ExplanationOfBenefit.diagnosis
FHIR attribute (stu3)
In the ExplanationOfBenefit resource for FHIR stu3 , the diagnosis attribute identifies the List of Diagnosis
diagnosis (ExplanationOfBenefit) description
Resource Type: ExplanationOfBenefit
Attribute Name: diagnosis
Description: List of Diagnosis
FHIR Version: stu3
Attribute Type :
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
"diagnosis": ExplanationOfBenefit attributes
AttributeField is listTypeDescription
Description: Claim reference
FHIR Version: stu3
Attribute Type : Reference
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"claim": {
"reference": "Claim/100150"
}Learn more about the (ExplanationOfBenefit) claim FHIR attribute
Description: Precedence (primary, secondary, etc.)
FHIR Version: stu3
Attribute Type : positiveInt
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"precedence": Learn more about the (ExplanationOfBenefit) precedence FHIR attribute
Description: Servicing Facility
FHIR Version: stu3
Attribute Type : Reference
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"facility": {
"reference": "Location/1"
}Learn more about the (ExplanationOfBenefit) facility FHIR attribute
Description: Related Claims which may be revelant to processing this claim
FHIR Version: stu3
Attribute Type : Data Type
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"related": Learn more about the (ExplanationOfBenefit) related FHIR attribute
Description: Original prescription if superceded by fulfiller
FHIR Version: stu3
Attribute Type : Reference
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"originalPrescription": Learn more about the (ExplanationOfBenefit) originalPrescription FHIR attribute
Description: Claim response reference
FHIR Version: stu3
Attribute Type : Reference
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"claimResponse": {
"reference": "ClaimResponse/R3500"
}Learn more about the (ExplanationOfBenefit) claimResponse FHIR attribute
Description: Period for charge submission
FHIR Version: stu3
Attribute Type : Period
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"billablePeriod": Learn more about the (ExplanationOfBenefit) billablePeriod FHIR attribute
Description: Processing notes
FHIR Version: stu3
Attribute Type : Data Type
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"processNote": Learn more about the (ExplanationOfBenefit) processNote FHIR attribute
Description: Insurance or medical plan
FHIR Version: stu3
Attribute Type : Data Type
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"insurance": {
"coverage": {
"reference": "Coverage/9876B1"
}
}Learn more about the (ExplanationOfBenefit) insurance FHIR attribute
Description: Total Cost of service from the Claim
FHIR Version: stu3
Attribute Type : Money
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"totalCost": {
"code": "USD",
"system": "urn:iso:std:iso:4217",
"value": 135.57
}Learn more about the (ExplanationOfBenefit) totalCost FHIR attribute
Description: Exceptions, special considerations, the condition, situation, prior or concurrent issues
FHIR Version: stu3
Attribute Type : Data Type
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"information": Learn more about the (ExplanationOfBenefit) information FHIR attribute
Description: Party to be paid any benefits payable
FHIR Version: stu3
Attribute Type : Data Type
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"payee": {
"resourceType": {
"coding": [
{
"code": "organization",
"system": "http://hl7.org/fhir/resource-type-link"
}
]
},
"party": {
"reference": "Organization/2"
},
"type": {
"coding": [
{
"code": "provider",
"system": "http://hl7.org/fhir/payeetype"
}
]
}
}Learn more about the (ExplanationOfBenefit) payee FHIR attribute
Description: Author
FHIR Version: stu3
Attribute Type : Reference
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"enterer": {
"reference": "Practitioner/1"
}Learn more about the (ExplanationOfBenefit) enterer FHIR attribute
Description: Responsible provider for the claim
FHIR Version: stu3
Attribute Type : Reference
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"provider": {
"reference": "Practitioner/1"
}Learn more about the (ExplanationOfBenefit) provider FHIR attribute
Description: Type or discipline
FHIR Version: stu3
Attribute Type : CodeableConcept
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"type": {
"coding": [
{
"code": "oral",
"system": "http://hl7.org/fhir/ex-claimtype"
}
]
}Learn more about the (ExplanationOfBenefit) type FHIR attribute
Description: active | cancelled | draft | entered-in-error
FHIR Version: stu3
Attribute Type : code
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"status": "active"Learn more about the (ExplanationOfBenefit) status FHIR attribute
Description: Balance by Benefit Category
FHIR Version: stu3
Attribute Type : Data Type
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"benefitBalance": Learn more about the (ExplanationOfBenefit) benefitBalance FHIR attribute
Description: The subject of the Products and Services
FHIR Version: stu3
Attribute Type : Reference
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"patient": {
"reference": "Patient/pat1"
}Learn more about the (ExplanationOfBenefit) patient FHIR attribute
Description: Period in hospital
FHIR Version: stu3
Attribute Type : Period
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"hospitalization": Learn more about the (ExplanationOfBenefit) hospitalization FHIR attribute
Description: Printed Form Identifier
