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
_source Token :missing Yes See here
care-team Reference :missing Yes Yes

Member of the CareTeam

coverage Reference :missing Yes Yes

The plan under which the claim was adjudicated

encounter Reference :missing Yes Yes

Encounters associated with a billed line item

identifier Token :missing Yes

The business identifier of the Explanation of Benefit

patient Reference :missing Yes Yes

The reference to the patient

provenance-agent Reference :missing Yes Yes

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

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

Sorts

Supports multiple sorts

Includes

Operations

To FHIR mappings

CareEvolution FHIR
Claim.AlternateIdentifier identifier
Claim.BillClass
Domain: BillClass
type
Claim.CaregiverRelationships.CaregiverID careTeam.provider Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Claim.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
careTeam.role
Bindings:  valueset-claim-careteamrole
Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider
Claim.ClaimSupportingInformation.EndDate information.timing
Claim.ClaimSupportingInformation.Reason
Domain: SupportingInformationReason
information.reason
Claim.ClaimSupportingInformation.Sequence information.sequence
Claim.ClaimSupportingInformation.StartDate information.timing
Claim.ClaimSupportingInformation.Term
Domain: SupportingInformationCode
information.code
Claim.ClaimSupportingInformation.Type
Domain: SupportingInformationType
information.category
Bindings:  valueset-claim-informationcategory
Claim.ClaimSupportingInformation.Value information.value
Claim.ClaimType
Domain: ClaimType
type
Bindings:  valueset-claim-type
Claim.Comment text
Claim.EndDate billablePeriod
Claim.Identifier identifier
Claim.InsuranceID insurance.coverage
Claim.InsuranceIdentifier insurance.coverage
Claim.NonPaymentReason
Domain: NonPaymentReason
extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-hha-clm-mdcr-non-pmt-rsn-cd-extension.html')
extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-snf-clm-mdcr-non-pmt-rsn-cd-extension.html')
extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-mdcr-non-pmt-rsn-cd-extension.html')
extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension.html')
Claim.PatientID patient
Claim.Problems.Date diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate')
Claim.Problems.OnAdmission
Domain: DiagnosisStatusOnAdmission
diagnosis.extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension.html')
Claim.Problems.Sequence diagnosis.sequence
Claim.Problems.Term
Domain: DiagnosisCode
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.Type
Domain: DiagnosisType
diagnosis.type
Claim.Procedures.Date procedure.date
Claim.Procedures.Sequence procedure.sequence
Claim.Procedures.Term
Domain: ProcedureCode
procedure.procedure
Bindings:  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  http://snomed.info/sct
Claim.Procedures.Type
Domain: ProcedureType
procedure.extension('http://careevolution.com/fhirextensions#claim-procedureType')
Claim.Properties extension('http://careevolution.com/fhirextensions#properties')
Claim.Property('FacilityNpi') facility.identifier
Claim.Property('FHIRExplanationOfBenefitDisposition') disposition
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-carrier-carr-clm-pmt-dnl-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-inpatient-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-outpatient-claim-query-cd-extension.html')
