail.modifier` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.subDetail.modifier` as `Equivalent`. For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.
ExplanationOfBenefit.item.detail.subDetail.programCode (programCode)is equivalent toExplanationOfBenefit.item.detail.subDetail.programCodeElement `ExplanationOfBenefit.item.detail.subDetail.programCode` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.subDetail.programCode` as `Equivalent`. For example: Neonatal program, child dental program or drug users recovery program.
ExplanationOfBenefit.item.detail.subDetail.quantity (quantity)is equivalent toExplanationOfBenefit.item.detail.subDetail.quantityElement `ExplanationOfBenefit.item.detail.subDetail.quantity` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.subDetail.quantity` as `Equivalent`.
ExplanationOfBenefit.item.detail.subDetail.unitPrice (unitPrice)is equivalent toExplanationOfBenefit.item.detail.subDetail.unitPriceElement `ExplanationOfBenefit.item.detail.subDetail.unitPrice` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.subDetail.unitPrice` as `Equivalent`.
ExplanationOfBenefit.item.detail.subDetail.factor (factor)is equivalent toExplanationOfBenefit.item.detail.subDetail.factorElement `ExplanationOfBenefit.item.detail.subDetail.factor` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.subDetail.factor` as `Equivalent`. To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).
ExplanationOfBenefit.item.detail.subDetail.net (net)is equivalent toExplanationOfBenefit.item.detail.subDetail.netElement `ExplanationOfBenefit.item.detail.subDetail.net` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.subDetail.net` as `Equivalent`. For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.
ExplanationOfBenefit.item.detail.subDetail.udi (udi)is equivalent toExplanationOfBenefit.item.detail.subDetail.udiElement `ExplanationOfBenefit.item.detail.subDetail.udi` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.subDetail.udi` as `Equivalent`.
ExplanationOfBenefit.item.detail.subDetail.noteNumber (noteNumber)is equivalent toExplanationOfBenefit.item.detail.subDetail.noteNumberElement `ExplanationOfBenefit.item.detail.subDetail.noteNumber` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.subDetail.noteNumber` as `Equivalent`.
ExplanationOfBenefit.item.detail.subDetail.adjudication (adjudication)is equivalent toExplanationOfBenefit.item.detail.subDetail.adjudicationElement `ExplanationOfBenefit.item.detail.subDetail.adjudication` is mapped to FHIR R4B element `ExplanationOfBenefit.item.detail.subDetail.adjudication` as `Equivalent`.
ExplanationOfBenefit.addItem (addItem)maps to wider conceptExplanationOfBenefit.addItemElement `ExplanationOfBenefit.addItem` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem` as `Equivalent`.
ExplanationOfBenefit.addItem.itemSequence (itemSequence)is equivalent toExplanationOfBenefit.addItem.itemSequenceElement `ExplanationOfBenefit.addItem.itemSequence` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.itemSequence` as `Equivalent`.
ExplanationOfBenefit.addItem.detailSequence (detailSequence)is equivalent toExplanationOfBenefit.addItem.detailSequenceElement `ExplanationOfBenefit.addItem.detailSequence` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.detailSequence` as `Equivalent`.
ExplanationOfBenefit.addItem.subDetailSequence (subDetailSequence)is equivalent toExplanationOfBenefit.addItem.subDetailSequenceElement `ExplanationOfBenefit.addItem.subDetailSequence` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.subDetailSequence` as `Equivalent`.
ExplanationOfBenefit.addItem.provider (provider)is equivalent toExplanationOfBenefit.addItem.providerElement `ExplanationOfBenefit.addItem.provider` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.provider` as `Equivalent`.
ExplanationOfBenefit.addItem.productOrService (productOrService)is equivalent toExplanationOfBenefit.addItem.productOrServiceElement `ExplanationOfBenefit.addItem.productOrService` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.productOrService` as `Equivalent`. If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.
ExplanationOfBenefit.addItem.modifier (modifier)is equivalent toExplanationOfBenefit.addItem.modifierElement `ExplanationOfBenefit.addItem.modifier` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.modifier` as `Equivalent`. For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.
ExplanationOfBenefit.addItem.programCode (programCode)is equivalent toExplanationOfBenefit.addItem.programCodeElement `ExplanationOfBenefit.addItem.programCode` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.programCode` as `Equivalent`. For example: Neonatal program, child dental program or drug users recovery program.
