ExplanationOfBenefit - FHIR v5.0.0
Release 5

This page is part of the FHIR Specification (v5.0.0: R5 - STU). This is the current published version. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4

13.10.32 Resource ExplanationOfBenefit - Maturity Dependency View

Financial Management icon Work GroupMaturity Level: 2 Trial Use Compartments: Device, Encounter, Patient, Practitioner, RelatedPerson

Dependency Graph for ExplanationOfBenefit FMM level 2

NameCard.TypeDependency Analysis
.. ExplanationOfBenefit DomainResource
... identifier 0..*Identifier
... traceNumber 0..*Identifier
... status 1..1code
... type 1..1CodeableConcept
... subType 0..1CodeableConcept
... use 1..1code
... patient 1..1Reference(Patient)
... billablePeriod 0..1Period
... created 1..1dateTime
... enterer 0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)
... insurer 0..1Reference(Organization)
... provider 0..1Reference(Practitioner | PractitionerRole | Organization)
... priority 0..1CodeableConcept
... fundsReserveRequested 0..1CodeableConcept
... fundsReserve 0..1CodeableConcept
... related 0..*BackboneElement
.... claim 0..1Reference(Claim)
.... relationship 0..1CodeableConcept
.... reference 0..1Identifier
... prescription 0..1Reference(MedicationRequest | VisionPrescription)
... originalPrescription 0..1Reference(MedicationRequest)
... event 0..*BackboneElement
.... type 1..1CodeableConcept
.... when[x] 1..1
..... whenDateTimedateTime
..... whenPeriodPeriod
... payee 0..1BackboneElement
.... type 0..1CodeableConcept
.... party 0..1Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson)
... referral 0..1Reference(ServiceRequest)
... encounter 0..*Reference(Encounter)
... facility 0..1Reference(Location | Organization)
... claim 0..1Reference(Claim)
... claimResponse 0..1Reference(ClaimResponse)
... outcome 1..1code
... decision 0..1CodeableConcept
... disposition 0..1string
... preAuthRef 0..*string
... preAuthRefPeriod 0..*Period
... diagnosisRelatedGroup 0..1CodeableConcept
... careTeam 0..*BackboneElement
.... sequence 1..1positiveInt
.... provider 1..1Reference(Practitioner | PractitionerRole | Organization)
.... responsible 0..1boolean
.... role 0..1CodeableConcept
.... specialty 0..1CodeableConcept
... supportingInfo 0..*BackboneElement
.... sequence 1..1positiveInt
.... category 1..1CodeableConcept
.... code 0..1CodeableConcept
.... timing[x] 0..1
..... timingDatedate
..... timingPeriodPeriod
.... value[x] 0..1
..... valueBooleanboolean
..... valueStringstring
..... valueQuantityQuantity
..... valueAttachmentAttachment
..... valueReferenceReference(AnyType Warning: (Any = FMM1-Trial Use vs. Element = FMM2-Trial Use)
..... valueIdentifierIdentifier
.... reason 0..1Coding
... diagnosis 0..*BackboneElement
.... sequence 1..1positiveInt
.... diagnosis[x] 1..1
..... diagnosisCodeableConceptCodeableConcept
..... diagnosisReferenceReference(Condition
.... type 0..*CodeableConcept
.... onAdmission 0..1CodeableConcept
... procedure 0..*BackboneElement
.... sequence 1..1positiveInt
.... type 0..*CodeableConcept
.... date 0..1dateTime
.... procedure[x] 1..1
..... procedureCodeableConceptCodeableConcept
..... procedureReferenceReference(Procedure
.... udi 0..*Reference(Device)
... precedence 0..1positiveInt
... insurance 0..*BackboneElement
.... focal 1..1boolean
