API end point: https://fhir.careevolution.com/Master.Adapter1.WebClient/api/fhir-r4.

Resource ExplanationOfBenefit (R4)

Maps CareEvolution Claim and contained Medication concepts

Supported interactions

Search parameters

Name Type Modifiers , prefixes Multiple values Can be chained Description
_id Token Yes

Resource id

_lastUpdated Date lt le gt ge

When the resource last changed

_source Uri :missing Yes

Where the resource comes from

care-team Reference (Practitioner) :missing Yes Yes

Member of the CareTeam

coverage Reference (Coverage) :missing Yes Yes

The plan under which the claim was adjudicated

created Date :missing eq ne lt le gt ge sa eb ap

The creation date for the EOB

encounter Reference (Encounter) :missing Yes Yes

Encounters associated with a billed line item

identifier Token :missing Yes

The business identifier of the Explanation of Benefit

patient Reference (Patient) :missing Yes Yes

The patient the ExplanationOfBenefit is about

provenance-agent Reference (Organization) :missing Yes Yes

Search by provenance, specified by its author (aka originator) Organization

provider Reference (Practitioner) :missing Yes Yes

The reference to the provider

service-date Date :missing eq ne lt le gt ge sa eb ap

Date of the service for the EOB

service-start-date Date :missing eq ne lt le gt ge sa eb ap

Starting Date of the service for the EOB.

type Token :missing Yes

Claim type

Sorts

Supports multiple sorts

Includes

Operations

Default to FHIR mappings

FHIR CareEvolution
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount Claim.TotalCoinsuranceAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount Claim.TotalPatientResponsibleAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount Claim.TotalNotCoveredAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount Claim.TotalPatientPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount Claim.TotalHsaPaidAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount Claim.TotalPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|adjustmentreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
Claim.NonPaymentReason
Domain: NonPaymentReason
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|benefitpaymentstatus).reason
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
Claim.InNetwork
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount Claim.TotalAllowed
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount Claim.TotalCopayAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount Claim.TotalDeductibleAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount Claim.TotalCharges
billablePeriod Claim.StartDate
Claim.EndDate
careTeam.provider Claim.CaregiverRelationships.CaregiverID Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Claim.Services.CaregiverRelationships.CaregiverID
careTeam.responsible Claim.CaregiverRelationships.Responsible Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Claim.Services.CaregiverRelationships.Responsible
careTeam.role
Bindings:  ValueSet-C4BBClaimInstitutionalCareTeamRole
Claim.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Claim.Services.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
created Claim.CreatedDate
Claim.AdjudicationDate
diagnosis.diagnosis
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Claim.Problems.Term
Domain: DiagnosisCode
diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate') Claim.Problems.Date
diagnosis.onAdmission
Bindings:  http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical
Claim.Problems.OnAdmission
Domain: DiagnosisStatusOnAdmission
diagnosis.sequence Claim.Problems.Sequence
diagnosis.type
Bindings:  CodeSystem-C4BBClaimDiagnosisType
Claim.Problems.Type
Domain: DiagnosisType
disposition Claim.Property('FHIRExplanationOfBenefitDisposition')
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-adjudicationDate') Claim.AdjudicationDate
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-claimRevision') Claim.Revision
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-controlNumber') Claim.ControlNumber
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-disposition') Claim.Disposition
Domain: ClaimDisposition
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-encounterID') Claim.EncounterID
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-mrn') Claim.Mrn
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-referralReference') Claim.ReferralID
extension('http://careevolution.com/fhirextensions#properties') Claim.Properties
facility.identifier Claim.Property('FacilityNpi')
identifier Claim.Identifier
Claim.AlternateIdentifier
insurance.coverage Claim.InsuranceID
Claim.InsuranceIdentifier
insurer Claim.InsuranceID
Claim.InsuranceIdentifier
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount Claim.Services.CoinsuranceAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount Claim.Services.PatientResponsibleAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount Claim.Services.NotCoveredAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount Claim.Services.PatientPaid
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount Claim.Services.HsaPaidAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount Medications.AmountPaid
Claim.Services.AmountPaid
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|adjustmentreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
Claim.Services.NonPaymentReason
Domain: NonPaymentReason
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount Claim.Services.AllowedAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount Claim.Services.CopayAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount Claim.Services.DeductibleAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount Medications.AmountBilled
Claim.Services.AmountClaimed
item.detail.productOrService.coding.display Medications.Comment
item.extension('http://careevolution.com/fhirextensions#dataSource') Medications.DataSource
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-alternateIdentifier') Medications.AlternateIdentifier
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-caregiverReference') Medications.CaregiverID
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-comment') Claim.Services.Comment
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-dose') Medications.Dose
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-doseUnits')
Bindings:  http://unitsofmeasure.org
Medications.DoseUnits
Domain: MedicationProfileDoseUnits
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-filledBy') Medications.FilledByID
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-frequency') Medications.Frequency
Domain: MedicationProfileFrequency
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-isGeneric') Medications.IsGeneric
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-prescribedDate') Medications.PrescribedDate
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-problems')
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Claim.Services.Problem1
Domain: DiagnosisCode
Claim.Services.Problem2
Domain: DiagnosisCode
Claim.Services.Problem3
Domain: DiagnosisCode
Claim.Services.Problem4
Domain: DiagnosisCode
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-reconcileStatus') Medications.ReconcileStatus
Domain: ReconcileStatus
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-refills') Medications.Refills
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-status') Medications.Status
Domain: MedicationStatus
Claim.Services.Status
Domain: ClaimServiceStatus
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-strength') Medications.Strength
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-therapeuticClass') Medications.TherapeuticClass
Domain: TherapeuticClass
item.extension('http://careevolution.com/fhirextensions#properties') Medications.Properties
Claim.Services.Properties
item.location
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
Claim.Services.LocationType
Domain: ServiceLocation
item.modifier
Bindings:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Claim.Services.Modifier1
Domain: BillingModifier
Claim.Services.Modifier2
Domain: BillingModifier
Claim.Services.Modifier3
Domain: BillingModifier
Claim.Services.Modifier4
Domain: BillingModifier
Claim.Services.Modifier5
Domain: BillingModifier
item.net Medications.AmountBilled
Claim.Services.AmountClaimed
item.productOrService
Bindings:  http://hl7.org/fhir/sid/cvx  http://hl7.org/fhir/sid/ndc  http://www.nlm.nih.gov/research/umls/rxnorm  http://snomed.info/sct  http://www.ada.org/cdt  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Medications.Term
Domain: MedicationType
Claim.Services.ServiceCode
Domain: ServiceCode
item.quantity
Bindings:  http://unitsofmeasure.org
Medications.Quantity
Medications.Units
Domain: MedicationUnits
Medications.Term
Domain: MedicationType
Claim.Services.Units
item.revenue
Bindings:  https://www.nubc.org/CodeSystem/RevenueCodes
Claim.Services.RevenueCode
Domain: RevenueCode
item.sequence Medications.Identifier
Medications.Sequence
Claim.Services.Sequence
item.serviced Medications.Date
Claim.Services.StartDate
Claim.Services.EndDate
patient Claim.PatientID
payee Claim.CaregiverRelationships Maps CaregiverRelationships with RelationshipType=PayToProvider
payment.amount Claim.TotalPaid
payment.date Claim.PaidDate
payment.type
Bindings:  ValueSet-C4BBPayerClaimPaymentStatusCode
Claim.Status
preAuthRef Claim.AuthorizationNumber
procedure.date Claim.Procedures.Date
procedure.procedure
Bindings:  http://www.ada.org/cdt  http://snomed.info/sct  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Claim.Procedures.Term
Domain: ProcedureCode
procedure.sequence Claim.Procedures.Sequence
procedure.type
Bindings:  ValueSet-C4BBClaimProcedureType
Claim.Procedures.Type
Domain: ProcedureType
provider Claim.CaregiverRelationships Maps CaregiverRelationships with RelationshipType=ClaimProvider
related Claim.Property('OriginalClaimNumber')
status
Bindings:  valueset-explanationofbenefit-status
Claim.Status
Domain: ClaimStatus
supportingInfo(category=http://careevolution.com/fhir/SupportingInfo|placeofservice).code
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
Claim.FacilityType
Domain: FacilityType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admissionperiod).timing Claim.AdmitDate
Claim.DischargeDate
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admtype).code
Bindings:  https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  https://rosetta.careevolution.com/UBFacilityType
Claim.AdmitType
Domain: AdmissionType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|dawcode).code Medications.DawCode
Domain: DispenseAsWritten
Medications.DispenseAsWritten
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|dayssupply).value Medications.DaysSupplied
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|discharge-status).code Claim.PatientStatus
Domain: PatientStatus
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|drg).code
Bindings:  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software
Claim.Drg
Domain: ClaimDrg
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|pointoforigin).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
Claim.AdmitSource
Domain: AdmitSource
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|refillnum).value Medications.RefillNumber
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|refillsauthorized).value Medications.Refills
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|typeofbill).code
Bindings:  https://www.nubc.org/CodeSystem/TypeOfBill
Claim.BillClass
Domain: BillClass
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/ClaimInformationCategory|admsrc).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
Claim.AdmitSource
Domain: AdmitSource
supportingInfo.category
Bindings:  ValueSet-C4BBSupportingInfoType
Claim.ClaimSupportingInformation.Type
Domain: SupportingInformationType
supportingInfo.code Claim.ClaimSupportingInformation.Term
Domain: SupportingInformationCode
supportingInfo.reason Claim.ClaimSupportingInformation.Reason
Domain: SupportingInformationReason
supportingInfo.sequence Claim.ClaimSupportingInformation.Sequence
supportingInfo.timing Claim.ClaimSupportingInformation.StartDate
Claim.ClaimSupportingInformation.EndDate
supportingInfo.value Claim.ClaimSupportingInformation.Value
text Claim.Comment
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount Claim.TotalCoinsuranceAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount Claim.TotalPatientResponsibleAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount Claim.TotalNotCoveredAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount Claim.TotalPatientPaid
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount Claim.TotalHsaPaidAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount Claim.TotalPaid
total(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount Claim.TotalAllowed
total(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount Claim.TotalCopayAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount Claim.TotalDeductibleAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount Claim.TotalCharges
total.category
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
Claim.InNetwork
type
Bindings:  valueset-claim-type
Claim.ClaimType
Domain: ClaimType