ExplanationOfBenefit.addItem.serviced[x] (serviced[x])is equivalent toExplanationOfBenefit.addItem.serviced[x]Element `ExplanationOfBenefit.addItem.serviced[x]` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.serviced[x]` as `Equivalent`. The target context `ExplanationOfBenefit.addItem.serviced[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `ExplanationOfBenefit.addItem`.
ExplanationOfBenefit.addItem.location[x] (location[x])is equivalent toExplanationOfBenefit.addItem.location[x]Element `ExplanationOfBenefit.addItem.location[x]` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.location[x]` as `Equivalent`. The target context `ExplanationOfBenefit.addItem.location[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `ExplanationOfBenefit.addItem`.
ExplanationOfBenefit.addItem.quantity (quantity)is equivalent toExplanationOfBenefit.addItem.quantityElement `ExplanationOfBenefit.addItem.quantity` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.quantity` as `Equivalent`.
ExplanationOfBenefit.addItem.unitPrice (unitPrice)is equivalent toExplanationOfBenefit.addItem.unitPriceElement `ExplanationOfBenefit.addItem.unitPrice` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.unitPrice` as `Equivalent`.
ExplanationOfBenefit.addItem.factor (factor)is equivalent toExplanationOfBenefit.addItem.factorElement `ExplanationOfBenefit.addItem.factor` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.factor` as `Equivalent`. To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).
ExplanationOfBenefit.addItem.net (net)is equivalent toExplanationOfBenefit.addItem.netElement `ExplanationOfBenefit.addItem.net` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.net` as `Equivalent`. For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.
ExplanationOfBenefit.addItem.bodySite (bodySite)is equivalent toExplanationOfBenefit.addItem.bodySiteElement `ExplanationOfBenefit.addItem.bodySite` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.bodySite` as `Equivalent`. For example, providing a tooth code allows an insurer to identify a provider performing a filling on a tooth that was previously removed.
ExplanationOfBenefit.addItem.subSite (subSite)is equivalent toExplanationOfBenefit.addItem.subSiteElement `ExplanationOfBenefit.addItem.subSite` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.subSite` as `Equivalent`.
ExplanationOfBenefit.addItem.noteNumber (noteNumber)is equivalent toExplanationOfBenefit.addItem.noteNumberElement `ExplanationOfBenefit.addItem.noteNumber` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.noteNumber` as `Equivalent`.
ExplanationOfBenefit.addItem.adjudication (adjudication)is equivalent toExplanationOfBenefit.addItem.adjudicationElement `ExplanationOfBenefit.addItem.adjudication` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.adjudication` as `Equivalent`.
ExplanationOfBenefit.addItem.detail (detail)maps to wider conceptExplanationOfBenefit.addItem.detailElement `ExplanationOfBenefit.addItem.detail` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.detail` as `Equivalent`.
ExplanationOfBenefit.addItem.detail.productOrService (productOrService)is equivalent toExplanationOfBenefit.addItem.detail.productOrServiceElement `ExplanationOfBenefit.addItem.detail.productOrService` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.detail.productOrService` as `Equivalent`. If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.
ExplanationOfBenefit.addItem.detail.modifier (modifier)is equivalent toExplanationOfBenefit.addItem.detail.modifierElement `ExplanationOfBenefit.addItem.detail.modifier` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.detail.modifier` as `Equivalent`. For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.
ExplanationOfBenefit.addItem.detail.quantity (quantity)is equivalent toExplanationOfBenefit.addItem.detail.quantityElement `ExplanationOfBenefit.addItem.detail.quantity` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.detail.quantity` as `Equivalent`.
ExplanationOfBenefit.addItem.detail.unitPrice (unitPrice)is equivalent toExplanationOfBenefit.addItem.detail.unitPriceElement `ExplanationOfBenefit.addItem.detail.unitPrice` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.detail.unitPrice` as `Equivalent`.
ExplanationOfBenefit.addItem.detail.factor (factor)is equivalent toExplanationOfBenefit.addItem.detail.factorElement `ExplanationOfBenefit.addItem.detail.factor` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.detail.factor` as `Equivalent`. To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).
ExplanationOfBenefit.addItem.detail.net (net)is equivalent toExplanationOfBenefit.addItem.detail.netElement `ExplanationOfBenefit.addItem.detail.net` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.detail.net` as `Equivalent`. For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.
