description: The No Surprises Act requires that group health plans and insurers provide advance cost estimates, called advanced explanations of benefits (advanced EOBs), for scheduled services. This profile is used for exchanging the Advanced EOB data.
package_name: hl7.fhir.us.davinci
derivation: constraint
name: PCTAdvancedEOB
type: ExplanationOfBenefit
elements:
  patient:
    type: Reference
    refers: ['http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-patient-demographics']
    index: 11
  insurance:
    elements:
      coverage:
        type: Reference
        refers: ['http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage']
        index: 20
  benefitBalance:
    index: 102
    elements:
      category:
        binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTBenefitBalanceCategoryVS'}
        index: 103
      unit:
        binding: {strength: required, valueSet: 'http://hl7.org/fhir/ValueSet/benefit-unit'}
        index: 104
      term:
        binding: {strength: required, valueSet: 'http://hl7.org/fhir/ValueSet/benefit-term'}
        index: 105
      financial:
        index: 106
        extensions:
          remaining: {url: 'http://hl7.org/fhir/us/davinci-pct/StructureDefinition/remaining-benefit', min: 0, max: 1, type: Extension, mustSupport: true, index: 108}
        elements:
          extension:
            index: 107
            slicing:
              rules: open
              ordered: false
              discriminator:
              - {path: url, type: value}
              min: null
              slices:
                remaining:
                  match: {url: null}
                  schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pct/StructureDefinition/remaining-benefit', index: 108}
                  min: 0
                  max: 1
          type:
            binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTFinancialTypeVS'}
            index: 109
          allowed:
            mustSupport: true
            choices: [allowedUnsignedInt, allowedMoney]
            index: 111
          allowedUnsignedInt: {type: unsignedInt, mustSupport: true, choiceOf: allowed, index: 112}
          allowedMoney: {type: Money, mustSupport: true, choiceOf: allowed, index: 113}
          used:
            mustSupport: true
            choices: [usedUnsignedInt, usedMoney]
            index: 115
          usedUnsignedInt: {type: unsignedInt, mustSupport: true, choiceOf: used, index: 116}
          usedMoney: {type: Money, mustSupport: true, choiceOf: used, index: 117}
        required: [allowedMoney, usedMoney, used, allowedUnsignedInt, allowed, usedUnsignedInt]
    required: [term, financial, unit]
  processNote:
    short: Disclaimers go here. Notes should be clear and as specific to the situation at hand as possible
    index: 98
    extensions:
      processNoteClass: {url: 'http://hl7.org/fhir/us/davinci-pct/StructureDefinition/processNoteClass', min: 0, max: 1, type: Extension, index: 100}
    elements:
      extension:
        index: 99
        slicing:
          rules: open
          ordered: false
          discriminator:
          - {path: url, type: value}
          min: null
          slices:
            processNoteClass:
              match: {url: null}
              schema: {type: Extension, url: 'http://hl7.org/fhir/us/davinci-pct/StructureDefinition/processNoteClass', index: 100}
              min: 0
              max: 1
  adjudication:
    type: BackboneElement
    mustSupport: true
    index: 52
    elements:
      category:
        binding: {strength: extensible, valueSet: 'http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTAdjudicationCategoryVS'}
        index: 53
    slicing:
      rules: open
      ordered: false
      description: Slice based on $this pattern
      discriminator:
      - {path: category, type: pattern}
      min: null
      slices:
        eligible:
          match:
            category:
              coding:
              - {code: eligible, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
          schema:
            short: Eligible amount
            type: BackboneElement
            mustSupport: true
            index: 76
            elements:
              category:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: eligible, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
                index: 77
        adjustmentreason:
          match:
            category:
              coding:
              - {code: adjustmentreason, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
          schema:
            type: BackboneElement
            short: Adjustment Reason
            mustSupport: true
            array: true
            index: 69
            elements:
              category:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: adjustmentreason, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
                index: 70
              reason:
                binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTAdjustmentReasonVS'}
                index: 71
        submitted:
          match:
            category:
              coding:
              - {code: submitted, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
          schema:
            type: BackboneElement
            short: Provider submitted amount
            mustSupport: true
            index: 72
            elements:
              category:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: submitted, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
                index: 73
        medicalmanagement:
          match:
            category:
              coding:
              - {code: medicalmanagement, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
          schema:
            type: BackboneElement
            mustSupport: true
            array: true
            index: 54
            extensions:
              subjectToMedicalMgmt: {url: 'http://hl7.org/fhir/us/davinci-pct/StructureDefinition/subjectToMedicalMgmt', min: 1, max: 1, type: Extension, index: 56}
            elements:
              extension:
                index: 55
                slicing:
                  rules: open
                  ordered: false
                  discriminator:
                  - {path: url, type: value}
                  min: 1
                  slices:
                    subjectToMedicalMgmt:
                      match: {url: null}
                      schema: {type: Extension, url: 'http://hl7.org/fhir/us/davinci-pct/StructureDefinition/subjectToMedicalMgmt', index: 56}
                      min: 1
                      max: 1
              category:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: medicalmanagement, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
                index: 57
