API end point: https://fhir.careevolution.com/Master.Adapter1.WebClient/api/fhir-stu3.

Resource ExplanationOfBenefit (STU3)

Maps CareEvolution Claim and contained Medication concepts

Supported interactions

Search parameters

Name Type Modifiers , prefixes Multiple values Can be chained Description
_id Token Yes See here
_lastUpdated Date lt le gt ge See here
care-team Reference :missing Yes Yes See here
coverage Reference :missing Yes Yes See here
identifier Token Yes See here
patient Reference :missing Yes Yes See here
provenance-agent Reference Yes Yes

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

service-date Date eq ne lt le gt ge sa eb ap See here
type Token Yes See here

Sorts

Supports multiple sorts

Includes

Operations

To FHIR mappings

FHIR CareEvolution
billablePeriod Claim.StartDate
Claim.EndDate
billablePeriod.extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-claim-query-cd-extension.html') Claim.Property('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-claim-query-cd-extension.html')
billablePeriod.extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension.html') Claim.Property('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension.html')
billablePeriod.extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-snf-claim-query-cd-extension.html') Claim.Property('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-snf-claim-query-cd-extension.html')
careTeam.provider Claim.CaregiverRelationships.CaregiverID Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Claim.Services.CaregiverRelationships.CaregiverID
careTeam.role
Bindings:  valueset-claim-careteamrole
Claim.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Claim.Services.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
diagnosis.diagnosis
Bindings:  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm  http://snomed.info/sct
Claim.Problems.Term
Domain: DiagnosisCode
diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate') Claim.Problems.Date
diagnosis.extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension.html') Claim.Problems.OnAdmission
Domain: DiagnosisStatusOnAdmission
diagnosis.sequence Claim.Problems.Sequence
diagnosis.type Claim.Problems.Type
Domain: DiagnosisType
disposition Claim.Property('FHIRExplanationOfBenefitDisposition')
extension('http://careevolution.com/fhirextensions#properties') Claim.Properties
extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-carrier-carr-clm-pmt-dnl-cd-extension.html') Claim.Property('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-carrier-carr-clm-pmt-dnl-cd-extension.html')
extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-hha-clm-mdcr-non-pmt-rsn-cd-extension.html') Claim.NonPaymentReason
Domain: NonPaymentReason
extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-mdcr-non-pmt-rsn-cd-extension.html') Claim.NonPaymentReason
Domain: NonPaymentReason
extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension.html') Claim.NonPaymentReason
Domain: NonPaymentReason
extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-snf-clm-mdcr-non-pmt-rsn-cd-extension.html') Claim.NonPaymentReason
Domain: NonPaymentReason
facility.extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-pde-phrmcy-srvc-type-cd-extension.html') Claim.Property('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-pde-phrmcy-srvc-type-cd-extension.html')
facility.identifier Claim.Property('FacilityNpi')
identifier Claim.Identifier