ExplanationOfBenefit.addItem.detail.noteNumber (noteNumber)is equivalent toExplanationOfBenefit.addItem.detail.noteNumberElement `ExplanationOfBenefit.addItem.detail.noteNumber` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.detail.noteNumber` as `Equivalent`.
ExplanationOfBenefit.addItem.detail.adjudication (adjudication)is equivalent toExplanationOfBenefit.addItem.detail.adjudicationElement `ExplanationOfBenefit.addItem.detail.adjudication` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.detail.adjudication` as `Equivalent`.
ExplanationOfBenefit.addItem.detail.subDetail (subDetail)maps to wider conceptExplanationOfBenefit.addItem.detail.subDetailElement `ExplanationOfBenefit.addItem.detail.subDetail` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.detail.subDetail` as `Equivalent`.
ExplanationOfBenefit.addItem.detail.subDetail.productOrService (productOrService)is equivalent toExplanationOfBenefit.addItem.detail.subDetail.productOrServiceElement `ExplanationOfBenefit.addItem.detail.subDetail.productOrService` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.detail.subDetail.productOrService` as `Equivalent`. If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.
ExplanationOfBenefit.addItem.detail.subDetail.modifier (modifier)is equivalent toExplanationOfBenefit.addItem.detail.subDetail.modifierElement `ExplanationOfBenefit.addItem.detail.subDetail.modifier` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.detail.subDetail.modifier` as `Equivalent`. For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.
ExplanationOfBenefit.addItem.detail.subDetail.quantity (quantity)is equivalent toExplanationOfBenefit.addItem.detail.subDetail.quantityElement `ExplanationOfBenefit.addItem.detail.subDetail.quantity` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.detail.subDetail.quantity` as `Equivalent`.
ExplanationOfBenefit.addItem.detail.subDetail.unitPrice (unitPrice)is equivalent toExplanationOfBenefit.addItem.detail.subDetail.unitPriceElement `ExplanationOfBenefit.addItem.detail.subDetail.unitPrice` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.detail.subDetail.unitPrice` as `Equivalent`.
ExplanationOfBenefit.addItem.detail.subDetail.factor (factor)is equivalent toExplanationOfBenefit.addItem.detail.subDetail.factorElement `ExplanationOfBenefit.addItem.detail.subDetail.factor` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.detail.subDetail.factor` as `Equivalent`. To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).
ExplanationOfBenefit.addItem.detail.subDetail.net (net)is equivalent toExplanationOfBenefit.addItem.detail.subDetail.netElement `ExplanationOfBenefit.addItem.detail.subDetail.net` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.detail.subDetail.net` as `Equivalent`. For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.
ExplanationOfBenefit.addItem.detail.subDetail.noteNumber (noteNumber)is equivalent toExplanationOfBenefit.addItem.detail.subDetail.noteNumberElement `ExplanationOfBenefit.addItem.detail.subDetail.noteNumber` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.detail.subDetail.noteNumber` as `Equivalent`.
ExplanationOfBenefit.addItem.detail.subDetail.adjudication (adjudication)is equivalent toExplanationOfBenefit.addItem.detail.subDetail.adjudicationElement `ExplanationOfBenefit.addItem.detail.subDetail.adjudication` is mapped to FHIR R4B element `ExplanationOfBenefit.addItem.detail.subDetail.adjudication` as `Equivalent`.
ExplanationOfBenefit.adjudication (adjudication)is equivalent toExplanationOfBenefit.adjudicationElement `ExplanationOfBenefit.adjudication` is mapped to FHIR R4B element `ExplanationOfBenefit.adjudication` as `Equivalent`.
ExplanationOfBenefit.total (total)maps to wider conceptExplanationOfBenefit.totalElement `ExplanationOfBenefit.total` is mapped to FHIR R4B element `ExplanationOfBenefit.total` as `Equivalent`. Totals for amounts submitted, co-pays, benefits payable etc.
ExplanationOfBenefit.total.category (category)is equivalent toExplanationOfBenefit.total.categoryElement `ExplanationOfBenefit.total.category` is mapped to FHIR R4B element `ExplanationOfBenefit.total.category` as `Equivalent`. For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.
ExplanationOfBenefit.total.amount (amount)is equivalent toExplanationOfBenefit.total.amountElement `ExplanationOfBenefit.total.amount` is mapped to FHIR R4B element `ExplanationOfBenefit.total.amount` as `Equivalent`.
