description: 'This resource provides: the claim details; adjudication details from the processing of a Claim; and optionally account balance information, for informing the subscriber of the benefits provided.' package_name: hl7.fhir.r4.core derivation: specialization name: ExplanationOfBenefit type: ExplanationOfBenefit elements: patient: short: The recipient of the products and services refers: ['http://hl7.org/fhir/StructureDefinition/Patient'] type: Reference isSummary: true index: 5 claimResponse: short: Claim response reference refers: ['http://hl7.org/fhir/StructureDefinition/ClaimResponse'] type: Reference index: 26 insurance: min: 1 short: Patient insurance information index: 72 type: BackboneElement array: true elements: focal: {short: Coverage to be used for adjudication, type: boolean, isSummary: true, index: 73} coverage: short: Insurance information refers: ['http://hl7.org/fhir/StructureDefinition/Coverage'] type: Reference isSummary: true index: 74 preAuthRef: {short: Prior authorization reference number, type: string, array: true, index: 75} required: [coverage, focal] isSummary: true benefitBalance: type: BackboneElement short: Balance by Benefit Category array: true index: 207 elements: category: short: Benefit classification type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/ex-benefitcategory'} index: 208 excluded: {type: boolean, short: Excluded from the plan, index: 209} name: {short: Short name for the benefit, type: string, index: 210} description: {short: Description of the benefit or services covered, type: string, index: 211} network: short: In or out of network type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/benefit-network'} index: 212 unit: short: Individual or family type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/benefit-unit'} index: 213 term: short: Annual or lifetime type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/benefit-term'} index: 214 financial: type: BackboneElement short: Benefit Summary array: true index: 215 elements: type: short: Benefit classification type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/benefit-type'} index: 216 allowed: short: Benefits allowed choices: [allowedUnsignedInt, allowedString, allowedMoney] index: 218 allowedUnsignedInt: {short: Benefits allowed, type: unsignedInt, choiceOf: allowed, index: 219} allowedString: {short: Benefits allowed, type: string, choiceOf: allowed, index: 220} allowedMoney: {short: Benefits allowed, type: Money, choiceOf: allowed, index: 221} used: short: Benefits used choices: [usedUnsignedInt, usedMoney] index: 223 usedUnsignedInt: {short: Benefits used, type: unsignedInt, choiceOf: used, index: 224} usedMoney: {short: Benefits used, type: Money, choiceOf: used, index: 225} required: [type] required: [category] facility: short: Servicing Facility refers: ['http://hl7.org/fhir/StructureDefinition/Location'] type: Reference index: 24 processNote: short: Note concerning adjudication type: BackboneElement array: true index: 201 elements: number: {type: positiveInt, short: Note instance identifier, index: 202} type: short: display | print | printoper type: code binding: {strength: required, valueSet: 'http://hl7.org/fhir/ValueSet/note-type|4.0.1'} index: 203 text: {type: string, short: Note explanatory text, index: 204} language: short: Language of the text type: CodeableConcept binding: {strength: preferred, valueSet: 'http://hl7.org/fhir/ValueSet/languages'} index: 205 diagnosis: short: Pertinent diagnosis information type: BackboneElement array: true index: 53 elements: sequence: {short: Diagnosis instance identifier, type: positiveInt, index: 54} diagnosis: short: Nature of illness or problem choices: [diagnosisCodeableConcept, diagnosisReference] index: 56 diagnosisCodeableConcept: {short: Nature of illness or problem, type: CodeableConcept, choiceOf: diagnosis, index: 57} diagnosisReference: short: Nature of illness or problem refers: ['http://hl7.org/fhir/StructureDefinition/Condition'] type: Reference choiceOf: diagnosis index: 58 type: short: Timing or nature of the diagnosis type: CodeableConcept array: true binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/ex-diagnosistype'} index: 59 onAdmission: short: Present on admission type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission'} index: 60 packageCode: short: Package billing code type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup'} index: 61 required: [diagnosisReference, diagnosis, diagnosisCodeableConcept, sequence] preAuthRef: {short: Preauthorization reference, type: string, array: true, index: 29} adjudication: short: Header-level adjudication elementReference: ['http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit', elements, item, elements, adjudication] array: true index: 188 enterer: short: Author of the claim refers: ['http://hl7.org/fhir/StructureDefinition/Practitioner', 'http://hl7.org/fhir/StructureDefinition/PractitionerRole'] type: Reference index: 8 supportingInfo: short: Supporting information type: BackboneElement array: true index: 37 elements: category: short: Classification of the supplied information type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/claim-informationcategory'} index: 39 valueReference: short: Data to be provided refers: ['http://hl7.org/fhir/StructureDefinition/Resource'] type: Reference choiceOf: value index: 51 valueQuantity: {short: Data to be provided, type: Quantity, choiceOf: value, index: 49} timingPeriod: {type: Period, short: When it occurred, choiceOf: timing, index: 44} value: short: Data to be provided choices: [valueBoolean, valueString, valueQuantity, valueAttachment, valueReference] index: 46 valueString: {short: Data to be provided, type: string, choiceOf: value, index: 48} valueBoolean: {short: Data to be provided, type: boolean, choiceOf: value, index: 47} reason: short: Explanation for the information type: Coding binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/missing-tooth-reason'} index: 52 timing: short: When it occurred choices: [timingDate, timingPeriod] index: 42 sequence: {type: positiveInt, short: Information instance identifier, index: 38} code: short: Type of information type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/claim-exception'} index: 40 timingDate: {type: date, short: When it occurred, choiceOf: timing, index: 43} valueAttachment: {short: Data to be provided, type: Attachment, choiceOf: value, index: 50} required: [sequence, category] use: short: claim | preauthorization | predetermination type: code binding: {strength: required, valueSet: 'http://hl7.org/fhir/ValueSet/claim-use|4.0.1'} isSummary: true index: 4 payment: short: Payment Details type: BackboneElement index: 192 elements: type: short: Partial or complete payment type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/ex-paymenttype'} index: 193 adjustment: {short: Payment adjustment for non-claim issues, type: Money, index: 194} adjustmentReason: short: Explanation for the variance type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/payment-adjustment-reason'} index: 195 date: {type: date, short: Expected date of payment, index: 196} amount: {type: Money, short: Payable amount after adjustment, index: 197} identifier: {short: Business identifier for the payment, type: Identifier, index: 198} item: short: Product or service provided type: BackboneElement array: true index: 83 elements: category: short: Benefit classification type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/ex-benefitcategory'} index: 90 diagnosisSequence: {type: positiveInt, short: Applicable diagnoses, array: true, index: 86} procedureSequence: {type: positiveInt, short: Applicable procedures, array: true, index: 87} locationAddress: {short: Place of service or where product was supplied, type: Address, choiceOf: location, index: 101} modifier: short: Product or service billing modifiers type: CodeableConcept array: true binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/claim-modifiers'} index: 92 revenue: short: Revenue or cost center code type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/ex-revenue-center'} index: 89 adjudication: short: Adjudication details type: BackboneElement array: true index: 112 elements: category: short: Type of adjudication information type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/adjudication'} index: 113 reason: short: Explanation of adjudication outcome type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/adjudication-reason'} index: 114 amount: {short: Monetary amount, type: Money, index: 115} value: {short: Non-monitary value, type: decimal, index: 116} required: [category] encounter: short: Encounters related to this billed item refers: ['http://hl7.org/fhir/StructureDefinition/Encounter'] type: Reference array: true index: 110 locationCodeableConcept: {short: Place of service or where product was supplied, type: CodeableConcept, choiceOf: location, index: 100} net: {short: Total item cost, type: Money, index: 106} serviced: short: Date or dates of service or product delivery choices: [servicedDate, servicedPeriod] index: 95 subSite: short: Anatomical sub-location type: CodeableConcept array: true binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/surface'} index: 109 careTeamSequence: {type: positiveInt, short: Applicable care team members, array: true, index: 85} productOrService: short: Billing, service, product, or drug code type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/service-uscls'} index: 91 locationReference: short: Place of service or where product was supplied refers: ['http://hl7.org/fhir/StructureDefinition/Location'] type: Reference choiceOf: location index: 102 udi: short: Unique device identifier refers: ['http://hl7.org/fhir/StructureDefinition/Device'] type: Reference array: true index: 107 informationSequence: {type: positiveInt, short: Applicable exception and supporting information, array: true, index: 88} programCode: short: Program the product or service is provided under type: CodeableConcept array: true binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/ex-program-code'} index: 93 factor: {short: Price scaling factor, type: decimal, index: 105} servicedDate: {short: Date or dates of service or product delivery, type: date, choiceOf: serviced, index: 96} sequence: {type: positiveInt, short: Item instance identifier, index: 84} bodySite: short: Anatomical location type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/tooth'} index: 108 quantity: {type: Quantity, short: Count of products or services, index: 103} location: short: Place of service or where