FHIR Version: stu3
Attribute Type : CodeableConcept
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"form": Learn more about the (ExplanationOfBenefit) form FHIR attribute
Description: Insurer responsible for the EOB
FHIR Version: stu3
Attribute Type : Reference
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"insurer": Learn more about the (ExplanationOfBenefit) insurer FHIR attribute
Description: Insurer added line items
FHIR Version: stu3
Attribute Type : Data Type
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"addItem": Learn more about the (ExplanationOfBenefit) addItem FHIR attribute
Description: complete | error | partial
FHIR Version: stu3
Attribute Type : CodeableConcept
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"outcome": {
"coding": [
{
"code": "complete",
"system": "http://hl7.org/fhir/remittance-outcome"
}
]
}Learn more about the (ExplanationOfBenefit) outcome FHIR attribute
Description: Disposition Message
FHIR Version: stu3
Attribute Type : string
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"disposition": "Claim settled as per contract."Learn more about the (ExplanationOfBenefit) disposition FHIR attribute
Description: Payment (if paid)
FHIR Version: stu3
Attribute Type : Data Type
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"payment": Learn more about the (ExplanationOfBenefit) payment FHIR attribute
Description: Period unable to work
FHIR Version: stu3
Attribute Type : Period
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"employmentImpacted": Learn more about the (ExplanationOfBenefit) employmentImpacted FHIR attribute
Description: Details of an accident
FHIR Version: stu3
Attribute Type : Data Type
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"accident": Learn more about the (ExplanationOfBenefit) accident FHIR attribute
Description: Prescription authorizing services or products
FHIR Version: stu3
Attribute Type : Reference
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"prescription": Learn more about the (ExplanationOfBenefit) prescription FHIR attribute
Description: Treatment Referral
FHIR Version: stu3
Attribute Type : Reference
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"referral": Learn more about the (ExplanationOfBenefit) referral FHIR attribute
Description: Creation date
FHIR Version: stu3
Attribute Type : dateTime
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"created": "2014-08-16"Learn more about the (ExplanationOfBenefit) created FHIR attribute
Description: Total benefit payable for the Claim
FHIR Version: stu3
Attribute Type : Money
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"totalBenefit": {
"code": "USD",
"system": "urn:iso:std:iso:4217",
"value": 96
}Learn more about the (ExplanationOfBenefit) totalBenefit FHIR attribute
Description: Unallocated deductable
FHIR Version: stu3
Attribute Type : Money
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"unallocDeductable": Learn more about the (ExplanationOfBenefit) unallocDeductable FHIR attribute
Description: Goods and Services
FHIR Version: stu3
Attribute Type : Data Type
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"item": [
{
"service": {
"coding": [
{
"code": "1200",
"system": "http://hl7.org/fhir/service-uscls"
}
]
},
"sequence": 1,
"servicedDate": "2014-08-16",
"careTeamLinkId": [
1
],
"net": {
"code": "USD",
"system": "urn:iso:std:iso:4217",
"value": 135.57
},
"adjudication": [
{
"category": {
"coding": [
{
"code": "eligible"
}
]
},
"amount": {
"code": "USD",
"system": "urn:iso:std:iso:4217",
"value": 120
}
},
{
"category": {
"coding": [
{
"code": "eligpercent"
}
]
},
"value": 0.8
},
{
"category": {
"coding": [
{
"code": "benefit"
}
]
},
"amount": {
"code": "USD",
"system": "urn:iso:std:iso:4217",
"value": 96
}
}
],
"unitPrice": {
"code": "USD",
"system": "urn:iso:std:iso:4217",
"value": 135.57
},
"encounter": [
{
"reference": "Encounter/example"
}
]
}
]Learn more about the (ExplanationOfBenefit) item FHIR attribute
Description: Finer grained claim type information
FHIR Version: stu3
Attribute Type : CodeableConcept
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"subType": Learn more about the (ExplanationOfBenefit) subType FHIR attribute
Description: List of Diagnosis
FHIR Version: stu3
Attribute Type : Data Type
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"diagnosis": Learn more about the (ExplanationOfBenefit) diagnosis FHIR attribute
Description: Care Team members
FHIR Version: stu3
Attribute Type : Data Type
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"careTeam": [
{
"provider": {
"reference": "Practitioner/example"
},
"sequence": 1
}
]Learn more about the (ExplanationOfBenefit) careTeam FHIR attribute
Description: Responsible organization for the claim
FHIR Version: stu3
Attribute Type : Reference
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"organization": {
"reference": "Organization/2"
}Learn more about the (ExplanationOfBenefit) organization FHIR attribute
Description: Business Identifier
FHIR Version: stu3
Attribute Type : Identifier
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"identifier": [
{
"system": "http://www.BenefitsInc.com/fhir/explanationofbenefit",
"value": "987654321"
}
]Learn more about the (ExplanationOfBenefit) identifier FHIR attribute
Description: Procedures performed
FHIR Version: stu3
Attribute Type : Data Type
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"procedure": Learn more about the (ExplanationOfBenefit) procedure FHIR attribute