Default from FHIR mappings

FHIR CareEvolution
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount Claim.TotalCoinsuranceAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount Claim.TotalPatientResponsibleAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount Claim.TotalNotCoveredAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount Claim.TotalPatientPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount Claim.TotalHsaPaidAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount Claim.TotalPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|adjustmentreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
Claim.NonPaymentReason
Domain: NonPaymentReason
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|benefitpaymentstatus).reason
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
Claim.InNetwork
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount Claim.TotalAllowed
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount Claim.TotalCopayAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount Claim.TotalDeductibleAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount Claim.TotalCharges
benefitBalance.financial.used Claim.Properties
billablePeriod Claim.StartDate
Claim.EndDate
careTeam.provider Claim.CaregiverRelationships.CaregiverID
Claim.Services.CaregiverRelationships.CaregiverID
careTeam.responsible Claim.CaregiverRelationships.Responsible
Claim.Services.CaregiverRelationships.Responsible
careTeam.role
Bindings:  ValueSet-C4BBClaimInstitutionalCareTeamRole
Claim.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
Claim.Services.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
created Claim.CreatedDate
diagnosis.diagnosis
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Claim.Problems.Term
Domain: DiagnosisCode
diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate') Claim.Problems.Date
diagnosis.onAdmission
Bindings:  http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical
Claim.Problems.OnAdmission
Domain: DiagnosisStatusOnAdmission
diagnosis.sequence Claim.Problems.Sequence
diagnosis.type
Bindings:  CodeSystem-C4BBClaimDiagnosisType
Claim.Problems.Type
Domain: DiagnosisType
disposition Claim.Property('FHIRExplanationOfBenefitDisposition')
extension Claim.Properties
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-adjudicationDate') Claim.AdjudicationDate
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-claimRevision') Claim.Revision
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-controlNumber') Claim.ControlNumber
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-disposition') Claim.Disposition
Domain: ClaimDisposition
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-encounterID') Claim.EncounterID
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-mrn') Claim.Mrn
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-referralReference') Claim.ReferralID
extension('http://careevolution.com/fhirextensions#properties') Claim.Properties
facility.identifier Claim.Property('FacilityNpi')
id Claim.Identifier
identifier Claim.Identifier
Claim.AlternateIdentifier
insurance.coverage Claim.InsuranceID
Claim.InsuranceIdentifier
insurer Claim.InsuranceID
Claim.InsuranceIdentifier
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount Claim.Services.CoinsuranceAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount Claim.Services.PatientResponsibleAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount Claim.Services.NotCoveredAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount Claim.Services.PatientPaid
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount Claim.Services.HsaPaidAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount Medications.AmountPaid
Claim.Services.AmountPaid
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|adjustmentreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
Claim.Services.NonPaymentReason
Domain: NonPaymentReason
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount Claim.Services.AllowedAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount Claim.Services.CopayAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount Claim.Services.DeductibleAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount Medications.AmountBilled
Claim.Services.AmountClaimed
item.detail.productOrService.coding.display Medications.Comment
item.extension Claim.Services.Properties
item.extension('http://careevolution.com/fhirextensions#dataSource') Medications.DataSource
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-alternateIdentifier') Medications.AlternateIdentifier
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-caregiverReference') Medications.CaregiverID
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-comment') Claim.Services.Comment
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-dose') Medications.Dose
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-doseUnits')
Bindings:  http://unitsofmeasure.org
Medications.DoseUnits
Domain: MedicationProfileDoseUnits
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-filledBy') Medications.FilledByID
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-frequency') Medications.Frequency
Domain: MedicationProfileFrequency
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-isGeneric') Medications.IsGeneric
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-prescribedDate') Medications.PrescribedDate
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-problems')
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Claim.Services.Problem1
Domain: DiagnosisCode
Claim.Services.Problem2
Domain: DiagnosisCode
Claim.Services.Problem3
Domain: DiagnosisCode
Claim.Services.Problem4
Domain: DiagnosisCode
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-reconcileStatus') Medications.ReconcileStatus
Domain: ReconcileStatus
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-refills') Medications.Refills
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-status') Medications.Status
Domain: MedicationStatus
Claim.Services.Status
Domain: ClaimServiceStatus
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-strength') Medications.Strength
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-therapeuticClass') Medications.TherapeuticClass
Domain: TherapeuticClass
item.extension('http://careevolution.com/fhirextensions#properties') Medications.Properties
Claim.Services.Properties
item.location
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
Claim.Services.LocationType
Domain: ServiceLocation
item.modifier
Bindings:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Claim.Services.Modifier1
Domain: BillingModifier
Claim.Services.Modifier2
Domain: BillingModifier
Claim.Services.Modifier3
Domain: BillingModifier
Claim.Services.Modifier4
Domain: BillingModifier
Claim.Services.Modifier5
Domain: BillingModifier
item.net Medications.AmountBilled
Claim.Services.AmountClaimed
item.productOrService
Bindings:  http://hl7.org/fhir/sid/cvx  http://hl7.org/fhir/sid/ndc  http://www.nlm.nih.gov/research/umls/rxnorm  http://snomed.info/sct  http://www.ada.org/cdt  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Medications.Term
Domain: MedicationType
Claim.Services.ServiceCode
Domain: ServiceCode
item.quantity
Bindings:  http://unitsofmeasure.org
Medications.Quantity
Medications.Units
Domain: MedicationUnits
Claim.Services.Units
item.revenue
Bindings:  https://www.nubc.org/CodeSystem/RevenueCodes
Claim.Services.RevenueCode
Domain: RevenueCode
item.sequence Medications.Identifier
Medications.Sequence
Claim.Services.Sequence
item.serviced Medications.Date
Claim.Services.StartDate
Claim.Services.EndDate
patient Claim.PatientID
payee Claim.CaregiverRelationships Maps CaregiverRelationships with RelationshipType=PayToProvider
payment.amount Claim.TotalPaid
payment.date Claim.PaidDate
preAuthRef Claim.AuthorizationNumber
procedure.date Claim.Procedures.Date
procedure.procedure
Bindings:  http://www.ada.org/cdt  http://snomed.info/sct  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Claim.Procedures.Term
Domain: ProcedureCode
procedure.sequence Claim.Procedures.Sequence
procedure.type
Bindings:  ValueSet-C4BBClaimProcedureType
Claim.Procedures.Type
Domain: ProcedureType
provider Claim.CaregiverRelationships Maps CaregiverRelationships with RelationshipType=ClaimProvider
related Claim.Property('OriginalClaimNumber')
status
Bindings:  valueset-explanationofbenefit-status
Claim.Status
Domain: ClaimStatus
supportingInfo(category=http://careevolution.com/fhir/SupportingInfo|placeofservice).code
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
Claim.FacilityType
Domain: FacilityType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admissionperiod).timing Claim.AdmitDate
Claim.DischargeDate
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admtype).code
Bindings:  https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  https://rosetta.careevolution.com/UBFacilityType
Claim.AdmitType
Domain: AdmissionType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|dawcode).code Medications.DawCode
Domain: DispenseAsWritten
Medications.DispenseAsWritten
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|dayssupply).value Medications.DaysSupplied
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|discharge-status).code Claim.PatientStatus
Domain: PatientStatus
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|drg).code
Bindings:  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software
Claim.Drg
Domain: ClaimDrg
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|pointoforigin).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
Claim.AdmitSource
Domain: AdmitSource
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|refillnum).value Medications.RefillNumber
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|refillsauthorized).value Medications.Refills
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|typeofbill).code
Bindings:  https://www.nubc.org/CodeSystem/TypeOfBill
Claim.BillClass
Domain: BillClass
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/ClaimInformationCategory|admsrc).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
Claim.AdmitSource
Domain: AdmitSource
supportingInfo.category
Bindings:  ValueSet-C4BBSupportingInfoType
Claim.ClaimSupportingInformation.Type
Domain: SupportingInformationType
supportingInfo.code Claim.ClaimSupportingInformation.Term
Domain: SupportingInformationCode
supportingInfo.reason Claim.ClaimSupportingInformation.Reason
Domain: SupportingInformationReason
supportingInfo.sequence Claim.ClaimSupportingInformation.Sequence
supportingInfo.timing Claim.ClaimSupportingInformation.StartDate
Claim.ClaimSupportingInformation.EndDate
supportingInfo.value Claim.ClaimSupportingInformation.Value
text Claim.Comment
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount Claim.TotalCoinsuranceAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount Claim.TotalPatientResponsibleAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount Claim.TotalNotCoveredAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount Claim.TotalPatientPaid
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount Claim.TotalHsaPaidAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount Claim.TotalPaid
total(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount Claim.TotalAllowed
total(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount Claim.TotalCopayAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount Claim.TotalDeductibleAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount Claim.TotalCharges
total.category
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
Claim.InNetwork
type
Bindings:  valueset-claim-type
Claim.ClaimType
Domain: ClaimType