Claim.AlternateIdentifier
information.category
Bindings:  valueset-claim-informationcategory
Claim.ClaimSupportingInformation.Type
Domain: SupportingInformationType
information.code Claim.ClaimSupportingInformation.Term
Domain: SupportingInformationCode
information.reason Claim.ClaimSupportingInformation.Reason
Domain: SupportingInformationReason
information.sequence Claim.ClaimSupportingInformation.Sequence
information.timing Claim.ClaimSupportingInformation.StartDate
Claim.ClaimSupportingInformation.EndDate
information.value Claim.ClaimSupportingInformation.Value
insurance.coverage Claim.InsuranceID
Claim.InsuranceIdentifier
item.category Claim.Services.RevenueCode
Domain: RevenueCode
Claim.Services.Property('IsFromFhirCategoryProperty')
item.detail.type.coding.display Medications.Comment
item.diagnosisLinkId Claim.Services.Property('FHIRDiagnosisLinkId')
item.extension('http://careevolution.com/fhirextensions#properties') Medications.Properties
item.extension('http://hl7.org/fhir/ValueSet/v3-ActInvoiceGroupCode') Claim.Services.Property('http://hl7.org/fhir/ValueSet/v3-ActInvoiceGroupCode')
item.extension('https://bluebutton.cms.gov/resources/variables/betos_cd') Claim.Services.Property('https://bluebutton.cms.gov/resources/variables/betos_cd')
item.extension('https://bluebutton.cms.gov/resources/variables/carr_line_mtus_cd') Claim.Services.Property('https://bluebutton.cms.gov/resources/variables/carr_line_mtus_cd')
item.extension('https://bluebutton.cms.gov/resources/variables/carr_line_mtus_cnt') Claim.Services.Property('https://bluebutton.cms.gov/resources/variables/carr_line_mtus_cnt')
item.extension('https://bluebutton.cms.gov/resources/variables/line_service_deductible') Claim.Services.Property('https://bluebutton.cms.gov/resources/variables/line_service_deductible')
item.location
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set
Claim.Services.LocationType
Domain: ServiceLocation
item.modifier
Bindings:  http://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.procedureLinkId Claim.Services.Property('FHIRProcedureLinkId')
item.quantity
Bindings:  http://unitsofmeasure.org
Medications.Quantity
Medications.Units
Domain: MedicationUnits
Medications.Term
Domain: MedicationType
Claim.Services.Units
item.quantity.extension('https://bluebutton.cms.gov/resources/variables/days_suply_num') Medications.DaysSupplied
item.quantity.extension('https://bluebutton.cms.gov/resources/variables/fill_num') Medications.RefillNumber
item.revenue Claim.Services.RevenueCode
Domain: RevenueCode
Claim.Services.Property('IsFromFhirCategoryProperty')
item.sequence Medications.Identifier
Claim.Services.Sequence
item.service
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.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.serviced Medications.Date
Claim.Services.StartDate
Claim.Services.EndDate
patient Claim.PatientID
payment.amount Claim.TotalPaid
procedure.date Claim.Procedures.Date
procedure.extension('http://careevolution.com/fhirextensions#claim-procedureType') Claim.Procedures.Type
Domain: ProcedureType
procedure.procedure Claim.Procedures.Term
Domain: ProcedureCode
procedure.sequence Claim.Procedures.Sequence
status
Bindings:  valueset-explanationofbenefit-status
Claim.Status
Domain: ClaimStatus
text Claim.Comment
totalBenefit Claim.TotalAllowed
totalCost Claim.Property('MDCR_INSTNL_TOT_CHRG_AMT')
type
Bindings:  valueset-claim-type
Claim.ClaimType
Domain: ClaimType
Claim.BillClass
Domain: BillClass