              amount: {index: 58}
              value: {index: 59}
            required: [extension]
        benefit:
          match:
            category:
              coding:
              - {code: benefit, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
          schema:
            short: Benefit amount
            type: BackboneElement
            mustSupport: true
            index: 78
            elements:
              category:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: benefit, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
                index: 79
        billingnetworkstatus:
          match:
            category:
              coding:
              - {code: billingnetworkstatus, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
          schema:
            type: BackboneElement
            short: Billing Provider Network Status
            mustSupport: true
            index: 60
            elements:
              category:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: billingnetworkstatus, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
                index: 61
              reason:
                binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTPayerBenefitPaymentStatusVS'}
                index: 62
        memberliability:
          match:
            category:
              coding:
              - {code: memberliability, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
          schema:
            short: Member liability
            type: BackboneElement
            mustSupport: true
            index: 74
            elements:
              category:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: memberliability, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
                index: 75
        renderingnetworkstatus:
          match:
            category:
              coding:
              - {code: renderingnetworkstatus, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
          schema:
            type: BackboneElement
            short: Rendering Provider Network Status
            mustSupport: true
            index: 63
            elements:
              category:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: renderingnetworkstatus, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
                index: 64
              reason:
                binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTPayerBenefitPaymentStatusVS'}
                index: 65
        benefitpaymentstatus:
          match:
            category:
              coding:
              - {code: benefitpaymentstatus, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
          schema:
            type: BackboneElement
            short: Benefit Payment Status
            mustSupport: true
            index: 66
            elements:
              category:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: benefitpaymentstatus, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
                index: 67
              reason:
                binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTPayerBenefitPaymentStatusVS'}
                index: 68
  use:
    pattern: {type: Code, value: predetermination}
    index: 10
  item:
    index: 21
    extensions:
      serviceDescription: {url: 'http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription', min: 0, max: 1, type: Extension, mustSupport: true, index: 23}
    elements:
      extension:
        index: 22
        slicing:
          rules: open
          ordered: false
          discriminator:
          - {path: url, type: value}
          min: null
          slices:
            serviceDescription:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription', index: 23}
              min: 0
              max: 1
      revenue:
        binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTGFEItemRevenueVS'}
        index: 24
      productOrService:
        binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/davinci-pct/ValueSet/USClaimMedicalProductOrServiceCodes'}
        index: 25
      modifier:
        binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTGFEItemCptHcpcsVS'}
        mustSupport: true
        array: true
        max: 4
        index: 26
      serviced:
        short: This is the planned or estimated date(s)s of service
        choices: []
        index: 28
      quantity: {mustSupport: true, index: 29}
      adjudication:
        mustSupport: true
        index: 30
        elements:
          category:
            binding: {strength: extensible, valueSet: 'http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTAdjudicationCategoryVS'}
            index: 31
        slicing:
          rules: open
          ordered: false
          description: Slice based on $this pattern
          discriminator:
          - {path: category, type: pattern}
          min: 1
          slices:
            medicalmanagement:
              match:
                category:
                  coding:
                  - {code: medicalmanagement, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
              schema:
                mustSupport: true
                array: true
                index: 32
                extensions:
                  subjectToMedicalMgmt: {url: 'http://hl7.org/fhir/us/davinci-pct/StructureDefinition/subjectToMedicalMgmt', min: 1, max: 1, type: Extension, index: 34}
                elements:
                  extension:
                    index: 33
                    slicing:
                      rules: open
                      ordered: false
                      discriminator:
                      - {path: url, type: value}
                      min: 1
                      slices:
                        subjectToMedicalMgmt:
                          match: {url: null}
                          schema: {type: Extension, url: 'http://hl7.org/fhir/us/davinci-pct/StructureDefinition/subjectToMedicalMgmt', index: 34}
                          min: 1
                          max: 1
                  category:
                    pattern:
                      type: CodeableConcept
                      value:
                        coding:
                        - {code: medicalmanagement, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
                    index: 35
                  amount: {index: 36}
                  value: {index: 37}
                required: [extension]
            benefitpaymentstatus:
              match:
                category:
                  coding:
                  - {code: benefitpaymentstatus, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
              schema:
                short: 'Benefit Payment Status: Line level benefit payment status associated with professional claim estimates only.'
