description: This profile is used for Explanation of Benefits (EOBs) based on claims submitted by retail pharmacies.\nThe claims data is based on submission standards adopted by the Department of Health and Human Services defined by NCPDP (National Council for Prescription Drug Program)\nThe profile has requirements for financial data.
package_name: hl7.fhir.us.carin-bb
derivation: constraint
name: C4BBExplanationOfBenefitPharmacy
type: ExplanationOfBenefit
elements:
  item:
    elements:
      adjudication:
        index: 0
        slicing:
          slices:
            adjudicationamounttype:
              match: {}
              schema:
                short: Line level adjudication type and amount
                mustSupport: true
                array: true
                min: 1
                _required: true
                index: 1
                elements:
                  category:
                    binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication'}
                    index: 2
                  amount: {mustSupport: true, index: 3}
                required: [amount]
    required: [adjudication]
  total:
    mustSupport: true
    index: 4
    elements:
      category:
        binding: {strength: extensible, valueSet: 'http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBTotalCategoryDiscriminator'}
        mustSupport: true
        index: 5
      amount: {index: 6}
    slicing:
      rules: open
      ordered: false
      description: Slice based on value
      discriminator:
      - {path: category, type: value}
      min: 1
      slices:
        adjudicationamounttype:
          match: {category: null}
          schema:
            short: Total adjudication type and amount
            mustSupport: true
            array: true
            min: 1
            _required: true
            index: 7
            elements:
              category:
                binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication'}
                index: 8
package_version: 2.1.0
class: profile
kind: resource
url: http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Pharmacy
base: http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Pharmacy-Basis
version: 2.1.0
required: [total]