Claim.Property('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-pde-phrmcy-srvc-type-cd-extension.html') 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-snf-claim-query-cd-extension.html') billablePeriod.extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-snf-claim-query-cd-extension.html')
Claim.Property('MDCR_INSTNL_TOT_CHRG_AMT') totalCost
Claim.Services.CaregiverRelationships.CaregiverID careTeam.provider
Claim.Services.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
careTeam.role
Bindings:  valueset-claim-careteamrole
Claim.Services.EndDate item.serviced
Claim.Services.LocationType
Domain: ServiceLocation
item.location
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  https://rosetta.careevolution.com/UBFacilityType  http://hl7.org/fhir/v3/ActCode
Claim.Services.Modifier1
Domain: BillingModifier
item.modifier
Bindings:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Claim.Services.Modifier2
Domain: BillingModifier
item.modifier
Bindings:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Claim.Services.Modifier3
Domain: BillingModifier
item.modifier
Bindings:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Claim.Services.Modifier4
Domain: BillingModifier
item.modifier
Bindings:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Claim.Services.Modifier5
Domain: BillingModifier
item.modifier
Bindings:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Claim.Services.Property('FHIRDiagnosisLinkId') item.diagnosisLinkId
Claim.Services.Property('FHIRProcedureLinkId') item.procedureLinkId
Claim.Services.Property('http://hl7.org/fhir/ValueSet/v3-ActInvoiceGroupCode') item.extension('http://hl7.org/fhir/ValueSet/v3-ActInvoiceGroupCode')
Claim.Services.Property('https://bluebutton.cms.gov/resources/variables/betos_cd') item.extension('https://bluebutton.cms.gov/resources/variables/betos_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_cd')
Claim.Services.Property('https://bluebutton.cms.gov/resources/variables/carr_line_mtus_cnt') item.extension('https://bluebutton.cms.gov/resources/variables/carr_line_mtus_cnt')
Claim.Services.Property('https://bluebutton.cms.gov/resources/variables/line_service_deductible') item.extension('https://bluebutton.cms.gov/resources/variables/line_service_deductible')
Claim.Services.Property('IsFromFhirCategoryProperty') item.category
item.revenue
Claim.Services.RevenueCode
Domain: RevenueCode
item.category
item.revenue
Claim.Services.Sequence item.sequence
Claim.Services.ServiceCode
Domain: ServiceCode
item.service
Bindings:  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  http://snomed.info/sct
Claim.Services.StartDate item.serviced
Claim.Services.Units item.quantity
Claim.StartDate billablePeriod
Claim.Status
Domain: ClaimStatus
status
Bindings:  valueset-explanationofbenefit-status
Claim.TotalAllowed totalBenefit
Claim.TotalPaid payment.amount
Medications.Comment item.detail.type.coding.display
Medications.Date item.serviced
Medications.DaysSupplied item.quantity.extension('https://bluebutton.cms.gov/resources/variables/days_suply_num')
Medications.Identifier item.sequence
Medications.Properties item.extension('http://careevolution.com/fhirextensions#properties')
Medications.Quantity item.quantity
Bindings:  http://unitsofmeasure.org
Medications.RefillNumber item.quantity.extension('https://bluebutton.cms.gov/resources/variables/fill_num')
Medications.Sequence item.sequence
Medications.Term
Domain: MedicationType
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
item.quantity
Bindings:  http://unitsofmeasure.org
Medications.Units
Domain: MedicationUnits
item.quantity
Bindings:  http://unitsofmeasure.org