From FHIR mappings

FHIR CareEvolution
benefitBalance.financial.used Claim.Properties
billablePeriod Claim.StartDate
Claim.EndDate
billablePeriod.extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-claim-query-cd-extension.html') Claim.Property('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-claim-query-cd-extension.html')
billablePeriod.extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension.html') Claim.Property('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension.html')
billablePeriod.extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-snf-claim-query-cd-extension.html') Claim.Property('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-snf-claim-query-cd-extension.html')
careTeam.provider Claim.CaregiverRelationships.CaregiverID
Claim.Services.CaregiverRelationships.CaregiverID
careTeam.role
Bindings:  valueset-claim-careteamrole
Claim.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
Claim.Services.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
diagnosis.diagnosis
Bindings:  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm  http://snomed.info/sct
Claim.Problems.Term
Domain: DiagnosisCode
diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate') Claim.Problems.Date
diagnosis.extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension.html') Claim.Problems.OnAdmission
Domain: DiagnosisStatusOnAdmission
diagnosis.packageCode Claim.Properties
diagnosis.sequence Claim.Problems.Sequence
diagnosis.type Claim.Problems.Type
Domain: DiagnosisType
disposition Claim.Property('FHIRExplanationOfBenefitDisposition')
extension Claim.Properties
extension('http://careevolution.com/fhirextensions#properties') Claim.Properties
extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-carrier-carr-clm-pmt-dnl-cd-extension.html') Claim.Property('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-carrier-carr-clm-pmt-dnl-cd-extension.html')
extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-hha-clm-mdcr-non-pmt-rsn-cd-extension.html') Claim.NonPaymentReason
Domain: NonPaymentReason
extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-mdcr-non-pmt-rsn-cd-extension.html') Claim.NonPaymentReason
Domain: NonPaymentReason
extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension.html') Claim.NonPaymentReason
Domain: NonPaymentReason
extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-snf-clm-mdcr-non-pmt-rsn-cd-extension.html') Claim.NonPaymentReason
Domain: NonPaymentReason
facility.extension Claim.Properties
facility.extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-pde-phrmcy-srvc-type-cd-extension.html') Claim.Property('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-pde-phrmcy-srvc-type-cd-extension.html')
facility.identifier Claim.Property('FacilityNpi')
id Claim.Identifier
identifier Claim.Identifier
Claim.AlternateIdentifier
information.category
Bindings:  valueset-claim-informationcategory
Claim.ClaimSupportingInformation.Type
Domain: SupportingInformationType
information.code Claim.ClaimSupportingInformation.Term
Domain: SupportingInformationCode
information.reason Claim.ClaimSupportingInformation.Reason
Domain: SupportingInformationReason
information.sequence Claim.ClaimSupportingInformation.Sequence
information.timing Claim.ClaimSupportingInformation.StartDate
Claim.ClaimSupportingInformation.EndDate
information.value Claim.ClaimSupportingInformation.Value
insurance.coverage Claim.InsuranceID
Claim.InsuranceIdentifier
item.adjudication Medications.AmountPaid
Medications.AmountBilled
Claim.Services.AmountPaid
Claim.Services.AmountClaimed
Claim.Services.Status
Domain: ClaimServiceStatus
item.category Claim.Services.RevenueCode
Domain: RevenueCode
Claim.Services.Property('IsFromFhirCategoryProperty')
item.detail.type.coding.display Medications.Comment
item.diagnosisLinkId Claim.Services.Property('FHIRDiagnosisLinkId')
item.extension Claim.Services.Properties
item.extension('http://careevolution.com/fhirextensions#properties') Medications.Properties
item.extension('http://hl7.org/fhir/ValueSet/v3-ActInvoiceGroupCode') Claim.Services.Property('http://hl7.org/fhir/ValueSet/v3-ActInvoiceGroupCode')
item.extension('https://bluebutton.cms.gov/resources/variables/betos_cd') Claim.Services.Property('https://bluebutton.cms.gov/resources/variables/betos_cd')
item.extension('https://bluebutton.cms.gov/resources/variables/carr_line_mtus_cd') Claim.Services.Property('https://bluebutton.cms.gov/resources/variables/carr_line_mtus_cd')
item.extension('https://bluebutton.cms.gov/resources/variables/carr_line_mtus_cnt') Claim.Services.Property('https://bluebutton.cms.gov/resources/variables/carr_line_mtus_cnt')
item.extension('https://bluebutton.cms.gov/resources/variables/line_service_deductible') Claim.Services.Property('https://bluebutton.cms.gov/resources/variables/line_service_deductible')
item.location
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set
Claim.Services.LocationType
Domain: ServiceLocation
item.modifier
Bindings:  http://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.procedureLinkId Claim.Services.Property('FHIRProcedureLinkId')
item.quantity
Bindings:  http://unitsofmeasure.org
Medications.Quantity
Medications.Units
Domain: MedicationUnits
Claim.Services.Units
item.quantity.extension('https://bluebutton.cms.gov/resources/variables/days_suply_num') Medications.DaysSupplied
item.quantity.extension('https://bluebutton.cms.gov/resources/variables/fill_num') Medications.RefillNumber
item.revenue Claim.Services.RevenueCode
Domain: RevenueCode
Claim.Services.Property('IsFromFhirCategoryProperty')
item.sequence Medications.Identifier
Claim.Services.Sequence
item.service
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.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.serviced Medications.Date
Claim.Services.StartDate
Claim.Services.EndDate
patient Claim.PatientID
payment.amount Claim.TotalPaid
procedure.date Claim.Procedures.Date
procedure.extension('http://careevolution.com/fhirextensions#claim-procedureType') Claim.Procedures.Type
Domain: ProcedureType
procedure.procedure Claim.Procedures.Term
Domain: ProcedureCode
procedure.sequence Claim.Procedures.Sequence
status
Bindings:  valueset-explanationofbenefit-status
Claim.Status
Domain: ClaimStatus
text Claim.Comment
totalBenefit Claim.TotalAllowed
totalCost Claim.Property('MDCR_INSTNL_TOT_CHRG_AMT')
type
Bindings:  valueset-claim-type
Claim.ClaimType
Domain: ClaimType
Claim.BillClass
Domain: BillClass