                mustSupport: true
                index: 38
                elements:
                  category:
                    pattern:
                      type: CodeableConcept
                      value:
                        coding:
                        - {code: benefitpaymentstatus, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
                    index: 39
                  reason:
                    binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTPayerBenefitPaymentStatusVS'}
                    index: 40
            adjustmentreason:
              match:
                category:
                  coding:
                  - {code: adjustmentreason, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
              schema:
                short: Adjustment Reason
                mustSupport: true
                array: true
                index: 41
                elements:
                  category:
                    pattern:
                      type: CodeableConcept
                      value:
                        coding:
                        - {code: adjustmentreason, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
                    index: 42
                  reason:
                    binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTAdjustmentReasonVS'}
                    index: 43
            submitted:
              match:
                category:
                  coding:
                  - {code: submitted, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
              schema:
                short: Provider submitted amount
                mustSupport: true
                index: 44
                elements:
                  category:
                    pattern:
                      type: CodeableConcept
                      value:
                        coding:
                        - {code: submitted, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
                    index: 45
            memberliability:
              match:
                category:
                  coding:
                  - {code: memberliability, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
              schema:
                short: Member liability
                mustSupport: true
                index: 46
                elements:
                  category:
                    pattern:
                      type: CodeableConcept
                      value:
                        coding:
                        - {code: memberliability, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
                    index: 47
            eligible:
              match:
                category:
                  coding:
                  - {code: eligible, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
              schema:
                short: Eligible amount
                mustSupport: true
                index: 48
                elements:
                  category:
                    pattern:
                      type: CodeableConcept
                      value:
                        coding:
                        - {code: eligible, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
                    index: 49
            benefit:
              match:
                category:
                  coding:
                  - {code: benefit, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
              schema:
                short: Benefit amount
                mustSupport: true
                index: 50
                elements:
                  category:
                    pattern:
                      type: CodeableConcept
                      value:
                        coding:
                        - {code: benefit, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
                    index: 51
    required: [adjudication, serviced]
  type:
    binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTAEOBTypeVS'}
    index: 9
  created: {short: The date and time this estimate was calculated., index: 12}
  extension:
    index: 0
    slicing:
      rules: open
      ordered: false
      discriminator:
      - {path: url, type: value}
      min: 1
      slices:
        gfeReference:
          match: {url: null}
          schema: {type: Extension, short: The GFE Bundle submitted by an entity that started the process for obtaining an Advanced EOB., url: 'http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeReference', index: 1}
          min: 1
        serviceDescription:
          match: {url: null}
          schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription', index: 2}
          min: 0
          max: 1
        outOfNetworkProviderInfo:
          match: {url: null}
          schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pct/StructureDefinition/inNetworkProviderOptionsLink', index: 3}
          min: 0
          max: 1
  total:
    index: 80
    elements:
      category:
        binding: {strength: extensible, valueSet: 'http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTTotal'}
        mustSupport: true
        index: 81
    slicing:
      rules: open
      ordered: false
      description: Slice based on value pattern
      discriminator:
      - {path: category, type: pattern}
      min: 1
      slices:
        submitted:
          match:
            category:
              coding:
              - {code: submitted, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
          schema:
            short: Total provider submitted amount
            mustSupport: true
            _required: true
            index: 82
            elements:
              category:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: submitted, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
                index: 83
        memberliability:
          match:
            category:
              coding:
              - {code: memberliability, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
          schema:
            short: Total member liability - Must include in non-zero total across all AEoBs
            mustSupport: true
            index: 84
            elements:
              category:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: memberliability, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS'}
                index: 85
        innetwork:
          match:
            category:
              coding:
              - {code: innetwork, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCS'}
          schema:
            short: Total in network amount - Must include in non-zero total across all AEoBs
            mustSupport: true
            index: 86
            elements:
              category:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: innetwork, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCS'}
                index: 87
        outofnetwork:
          match:
            category:
              coding:
              - {code: outofnetwork, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCS'}
          schema:
            short: Total out of network amount - Must include in non-zero total across all AEoBs
            mustSupport: true
            index: 88
            elements:
              category:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: outofnetwork, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCS'}
                index: 89
        noncovered:
          match:
            category:
              coding:
              - {code: noncovered, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudication'}
          schema:
            short: Total noncovered amount - Must include in non-zero total across all AEoBs
            mustSupport: true
            index: 90
            elements:
              category:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: noncovered, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudication'}
                index: 91
        negotiated:
          match:
            category:
              coding:
              - {code: negotiated, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCS'}
          schema:
            short: Total negotiated amount - Must include in non-zero total across all AEoBs
            mustSupport: true
            index: 92
            elements:
              category:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: negotiated, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCS'}
                index: 93
        eligible:
          match:
            category:
              coding:
              - {code: eligible, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
          schema:
            short: Total eligible amount - Must include in non-zero total across all AEoBs
            mustSupport: true
            index: 94
            elements:
              category:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: eligible, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
                index: 95
        benefit:
          match:
            category:
              coding:
              - {code: benefit, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
          schema:
            short: Total benefit amount - Must include in non-zero total across all AEoBs
            mustSupport: true
            index: 96
            elements:
              category:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: benefit, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
                index: 97
  insurer:
    type: Reference
    refers: ['http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization']
    index: 13
  priority:
    binding: {strength: required, valueSet: 'http://hl7.org/fhir/ValueSet/process-priority'}
    mustSupport: true
    index: 15
  identifier:
    index: 4
    slicing:
      rules: open
      description: Slice based on type pattern
      discriminator:
      - {path: type, type: pattern}
      min: 1
      slices:
        INTER:
          match:
            type:
              coding:
              - {code: INTER, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTIdentifierType', display: Intermediary System Identifier}
          schema:
            short: Intermediary System Identifier
            array: true
            index: 5
            elements:
              type:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: INTER, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTIdentifierType', display: Intermediary System Identifier}
                index: 6
            required: [type]
        uniqueclaimid:
          match:
            type:
              coding:
              - {code: uc, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTIdentifierType', display: Unique Claim ID}
          schema:
            short: Unique Claim ID
            _required: true
            index: 7
            elements:
              type:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: uc, system: 'http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTIdentifierType', display: Unique Claim ID}
                index: 8
            required: [type]
  benefitPeriod: {index: 101}
  provider:
    type: Reference
    refers: ['http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization', 'http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-practitioner']
    index: 14
  claim:
    index: 16
    elements:
      identifier:
        short: GFE identifier of the originally submitted claim
        index: 17
        elements:
          system: {mustSupport: true, index: 18}
          value: {index: 19}
        required: [value]
    required: [identifier]
package_version: pct-2.0.0-ballot
extensions:
  gfeReference: {url: 'http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeReference', min: 1, type: Extension, short: The GFE Bundle submitted by an entity that started the process for obtaining an Advanced EOB., index: 1}
  serviceDescription: {url: 'http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription', min: 0, max: 1, type: Extension, mustSupport: true, index: 2}
  outOfNetworkProviderInfo: {url: 'http://hl7.org/fhir/us/davinci-pct/StructureDefinition/inNetworkProviderOptionsLink', min: 0, max: 1, type: Extension, mustSupport: true, index: 3}
class: profile
kind: resource
url: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-aeob
base: http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit
version: 2.0.0-ballot
required: [total, benefitPeriod, processNote, claim, extension, identifier, item, benefitBalance]