Inpatient profile to FHIR mappings

FHIR CareEvolution
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount TotalCoinsuranceAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount TotalPatientResponsibleAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount TotalNotCoveredAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount TotalPatientPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount TotalHsaPaidAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount TotalPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|adjustmentreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
NonPaymentReason
Domain: NonPaymentReason
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|benefitpaymentstatus).reason
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
InNetwork
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount TotalAllowed
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount TotalCopayAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount TotalDeductibleAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount TotalCharges
billablePeriod StartDate
EndDate
careTeam.provider CaregiverRelationships.CaregiverID Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Services.CaregiverRelationships.CaregiverID
careTeam.responsible CaregiverRelationships.Responsible Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Services.CaregiverRelationships.Responsible
careTeam.role
Bindings:  ValueSet-C4BBClaimInstitutionalCareTeamRole
CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Services.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
created CreatedDate
AdjudicationDate
diagnosis.diagnosis
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Problems.Term
Domain: DiagnosisCode
diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate') Problems.Date
diagnosis.onAdmission
Bindings:  http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical
Problems.OnAdmission
Domain: DiagnosisStatusOnAdmission
diagnosis.sequence Problems.Sequence
diagnosis.type
Bindings:  CodeSystem-C4BBClaimDiagnosisType
Problems.Type
Domain: DiagnosisType
disposition Property('FHIRExplanationOfBenefitDisposition')
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-adjudicationDate') AdjudicationDate
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-claimRevision') Revision
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-controlNumber') ControlNumber
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-disposition') Disposition
Domain: ClaimDisposition
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-encounterID') EncounterID
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-mrn') Mrn
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-referralReference') ReferralID
extension('http://careevolution.com/fhirextensions#properties') Properties
facility.identifier Property('FacilityNpi')
identifier Identifier
AlternateIdentifier
insurance.coverage InsuranceID
InsuranceIdentifier
insurer InsuranceID
InsuranceIdentifier
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount Services.CoinsuranceAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount Services.PatientResponsibleAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount Services.NotCoveredAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount Services.PatientPaid
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount Services.HsaPaidAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount Services.AmountPaid
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|adjustmentreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
Services.NonPaymentReason
Domain: NonPaymentReason
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount Services.AllowedAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount Services.CopayAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount Services.DeductibleAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount Services.AmountClaimed
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-comment') Services.Comment
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-problems')
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Services.Problem1
Domain: DiagnosisCode
Services.Problem2
Domain: DiagnosisCode
Services.Problem3
Domain: DiagnosisCode
Services.Problem4
Domain: DiagnosisCode
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-status') Services.Status
Domain: ClaimServiceStatus
item.extension('http://careevolution.com/fhirextensions#properties') Services.Properties
item.location
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
Services.LocationType
Domain: ServiceLocation
item.modifier
Bindings:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Services.Modifier1
Domain: BillingModifier
Services.Modifier2
Domain: BillingModifier
Services.Modifier3
Domain: BillingModifier
Services.Modifier4
Domain: BillingModifier
Services.Modifier5
Domain: BillingModifier
item.net Services.AmountClaimed
item.productOrService
Bindings:  http://www.ada.org/cdt  http://snomed.info/sct  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Services.ServiceCode
Domain: ServiceCode
item.quantity Services.Units
item.revenue
Bindings:  https://www.nubc.org/CodeSystem/RevenueCodes
Services.RevenueCode
Domain: RevenueCode
item.sequence Services.Sequence
item.serviced Services.StartDate
Services.EndDate
patient PatientID
payee CaregiverRelationships Maps CaregiverRelationships with RelationshipType=PayToProvider
payment.amount TotalPaid
payment.date PaidDate
payment.type
Bindings:  ValueSet-C4BBPayerClaimPaymentStatusCode
Status
preAuthRef AuthorizationNumber
procedure.date Procedures.Date
procedure.procedure
Bindings:  http://www.ada.org/cdt  http://snomed.info/sct  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Procedures.Term
Domain: ProcedureCode
procedure.sequence Procedures.Sequence
procedure.type
Bindings:  ValueSet-C4BBClaimProcedureType
Procedures.Type
Domain: ProcedureType
provider CaregiverRelationships Maps CaregiverRelationships with RelationshipType=ClaimProvider
related Property('OriginalClaimNumber')
status
Bindings:  valueset-explanationofbenefit-status
Status
Domain: ClaimStatus
subType
Bindings:  ValueSet-C4BBInstitutionalClaimSubType
ClaimType
Domain: ClaimType
BillClass
Domain: BillClass
supportingInfo(category=http://careevolution.com/fhir/SupportingInfo|placeofservice).code
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
FacilityType
Domain: FacilityType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admissionperiod).timing AdmitDate
DischargeDate
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admtype).code
Bindings:  https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  https://rosetta.careevolution.com/UBFacilityType
AdmitType
Domain: AdmissionType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|discharge-status).code PatientStatus
Domain: PatientStatus
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|drg).code
Bindings:  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software
Drg
Domain: ClaimDrg
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|pointoforigin).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
AdmitSource
Domain: AdmitSource
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|typeofbill).code
Bindings:  https://www.nubc.org/CodeSystem/TypeOfBill
BillClass
Domain: BillClass
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/ClaimInformationCategory|admsrc).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
AdmitSource
Domain: AdmitSource
supportingInfo.category
Bindings:  ValueSet-C4BBSupportingInfoType
ClaimSupportingInformation.Type
Domain: SupportingInformationType
supportingInfo.code ClaimSupportingInformation.Term
Domain: SupportingInformationCode
supportingInfo.reason ClaimSupportingInformation.Reason
Domain: SupportingInformationReason
supportingInfo.sequence ClaimSupportingInformation.Sequence
supportingInfo.timing ClaimSupportingInformation.StartDate
ClaimSupportingInformation.EndDate
supportingInfo.value ClaimSupportingInformation.Value
text Comment
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount TotalCoinsuranceAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount TotalPatientResponsibleAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount TotalNotCoveredAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount TotalPatientPaid
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount TotalHsaPaidAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount TotalPaid
total(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount TotalAllowed
total(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount TotalCopayAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount TotalDeductibleAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount TotalCharges
total.category
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
InNetwork
type
Bindings:  valueset-claim-type
ClaimType
Domain: ClaimType

Inpatient profile from FHIR mappings

FHIR CareEvolution
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount TotalCoinsuranceAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount TotalPatientResponsibleAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount TotalNotCoveredAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount TotalPatientPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount TotalHsaPaidAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount TotalPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|adjustmentreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
NonPaymentReason
Domain: NonPaymentReason
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|benefitpaymentstatus).reason
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
InNetwork
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount TotalAllowed
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount TotalCopayAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount TotalDeductibleAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount TotalCharges
benefitBalance.financial.used Properties
billablePeriod StartDate
EndDate
careTeam.provider CaregiverRelationships.CaregiverID
Services.CaregiverRelationships.CaregiverID
careTeam.responsible CaregiverRelationships.Responsible
Services.CaregiverRelationships.Responsible
careTeam.role
Bindings:  ValueSet-C4BBClaimInstitutionalCareTeamRole
CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
Services.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
created CreatedDate
diagnosis.diagnosis
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Problems.Term
Domain: DiagnosisCode
diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate') Problems.Date
diagnosis.onAdmission
Bindings:  http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical
Problems.OnAdmission
Domain: DiagnosisStatusOnAdmission
diagnosis.sequence Problems.Sequence
diagnosis.type
Bindings:  CodeSystem-C4BBClaimDiagnosisType
Problems.Type
Domain: DiagnosisType
disposition Property('FHIRExplanationOfBenefitDisposition')
extension Properties
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-adjudicationDate') AdjudicationDate
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-claimRevision') Revision
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-controlNumber') ControlNumber
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-disposition') Disposition
Domain: ClaimDisposition
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-encounterID') EncounterID
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-mrn') Mrn
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-referralReference') ReferralID
extension('http://careevolution.com/fhirextensions#properties') Properties
facility.identifier Property('FacilityNpi')
id Identifier
identifier Identifier
AlternateIdentifier
insurance.coverage InsuranceID
InsuranceIdentifier
insurer InsuranceID
InsuranceIdentifier
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount Services.CoinsuranceAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount Services.PatientResponsibleAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount Services.NotCoveredAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount Services.PatientPaid
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount Services.HsaPaidAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount Services.AmountPaid
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|adjustmentreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
Services.NonPaymentReason
Domain: NonPaymentReason
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount Services.AllowedAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount Services.CopayAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount Services.DeductibleAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount Services.AmountClaimed
item.extension Services.Properties
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-comment') Services.Comment
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-problems')
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Services.Problem1
Domain: DiagnosisCode
Services.Problem2
Domain: DiagnosisCode
Services.Problem3
Domain: DiagnosisCode
Services.Problem4
Domain: DiagnosisCode
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-status') Services.Status
Domain: ClaimServiceStatus
item.extension('http://careevolution.com/fhirextensions#properties') Services.Properties
item.location
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
Services.LocationType
Domain: ServiceLocation
item.modifier
Bindings:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Services.Modifier1
Domain: BillingModifier
Services.Modifier2
Domain: BillingModifier
Services.Modifier3
Domain: BillingModifier
Services.Modifier4
Domain: BillingModifier
Services.Modifier5
Domain: BillingModifier
item.net Services.AmountClaimed
item.productOrService
Bindings:  http://www.ada.org/cdt  http://snomed.info/sct  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Services.ServiceCode
Domain: ServiceCode
item.quantity Services.Units
item.revenue
Bindings:  https://www.nubc.org/CodeSystem/RevenueCodes
Services.RevenueCode
Domain: RevenueCode
item.sequence Services.Sequence
item.serviced Services.StartDate
Services.EndDate
patient PatientID
payee CaregiverRelationships Maps CaregiverRelationships with RelationshipType=PayToProvider
payment.amount TotalPaid
payment.date PaidDate
preAuthRef AuthorizationNumber
procedure.date Procedures.Date
procedure.procedure
Bindings:  http://www.ada.org/cdt  http://snomed.info/sct  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Procedures.Term
Domain: ProcedureCode
procedure.sequence Procedures.Sequence
procedure.type
Bindings:  ValueSet-C4BBClaimProcedureType
Procedures.Type
Domain: ProcedureType
provider CaregiverRelationships Maps CaregiverRelationships with RelationshipType=ClaimProvider
related Property('OriginalClaimNumber')
status
Bindings:  valueset-explanationofbenefit-status
Status
Domain: ClaimStatus
supportingInfo(category=http://careevolution.com/fhir/SupportingInfo|placeofservice).code
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
FacilityType
Domain: FacilityType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admissionperiod).timing AdmitDate
DischargeDate
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admtype).code
Bindings:  https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  https://rosetta.careevolution.com/UBFacilityType
AdmitType
Domain: AdmissionType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|discharge-status).code PatientStatus
Domain: PatientStatus
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|drg).code
Bindings:  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software
Drg
Domain: ClaimDrg
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|pointoforigin).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
AdmitSource
Domain: AdmitSource
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|typeofbill).code
Bindings:  https://www.nubc.org/CodeSystem/TypeOfBill
BillClass
Domain: BillClass
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/ClaimInformationCategory|admsrc).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
AdmitSource
Domain: AdmitSource
supportingInfo.category
Bindings:  ValueSet-C4BBSupportingInfoType
ClaimSupportingInformation.Type
Domain: SupportingInformationType
supportingInfo.code ClaimSupportingInformation.Term
Domain: SupportingInformationCode
supportingInfo.reason ClaimSupportingInformation.Reason
Domain: SupportingInformationReason
supportingInfo.sequence ClaimSupportingInformation.Sequence
supportingInfo.timing ClaimSupportingInformation.StartDate
ClaimSupportingInformation.EndDate
supportingInfo.value ClaimSupportingInformation.Value
text Comment
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount TotalCoinsuranceAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount TotalPatientResponsibleAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount TotalNotCoveredAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount TotalPatientPaid
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount TotalHsaPaidAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount TotalPaid
total(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount TotalAllowed
total(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount TotalCopayAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount TotalDeductibleAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount TotalCharges
total.category
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
InNetwork
type
Bindings:  valueset-claim-type
ClaimType
Domain: ClaimType