.... coverage 1..1Reference(Coverage)
.... preAuthRef 0..*string
... accident 0..1BackboneElement
.... date 0..1date
.... type 0..1CodeableConcept
.... location[x] 0..1
..... locationAddressAddress
..... locationReferenceReference(Location
... patientPaid 0..1Money
... item 0..*BackboneElement
.... sequence 1..1positiveInt
.... careTeamSequence 0..*positiveInt
.... diagnosisSequence 0..*positiveInt
.... procedureSequence 0..*positiveInt
.... informationSequence 0..*positiveInt
.... traceNumber 0..*Identifier
.... revenue 0..1CodeableConcept
.... category 0..1CodeableConcept
.... productOrService 0..1CodeableConcept
.... productOrServiceEnd 0..1CodeableConcept
.... request 0..*Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | SupplyRequest | VisionPrescription)Type Warning: (DeviceRequest = FMM1-Trial Use vs. Element = FMM2-Trial Use)
Type Warning: (SupplyRequest = FMM1-Trial Use vs. Element = FMM2-Trial Use)
.... modifier 0..*CodeableConcept
.... programCode 0..*CodeableConcept
.... serviced[x] 0..1
..... servicedDatedate
..... servicedPeriodPeriod
.... location[x] 0..1
..... locationCodeableConceptCodeableConcept
..... locationAddressAddress
..... locationReferenceReference(Location
.... patientPaid 0..1Money
.... quantity 0..1SimpleQuantity
.... unitPrice 0..1Money
.... factor 0..1decimal
.... tax 0..1Money
.... net 0..1Money
.... udi 0..*Reference(Device)
.... bodySite 0..*BackboneElement
..... site 1..*CodeableReferenceType Error: (CodeableReference = FMM5-Draft vs. Element = FMM2-Trial Use)
..... subSite 0..*CodeableConcept
.... encounter 0..*Reference(Encounter)
.... noteNumber 0..*positiveInt
.... reviewOutcome 0..1BackboneElement
..... decision 0..1CodeableConcept
..... reason 0..*CodeableConcept
..... preAuthRef 0..1string
..... preAuthPeriod 0..1Period
.... adjudication 0..*BackboneElement
..... category 1..1CodeableConcept
..... reason 0..1CodeableConcept
..... amount 0..1Money
..... quantity 0..1Quantity
.... detail 0..*BackboneElement
..... sequence 1..1positiveInt
..... traceNumber 0..*Identifier
..... revenue 0..1CodeableConcept
..... category 0..1CodeableConcept
..... productOrService 0..1CodeableConcept
..... productOrServiceEnd 0..1CodeableConcept
..... modifier 0..*CodeableConcept
..... programCode 0..*CodeableConcept
..... patientPaid 0..1Money
..... quantity 0..1SimpleQuantity
..... unitPrice 0..1Money
..... factor 0..1decimal
..... tax 0..1Money
..... net 0..1Money
..... udi 0..*Reference(Device)
..... noteNumber 0..*positiveInt
..... reviewOutcome 0..1see reviewOutcome
..... adjudication 0..*see adjudication
..... subDetail 0..*BackboneElement
...... sequence 1..1positiveInt
...... traceNumber 0..*Identifier
...... revenue 0..1CodeableConcept
...... category 0..1CodeableConcept
...... productOrService 0..1CodeableConcept
...... productOrServiceEnd 0..1CodeableConcept
...... modifier 0..*CodeableConcept
...... programCode 0..*CodeableConcept
...... patientPaid 0..1Money
...... quantity 0..1SimpleQuantity
...... unitPrice 0..1Money
...... factor 0..1decimal
...... tax 0..1Money
...... net 0..1Money
...... udi 0..*Reference(Device)
...... noteNumber 0..*positiveInt
...... reviewOutcome 0..1see reviewOutcome
...... adjudication 0..*see adjudication
... addItem 0..*BackboneElement
.... itemSequence 0..*positiveInt
