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
• Sorts
• Includes
• Operations
• To FHIR mappings
• From FHIR mappings

Supported interactions

• read
• search
• create
• update
• delete

Search parameters

Name	Type	Modifiers , prefixes	Multiple values	Can be chained	Description
_count	Special	eq			The maximum number of resources to return in a result page.
_elements	Special	eq			Used to request a specific set of elements be returned as part of a resource.
_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
_summary	Special	eq			Used to return only a portion of the resouces. Defaults to 'false', which returns the whole resource.
_total	Special	eq			Use the value 'estimate' to populate the result bundle's 'total' element with an estimate of the matching number of resources.
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
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
service-date	Date	:missing eq ne lt le gt ge sa eb ap			Date of the service for the EOB
type	Token	:missing	Yes		Claim type

Sorts

• _id
• identifier

Supports multiple sorts

Includes

• care-team
• coverage
• encounter
• patient
• provenance-agent
• Provenance:target

Operations

• validate - Validate a resource

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.Priority Domain: ClaimPriority	extension('http://careevolution.com/fhirextensions#explanationOfBenefit-priority')
Claim.PriorityAlternateTerms Domain: ClaimPriority	extension('http://careevolution.com/fhirextensions#explanationOfBenefit-priority')
Claim.PriorityText	extension('http://careevolution.com/fhirextensions#explanationOfBenefit-priority')
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://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
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  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.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  http://hl7.org/fhir/v3/ActCode  https://rosetta.careevolution.com/UBFacilityType
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  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.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.Priority Domain: ClaimPriority	extension('http://careevolution.com/fhirextensions#explanationOfBenefit-priority')
Claim.PriorityAlternateTerms Domain: ClaimPriority	extension('http://careevolution.com/fhirextensions#explanationOfBenefit-priority')
Claim.PriorityText	extension('http://careevolution.com/fhirextensions#explanationOfBenefit-priority')
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://snomed.info/sct  http://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm
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  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.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  http://hl7.org/fhir/v3/ActCode  https://rosetta.careevolution.com/UBFacilityType
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  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.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

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