Outpatient profile to FHIR mappings

FHIR CareEvolution
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount TotalCoinsuranceAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount TotalPatientResponsibleAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount TotalNotCoveredAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount TotalPatientPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount TotalHsaPaidAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount TotalPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|adjustmentreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
NonPaymentReason
Domain: NonPaymentReason
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|benefitpaymentstatus).reason
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
InNetwork
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount TotalAllowed
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount TotalCopayAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount TotalDeductibleAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount TotalCharges
billablePeriod StartDate
EndDate
careTeam.provider CaregiverRelationships.CaregiverID Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Services.CaregiverRelationships.CaregiverID
careTeam.responsible CaregiverRelationships.Responsible Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Services.CaregiverRelationships.Responsible
careTeam.role
Bindings:  ValueSet-C4BBClaimInstitutionalCareTeamRole
CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Services.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
created CreatedDate
AdjudicationDate
diagnosis.diagnosis
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Problems.Term
Domain: DiagnosisCode
diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate') Problems.Date
diagnosis.onAdmission
Bindings:  http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical
Problems.OnAdmission
Domain: DiagnosisStatusOnAdmission
diagnosis.sequence Problems.Sequence
diagnosis.type
Bindings:  CodeSystem-C4BBClaimDiagnosisType
Problems.Type
Domain: DiagnosisType
disposition Property('FHIRExplanationOfBenefitDisposition')
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-adjudicationDate') AdjudicationDate
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-claimRevision') Revision
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-controlNumber') ControlNumber
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-disposition') Disposition
Domain: ClaimDisposition
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-encounterID') EncounterID
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-mrn') Mrn
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-referralReference') ReferralID
extension('http://careevolution.com/fhirextensions#properties') Properties
facility.identifier Property('FacilityNpi')
identifier Identifier
AlternateIdentifier
insurance.coverage InsuranceID
InsuranceIdentifier
insurer InsuranceID
InsuranceIdentifier
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount Services.CoinsuranceAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount Services.PatientResponsibleAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount Services.NotCoveredAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount Services.PatientPaid
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount Services.HsaPaidAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount Services.AmountPaid
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|adjustmentreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
Services.NonPaymentReason
Domain: NonPaymentReason
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount Services.AllowedAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount Services.CopayAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount Services.DeductibleAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount Services.AmountClaimed
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-comment') Services.Comment
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-problems')
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Services.Problem1
Domain: DiagnosisCode
Services.Problem2
Domain: DiagnosisCode
Services.Problem3
Domain: DiagnosisCode
Services.Problem4
Domain: DiagnosisCode
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-status') Services.Status
Domain: ClaimServiceStatus
item.extension('http://careevolution.com/fhirextensions#properties') Services.Properties
item.location
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
Services.LocationType
Domain: ServiceLocation
item.modifier
Bindings:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Services.Modifier1
Domain: BillingModifier
Services.Modifier2
Domain: BillingModifier
Services.Modifier3
Domain: BillingModifier
Services.Modifier4
Domain: BillingModifier
Services.Modifier5
Domain: BillingModifier
item.net Services.AmountClaimed
item.productOrService
Bindings:  http://www.ada.org/cdt  http://snomed.info/sct  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Services.ServiceCode
Domain: ServiceCode
item.quantity Services.Units
item.revenue
Bindings:  https://www.nubc.org/CodeSystem/RevenueCodes
Services.RevenueCode
Domain: RevenueCode
item.sequence Services.Sequence
item.serviced Services.StartDate
Services.EndDate
patient PatientID
payee CaregiverRelationships Maps CaregiverRelationships with RelationshipType=PayToProvider
payment.amount TotalPaid
payment.date PaidDate
payment.type
Bindings:  ValueSet-C4BBPayerClaimPaymentStatusCode
Status
preAuthRef AuthorizationNumber
procedure.date Procedures.Date
procedure.procedure
Bindings:  http://www.ada.org/cdt  http://snomed.info/sct  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Procedures.Term
Domain: ProcedureCode
procedure.sequence Procedures.Sequence
procedure.type
Bindings:  ValueSet-C4BBClaimProcedureType
Procedures.Type
Domain: ProcedureType
provider CaregiverRelationships Maps CaregiverRelationships with RelationshipType=ClaimProvider
related Property('OriginalClaimNumber')
status
Bindings:  valueset-explanationofbenefit-status
Status
Domain: ClaimStatus
subType
Bindings:  ValueSet-C4BBInstitutionalClaimSubType
ClaimType
Domain: ClaimType
BillClass
Domain: BillClass
supportingInfo(category=http://careevolution.com/fhir/SupportingInfo|placeofservice).code
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
FacilityType
Domain: FacilityType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admissionperiod).timing AdmitDate
DischargeDate
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admtype).code
Bindings:  https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  https://rosetta.careevolution.com/UBFacilityType
AdmitType
Domain: AdmissionType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|discharge-status).code PatientStatus
Domain: PatientStatus
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|drg).code
Bindings:  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software
Drg
Domain: ClaimDrg
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|pointoforigin).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
AdmitSource
Domain: AdmitSource
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|typeofbill).code
Bindings:  https://www.nubc.org/CodeSystem/TypeOfBill
BillClass
Domain: BillClass
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/ClaimInformationCategory|admsrc).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
AdmitSource
Domain: AdmitSource
supportingInfo.category
Bindings:  ValueSet-C4BBSupportingInfoType
ClaimSupportingInformation.Type
Domain: SupportingInformationType
supportingInfo.code ClaimSupportingInformation.Term
Domain: SupportingInformationCode
supportingInfo.reason ClaimSupportingInformation.Reason
Domain: SupportingInformationReason
supportingInfo.sequence ClaimSupportingInformation.Sequence
supportingInfo.timing ClaimSupportingInformation.StartDate
ClaimSupportingInformation.EndDate
supportingInfo.value ClaimSupportingInformation.Value
text Comment
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount TotalCoinsuranceAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount TotalPatientResponsibleAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount TotalNotCoveredAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount TotalPatientPaid
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount TotalHsaPaidAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount TotalPaid
total(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount TotalAllowed
total(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount TotalCopayAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount TotalDeductibleAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount TotalCharges
total.category
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
InNetwork
type
Bindings:  valueset-claim-type
ClaimType
Domain: ClaimType

Outpatient profile from FHIR mappings

FHIR CareEvolution
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount TotalCoinsuranceAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount TotalPatientResponsibleAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount TotalNotCoveredAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount TotalPatientPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount TotalHsaPaidAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount TotalPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|adjustmentreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
NonPaymentReason
Domain: NonPaymentReason
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|benefitpaymentstatus).reason
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
InNetwork
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount TotalAllowed
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount TotalCopayAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount TotalDeductibleAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount TotalCharges
benefitBalance.financial.used Properties
billablePeriod StartDate
EndDate
careTeam.provider CaregiverRelationships.CaregiverID
Services.CaregiverRelationships.CaregiverID
careTeam.responsible CaregiverRelationships.Responsible
Services.CaregiverRelationships.Responsible
careTeam.role
Bindings:  ValueSet-C4BBClaimInstitutionalCareTeamRole
CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
Services.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
created CreatedDate
diagnosis.diagnosis
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Problems.Term
Domain: DiagnosisCode
diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate') Problems.Date
diagnosis.onAdmission
Bindings:  http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical
Problems.OnAdmission
Domain: DiagnosisStatusOnAdmission
diagnosis.sequence Problems.Sequence
diagnosis.type
Bindings:  CodeSystem-C4BBClaimDiagnosisType
Problems.Type
Domain: DiagnosisType
disposition Property('FHIRExplanationOfBenefitDisposition')
extension Properties
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-adjudicationDate') AdjudicationDate
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-claimRevision') Revision
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-controlNumber') ControlNumber
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-disposition') Disposition
Domain: ClaimDisposition
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-encounterID') EncounterID
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-mrn') Mrn
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-referralReference') ReferralID
extension('http://careevolution.com/fhirextensions#properties') Properties
facility.identifier Property('FacilityNpi')
id Identifier
identifier Identifier
AlternateIdentifier
insurance.coverage InsuranceID
InsuranceIdentifier
insurer InsuranceID
InsuranceIdentifier
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount Services.CoinsuranceAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount Services.PatientResponsibleAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount Services.NotCoveredAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount Services.PatientPaid
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount Services.HsaPaidAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount Services.AmountPaid
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|adjustmentreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
Services.NonPaymentReason
Domain: NonPaymentReason
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount Services.AllowedAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount Services.CopayAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount Services.DeductibleAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount Services.AmountClaimed
item.extension Services.Properties
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-comment') Services.Comment
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-problems')
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Services.Problem1
Domain: DiagnosisCode
Services.Problem2
Domain: DiagnosisCode
Services.Problem3
Domain: DiagnosisCode
Services.Problem4
Domain: DiagnosisCode
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-status') Services.Status
Domain: ClaimServiceStatus
item.extension('http://careevolution.com/fhirextensions#properties') Services.Properties
item.location
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
Services.LocationType
Domain: ServiceLocation
item.modifier
Bindings:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Services.Modifier1
Domain: BillingModifier
Services.Modifier2
Domain: BillingModifier
Services.Modifier3
Domain: BillingModifier
Services.Modifier4
Domain: BillingModifier
Services.Modifier5
Domain: BillingModifier
item.net Services.AmountClaimed
item.productOrService
Bindings:  http://www.ada.org/cdt  http://snomed.info/sct  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Services.ServiceCode
Domain: ServiceCode
item.quantity Services.Units
item.revenue
Bindings:  https://www.nubc.org/CodeSystem/RevenueCodes
Services.RevenueCode
Domain: RevenueCode
item.sequence Services.Sequence
item.serviced Services.StartDate
Services.EndDate
patient PatientID
payee CaregiverRelationships Maps CaregiverRelationships with RelationshipType=PayToProvider
payment.amount TotalPaid
payment.date PaidDate
preAuthRef AuthorizationNumber
procedure.date Procedures.Date
procedure.procedure
Bindings:  http://www.ada.org/cdt  http://snomed.info/sct  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Procedures.Term
Domain: ProcedureCode
procedure.sequence Procedures.Sequence
procedure.type
Bindings:  ValueSet-C4BBClaimProcedureType
Procedures.Type
Domain: ProcedureType
provider CaregiverRelationships Maps CaregiverRelationships with RelationshipType=ClaimProvider
related Property('OriginalClaimNumber')
status
Bindings:  valueset-explanationofbenefit-status
Status
Domain: ClaimStatus
supportingInfo(category=http://careevolution.com/fhir/SupportingInfo|placeofservice).code
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
FacilityType
Domain: FacilityType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admissionperiod).timing AdmitDate
DischargeDate
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admtype).code
Bindings:  https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  https://rosetta.careevolution.com/UBFacilityType
AdmitType
Domain: AdmissionType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|discharge-status).code PatientStatus
Domain: PatientStatus
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|drg).code
Bindings:  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software
Drg
Domain: ClaimDrg
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|pointoforigin).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
AdmitSource
Domain: AdmitSource
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|typeofbill).code
Bindings:  https://www.nubc.org/CodeSystem/TypeOfBill
BillClass
Domain: BillClass
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/ClaimInformationCategory|admsrc).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
AdmitSource
Domain: AdmitSource
supportingInfo.category
Bindings:  ValueSet-C4BBSupportingInfoType
ClaimSupportingInformation.Type
Domain: SupportingInformationType
supportingInfo.code ClaimSupportingInformation.Term
Domain: SupportingInformationCode
supportingInfo.reason ClaimSupportingInformation.Reason
Domain: SupportingInformationReason
supportingInfo.sequence ClaimSupportingInformation.Sequence
supportingInfo.timing ClaimSupportingInformation.StartDate
ClaimSupportingInformation.EndDate
supportingInfo.value ClaimSupportingInformation.Value
text Comment
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount TotalCoinsuranceAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount TotalPatientResponsibleAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount TotalNotCoveredAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount TotalPatientPaid
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount TotalHsaPaidAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount TotalPaid
total(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount TotalAllowed
total(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount TotalCopayAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount TotalDeductibleAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount TotalCharges
total.category
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
InNetwork
type
Bindings:  valueset-claim-type
ClaimType
Domain: ClaimType