.... detailSequence 0..*positiveInt
.... subDetailSequence 0..*positiveInt
.... traceNumber 0..*Identifier
.... provider 0..*Reference(Practitioner | PractitionerRole | Organization)
.... revenue 0..1CodeableConcept
.... productOrService 0..1CodeableConcept
.... productOrServiceEnd 0..1CodeableConcept
.... request 0..*Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | SupplyRequest | VisionPrescription)Type Warning: (DeviceRequest = FMM1-Trial Use vs. Element = FMM2-Trial Use)
Type Warning: (SupplyRequest = FMM1-Trial Use vs. Element = FMM2-Trial Use)
.... modifier 0..*CodeableConcept
.... programCode 0..*CodeableConcept
.... serviced[x] 0..1
..... servicedDatedate
..... servicedPeriodPeriod
.... location[x] 0..1
..... locationCodeableConceptCodeableConcept
..... locationAddressAddress
..... locationReferenceReference(Location
.... patientPaid 0..1Money
.... quantity 0..1SimpleQuantity
.... unitPrice 0..1Money
.... factor 0..1decimal
.... tax 0..1Money
.... net 0..1Money
.... bodySite 0..*BackboneElement
..... site 1..*CodeableReferenceType Error: (CodeableReference = FMM5-Draft vs. Element = FMM2-Trial Use)
..... subSite 0..*CodeableConcept
.... noteNumber 0..*positiveInt
.... reviewOutcome 0..1see reviewOutcome
.... adjudication 0..*see adjudication
.... detail 0..*BackboneElement
..... traceNumber 0..*Identifier
..... revenue 0..1CodeableConcept
..... productOrService 0..1CodeableConcept
..... productOrServiceEnd 0..1CodeableConcept
..... modifier 0..*CodeableConcept
..... patientPaid 0..1Money
..... quantity 0..1SimpleQuantity
..... unitPrice 0..1Money
..... factor 0..1decimal
..... tax 0..1Money
..... net 0..1Money
..... noteNumber 0..*positiveInt
..... reviewOutcome 0..1see reviewOutcome
..... adjudication 0..*see adjudication
..... subDetail 0..*BackboneElement
...... traceNumber 0..*Identifier
...... revenue 0..1CodeableConcept
...... productOrService 0..1CodeableConcept
...... productOrServiceEnd 0..1CodeableConcept
...... modifier 0..*CodeableConcept
...... patientPaid 0..1Money
...... quantity 0..1SimpleQuantity
...... unitPrice 0..1Money
...... factor 0..1decimal
...... tax 0..1Money
...... net 0..1Money
...... noteNumber 0..*positiveInt
...... reviewOutcome 0..1see reviewOutcome
...... adjudication 0..*see adjudication
... adjudication 0..*see adjudication
... total 0..*BackboneElement
.... category 1..1CodeableConcept
.... amount 1..1Money
... payment 0..1BackboneElement
.... type 0..1CodeableConcept
.... adjustment 0..1Money
.... adjustmentReason 0..1CodeableConcept
.... date 0..1date
.... amount 0..1Money
.... identifier 0..1Identifier
... formCode 0..1CodeableConcept
... form 0..1Attachment
... processNote 0..*BackboneElement
.... number 0..1positiveInt
.... type 0..1CodeableConcept
.... text 0..1string
.... language 0..1CodeableConcept
... benefitPeriod 0..1Period
... benefitBalance 0..*BackboneElement
.... category 1..1CodeableConcept
.... excluded 0..1boolean
.... name 0..1string
.... description 0..1string
.... network 0..1CodeableConcept
.... unit 0..1CodeableConcept
.... term 0..1CodeableConcept
.... financial 0..*BackboneElement
..... type 1..1CodeableConcept
..... allowed[x] 0..1
...... allowedUnsignedIntunsignedInt
...... allowedStringstring
...... allowedMoneyMoney
..... used[x] 0..1
...... usedUnsignedIntunsignedInt
...... usedMoneyMoney