Release 5 R6 Ballot (2nd Draft)

This page is part of the FHIR Specification (v5.0.0: R5 - STU v6.0.0-ballot2: Release 6 Ballot (2nd Draft) (see Ballot Notes ). This is the The current published version in it's permanent home (it will always be available at this URL). is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4

13.10.32 13.10.31 Resource ExplanationOfBenefit - Maturity Dependency View

Financial Management icon Work Group Maturity Level : 2   Trial Use Compartments : Device , Encounter , Patient , Practitioner , RelatedPerson

Dependency Graph for ExplanationOfBenefit FMM level 2

Name Card. Type Dependency Analysis
. . ExplanationOfBenefit DomainResource
. . . identifier 0..* Identifier
. . . traceNumber 0..* Identifier
. . . status 1..1 code
. . . type 1..1 CodeableConcept
. . . subType 0..1 CodeableConcept
. . . use 1..1 code
. . . patient 1..1 Reference ( Patient )
. . . billablePeriod 0..1 Period
. . . created 1..1 dateTime
. . . enterer 0..1 Reference ( Practitioner | PractitionerRole | Patient | RelatedPerson )
. . . insurer 0..1 Reference ( Organization )
. . . provider 0..1 Reference ( Practitioner | PractitionerRole | Organization )
. . . priority 0..1 CodeableConcept
. . . fundsReserveRequested 0..1 CodeableConcept
. . . fundsReserve 0..1 CodeableConcept
. . . related 0..* BackboneElement
. . . . claim 0..1 Reference ( Claim )
. . . . relationship 0..1 CodeableConcept
. . . . reference 0..1 Identifier
. . . prescription 0..1 Reference ( MedicationRequest | VisionPrescription )
. . . originalPrescription 0..1 Reference ( MedicationRequest )
. . . event 0..* BackboneElement
. . . . type 1..1 CodeableConcept
. . . . when[x] 1..1
. . . . . whenDateTime dateTime
. . . . . whenPeriod Period
. . . payee 0..1 BackboneElement
. . . . type 0..1 CodeableConcept
. . . . party 0..1 Reference ( Practitioner | PractitionerRole | Organization | Patient | RelatedPerson )
. . . referral 0..1 Reference ( ServiceRequest )
. . . encounter 0..* Reference ( Encounter )
. . . facility 0..1 Reference ( Location | Organization )
. . . claim 0..1 Reference ( Claim )
. . . claimResponse 0..1 Reference ( ClaimResponse )
. . . outcome 1..1 code
. . . decision 0..1 CodeableConcept
. . . disposition 0..1 string
. . . preAuthRef 0..* string
. . . preAuthRefPeriod 0..* Period
. . . diagnosisRelatedGroup 0..1 CodeableConcept
. . . careTeam 0..* BackboneElement
. . . . sequence 1..1 positiveInt
. . . . provider 1..1 Reference ( Practitioner | PractitionerRole | Organization )
. . . . responsible 0..1 boolean
. . . . role 0..1 CodeableConcept
. . . . specialty 0..1 CodeableConcept
. . . supportingInfo 0..* BackboneElement
. . . . sequence 1..1 positiveInt
. . . . category 1..1 CodeableConcept
. . . . code 0..1 CodeableConcept
. . . . timing[x] 0..1
. . . . . timingDate date
. . . . . timingPeriod Period
. . . . value[x] 0..1
. . . . . valueBoolean boolean
. . . . . valueString string
. . . . . valueQuantity Quantity
. . . . . valueAttachment Attachment
. . . . . valueReference Reference ( Any Type Warning: (Any = FMM1-Trial Use vs. Element = FMM2-Trial Use)
. . . . . valueIdentifier Identifier
. . . . reason 0..1 Coding
. . . diagnosis 0..* BackboneElement
. . . . sequence 1..1 positiveInt
. . . . diagnosis[x] 1..1
. . . . . diagnosisCodeableConcept CodeableConcept
. . . . . diagnosisReference Reference ( Condition
. . . . type 0..* CodeableConcept
. . . . onAdmission 0..1 CodeableConcept
. . . procedure 0..* BackboneElement
. . . . sequence 1..1 positiveInt
. . . . type 0..* CodeableConcept
. . . . date 0..1 dateTime
. . . . procedure[x] 1..1
. . . . . procedureCodeableConcept CodeableConcept
. . . . . procedureReference Reference ( Procedure
. . . . udi 0..* Reference ( Device )
. . . precedence 0..1 positiveInt
. . . insurance 0..* BackboneElement