Pharmacy profile to FHIR mappings

FHIR CareEvolution
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount Claim.TotalCoinsuranceAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount Claim.TotalPatientResponsibleAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount Claim.TotalNotCoveredAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount Claim.TotalPatientPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount Claim.TotalHsaPaidAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount Claim.TotalPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|benefitpaymentstatus).reason
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
Claim.InNetwork
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|denialreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
Claim.NonPaymentReason
Domain: NonPaymentReason
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount Claim.TotalAllowed
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount Claim.TotalCopayAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount Claim.TotalDeductibleAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount Claim.TotalCharges
billablePeriod Claim.StartDate
Claim.EndDate
careTeam.provider Claim.CaregiverRelationships.CaregiverID Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Claim.Services.CaregiverRelationships.CaregiverID
careTeam.responsible Claim.CaregiverRelationships.Responsible Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Claim.Services.CaregiverRelationships.Responsible
careTeam.role
Bindings:  ValueSet-C4BBClaimInstitutionalCareTeamRole
Claim.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Claim.Services.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
created Claim.CreatedDate
Claim.AdjudicationDate
diagnosis.diagnosis
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Claim.Problems.Term
Domain: DiagnosisCode
diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate') Claim.Problems.Date
diagnosis.onAdmission
Bindings:  http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical
Claim.Problems.OnAdmission
Domain: DiagnosisStatusOnAdmission
diagnosis.sequence Claim.Problems.Sequence
diagnosis.type
Bindings:  CodeSystem-C4BBClaimDiagnosisType
Claim.Problems.Type
Domain: DiagnosisType
disposition Claim.Property('FHIRExplanationOfBenefitDisposition')
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-adjudicationDate') Claim.AdjudicationDate
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-claimRevision') Claim.Revision
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-controlNumber') Claim.ControlNumber
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-disposition') Claim.Disposition
Domain: ClaimDisposition
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-encounterID') Claim.EncounterID
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-mrn') Claim.Mrn
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-referralReference') Claim.ReferralID
extension('http://careevolution.com/fhirextensions#properties') Claim.Properties
facility.identifier Claim.Property('FacilityNpi')
identifier Claim.Identifier
Claim.AlternateIdentifier
insurance.coverage Claim.InsuranceID
Claim.InsuranceIdentifier
insurer Claim.InsuranceID
Claim.InsuranceIdentifier
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount Medications.AmountPaid
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount Medications.AmountBilled
item.detail.productOrService.coding.display Medications.Comment
item.extension('http://careevolution.com/fhirextensions#dataSource') Medications.DataSource
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-alternateIdentifier') Medications.AlternateIdentifier
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-caregiverReference') Medications.CaregiverID
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-dose') Medications.Dose
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-doseUnits')
Bindings:  http://unitsofmeasure.org
Medications.DoseUnits
Domain: MedicationProfileDoseUnits
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-filledBy') Medications.FilledByID
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-frequency') Medications.Frequency
Domain: MedicationProfileFrequency
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-isGeneric') Medications.IsGeneric
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-prescribedDate') Medications.PrescribedDate
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-reconcileStatus') Medications.ReconcileStatus
Domain: ReconcileStatus
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-refills') Medications.Refills
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-status') Medications.Status
Domain: MedicationStatus
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-strength') Medications.Strength
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-therapeuticClass') Medications.TherapeuticClass
Domain: TherapeuticClass
item.extension('http://careevolution.com/fhirextensions#properties') Medications.Properties
item.net Medications.AmountBilled
item.productOrService
Bindings:  http://hl7.org/fhir/sid/cvx  http://hl7.org/fhir/sid/ndc  http://www.nlm.nih.gov/research/umls/rxnorm  http://snomed.info/sct  http://www.ada.org/cdt  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Medications.Term
Domain: MedicationType
item.quantity
Bindings:  http://unitsofmeasure.org
Medications.Quantity
Medications.Units
Domain: MedicationUnits
Medications.Term
Domain: MedicationType
item.sequence Medications.Identifier
Medications.Sequence
item.serviced Medications.Date
patient Claim.PatientID
payee Claim.CaregiverRelationships Maps CaregiverRelationships with RelationshipType=PayToProvider
payment.amount Claim.TotalPaid
payment.date Claim.PaidDate
payment.type
Bindings:  ValueSet-C4BBPayerClaimPaymentStatusCode
Claim.Status
preAuthRef Claim.AuthorizationNumber
procedure.date Claim.Procedures.Date
procedure.procedure
Bindings:  http://www.ada.org/cdt  http://snomed.info/sct  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Claim.Procedures.Term
Domain: ProcedureCode
procedure.sequence Claim.Procedures.Sequence
procedure.type
Bindings:  ValueSet-C4BBClaimProcedureType
Claim.Procedures.Type
Domain: ProcedureType
provider Claim.CaregiverRelationships Maps CaregiverRelationships with RelationshipType=ClaimProvider
related Claim.Property('OriginalClaimNumber')
status
Bindings:  valueset-explanationofbenefit-status
Claim.Status
Domain: ClaimStatus
supportingInfo(category=http://careevolution.com/fhir/SupportingInfo|placeofservice).code
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
Claim.FacilityType
Domain: FacilityType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admissionperiod).timing Claim.AdmitDate
Claim.DischargeDate
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admtype).code
Bindings:  https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  https://rosetta.careevolution.com/UBFacilityType
Claim.AdmitType
Domain: AdmissionType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|dawcode).code Medications.DawCode
Domain: DispenseAsWritten
Medications.DispenseAsWritten
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|dayssupply).value Medications.DaysSupplied
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|discharge-status).code Claim.PatientStatus
Domain: PatientStatus
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|drg).code
Bindings:  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software
Claim.Drg
Domain: ClaimDrg
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|pointoforigin).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
Claim.AdmitSource
Domain: AdmitSource
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|refillnum).value Medications.RefillNumber
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|refillsauthorized).value Medications.Refills
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|typeofbill).code
Bindings:  https://www.nubc.org/CodeSystem/TypeOfBill
Claim.BillClass
Domain: BillClass
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/ClaimInformationCategory|admsrc).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
Claim.AdmitSource
Domain: AdmitSource
supportingInfo.category
Bindings:  ValueSet-C4BBSupportingInfoType
Claim.ClaimSupportingInformation.Type
Domain: SupportingInformationType
supportingInfo.code Claim.ClaimSupportingInformation.Term
Domain: SupportingInformationCode
supportingInfo.reason Claim.ClaimSupportingInformation.Reason
Domain: SupportingInformationReason
supportingInfo.sequence Claim.ClaimSupportingInformation.Sequence
supportingInfo.timing Claim.ClaimSupportingInformation.StartDate
Claim.ClaimSupportingInformation.EndDate
supportingInfo.value Claim.ClaimSupportingInformation.Value
text Claim.Comment
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount Claim.TotalCoinsuranceAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount Claim.TotalPatientResponsibleAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount Claim.TotalNotCoveredAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount Claim.TotalPatientPaid
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount Claim.TotalHsaPaidAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount Claim.TotalPaid
total(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount Claim.TotalAllowed
total(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount Claim.TotalCopayAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount Claim.TotalDeductibleAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount Claim.TotalCharges
total.category
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
Claim.InNetwork
type
Bindings:  valueset-claim-type
Claim.ClaimType
Domain: ClaimType

