API end point: https://clover.careevolution.com/WebClient/api/fhir-r4.
Maps CareEvolution Claim and contained Medication concepts
Supports multiple sorts
| FHIR | CareEvolution | |
|---|---|---|
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount | Claim.TotalCoinsuranceAmount | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount | Claim.TotalPatientResponsibleAmount | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount | Claim.TotalNotCoveredAmount | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount | Claim.TotalPatientPaid | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount | Claim.TotalHsaPaidAmount | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount | Claim.TotalPaid | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|adjustmentreason).reason
Bindings: https://x12.org/codes/remittance-advice-remark-codes https://x12.org/codes/claim-adjustment-reason-codes |
Claim.NonPaymentReason
Domain: NonPaymentReason |
|
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|benefitpaymentstatus).reason
Bindings: ValueSet-C4BBPayerBenefitPaymentStatus |
Claim.InNetwork | |
| adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount | Claim.TotalAllowed | |
| adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount | Claim.TotalCopayAmount | |
| adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount | Claim.TotalDeductibleAmount | |
| adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount | Claim.TotalCharges | |
| billablePeriod | Claim.StartDate | |
| Claim.EndDate | ||
| careTeam.provider | Claim.CaregiverRelationships.CaregiverID | Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider |
| Claim.Services.CaregiverRelationships.CaregiverID | ||
| careTeam.responsible | Claim.CaregiverRelationships.Responsible | Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider |
| Claim.Services.CaregiverRelationships.Responsible | ||
| careTeam.role
Bindings: ValueSet-C4BBClaimInstitutionalCareTeamRole |
Claim.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType |
Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider |
|
Claim.Services.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType |
||
| created | Claim.CreatedDate | |
| Claim.AdjudicationDate | ||
| 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.Term
Domain: DiagnosisCode |
|
| diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate') | Claim.Problems.Date | |
| diagnosis.extension('http://careevolution.com/fhirextensions#derived') | Claim.Problems.ID | |
| diagnosis.onAdmission |
Claim.Problems.OnAdmission
Domain: DiagnosisStatusOnAdmission |
|
| diagnosis.sequence | Claim.Problems.Sequence | |
| diagnosis.type
Bindings: CodeSystem-C4BBClaimDiagnosisType |
Claim.Problems.Type
Domain: DiagnosisType |
|
| disposition | Claim.Property('FHIRExplanationOfBenefitDisposition') | |
| extension('http://careevolution.com/fhirextensions#dataSource') | Claim.DataSource | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-adjudicationDate') | Claim.AdjudicationDate | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-claimRevision') | Claim.Revision | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-controlNumber') | Claim.ControlNumber | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-disposition') |
Claim.Disposition
Domain: ClaimDisposition |
|
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-encounterID') | Claim.EncounterID | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-mrn') | Claim.Mrn | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-referralReference') | Claim.ReferralID | |
| extension('http://careevolution.com/fhirextensions#properties') | Claim.Properties | |
| facility.identifier | Claim.Property('FacilityNpi') | |
| identifier | Claim.Identifier | |
| Claim.AlternateIdentifier | ||
| insurance.coverage | Claim.InsuranceID | |
| Claim.InsuranceIdentifier | ||
| insurer | Claim.InsuranceID | |
| Claim.InsuranceIdentifier | ||
| item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount | Claim.Services.CoinsuranceAmount | |
| item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount | Claim.Services.PatientResponsibleAmount | |
| item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount | Claim.Services.NotCoveredAmount | |
| item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount | Claim.Services.PatientPaid | |
| item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount | Claim.Services.HsaPaidAmount | |
| item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount | Medications.AmountPaid | |
| Claim.Services.AmountPaid | ||
| item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|adjustmentreason).reason
Bindings: https://x12.org/codes/remittance-advice-remark-codes https://x12.org/codes/claim-adjustment-reason-codes |
Claim.Services.NonPaymentReason
Domain: NonPaymentReason |
|
| item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount | Claim.Services.AllowedAmount | |
| item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount | Claim.Services.CopayAmount | |
| item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount | Claim.Services.DeductibleAmount | |
| item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount | Medications.AmountBilled | |
| Claim.Services.AmountClaimed | ||
| item.detail.productOrService.coding.display | Medications.Comment | |
| item.encounter | Medications.EncounterID | |
| item.extension('http://careevolution.com/fhirextensions#dataSource') | Medications.DataSource | |
| item.extension('http://careevolution.com/fhirextensions#derived') | Medications.ID | |
| Claim.Services.ID | ||
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-alternateIdentifier') | Medications.AlternateIdentifier | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-caregiverReference') | Medications.CaregiverID | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-comment') | Claim.Services.Comment | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-dose') | Medications.Dose | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-doseUnits')