product was supplied choices: [locationCodeableConcept, locationAddress, locationReference] index: 99 noteNumber: {type: positiveInt, short: Applicable note numbers, array: true, index: 111} unitPrice: {type: Money, short: 'Fee, charge or cost per item', index: 104} servicedPeriod: {short: Date or dates of service or product delivery, type: Period, choiceOf: serviced, index: 97} detail: type: BackboneElement short: Additional items array: true index: 117 elements: category: short: Benefit classification type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/ex-benefitcategory'} index: 120 modifier: short: Service/Product billing modifiers type: CodeableConcept array: true binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/claim-modifiers'} index: 122 revenue: short: Revenue or cost center code type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/ex-revenue-center'} index: 119 adjudication: short: Detail level adjudication details elementReference: ['http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit', elements, item, elements, adjudication] array: true index: 130 net: {short: Total item cost, type: Money, index: 127} productOrService: short: Billing, service, product, or drug code type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/service-uscls'} index: 121 udi: short: Unique device identifier refers: ['http://hl7.org/fhir/StructureDefinition/Device'] type: Reference array: true index: 128 programCode: short: Program the product or service is provided under type: CodeableConcept array: true binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/ex-program-code'} index: 123 factor: {short: Price scaling factor, type: decimal, index: 126} sequence: {type: positiveInt, short: Product or service provided, index: 118} subDetail: type: BackboneElement short: Additional items array: true index: 131 elements: category: short: Benefit classification type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/ex-benefitcategory'} index: 134 modifier: short: Service/Product billing modifiers type: CodeableConcept array: true binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/claim-modifiers'} index: 136 revenue: short: Revenue or cost center code type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/ex-revenue-center'} index: 133 adjudication: short: Subdetail level adjudication details elementReference: ['http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit', elements, item, elements, adjudication] array: true index: 144 net: {short: Total item cost, type: Money, index: 141} productOrService: short: Billing, service, product, or drug code type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/service-uscls'} index: 135 udi: short: Unique device identifier refers: ['http://hl7.org/fhir/StructureDefinition/Device'] type: Reference array: true index: 142 programCode: short: Program the product or service is provided under type: CodeableConcept array: true binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/ex-program-code'} index: 137 factor: {short: Price scaling factor, type: decimal, index: 140} sequence: {type: positiveInt, short: Product or service provided, index: 132} quantity: {type: Quantity, short: Count of products or services, index: 138} noteNumber: {type: positiveInt, short: Applicable note numbers, array: true, index: 143} unitPrice: {type: Money, short: 'Fee, charge or cost per item', index: 139} required: [sequence, productOrService] quantity: {type: Quantity, short: Count of products or services, index: 124} noteNumber: {type: positiveInt, short: Applicable note numbers, array: true, index: 129} unitPrice: {type: Money, short: 'Fee, charge or cost per item', index: 125} required: [sequence, productOrService] required: [sequence, productOrService] type: short: Category or discipline type: CodeableConcept binding: {strength: extensible, valueSet: 'http://hl7.org/fhir/ValueSet/claim-type'} isSummary: true index: 2 created: {short: Response creation date, type: dateTime, isSummary: true, index: 7} procedure: short: Clinical procedures performed type: BackboneElement array: true index: 62 elements: sequence: {type: positiveInt, short: Procedure instance identifier, index: 63} type: short: Category of Procedure type: CodeableConcept array: true binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/ex-procedure-type'} index: 64 date: {type: dateTime, short: When the procedure was performed, index: 65} procedure: short: Specific clinical procedure choices: [procedureCodeableConcept, procedureReference] index: 67 procedureCodeableConcept: {short: Specific clinical procedure, type: CodeableConcept, choiceOf: procedure, index: 68} procedureReference: short: Specific clinical procedure refers: ['http://hl7.org/fhir/StructureDefinition/Procedure'] type: Reference choiceOf: procedure index: 69 udi: short: Unique device identifier refers: ['http://hl7.org/fhir/StructureDefinition/Device'] type: Reference array: true index: 70 required: [procedureReference, sequence, procedure, procedureCodeableConcept] outcome: short: queued | complete | error | partial type: code binding: {strength: required, valueSet: 'http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1'} isSummary: true index: 27 related: short: Prior or corollary claims type: BackboneElement array: true index: 14 elements: claim: short: Reference to the related claim refers: ['http://hl7.org/fhir/StructureDefinition/Claim'] type: Reference index: 15 relationship: short: How the reference claim is related type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/related-claim-relationship'} index: 16 reference: {short: File or case reference, type: Identifier, index: 17} disposition: {type: string, short: Disposition Message, index: 28} referral: short: Treatment Referral refers: ['http://hl7.org/fhir/StructureDefinition/ServiceRequest'] type: Reference index: 23 preAuthRefPeriod: {short: Preauthorization in-effect period, type: Period, array: true, index: 30} total: short: Adjudication totals type: BackboneElement array: true isSummary: true index: 189 elements: category: short: Type of adjudication information type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/adjudication'} isSummary: true index: 190 amount: {short: Financial total for the category, type: Money, isSummary: true, index: 191} required: [amount, category] insurer: short: Party responsible for reimbursement refers: ['http://hl7.org/fhir/StructureDefinition/Organization'] type: Reference isSummary: true index: 9 fundsReserve: short: Funds reserved status type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/fundsreserve'} index: 13 priority: short: Desired processing urgency type: CodeableConcept binding: {strength: example, valueSet: 'http://terminology.hl7.org/CodeSystem/processpriority'} index: 11 accident: short: Details of the event type: BackboneElement index: 76 elements: date: {short: When the incident occurred, type: date, index: 77} type: short: The nature of the accident type: CodeableConcept binding: {strength: extensible, valueSet: 'http://terminology.hl7.org/ValueSet/v3-ActIncidentCode'} index: 78 location: short: Where the event occurred choices: [locationAddress, locationReference] index: 80 locationAddress: {short: Where the event occurred, type: Address, choiceOf: location, index: 81} locationReference: short: Where the event occurred refers: ['http://hl7.org/fhir/StructureDefinition/Location'] type: Reference choiceOf: location index: 82 status: isModifier: true short: active | cancelled | draft | entered-in-error type: code binding: {strength: required, valueSet: 'http://hl7.org/fhir/ValueSet/explanationofbenefit-status|4.0.1'} isModifierReason: This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid isSummary: true index: 1 payee: short: Recipient of benefits payable type: BackboneElement index: 20 elements: type: short: Category of recipient type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/payeetype'} index: 21 party: short: Recipient reference refers: ['http://hl7.org/fhir/StructureDefinition/Organization', 'http://hl7.org/fhir/StructureDefinition/Patient', 'http://hl7.org/fhir/StructureDefinition/Practitioner', 'http://hl7.org/fhir/StructureDefinition/PractitionerRole', 'http://hl7.org/fhir/StructureDefinition/RelatedPerson'] type: Reference index: 22 prescription: short: Prescription authorizing services or products refers: ['http://hl7.org/fhir/StructureDefinition/MedicationRequest', 'http://hl7.org/fhir/StructureDefinition/VisionPrescription'] type: Reference index: 18 billablePeriod: {short: Relevant time frame for the claim, type: Period, isSummary: true, index: 6} identifier: {short: Business Identifier for the resource, type: Identifier, array: true, index: 0} form: {short: Printed reference or actual form, type: Attachment, index: 200} subType: short: More granular claim type type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/claim-subtype'} index: 3 fundsReserveRequested: short: For whom to reserve funds type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/fundsreserve'} index: 12 benefitPeriod: {short: When the benefits are applicable, type: Period, index: 206} precedence: {type: positiveInt, short: 'Precedence (primary, secondary, etc.)', index: 71} formCode: short: Printed form identifier type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/forms'} index: 199 provider: short: Party responsible for the claim refers: ['http://hl7.org/fhir/StructureDefinition/Organization', 'http://hl7.org/fhir/StructureDefinition/Practitioner', 'http://hl7.org/fhir/StructureDefinition/PractitionerRole'] type: Reference isSummary: true index: 10 addItem: short: Insurer added line items type: BackboneElement array: true index: 145 elements: locationAddress: {short: Place of service or where product was supplied, type: Address, choiceOf: location, index: 160} modifier: short: Service/Product billing modifiers type: CodeableConcept array: true binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/claim-modifiers'} index: 151 adjudication: short: Added items adjudication elementReference: ['http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit', elements, item, elements, adjudication] array: true index: 169 locationCodeableConcept: {short: Place of service or where product was supplied, type: CodeableConcept, choiceOf: location, index: 159} itemSequence: {type: positiveInt, short: Item sequence number, array: true, index: 146} net: {short: Total item cost, type: Money, index: 165} serviced: short: Date or dates of service or product delivery choices: [servicedDate, servicedPeriod] index: 154 detailSequence: {type: positiveInt, short: Detail sequence number, array: true, index: 147} subSite: short: Anatomical sub-location type: CodeableConcept array: true binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/surface'} index: 167 productOrService: short: Billing, service, product, or drug code type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/service-uscls'} index: 150 locationReference: short: Place of service or where product was supplied refers: ['http://hl7.org/fhir/StructureDefinition/Location'] type: Reference choiceOf: location index: 161 programCode: short: Program the product or service is provided under type: CodeableConcept array: true binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/ex-program-code'} index: 152 factor: {short: Price scaling factor, type: decimal, index: 164} servicedDate: {short: Date or dates of service or product delivery, type: date, choiceOf: serviced, index: 155} subDetailSequence: {type: positiveInt, short: Subdetail sequence number, array: true, index: 148} bodySite: short: Anatomical location type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/tooth'} index: 166 quantity: {type: Quantity, short: Count of products or services, index: 162} location: short: Place of service or where product was supplied choices: [locationCodeableConcept, locationAddress, locationReference] index: 158 provider: short: Authorized providers refers: ['http://hl7.org/fhir/StructureDefinition/Organization', 'http://hl7.org/fhir/StructureDefinition/Practitioner', 'http://hl7.org/fhir/StructureDefinition/PractitionerRole'] type: Reference array: true index: 149 noteNumber: {type: positiveInt, short: Applicable note numbers, array: true, index: 168} unitPrice: {type: Money, short: 'Fee, charge or cost per item', index: 163} servicedPeriod: {short: Date or dates of service or product delivery, type: Period, choiceOf: serviced, index: 156} detail: type: BackboneElement short: Insurer added line items array: true index: 170 elements: modifier: short: Service/Product billing modifiers type: CodeableConcept array: true binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/claim-modifiers'} index: 172 adjudication: short: Added items adjudication elementReference: ['http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit', elements, item, elements, adjudication] array: true index: 178 net: {short: Total item cost, type: Money, index: 176} productOrService: short: Billing, service, product, or drug code type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/service-uscls'} index: 171 factor: {short: Price scaling factor, type: decimal, index: 175} subDetail: type: BackboneElement short: Insurer added line items array: true index: 179 elements: productOrService: short: Billing, service, product, or drug code type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/service-uscls'} index: 180 modifier: short: Service/Product billing modifiers type: CodeableConcept array: true binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/claim-modifiers'} index: 181 quantity: {type: Quantity, short: Count of products or services, index: 182} unitPrice: {type: Money, short: 'Fee, charge or cost per item', index: 183} factor: {short: Price scaling factor, type: decimal, index: 184} net: {short: Total item cost, type: Money, index: 185} noteNumber: {type: positiveInt, short: Applicable note numbers, array: true, index: 186} adjudication: short: Added items adjudication elementReference: ['http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit', elements, item, elements, adjudication] array: true index: 187 required: [productOrService] quantity: {type: Quantity, short: Count of products or services, index: 173} noteNumber: {type: positiveInt, short: Applicable note numbers, array: true, index: 177} unitPrice: {type: Money, short: 'Fee, charge or cost per item', index: 174} required: [productOrService] required: [productOrService] originalPrescription: short: Original prescription if superceded by fulfiller refers: ['http://hl7.org/fhir/StructureDefinition/MedicationRequest'] type: Reference index: 19 careTeam: short: Care Team members type: BackboneElement array: true index: 31 elements: sequence: {type: positiveInt, short: Order of care team, index: 32} provider: short: Practitioner or organization refers: ['http://hl7.org/fhir/StructureDefinition/Organization', 'http://hl7.org/fhir/StructureDefinition/Practitioner', 'http://hl7.org/fhir/StructureDefinition/PractitionerRole'] type: Reference index: 33 responsible: {short: Indicator of the lead practitioner, type: boolean, index: 34} role: short: Function within the team type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/claim-careteamrole'} index: 35 qualification: short: Practitioner credential or specialization type: CodeableConcept binding: {strength: example, valueSet: 'http://hl7.org/fhir/ValueSet/provider-qualification'} index: 36 required: [provider, sequence] claim: short: Claim reference refers: ['http://hl7.org/fhir/StructureDefinition/Claim'] type: Reference index: 25 package_version: 4.0.1 class: resource kind: resource url: http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit base: http://hl7.org/fhir/StructureDefinition/DomainResource version: 4.0.1 required: [created, insurer, provider, status, insurance, type, patient, use, outcome]