Pharmacy profile from FHIR mappings

FHIR CareEvolution
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount Claim.TotalCoinsuranceAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount Claim.TotalPatientResponsibleAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount Claim.TotalNotCoveredAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount Claim.TotalPatientPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount Claim.TotalHsaPaidAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount Claim.TotalPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|benefitpaymentstatus).reason
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
Claim.InNetwork
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|denialreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
Claim.NonPaymentReason
Domain: NonPaymentReason
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount Claim.TotalAllowed
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount Claim.TotalCopayAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount Claim.TotalDeductibleAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount Claim.TotalCharges
benefitBalance.financial.used Claim.Properties
billablePeriod Claim.StartDate
Claim.EndDate
careTeam.provider Claim.CaregiverRelationships.CaregiverID
Claim.Services.CaregiverRelationships.CaregiverID
careTeam.responsible Claim.CaregiverRelationships.Responsible
Claim.Services.CaregiverRelationships.Responsible
careTeam.role
Bindings:  ValueSet-C4BBClaimInstitutionalCareTeamRole
Claim.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
Claim.Services.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
created Claim.CreatedDate
diagnosis.diagnosis
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Claim.Problems.Term
Domain: DiagnosisCode
diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate') Claim.Problems.Date
diagnosis.onAdmission
Bindings:  http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical
Claim.Problems.OnAdmission
Domain: DiagnosisStatusOnAdmission
diagnosis.sequence Claim.Problems.Sequence
diagnosis.type
Bindings:  CodeSystem-C4BBClaimDiagnosisType
Claim.Problems.Type
Domain: DiagnosisType
disposition Claim.Property('FHIRExplanationOfBenefitDisposition')
extension Claim.Properties
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-adjudicationDate') Claim.AdjudicationDate
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-claimRevision') Claim.Revision
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-controlNumber') Claim.ControlNumber
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-disposition') Claim.Disposition
Domain: ClaimDisposition
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-encounterID') Claim.EncounterID
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-mrn') Claim.Mrn
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-referralReference') Claim.ReferralID
extension('http://careevolution.com/fhirextensions#properties') Claim.Properties
facility.identifier Claim.Property('FacilityNpi')
id Claim.Identifier
identifier Claim.Identifier
Claim.AlternateIdentifier
insurance.coverage Claim.InsuranceID
Claim.InsuranceIdentifier
insurer Claim.InsuranceID
Claim.InsuranceIdentifier
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount Medications.AmountPaid
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount Medications.AmountBilled
item.detail.productOrService.coding.display Medications.Comment
item.extension('http://careevolution.com/fhirextensions#dataSource') Medications.DataSource
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-alternateIdentifier') Medications.AlternateIdentifier
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-caregiverReference') Medications.CaregiverID
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-dose') Medications.Dose
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-doseUnits')
Bindings:  http://unitsofmeasure.org
Medications.DoseUnits
Domain: MedicationProfileDoseUnits
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-filledBy') Medications.FilledByID
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-frequency') Medications.Frequency
Domain: MedicationProfileFrequency
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-isGeneric') Medications.IsGeneric
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-prescribedDate') Medications.PrescribedDate
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-reconcileStatus') Medications.ReconcileStatus
Domain: ReconcileStatus
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-refills') Medications.Refills
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-status') Medications.Status
Domain: MedicationStatus
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-strength') Medications.Strength
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-therapeuticClass') Medications.TherapeuticClass
Domain: TherapeuticClass
item.extension('http://careevolution.com/fhirextensions#properties') Medications.Properties
item.net Medications.AmountBilled
item.productOrService
Bindings:  http://hl7.org/fhir/sid/cvx  http://hl7.org/fhir/sid/ndc  http://www.nlm.nih.gov/research/umls/rxnorm  http://snomed.info/sct  http://www.ada.org/cdt  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Medications.Term
Domain: MedicationType
item.quantity
Bindings:  http://unitsofmeasure.org
Medications.Quantity
Medications.Units
Domain: MedicationUnits
item.sequence Medications.Identifier
Medications.Sequence
item.serviced Medications.Date
patient Claim.PatientID
payee Claim.CaregiverRelationships Maps CaregiverRelationships with RelationshipType=PayToProvider
payment.amount Claim.TotalPaid
payment.date Claim.PaidDate
preAuthRef Claim.AuthorizationNumber
procedure.date Claim.Procedures.Date
procedure.procedure
Bindings:  http://www.ada.org/cdt  http://snomed.info/sct  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Claim.Procedures.Term
Domain: ProcedureCode
procedure.sequence Claim.Procedures.Sequence
procedure.type
Bindings:  ValueSet-C4BBClaimProcedureType
Claim.Procedures.Type
Domain: ProcedureType
provider Claim.CaregiverRelationships Maps CaregiverRelationships with RelationshipType=ClaimProvider
related Claim.Property('OriginalClaimNumber')
status
Bindings:  valueset-explanationofbenefit-status
Claim.Status
Domain: ClaimStatus
supportingInfo(category=http://careevolution.com/fhir/SupportingInfo|placeofservice).code
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
Claim.FacilityType
Domain: FacilityType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admissionperiod).timing Claim.AdmitDate
Claim.DischargeDate
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admtype).code
Bindings:  https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  https://rosetta.careevolution.com/UBFacilityType
Claim.AdmitType
Domain: AdmissionType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|dawcode).code Medications.DawCode
Domain: DispenseAsWritten
Medications.DispenseAsWritten
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|dayssupply).value Medications.DaysSupplied
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|discharge-status).code Claim.PatientStatus
Domain: PatientStatus
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|drg).code
Bindings:  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software
Claim.Drg
Domain: ClaimDrg
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|pointoforigin).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
Claim.AdmitSource
Domain: AdmitSource
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|refillnum).value Medications.RefillNumber
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|refillsauthorized).value Medications.Refills
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|typeofbill).code
Bindings:  https://www.nubc.org/CodeSystem/TypeOfBill
Claim.BillClass
Domain: BillClass
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/ClaimInformationCategory|admsrc).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
Claim.AdmitSource
Domain: AdmitSource
supportingInfo.category
Bindings:  ValueSet-C4BBSupportingInfoType
Claim.ClaimSupportingInformation.Type
Domain: SupportingInformationType
supportingInfo.code Claim.ClaimSupportingInformation.Term
Domain: SupportingInformationCode
supportingInfo.reason Claim.ClaimSupportingInformation.Reason
Domain: SupportingInformationReason
supportingInfo.sequence Claim.ClaimSupportingInformation.Sequence
supportingInfo.timing Claim.ClaimSupportingInformation.StartDate
Claim.ClaimSupportingInformation.EndDate
supportingInfo.value Claim.ClaimSupportingInformation.Value
text Claim.Comment
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount Claim.TotalCoinsuranceAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount Claim.TotalPatientResponsibleAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount Claim.TotalNotCoveredAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount Claim.TotalPatientPaid
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount Claim.TotalHsaPaidAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount Claim.TotalPaid
total(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount Claim.TotalAllowed
total(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount Claim.TotalCopayAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount Claim.TotalDeductibleAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount Claim.TotalCharges
total.category
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
Claim.InNetwork
type
Bindings:  valueset-claim-type
Claim.ClaimType
Domain: ClaimType

Professional profile to FHIR mappings

FHIR CareEvolution
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount TotalCoinsuranceAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount TotalPatientResponsibleAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount TotalNotCoveredAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount TotalPatientPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount TotalHsaPaidAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount TotalPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|benefitpaymentstatus).reason
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
InNetwork
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|denialreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
NonPaymentReason
Domain: NonPaymentReason
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount TotalAllowed
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount TotalCopayAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount TotalDeductibleAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount TotalCharges
billablePeriod StartDate
EndDate
careTeam.provider CaregiverRelationships.CaregiverID Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Services.CaregiverRelationships.CaregiverID
careTeam.responsible CaregiverRelationships.Responsible Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Services.CaregiverRelationships.Responsible
careTeam.role
Bindings:  ValueSet-C4BBClaimInstitutionalCareTeamRole
CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Services.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
created CreatedDate
AdjudicationDate
diagnosis.diagnosis
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Problems.Term
Domain: DiagnosisCode
diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate') Problems.Date
diagnosis.onAdmission
Bindings:  http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical
Problems.OnAdmission
Domain: DiagnosisStatusOnAdmission
diagnosis.sequence Problems.Sequence
diagnosis.type
Bindings:  CodeSystem-C4BBClaimDiagnosisType
Problems.Type
Domain: DiagnosisType
disposition Property('FHIRExplanationOfBenefitDisposition')
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-adjudicationDate') AdjudicationDate
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-claimRevision') Revision
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-controlNumber') ControlNumber
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-disposition') Disposition
Domain: ClaimDisposition
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-encounterID') EncounterID
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-mrn') Mrn
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-referralReference') ReferralID
extension('http://careevolution.com/fhirextensions#properties') Properties
facility.identifier Property('FacilityNpi')
identifier Identifier
AlternateIdentifier
insurance.coverage InsuranceID
InsuranceIdentifier
insurer InsuranceID
InsuranceIdentifier
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount Services.CoinsuranceAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount Services.PatientResponsibleAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount Services.NotCoveredAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount Services.PatientPaid
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount Services.HsaPaidAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount Services.AmountPaid
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|adjustmentreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
Services.NonPaymentReason
Domain: NonPaymentReason
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|benefitpaymentstatus).reason
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
Services.Property('benefitpaymentstatus')
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount Services.AllowedAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount Services.CopayAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount Services.DeductibleAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount Services.AmountClaimed
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-comment') Services.Comment
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-problems')
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Services.Problem1
Domain: DiagnosisCode
Services.Problem2
Domain: DiagnosisCode
Services.Problem3
Domain: DiagnosisCode
Services.Problem4
Domain: DiagnosisCode
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-status') Services.Status
Domain: ClaimServiceStatus
item.extension('http://careevolution.com/fhirextensions#properties') Services.Properties
item.location
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
Services.LocationType
Domain: ServiceLocation
item.modifier
Bindings:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Services.Modifier1
Domain: BillingModifier
Services.Modifier2
Domain: BillingModifier
Services.Modifier3
Domain: BillingModifier
Services.Modifier4
Domain: BillingModifier
Services.Modifier5
Domain: BillingModifier
item.net Services.AmountClaimed
item.productOrService
Bindings:  http://www.ada.org/cdt  http://snomed.info/sct  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Services.ServiceCode
Domain: ServiceCode
item.quantity Services.Units
item.revenue
Bindings:  https://www.nubc.org/CodeSystem/RevenueCodes
Services.RevenueCode
Domain: RevenueCode
item.sequence Services.Sequence
item.serviced Services.StartDate
Services.EndDate
patient PatientID
payee CaregiverRelationships Maps CaregiverRelationships with RelationshipType=PayToProvider
payment.amount TotalPaid
payment.date PaidDate
payment.type
Bindings:  ValueSet-C4BBPayerClaimPaymentStatusCode
Status
preAuthRef AuthorizationNumber
procedure.date Procedures.Date
procedure.procedure
Bindings:  http://www.ada.org/cdt  http://snomed.info/sct  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Procedures.Term
Domain: ProcedureCode
procedure.sequence Procedures.Sequence
procedure.type
Bindings:  ValueSet-C4BBClaimProcedureType
Procedures.Type
Domain: ProcedureType
provider CaregiverRelationships Maps CaregiverRelationships with RelationshipType=ClaimProvider
related Property('OriginalClaimNumber')
status
Bindings:  valueset-explanationofbenefit-status
Status
Domain: ClaimStatus
supportingInfo(category=http://careevolution.com/fhir/SupportingInfo|placeofservice).code
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
FacilityType
Domain: FacilityType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admissionperiod).timing AdmitDate
DischargeDate
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admtype).code
Bindings:  https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  https://rosetta.careevolution.com/UBFacilityType
AdmitType
Domain: AdmissionType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|ambulancetransportreason).reason Services.Property('AmbulanceTransportReason')
Services.Property('AmbulanceTransportReason_SystemUri')
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|discharge-status).code PatientStatus
Domain: PatientStatus
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|drg).code
Bindings:  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software
Drg
Domain: ClaimDrg
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|dropofflocation).value Services.Property('DropOffLocation')
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|patientweight).value Services.Property('TransportPatientWeight')
Services.Property('TransportPatientWeight_Unit')
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|pickuplocation).value Services.Property('PickupLocation')
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|pointoforigin).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
AdmitSource
Domain: AdmitSource
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|roudtrippurpose).value Services.Property('RoundTripPurpose')
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|stretcherpurpose).value Services.Property('StretcherPurpose')
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|transportationdistance).value Services.Property('TransportDistance')
Services.Property('TransportDistance_Unit')
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|typeofbill).code
Bindings:  https://www.nubc.org/CodeSystem/TypeOfBill
BillClass
Domain: BillClass
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/ClaimInformationCategory|admsrc).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
AdmitSource
Domain: AdmitSource
supportingInfo.category
Bindings:  ValueSet-C4BBSupportingInfoType
ClaimSupportingInformation.Type
Domain: SupportingInformationType
supportingInfo.code ClaimSupportingInformation.Term
Domain: SupportingInformationCode
supportingInfo.reason ClaimSupportingInformation.Reason
Domain: SupportingInformationReason
supportingInfo.sequence ClaimSupportingInformation.Sequence
supportingInfo.timing ClaimSupportingInformation.StartDate
ClaimSupportingInformation.EndDate
supportingInfo.value ClaimSupportingInformation.Value
text Comment
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount TotalCoinsuranceAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount TotalPatientResponsibleAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount TotalNotCoveredAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount TotalPatientPaid
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount TotalHsaPaidAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount TotalPaid
total(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount TotalAllowed
total(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount TotalCopayAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount TotalDeductibleAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount TotalCharges
total.category
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
InNetwork
type
Bindings:  valueset-claim-type
ClaimType
Domain: ClaimType