ExplanationOfBenefit.payment (payment)maps to wider conceptExplanationOfBenefit.paymentElement `ExplanationOfBenefit.payment` is mapped to FHIR R4B element `ExplanationOfBenefit.payment` as `Equivalent`.
ExplanationOfBenefit.payment.type (type)is equivalent toExplanationOfBenefit.payment.typeElement `ExplanationOfBenefit.payment.type` is mapped to FHIR R4B element `ExplanationOfBenefit.payment.type` as `Equivalent`.
ExplanationOfBenefit.payment.adjustment (adjustment)is equivalent toExplanationOfBenefit.payment.adjustmentElement `ExplanationOfBenefit.payment.adjustment` is mapped to FHIR R4B element `ExplanationOfBenefit.payment.adjustment` as `Equivalent`. Insurers will deduct amounts owing from the provider (adjustment), such as a prior overpayment, from the amount owing to the provider (benefits payable) when payment is made to the provider.
ExplanationOfBenefit.payment.adjustmentReason (adjustmentReason)is equivalent toExplanationOfBenefit.payment.adjustmentReasonElement `ExplanationOfBenefit.payment.adjustmentReason` is mapped to FHIR R4B element `ExplanationOfBenefit.payment.adjustmentReason` as `Equivalent`.
ExplanationOfBenefit.payment.date (date)is equivalent toExplanationOfBenefit.payment.dateElement `ExplanationOfBenefit.payment.date` is mapped to FHIR R4B element `ExplanationOfBenefit.payment.date` as `Equivalent`.
ExplanationOfBenefit.payment.amount (amount)is equivalent toExplanationOfBenefit.payment.amountElement `ExplanationOfBenefit.payment.amount` is mapped to FHIR R4B element `ExplanationOfBenefit.payment.amount` as `Equivalent`.
ExplanationOfBenefit.payment.identifier (identifier)is equivalent toExplanationOfBenefit.payment.identifierElement `ExplanationOfBenefit.payment.identifier` is mapped to FHIR R4B element `ExplanationOfBenefit.payment.identifier` as `Equivalent`. For example: EFT number or check number.
ExplanationOfBenefit.formCode (formCode)is equivalent toExplanationOfBenefit.formCodeElement `ExplanationOfBenefit.formCode` is mapped to FHIR R4B element `ExplanationOfBenefit.formCode` as `Equivalent`. May be needed to identify specific jurisdictional forms.
ExplanationOfBenefit.form (form)is equivalent toExplanationOfBenefit.formElement `ExplanationOfBenefit.form` is mapped to FHIR R4B element `ExplanationOfBenefit.form` as `Equivalent`. Needed to permit insurers to include the actual form.
ExplanationOfBenefit.processNote (processNote)maps to wider conceptExplanationOfBenefit.processNoteElement `ExplanationOfBenefit.processNote` is mapped to FHIR R4B element `ExplanationOfBenefit.processNote` as `Equivalent`.
ExplanationOfBenefit.processNote.number (number)is equivalent toExplanationOfBenefit.processNote.numberElement `ExplanationOfBenefit.processNote.number` is mapped to FHIR R4B element `ExplanationOfBenefit.processNote.number` as `Equivalent`.
ExplanationOfBenefit.processNote.type (type)is equivalent toExplanationOfBenefit.processNote.typeElement `ExplanationOfBenefit.processNote.type` is mapped to FHIR R4B element `ExplanationOfBenefit.processNote.type` as `Equivalent`.
ExplanationOfBenefit.processNote.text (text)is equivalent toExplanationOfBenefit.processNote.textElement `ExplanationOfBenefit.processNote.text` is mapped to FHIR R4B element `ExplanationOfBenefit.processNote.text` as `Equivalent`.
ExplanationOfBenefit.processNote.language (language)is equivalent toExplanationOfBenefit.processNote.languageElement `ExplanationOfBenefit.processNote.language` is mapped to FHIR R4B element `ExplanationOfBenefit.processNote.language` as `Equivalent`. Only required if the language is different from the resource language.
ExplanationOfBenefit.benefitPeriod (benefitPeriod)is equivalent toExplanationOfBenefit.benefitPeriodElement `ExplanationOfBenefit.benefitPeriod` is mapped to FHIR R4B element `ExplanationOfBenefit.benefitPeriod` as `Equivalent`. Not applicable when use=claim.