. . . . focal 1..1 boolean
. . . . coverage 1..1 Reference ( Coverage )
. . . . preAuthRef 0..* string
. . . accident 0..1 BackboneElement
. . . . date 0..1 date
. . . . type 0..1 CodeableConcept
. . . . location[x] 0..1
. . . . . locationAddress Address
. . . . . locationReference Reference ( Location
. . . patientPaid 0..1 Money
. . . item 0..* BackboneElement
. . . . sequence 1..1 positiveInt
. . . . careTeamSequence 0..* positiveInt
. . . . diagnosisSequence 0..* positiveInt
. . . . procedureSequence 0..* positiveInt
. . . . informationSequence 0..* positiveInt
. . . . traceNumber 0..* Identifier
. . . . revenue 0..1 CodeableConcept
. . . . category 0..1 CodeableConcept
. . . . productOrService 0..1 CodeableConcept
. . . . productOrServiceEnd 0..1 CodeableConcept
. . . . request 0..* Reference ( DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | SupplyRequest | VisionPrescription ) Type Warning: (DeviceRequest = FMM1-Trial Use vs. Element = FMM2-Trial Use)
Type Warning: (SupplyRequest = FMM1-Trial Use vs. Element = FMM2-Trial Use)
. . . . modifier 0..* CodeableConcept
. . . . programCode 0..* CodeableConcept
. . . . serviced[x] 0..1
. . . . . servicedDate date
. . . . . servicedPeriod Period
. . . . location[x] 0..1
. . . . . locationCodeableConcept CodeableConcept
. . . . . locationAddress Address
. . . . . locationReference Reference ( Location
. . . . patientPaid 0..1 Money
. . . . quantity 0..1 SimpleQuantity
. . . . unitPrice 0..1 Money
. . . . factor 0..1 decimal
. . . . tax 0..1 Money
. . . . net 0..1 Money
. . . . udi 0..* Reference ( Device )
. . . . bodySite 0..* BackboneElement
. . . . . site 1..* CodeableReference Type Error: (CodeableReference = FMM5-Draft vs. Element = FMM2-Trial Use)
. . . . . subSite 0..* CodeableConcept
. . . . encounter 0..* Reference ( Encounter )
. . . . noteNumber 0..* positiveInt
. . . . reviewOutcome 0..1 BackboneElement
. . . . . decision 0..1 CodeableConcept
. . . . . reason 0..* CodeableConcept
. . . . . preAuthRef 0..1 string
. . . . . preAuthPeriod 0..1 Period
. . . . adjudication 0..* BackboneElement
. . . . . category 1..1 CodeableConcept
. . . . . reason 0..1 CodeableConcept
. . . . . amount 0..1 Money
. . . . . quantity 0..1 Quantity
. . . . detail 0..* BackboneElement
. . . . . sequence 1..1 positiveInt
. . . . . traceNumber 0..* Identifier
. . . . . revenue 0..1 CodeableConcept
. . . . . category 0..1 CodeableConcept
. . . . . productOrService 0..1 CodeableConcept
. . . . . productOrServiceEnd 0..1 CodeableConcept
. . . . . modifier 0..* CodeableConcept
. . . . . programCode 0..* CodeableConcept
. . . . . patientPaid 0..1 Money
. . . . . quantity 0..1 SimpleQuantity
. . . . . unitPrice 0..1 Money
. . . . . factor 0..1 decimal
. . . . . tax 0..1 Money
. . . . . net 0..1 Money
. . . . . udi 0..* Reference ( Device )
. . . . . noteNumber 0..* positiveInt
. . . . . reviewOutcome 0..1 see reviewOutcome
. . . . . adjudication 0..* see adjudication
. . . . . subDetail 0..* BackboneElement
. . . . . . sequence 1..1 positiveInt
. . . . . . traceNumber 0..* Identifier
. . . . . . revenue 0..1 CodeableConcept
. . . . . . category 0..1 CodeableConcept
. . . . . . productOrService 0..1 CodeableConcept
. . . . . . productOrServiceEnd 0..1 CodeableConcept
. . . . . . modifier 0..* CodeableConcept
. . . . . . programCode 0..* CodeableConcept
. . . . . . patientPaid 0..1 Money
. . . . . . quantity 0..1 SimpleQuantity
. . . . . . unitPrice 0..1 Money
. . . . . . factor 0..1 decimal
. . . . . . tax 0..1 Money
. . . . . . net 0..1 Money
. . . . . . udi 0..* Reference ( Device )
. . . . . . noteNumber 0..* positiveInt
. . . . . . reviewOutcome 0..1 see reviewOutcome
. . . . . . adjudication 0..* see adjudication
. . . addItem 0..* BackboneElement
. . . . itemSequence 0..* positiveInt