Professional profile from FHIR mappings

FHIR CareEvolution
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount TotalCoinsuranceAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount TotalPatientResponsibleAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount TotalNotCoveredAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount TotalPatientPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount TotalHsaPaidAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount TotalPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|benefitpaymentstatus).reason
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
InNetwork
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|denialreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
NonPaymentReason
Domain: NonPaymentReason
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount TotalAllowed
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount TotalCopayAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount TotalDeductibleAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount TotalCharges
benefitBalance.financial.used Properties
billablePeriod StartDate
EndDate
careTeam.provider CaregiverRelationships.CaregiverID
Services.CaregiverRelationships.CaregiverID
careTeam.responsible CaregiverRelationships.Responsible
Services.CaregiverRelationships.Responsible
careTeam.role
Bindings:  ValueSet-C4BBClaimInstitutionalCareTeamRole
CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
Services.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
created CreatedDate
diagnosis.diagnosis
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Problems.Term
Domain: DiagnosisCode
diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate') Problems.Date
diagnosis.onAdmission
Bindings:  http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical
Problems.OnAdmission
Domain: DiagnosisStatusOnAdmission
diagnosis.sequence Problems.Sequence
diagnosis.type
Bindings:  CodeSystem-C4BBClaimDiagnosisType
Problems.Type
Domain: DiagnosisType
disposition Property('FHIRExplanationOfBenefitDisposition')
extension Properties
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-adjudicationDate') AdjudicationDate
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-claimRevision') Revision
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-controlNumber') ControlNumber
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-disposition') Disposition
Domain: ClaimDisposition
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-encounterID') EncounterID
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-mrn') Mrn
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-referralReference') ReferralID
extension('http://careevolution.com/fhirextensions#properties') Properties
facility.identifier Property('FacilityNpi')
id Identifier
identifier Identifier
AlternateIdentifier
insurance.coverage InsuranceID
InsuranceIdentifier
insurer InsuranceID
InsuranceIdentifier
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount Services.CoinsuranceAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount Services.PatientResponsibleAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount Services.NotCoveredAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount Services.PatientPaid
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount Services.HsaPaidAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount Services.AmountPaid
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|adjustmentreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
Services.NonPaymentReason
Domain: NonPaymentReason
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|benefitpaymentstatus).reason
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
Services.Property('benefitpaymentstatus')
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount Services.AllowedAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount Services.CopayAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount Services.DeductibleAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount Services.AmountClaimed
item.extension Services.Properties
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-comment') Services.Comment
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-problems')
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Services.Problem1
Domain: DiagnosisCode
Services.Problem2
Domain: DiagnosisCode
Services.Problem3
Domain: DiagnosisCode
Services.Problem4
Domain: DiagnosisCode
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-status') Services.Status
Domain: ClaimServiceStatus
item.extension('http://careevolution.com/fhirextensions#properties') Services.Properties
item.location
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
Services.LocationType
Domain: ServiceLocation
item.modifier
Bindings:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Services.Modifier1
Domain: BillingModifier
Services.Modifier2
Domain: BillingModifier
Services.Modifier3
Domain: BillingModifier
Services.Modifier4
Domain: BillingModifier
Services.Modifier5
Domain: BillingModifier
item.net Services.AmountClaimed
item.productOrService
Bindings:  http://www.ada.org/cdt  http://snomed.info/sct  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Services.ServiceCode
Domain: ServiceCode
item.quantity Services.Units
item.revenue
Bindings:  https://www.nubc.org/CodeSystem/RevenueCodes
Services.RevenueCode
Domain: RevenueCode
item.sequence Services.Sequence
item.serviced Services.StartDate
Services.EndDate
patient PatientID
payee CaregiverRelationships Maps CaregiverRelationships with RelationshipType=PayToProvider
payment.amount TotalPaid
payment.date PaidDate
preAuthRef AuthorizationNumber
procedure.date Procedures.Date
procedure.procedure
Bindings:  http://www.ada.org/cdt  http://snomed.info/sct  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Procedures.Term
Domain: ProcedureCode
procedure.sequence Procedures.Sequence
procedure.type
Bindings:  ValueSet-C4BBClaimProcedureType
Procedures.Type
Domain: ProcedureType
provider CaregiverRelationships Maps CaregiverRelationships with RelationshipType=ClaimProvider
related Property('OriginalClaimNumber')
status
Bindings:  valueset-explanationofbenefit-status
Status
Domain: ClaimStatus
supportingInfo(category=http://careevolution.com/fhir/SupportingInfo|placeofservice).code
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
FacilityType
Domain: FacilityType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admissionperiod).timing AdmitDate
DischargeDate
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admtype).code
Bindings:  https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  https://rosetta.careevolution.com/UBFacilityType
AdmitType
Domain: AdmissionType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|ambulancetransportreason).reason Services.Property('AmbulanceTransportReason')
Services.Property('AmbulanceTransportReason_SystemUri')
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|discharge-status).code PatientStatus
Domain: PatientStatus
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|drg).code
Bindings:  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software
Drg
Domain: ClaimDrg
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|dropofflocation).value Services.Property('DropOffLocation')
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|patientweight).value Services.Property('TransportPatientWeight')
Services.Property('TransportPatientWeight_Unit')
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|pickuplocation).value Services.Property('PickupLocation')
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|pointoforigin).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
AdmitSource
Domain: AdmitSource
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|roudtrippurpose).value Services.Property('RoundTripPurpose')
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|stretcherpurpose).value Services.Property('StretcherPurpose')
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|transportationdistance).value Services.Property('TransportDistance')
Services.Property('TransportDistance_Unit')
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|typeofbill).code
Bindings:  https://www.nubc.org/CodeSystem/TypeOfBill
BillClass
Domain: BillClass
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/ClaimInformationCategory|admsrc).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
AdmitSource
Domain: AdmitSource
supportingInfo.category
Bindings:  ValueSet-C4BBSupportingInfoType
ClaimSupportingInformation.Type
Domain: SupportingInformationType
supportingInfo.code ClaimSupportingInformation.Term
Domain: SupportingInformationCode
supportingInfo.reason ClaimSupportingInformation.Reason
Domain: SupportingInformationReason
supportingInfo.sequence ClaimSupportingInformation.Sequence
supportingInfo.timing ClaimSupportingInformation.StartDate
ClaimSupportingInformation.EndDate
supportingInfo.value ClaimSupportingInformation.Value
text Comment
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount TotalCoinsuranceAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount TotalPatientResponsibleAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount TotalNotCoveredAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount TotalPatientPaid
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount TotalHsaPaidAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount TotalPaid
total(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount TotalAllowed
total(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount TotalCopayAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount TotalDeductibleAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount TotalCharges
total.category
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
InNetwork
type
Bindings:  valueset-claim-type
ClaimType
Domain: ClaimType

Oral profile to FHIR mappings

FHIR CareEvolution
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount TotalCoinsuranceAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount TotalPatientResponsibleAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount TotalNotCoveredAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount TotalPatientPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount TotalHsaPaidAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount TotalPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|benefitpaymentstatus).reason
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
InNetwork
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|denialreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
NonPaymentReason
Domain: NonPaymentReason
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|renderingnetworkstatus).reason
Bindings:  ValueSet-C4BBPayerProviderNetworkStatus
Property('renderingnetworkstatus')
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount TotalAllowed
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount TotalCopayAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount TotalDeductibleAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount TotalCharges
billablePeriod StartDate
EndDate
careTeam.provider CaregiverRelationships.CaregiverID Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Services.CaregiverRelationships.CaregiverID
careTeam.responsible CaregiverRelationships.Responsible Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Services.CaregiverRelationships.Responsible
careTeam.role
Bindings:  ValueSet-C4BBClaimInstitutionalCareTeamRole
CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Services.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
created CreatedDate
AdjudicationDate
diagnosis.diagnosis
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Problems.Term
Domain: DiagnosisCode
diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate') Problems.Date
diagnosis.onAdmission
Bindings:  http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical
Problems.OnAdmission
Domain: DiagnosisStatusOnAdmission
diagnosis.sequence Problems.Sequence
diagnosis.type
Bindings:  CodeSystem-C4BBClaimDiagnosisType
Problems.Type
Domain: DiagnosisType
disposition Property('FHIRExplanationOfBenefitDisposition')
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-adjudicationDate') AdjudicationDate
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-claimRevision') Revision
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-controlNumber') ControlNumber
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-disposition') Disposition
Domain: ClaimDisposition
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-encounterID') EncounterID
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-mrn') Mrn
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-referralReference') ReferralID
extension('http://careevolution.com/fhirextensions#properties') Properties
facility.identifier Property('FacilityNpi')
identifier Identifier
AlternateIdentifier
insurance.coverage InsuranceID
InsuranceIdentifier
insurer InsuranceID
InsuranceIdentifier
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount Services.CoinsuranceAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount Services.PatientResponsibleAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount Services.NotCoveredAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount Services.PatientPaid
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount Services.HsaPaidAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount Services.AmountPaid
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|adjustmentreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
Services.NonPaymentReason
Domain: NonPaymentReason
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|benefitpaymentstatus).reason
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
Services.Property('benefitpaymentstatus')
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount Services.AllowedAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount Services.CopayAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount Services.DeductibleAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount Services.AmountClaimed
item.bodySite
Bindings:  ValueSet-OralBodySite  ValueSet-ADAUniversalNumberingSystem
Services.Property('OralCavityDesignation')
Services.Property('ToothNumber')
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-comment') Services.Comment
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-problems')
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Services.Problem1
Domain: DiagnosisCode
Services.Problem2
Domain: DiagnosisCode
Services.Problem3
Domain: DiagnosisCode
Services.Problem4
Domain: DiagnosisCode
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-status') Services.Status
Domain: ClaimServiceStatus
item.extension('http://careevolution.com/fhirextensions#properties') Services.Properties
item.location
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
Services.LocationType
Domain: ServiceLocation
item.modifier
Bindings:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Services.Modifier1
Domain: BillingModifier
Services.Modifier2
Domain: BillingModifier
Services.Modifier3
Domain: BillingModifier
Services.Modifier4
Domain: BillingModifier
Services.Modifier5
Domain: BillingModifier
item.net Services.AmountClaimed
item.productOrService
Bindings:  http://www.ada.org/cdt  http://snomed.info/sct  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Services.ServiceCode
Domain: ServiceCode
item.quantity Services.Units
item.revenue
Bindings:  https://www.nubc.org/CodeSystem/RevenueCodes
Services.RevenueCode
Domain: RevenueCode
item.sequence Services.Sequence
item.serviced Services.StartDate
Services.EndDate
patient PatientID
payee CaregiverRelationships Maps CaregiverRelationships with RelationshipType=PayToProvider
payment.amount TotalPaid
payment.date PaidDate
payment.type
Bindings:  ValueSet-C4BBPayerClaimPaymentStatusCode
Status
preAuthRef AuthorizationNumber
procedure.date Procedures.Date
procedure.procedure
Bindings:  http://www.ada.org/cdt  http://snomed.info/sct  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Procedures.Term
Domain: ProcedureCode
procedure.sequence Procedures.Sequence
procedure.type
Bindings:  ValueSet-C4BBClaimProcedureType
Procedures.Type
Domain: ProcedureType
provider CaregiverRelationships Maps CaregiverRelationships with RelationshipType=ClaimProvider
related Property('OriginalClaimNumber')
status
Bindings:  valueset-explanationofbenefit-status
Status
Domain: ClaimStatus
supportingInfo(category=http://careevolution.com/fhir/SupportingInfo|placeofservice).code
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
FacilityType
Domain: FacilityType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|additionalbodysite).code
Bindings:  ValueSet-ADAUniversalNumberingSystem
Services.Property('ToothNumber')
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admissionperiod).timing AdmitDate
DischargeDate
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admtype).code
Bindings:  https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  https://rosetta.careevolution.com/UBFacilityType
AdmitType
Domain: AdmissionType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|discharge-status).code PatientStatus
Domain: PatientStatus
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|drg).code
Bindings:  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software
Drg
Domain: ClaimDrg
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|missingtoothnumber).code
Bindings:  ValueSet-ADAUniversalNumberingSystem
Services.Property('MissingToothNumber')
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|pointoforigin).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
AdmitSource
Domain: AdmitSource
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|typeofbill).code
Bindings:  https://www.nubc.org/CodeSystem/TypeOfBill
BillClass
Domain: BillClass
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/ClaimInformationCategory|admsrc).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
AdmitSource
Domain: AdmitSource
supportingInfo.category
Bindings:  ValueSet-C4BBSupportingInfoType
ClaimSupportingInformation.Type
Domain: SupportingInformationType
supportingInfo.code ClaimSupportingInformation.Term
Domain: SupportingInformationCode
supportingInfo.reason ClaimSupportingInformation.Reason
Domain: SupportingInformationReason
supportingInfo.sequence ClaimSupportingInformation.Sequence
supportingInfo.timing ClaimSupportingInformation.StartDate
ClaimSupportingInformation.EndDate
supportingInfo.value ClaimSupportingInformation.Value
text Comment
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount TotalCoinsuranceAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount TotalPatientResponsibleAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount TotalNotCoveredAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount TotalPatientPaid
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount TotalHsaPaidAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount TotalPaid
total(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount TotalAllowed
total(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount TotalCopayAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount TotalDeductibleAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount TotalCharges
total.category
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
InNetwork
type
Bindings:  valueset-claim-type
ClaimType
Domain: ClaimType