From FHIR mappings

CareEvolution FHIR
Claim.AlternateIdentifier identifier
Claim.BillClass
Domain: BillClass
type
Claim.CaregiverRelationships.CaregiverID careTeam.provider
Claim.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
careTeam.role
Bindings:  valueset-claim-careteamrole
Claim.ClaimSupportingInformation.EndDate information.timing
Claim.ClaimSupportingInformation.Reason
Domain: SupportingInformationReason
information.reason
Claim.ClaimSupportingInformation.Sequence information.sequence
Claim.ClaimSupportingInformation.StartDate information.timing
Claim.ClaimSupportingInformation.Term
Domain: SupportingInformationCode
information.code
Claim.ClaimSupportingInformation.Type
Domain: SupportingInformationType
information.category
Bindings:  valueset-claim-informationcategory
Claim.ClaimSupportingInformation.Value information.value
Claim.ClaimType
Domain: ClaimType
type
Bindings:  valueset-claim-type
Claim.Comment text
Claim.EndDate billablePeriod
Claim.Identifier identifier
id
Claim.InsuranceID insurance.coverage
Claim.InsuranceIdentifier insurance.coverage
Claim.NonPaymentReason
Domain: NonPaymentReason
extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-hha-clm-mdcr-non-pmt-rsn-cd-extension.html')
extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-snf-clm-mdcr-non-pmt-rsn-cd-extension.html')
extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-mdcr-non-pmt-rsn-cd-extension.html')
extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension.html')
Claim.PatientID patient
Claim.Problems.Date diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate')
Claim.Problems.OnAdmission
Domain: DiagnosisStatusOnAdmission
diagnosis.extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension.html')
Claim.Problems.Sequence diagnosis.sequence
Claim.Problems.Term
Domain: DiagnosisCode
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.Type
Domain: DiagnosisType
diagnosis.type
Claim.Procedures.Date procedure.date
Claim.Procedures.Sequence procedure.sequence
Claim.Procedures.Term
Domain: ProcedureCode
procedure.procedure
Bindings:  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  http://snomed.info/sct
Claim.Procedures.Type
Domain: ProcedureType
procedure.extension('http://careevolution.com/fhirextensions#claim-procedureType')
Claim.Properties extension('http://careevolution.com/fhirextensions#properties')
facility.extension
extension
diagnosis.packageCode
benefitBalance.financial.used
Claim.Property('FacilityNpi') facility.identifier
Claim.Property('FHIRExplanationOfBenefitDisposition') disposition
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-carrier-carr-clm-pmt-dnl-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-inpatient-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-outpatient-claim-query-cd-extension.html')
Claim.Property('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-pde-phrmcy-srvc-type-cd-extension.html') 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-snf-claim-query-cd-extension.html') billablePeriod.extension('https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-snf-claim-query-cd-extension.html')
Claim.Property('MDCR_INSTNL_TOT_CHRG_AMT') totalCost
Claim.Services.AmountClaimed item.adjudication
Claim.Services.AmountPaid item.adjudication
Claim.Services.CaregiverRelationships.CaregiverID careTeam.provider
Claim.Services.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType
careTeam.role
Bindings:  valueset-claim-careteamrole
Claim.Services.EndDate item.serviced
Claim.Services.LocationType
Domain: ServiceLocation
item.location
Bindings:  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set  https://rosetta.careevolution.com/UBFacilityType  http://hl7.org/fhir/v3/ActCode
Claim.Services.Modifier1
Domain: BillingModifier
item.modifier
Bindings:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Claim.Services.Modifier2
Domain: BillingModifier
item.modifier
Bindings:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Claim.Services.Modifier3
Domain: BillingModifier
item.modifier
Bindings:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Claim.Services.Modifier4
Domain: BillingModifier
item.modifier
Bindings:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Claim.Services.Modifier5
Domain: BillingModifier
item.modifier
Bindings:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Claim.Services.Properties item.extension
Claim.Services.Property('FHIRDiagnosisLinkId') item.diagnosisLinkId
Claim.Services.Property('FHIRProcedureLinkId') item.procedureLinkId
Claim.Services.Property('http://hl7.org/fhir/ValueSet/v3-ActInvoiceGroupCode') item.extension('http://hl7.org/fhir/ValueSet/v3-ActInvoiceGroupCode')
Claim.Services.Property('https://bluebutton.cms.gov/resources/variables/betos_cd') item.extension('https://bluebutton.cms.gov/resources/variables/betos_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_cd')
Claim.Services.Property('https://bluebutton.cms.gov/resources/variables/carr_line_mtus_cnt') item.extension('https://bluebutton.cms.gov/resources/variables/carr_line_mtus_cnt')
Claim.Services.Property('https://bluebutton.cms.gov/resources/variables/line_service_deductible') item.extension('https://bluebutton.cms.gov/resources/variables/line_service_deductible')
Claim.Services.Property('IsFromFhirCategoryProperty') item.category
item.revenue
Claim.Services.RevenueCode
Domain: RevenueCode
item.category
item.revenue
Claim.Services.Sequence item.sequence
Claim.Services.ServiceCode
Domain: ServiceCode
item.service
Bindings:  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  http://snomed.info/sct
Claim.Services.StartDate item.serviced
Claim.Services.Status
Domain: ClaimServiceStatus
item.adjudication
Claim.Services.Units item.quantity
Claim.StartDate billablePeriod
Claim.Status
Domain: ClaimStatus
status
Bindings:  valueset-explanationofbenefit-status
Claim.TotalAllowed totalBenefit
Claim.TotalPaid payment.amount
Medications.AmountBilled item.adjudication
Medications.AmountPaid item.adjudication
Medications.Comment item.detail.type.coding.display
Medications.Date item.serviced
Medications.DaysSupplied item.quantity.extension('https://bluebutton.cms.gov/resources/variables/days_suply_num')
Medications.Identifier item.sequence
Medications.Properties item.extension('http://careevolution.com/fhirextensions#properties')
Medications.Quantity item.quantity
Bindings:  http://unitsofmeasure.org
Medications.RefillNumber item.quantity.extension('https://bluebutton.cms.gov/resources/variables/fill_num')
Medications.Sequence item.sequence
Medications.Term
Domain: MedicationType
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
Medications.Units
Domain: MedicationUnits
item.quantity
Bindings:  http://unitsofmeasure.org