. . . . detailSequence 0..* positiveInt
. . . . subDetailSequence 0..* positiveInt
. . . . traceNumber 0..* Identifier
. . . . provider 0..* Reference ( Practitioner | PractitionerRole | Organization )
. . . . revenue 0..1 CodeableConcept
. . . . productOrService 0..1 CodeableConcept
. . . . productOrServiceEnd 0..1 CodeableConcept
. . . . request 0..* Reference ( DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | SupplyRequest | VisionPrescription ) Type Warning: (DeviceRequest = FMM1-Trial Use vs. Element = FMM2-Trial Use)
Type Warning: (SupplyRequest = FMM1-Trial Use vs. Element = FMM2-Trial Use)
. . . . modifier 0..* CodeableConcept
. . . . programCode 0..* CodeableConcept
. . . . serviced[x] 0..1
. . . . . servicedDate date
. . . . . servicedPeriod Period
. . . . location[x] 0..1
. . . . . locationCodeableConcept CodeableConcept
. . . . . locationAddress Address
. . . . . locationReference Reference ( Location
. . . . patientPaid 0..1 Money
. . . . quantity 0..1 SimpleQuantity
. . . . unitPrice 0..1 Money
. . . . factor 0..1 decimal
. . . . tax 0..1 Money
. . . . net 0..1 Money
. . . . bodySite 0..* BackboneElement
. . . . . site 1..* CodeableReference Type Error: (CodeableReference = FMM5-Draft vs. Element = FMM2-Trial Use)
. . . . . subSite 0..* CodeableConcept
. . . . noteNumber 0..* positiveInt
. . . . reviewOutcome 0..1 see reviewOutcome
. . . . adjudication 0..* see adjudication
. . . . detail 0..* BackboneElement
. . . . . traceNumber 0..* Identifier
. . . . . revenue 0..1 CodeableConcept
. . . . . productOrService 0..1 CodeableConcept
. . . . . productOrServiceEnd 0..1 CodeableConcept
. . . . . modifier 0..* CodeableConcept
. . . . . patientPaid 0..1 Money
. . . . . quantity 0..1 SimpleQuantity
. . . . . unitPrice 0..1 Money
. . . . . factor 0..1 decimal
. . . . . tax 0..1 Money
. . . . . net 0..1 Money
. . . . . noteNumber 0..* positiveInt
. . . . . reviewOutcome 0..1 see reviewOutcome
. . . . . adjudication 0..* see adjudication
. . . . . subDetail 0..* BackboneElement
. . . . . . traceNumber 0..* Identifier
. . . . . . revenue 0..1 CodeableConcept
. . . . . . productOrService 0..1 CodeableConcept
. . . . . . productOrServiceEnd 0..1 CodeableConcept
. . . . . . modifier 0..* CodeableConcept
. . . . . . patientPaid 0..1 Money
. . . . . . quantity 0..1 SimpleQuantity
. . . . . . unitPrice 0..1 Money
. . . . . . factor 0..1 decimal
. . . . . . tax 0..1 Money
. . . . . . net 0..1 Money
. . . . . . noteNumber 0..* positiveInt
. . . . . . reviewOutcome 0..1 see reviewOutcome
. . . . . . adjudication 0..* see adjudication
. . . adjudication 0..* see adjudication
. . . total 0..* BackboneElement
. . . . category 1..1 CodeableConcept
. . . . amount 1..1 Money
. . . payment 0..1 BackboneElement
. . . . type 0..1 CodeableConcept
. . . . adjustment 0..1 Money
. . . . adjustmentReason 0..1 CodeableConcept
. . . . date 0..1 date
. . . . amount 0..1 Money
. . . . identifier 0..1 Identifier
. . . formCode 0..1 CodeableConcept
. . . form 0..1 Attachment
. . . processNote 0..* BackboneElement
. . . . number 0..1 positiveInt
. . . . type 0..1 CodeableConcept
. . . . text 0..1 string
. . . . language 0..1 CodeableConcept
. . . benefitPeriod 0..1 Period
. . . benefitBalance 0..* BackboneElement
. . . . category 1..1 CodeableConcept
. . . . excluded 0..1 boolean
. . . . name 0..1 string
. . . . description 0..1 string
. . . . network 0..1 CodeableConcept
. . . . unit 0..1 CodeableConcept
. . . . term 0..1 CodeableConcept
. . . . financial 0..* BackboneElement
. . . . . type 1..1 CodeableConcept
. . . . . allowed[x] 0..1
. . . . . . allowedUnsignedInt unsignedInt
. . . . . . allowedString string
. . . . . . allowedMoney Money
. . . . . used[x] 0..1
. . . . . . usedUnsignedInt unsignedInt
. . . . . . usedMoney Money