Oral profile from FHIR mappings

FHIR CareEvolution
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount TotalCoinsuranceAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount TotalPatientResponsibleAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount TotalNotCoveredAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount TotalPatientPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount TotalHsaPaidAmount
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount TotalPaid
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|benefitpaymentstatus).reason
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
InNetwork
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|denialreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
NonPaymentReason
Domain: NonPaymentReason
adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|renderingnetworkstatus).reason
Bindings:  ValueSet-C4BBPayerProviderNetworkStatus
Property('renderingnetworkstatus')
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount TotalAllowed
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount TotalCopayAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount TotalDeductibleAmount
adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount TotalCharges
benefitBalance.financial.used Properties
billablePeriod StartDate
EndDate
careTeam.provider CaregiverRelationships.CaregiverID
Services.CaregiverRelationships.CaregiverID
careTeam.responsible CaregiverRelationships.Responsible
Services.CaregiverRelationships.Responsible
careTeam.role
Bindings:  ValueSet-C4BBClaimInstitutionalCareTeamRole
CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
Services.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
created CreatedDate
diagnosis.diagnosis
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Problems.Term
Domain: DiagnosisCode
diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate') Problems.Date
diagnosis.onAdmission
Bindings:  http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical
Problems.OnAdmission
Domain: DiagnosisStatusOnAdmission
diagnosis.sequence Problems.Sequence
diagnosis.type
Bindings:  CodeSystem-C4BBClaimDiagnosisType
Problems.Type
Domain: DiagnosisType
disposition Property('FHIRExplanationOfBenefitDisposition')
extension Properties
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-adjudicationDate') AdjudicationDate
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-claimRevision') Revision
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-controlNumber') ControlNumber
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-disposition') Disposition
Domain: ClaimDisposition
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-encounterID') EncounterID
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-mrn') Mrn
extension('http://careevolution.com/fhirextensions#explanationOfBenefit-referralReference') ReferralID
extension('http://careevolution.com/fhirextensions#properties') Properties
facility.identifier Property('FacilityNpi')
id Identifier
identifier Identifier
AlternateIdentifier
insurance.coverage InsuranceID
InsuranceIdentifier
insurer InsuranceID
InsuranceIdentifier
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount Services.CoinsuranceAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount Services.PatientResponsibleAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount Services.NotCoveredAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount Services.PatientPaid
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount Services.HsaPaidAmount
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount Services.AmountPaid
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|adjustmentreason).reason
Bindings:  https://x12.org/codes/remittance-advice-remark-codes  https://x12.org/codes/claim-adjustment-reason-codes
Services.NonPaymentReason
Domain: NonPaymentReason
item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|benefitpaymentstatus).reason
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
Services.Property('benefitpaymentstatus')
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount Services.AllowedAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount Services.CopayAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount Services.DeductibleAmount
item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount Services.AmountClaimed
item.bodySite
Bindings:  ValueSet-OralBodySite  ValueSet-ADAUniversalNumberingSystem
Services.Property('OralCavityDesignation')
Services.Property('ToothNumber')
item.extension Services.Properties
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-comment') Services.Comment
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-problems')
Bindings:  http://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
Services.Problem1
Domain: DiagnosisCode
Services.Problem2
Domain: DiagnosisCode
Services.Problem3
Domain: DiagnosisCode
Services.Problem4
Domain: DiagnosisCode
item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-status') Services.Status
Domain: ClaimServiceStatus
item.extension('http://careevolution.com/fhirextensions#properties') Services.Properties
item.location
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
Services.LocationType
Domain: ServiceLocation
item.modifier
Bindings:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Services.Modifier1
Domain: BillingModifier
Services.Modifier2
Domain: BillingModifier
Services.Modifier3
Domain: BillingModifier
Services.Modifier4
Domain: BillingModifier
Services.Modifier5
Domain: BillingModifier
item.net Services.AmountClaimed
item.productOrService
Bindings:  http://www.ada.org/cdt  http://snomed.info/sct  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Services.ServiceCode
Domain: ServiceCode
item.quantity Services.Units
item.revenue
Bindings:  https://www.nubc.org/CodeSystem/RevenueCodes
Services.RevenueCode
Domain: RevenueCode
item.sequence Services.Sequence
item.serviced Services.StartDate
Services.EndDate
patient PatientID
payee CaregiverRelationships Maps CaregiverRelationships with RelationshipType=PayToProvider
payment.amount TotalPaid
payment.date PaidDate
preAuthRef AuthorizationNumber
procedure.date Procedures.Date
procedure.procedure
Bindings:  http://www.ada.org/cdt  http://snomed.info/sct  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://www.cms.gov/Medicare/Coding/ICD10  http://hl7.org/fhir/sid/icd-9-cm
Procedures.Term
Domain: ProcedureCode
procedure.sequence Procedures.Sequence
procedure.type
Bindings:  ValueSet-C4BBClaimProcedureType
Procedures.Type
Domain: ProcedureType
provider CaregiverRelationships Maps CaregiverRelationships with RelationshipType=ClaimProvider
related Property('OriginalClaimNumber')
status
Bindings:  valueset-explanationofbenefit-status
Status
Domain: ClaimStatus
supportingInfo(category=http://careevolution.com/fhir/SupportingInfo|placeofservice).code
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://rosetta.careevolution.com/UBFacilityType
FacilityType
Domain: FacilityType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|additionalbodysite).code
Bindings:  ValueSet-ADAUniversalNumberingSystem
Services.Property('ToothNumber')
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admissionperiod).timing AdmitDate
DischargeDate
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admtype).code
Bindings:  https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit  http://terminology.hl7.org/CodeSystem/v3-ActCode  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  https://rosetta.careevolution.com/UBFacilityType
AdmitType
Domain: AdmissionType
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|discharge-status).code PatientStatus
Domain: PatientStatus
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|drg).code
Bindings:  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software
Drg
Domain: ClaimDrg
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|missingtoothnumber).code
Bindings:  ValueSet-ADAUniversalNumberingSystem
Services.Property('MissingToothNumber')
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|pointoforigin).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
AdmitSource
Domain: AdmitSource
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|typeofbill).code
Bindings:  https://www.nubc.org/CodeSystem/TypeOfBill
BillClass
Domain: BillClass
supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/ClaimInformationCategory|admsrc).code
Bindings:  https://www.nubc.org/CodeSystem/PointOfOrigin  https://www.nubc.org/CodeSystem/PointOfOriginNewBorn
AdmitSource
Domain: AdmitSource
supportingInfo.category
Bindings:  ValueSet-C4BBSupportingInfoType
ClaimSupportingInformation.Type
Domain: SupportingInformationType
supportingInfo.code ClaimSupportingInformation.Term
Domain: SupportingInformationCode
supportingInfo.reason ClaimSupportingInformation.Reason
Domain: SupportingInformationReason
supportingInfo.sequence ClaimSupportingInformation.Sequence
supportingInfo.timing ClaimSupportingInformation.StartDate
ClaimSupportingInformation.EndDate
supportingInfo.value ClaimSupportingInformation.Value
text Comment
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount TotalCoinsuranceAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount TotalPatientResponsibleAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount TotalNotCoveredAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount TotalPatientPaid
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount TotalHsaPaidAmount
total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount TotalPaid
total(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount TotalAllowed
total(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount TotalCopayAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount TotalDeductibleAmount
total(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount TotalCharges
total.category
Bindings:  ValueSet-C4BBPayerBenefitPaymentStatus
InNetwork
type
Bindings:  valueset-claim-type
ClaimType
Domain: ClaimType