Package | hl7.fhir.us.carin-bb |
Type | StructureDefinition |
Id | Id |
FHIR Version | R4 |
Source | http://hl7.org/fhir/us/carin-bb/https://build.fhir.org/ig/HL7/carin-bb/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician-Basis.html |
Url | http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Professional-NonClinician-Basis |
Version | 2.1.0 |
Status | active |
Date | 2025-02-17T19:01:44+00:00 |
Name | C4BBExplanationOfBenefitProfessionalNonClinicianBasis |
Title | C4BB ExplanationOfBenefit Professional NonClinician Basis |
Experimental | False |
Realm | us |
Authority | hl7 |
Description | This profile is used for Explanation of Benefits (EOBs) based on claims submitted by physicians, suppliers and other non-institutional providers for professional and vision services. These services may be rendered in inpatient or outpatient, including office locations. The claims data is based on the professional claim form 1500, submission standards adopted by the Department of Health and Human Services as form CMS-1500. The basis profile does not have requirements for financial data. |
Type | ExplanationOfBenefit |
Kind | resource |
StructureDefinition | |
C4BB-ExplanationOfBenefit-Professional-NonClinician ![]() | C4BB ExplanationOfBenefit Professional NonClinician |
Note: links and images are rebased to the (stated) source
Generated Narrative: StructureDefinition C4BB-ExplanationOfBenefit-Professional-NonClinician-Basis
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
![]() ![]() | C | 0..* | C4BBExplanationOfBenefit | Explanation of Benefit resource EOB-prof-all-transportation-supportinginfo-linked-to-line: Professional EOB: SupportingInfo repetitions with with transportation category code must be referred to by one or more repetitions of item.informationSequence EOB-vision-item-productorservice: Vision EOB: Item productOrService not required in item.productOrService if and only if type is vision. |
![]() ![]() ![]() | 1..1 | CodeableConcept | Category or discipline Binding: C4BB Professional And Non Clinician Claim Type Value Set (required) | |
![]() ![]() ![]() | C | 0..* | BackboneElement | Care Team members EOB-prof-careTeam-practitioner: Professional EOB: Careteam roles refer to a practitioner |
![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Function within the team Binding: C4BB Claim Professional And Non Clinician Care Team Role Value Set (required) | |
![]() ![]() ![]() ![]() | S | 0..1 | CodeableConcept | Practitioner credential or specialization Binding: Healthcare Provider Taxonomy ![]() |
![]() ![]() ![]() | 0..* | BackboneElement | Supporting information Slice: Unordered, Open by value:category | |
![]() ![]() ![]() ![]() | S | 0..1 | BackboneElement | Claim received date |
![]() ![]() ![]() ![]() ![]() | S | 1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following |
![]() ![]() ![]() ![]() ![]() ![]() | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | code | Symbol in syntax defined by the system Fixed Value: clmrecvddate | |
![]() ![]() ![]() ![]() ![]() | S | 1..1 | date | When it occurred |
![]() ![]() ![]() ![]() | S | 0..1 | BackboneElement | Service facility |
![]() ![]() ![]() ![]() ![]() | S | 1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following |
![]() ![]() ![]() ![]() ![]() ![]() | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | code | Symbol in syntax defined by the system Fixed Value: servicefacility | |
![]() ![]() ![]() ![]() ![]() | 1..1 | Reference(Resource) | Data to be provided Slice: Unordered, Open by type:$this | |
![]() ![]() ![]() ![]() ![]() ![]() | S | 1..1 | Reference(C4BB Organization) | Data to be provided |
![]() ![]() ![]() ![]() | S | 0..1 | BackboneElement | Medical record number |
![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
![]() ![]() ![]() ![]() ![]() ![]() | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | code | Symbol in syntax defined by the system Fixed Value: medicalrecordnumber | |
![]() ![]() ![]() ![]() ![]() | 1..1 | string | Data to be provided Slice: Unordered, Open by type:$this | |
![]() ![]() ![]() ![]() ![]() ![]() | S | 1..1 | string | Data to be provided |
![]() ![]() ![]() ![]() | S | 0..1 | BackboneElement | Patient account number |
![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
![]() ![]() ![]() ![]() ![]() ![]() | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | code | Symbol in syntax defined by the system Fixed Value: patientaccountnumber | |