ExplanationOfBenefit.benefitBalance (benefitBalance)maps to wider conceptExplanationOfBenefit.benefitBalanceElement `ExplanationOfBenefit.benefitBalance` is mapped to FHIR R4B element `ExplanationOfBenefit.benefitBalance` as `Equivalent`.
ExplanationOfBenefit.benefitBalance.category (category)is equivalent toExplanationOfBenefit.benefitBalance.categoryElement `ExplanationOfBenefit.benefitBalance.category` is mapped to FHIR R4B element `ExplanationOfBenefit.benefitBalance.category` as `Equivalent`. Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.
ExplanationOfBenefit.benefitBalance.excluded (excluded)is equivalent toExplanationOfBenefit.benefitBalance.excludedElement `ExplanationOfBenefit.benefitBalance.excluded` is mapped to FHIR R4B element `ExplanationOfBenefit.benefitBalance.excluded` as `Equivalent`.
ExplanationOfBenefit.benefitBalance.name (name)is equivalent toExplanationOfBenefit.benefitBalance.nameElement `ExplanationOfBenefit.benefitBalance.name` is mapped to FHIR R4B element `ExplanationOfBenefit.benefitBalance.name` as `Equivalent`. For example: MED01, or DENT2.
ExplanationOfBenefit.benefitBalance.description (description)is equivalent toExplanationOfBenefit.benefitBalance.descriptionElement `ExplanationOfBenefit.benefitBalance.description` is mapped to FHIR R4B element `ExplanationOfBenefit.benefitBalance.description` as `Equivalent`. For example, 'DENT2 covers 100% of basic, 50% of major but excludes Ortho, Implants and Cosmetic services'.
ExplanationOfBenefit.benefitBalance.network (network)is equivalent toExplanationOfBenefit.benefitBalance.networkElement `ExplanationOfBenefit.benefitBalance.network` is mapped to FHIR R4B element `ExplanationOfBenefit.benefitBalance.network` as `Equivalent`.
ExplanationOfBenefit.benefitBalance.unit (unit)is equivalent toExplanationOfBenefit.benefitBalance.unitElement `ExplanationOfBenefit.benefitBalance.unit` is mapped to FHIR R4B element `ExplanationOfBenefit.benefitBalance.unit` as `Equivalent`.
ExplanationOfBenefit.benefitBalance.term (term)is equivalent toExplanationOfBenefit.benefitBalance.termElement `ExplanationOfBenefit.benefitBalance.term` is mapped to FHIR R4B element `ExplanationOfBenefit.benefitBalance.term` as `Equivalent`.
ExplanationOfBenefit.benefitBalance.financial (financial)maps to wider conceptExplanationOfBenefit.benefitBalance.financialElement `ExplanationOfBenefit.benefitBalance.financial` is mapped to FHIR R4B element `ExplanationOfBenefit.benefitBalance.financial` as `Equivalent`.
ExplanationOfBenefit.benefitBalance.financial.type (type)is equivalent toExplanationOfBenefit.benefitBalance.financial.typeElement `ExplanationOfBenefit.benefitBalance.financial.type` is mapped to FHIR R4B element `ExplanationOfBenefit.benefitBalance.financial.type` as `Equivalent`. For example: deductible, visits, benefit amount.
ExplanationOfBenefit.benefitBalance.financial.allowed[x] (allowed[x])is equivalent toExplanationOfBenefit.benefitBalance.financial.allowed[x]Element `ExplanationOfBenefit.benefitBalance.financial.allowed[x]` is mapped to FHIR R4B element `ExplanationOfBenefit.benefitBalance.financial.allowed[x]` as `Equivalent`. The target context `ExplanationOfBenefit.benefitBalance.financial.allowed[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `ExplanationOfBenefit.benefitBalance.financial`.
ExplanationOfBenefit.benefitBalance.financial.used[x] (used[x])is equivalent toExplanationOfBenefit.benefitBalance.financial.used[x]Element `ExplanationOfBenefit.benefitBalance.financial.used[x]` is mapped to FHIR R4B element `ExplanationOfBenefit.benefitBalance.financial.used[x]` as `Equivalent`. The target context `ExplanationOfBenefit.benefitBalance.financial.used[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `ExplanationOfBenefit.benefitBalance.financial`.