![]() ![]() ![]() ![]() ![]() | 1..1 | string | Data to be provided Slice: Unordered, Open by type:$this | |
![]() ![]() ![]() ![]() ![]() ![]() | S | 1..1 | string | Data to be provided |
![]() ![]() ![]() ![]() | S | 0..* | BackboneElement | Supporting information |
![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
![]() ![]() ![]() ![]() ![]() ![]() | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | code | Symbol in syntax defined by the system Fixed Value: patientweight | |
![]() ![]() ![]() ![]() ![]() | 0..0 | |||
![]() ![]() ![]() ![]() ![]() | 0..0 | |||
![]() ![]() ![]() ![]() ![]() | 1..1 | Quantity | Data to be provided | |
![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | decimal | Numerical value (with implicit precision) | |
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | string | Unit representation Required Pattern: [lb_av] | |
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | uri | System that defines coded unit form Required Pattern: http://unitsofmeasure.org | |
![]() ![]() ![]() ![]() | S | 0..* | BackboneElement | Supporting information |
![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
![]() ![]() ![]() ![]() ![]() ![]() | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | code | Symbol in syntax defined by the system Fixed Value: ambulancetransportreason | |
![]() ![]() ![]() ![]() ![]() | 0..0 | |||
![]() ![]() ![]() ![]() ![]() | 0..0 | |||
![]() ![]() ![]() ![]() ![]() | 1..1 | Coding | Explanation for the information Binding: C4BB Ambulance Transport Reasons Value Set (required) | |
![]() ![]() ![]() ![]() | S | 0..* | BackboneElement | Supporting information |
![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
![]() ![]() ![]() ![]() ![]() ![]() | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | code | Symbol in syntax defined by the system Fixed Value: transportationdistance | |
![]() ![]() ![]() ![]() ![]() | 0..0 | |||
![]() ![]() ![]() ![]() ![]() | 0..0 | |||
![]() ![]() ![]() ![]() ![]() | 1..1 | Quantity | Data to be provided | |
![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | decimal | Numerical value (with implicit precision) | |
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | string | Unit representation Required Pattern: [mi_i] | |
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | uri | System that defines coded unit form Required Pattern: http://unitsofmeasure.org | |
![]() ![]() ![]() ![]() | S | 0..* | BackboneElement | Supporting information |
![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
![]() ![]() ![]() ![]() ![]() ![]() | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | code | Symbol in syntax defined by the system Fixed Value: roudtrippurpose | |
![]() ![]() ![]() ![]() ![]() | 0..0 | |||
![]() ![]() ![]() ![]() ![]() | 0..0 | |||
![]() ![]() ![]() ![]() ![]() | 1..1 | string | Data to be provided | |
![]() ![]() ![]() ![]() | S | 0..* | BackboneElement | Supporting information |
![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
![]() ![]() ![]() ![]() ![]() ![]() | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | code | Symbol in syntax defined by the system Fixed Value: stretcherpurpose | |
![]() ![]() ![]() ![]() ![]() | 0..0 | |||
![]() ![]() ![]() ![]() ![]() | 0..0 | |||
![]() ![]() ![]() ![]() ![]() | 1..1 | string | Data to be provided | |
![]() ![]() ![]() ![]() | S | 0..* | BackboneElement | Supporting information |
![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
![]() ![]() ![]() ![]() ![]() ![]() | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | code | Symbol in syntax defined by the system Fixed Value: pickuplocation | |
![]() ![]() ![]() ![]() ![]() | 0..0 | |||
![]() ![]() ![]() ![]() ![]() | 0..0 | |||
![]() ![]() ![]() ![]() ![]() | 1..1 | string | Data to be provided | |
![]() ![]() ![]() ![]() | S | 0..* | BackboneElement | Supporting information |
![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
![]() ![]() ![]() ![]() ![]() ![]() | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | code | Symbol in syntax defined by the system Fixed Value: dropofflocation | |
![]() ![]() ![]() ![]() ![]() | 0..0 | |||
![]() ![]() ![]() ![]() ![]() | 0..0 | |||
![]() ![]() ![]() ![]() ![]() | 1..1 | string | Data to be provided | |
![]() ![]() ![]() | S | 1..* | BackboneElement | Pertinent diagnosis information |
![]() |