Bindings: http://unitsofmeasure.org |
Medications.DoseUnits
Domain: MedicationProfileDoseUnits |
|
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-filledBy') | Medications.FilledByID | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-frequency') |
Medications.Frequency
Domain: MedicationProfileFrequency |
|
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-isGeneric') | Medications.IsGeneric | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-prescribedDate') | Medications.PrescribedDate | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-problems')
Bindings: http://snomed.info/sct http://hl7.org/fhir/sid/icd-10-cm http://hl7.org/fhir/sid/icd-9-cm |
Claim.Services.Problem1
Domain: DiagnosisCode |
|
|
Claim.Services.Problem2
Domain: DiagnosisCode |
||
|
Claim.Services.Problem3
Domain: DiagnosisCode |
||
|
Claim.Services.Problem4
Domain: DiagnosisCode |
||
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-reconcileStatus') |
Medications.ReconcileStatus
Domain: ReconcileStatus |
|
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-refills') | Medications.Refills | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-status') |
Medications.Status
Domain: MedicationStatus |
|
|
Claim.Services.Status
Domain: ClaimServiceStatus |
||
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-strength') | Medications.Strength | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-therapeuticClass') |
Medications.TherapeuticClass
Domain: TherapeuticClass |
|
| item.extension('http://careevolution.com/fhirextensions#properties') | Medications.Properties | |
| Claim.Services.Properties | ||
| item.location
Bindings: https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set http://terminology.hl7.org/CodeSystem/v3-ActCode https://rosetta.careevolution.com/UBFacilityType |
Claim.Services.LocationType
Domain: ServiceLocation |
|
| item.modifier
Bindings: https://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.net | Medications.AmountBilled | |
| Claim.Services.AmountClaimed | ||
| item.productOrService
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.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 |
Medications.Term
Domain: MedicationType |
|
|
Claim.Services.ServiceCode
Domain: ServiceCode |
||
| item.quantity
Bindings: http://unitsofmeasure.org |
Medications.Quantity | |
|
Medications.Units
Domain: MedicationUnits |
||
|
Medications.Term
Domain: MedicationType |
||
| Claim.Services.Units | ||
| item.revenue
Bindings: https://www.nubc.org/CodeSystem/RevenueCodes |
Claim.Services.RevenueCode
Domain: RevenueCode |
|
| item.sequence | Medications.Identifier | |
| Medications.Sequence | ||
| Claim.Services.Sequence | ||
| item.serviced | Medications.Date | |
| Claim.Services.StartDate | ||
| Claim.Services.EndDate | ||
| patient | Claim.PatientID | |
| payee | Claim.CaregiverRelationships | Maps CaregiverRelationships with RelationshipType=PayToProvider |
| payment.amount | Claim.TotalPaid | |
| payment.date | Claim.PaidDate | |
| payment.type
Bindings: ValueSet-C4BBPayerClaimPaymentStatusCode |
Claim.Status | |
| preAuthRef | Claim.AuthorizationNumber | |
| priority |
Claim.Priority
Domain: ClaimPriority |
|
|
Claim.PriorityAlternateTerms
Domain: ClaimPriority |
||
| Claim.PriorityText | ||
| procedure.date | Claim.Procedures.Date | |
| procedure.extension('http://careevolution.com/fhirextensions#derived') | Claim.Procedures.ID | |
| 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.Term
Domain: ProcedureCode |
|
| procedure.sequence | Claim.Procedures.Sequence | |
| procedure.type
Bindings: ValueSet-C4BBClaimProcedureType |
Claim.Procedures.Type
Domain: ProcedureType |
|
| provider | Claim.CaregiverRelationships | Maps CaregiverRelationships with RelationshipType=ClaimProvider |
| related | Claim.Property('OriginalClaimNumber') | |
| status
Bindings: valueset-explanationofbenefit-status |
Claim.Status
Domain: ClaimStatus |
|
| supportingInfo(category=http://careevolution.com/fhir/SupportingInfo|placeofservice).code
Bindings: https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set http://terminology.hl7.org/CodeSystem/v3-ActCode https://rosetta.careevolution.com/UBFacilityType |
Claim.FacilityType
Domain: FacilityType |
|
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admissionperiod).timing | Claim.AdmitDate | |
| Claim.DischargeDate | ||
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admtype).code
Bindings: https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set https://rosetta.careevolution.com/UBFacilityType http://terminology.hl7.org/CodeSystem/v3-ActCode |
Claim.AdmitType
Domain: AdmissionType |
|
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|dawcode).code |
Medications.DawCode
Domain: DispenseAsWritten |
|
| Medications.DispenseAsWritten | ||
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|dayssupply).value | Medications.DaysSupplied | |
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|discharge-status).code |
Claim.PatientStatus
Domain: PatientStatus |
|
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|drg).code
Bindings: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software |
Claim.Drg
Domain: ClaimDrg |
|
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|pointoforigin).code
Bindings: https://www.nubc.org/CodeSystem/PointOfOrigin https://www.nubc.org/CodeSystem/PointOfOriginNewBorn |
Claim.AdmitSource
Domain: AdmitSource |
|
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|refillnum).value | Medications.RefillNumber | |
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|refillsauthorized).value | Medications.Refills | |
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|typeofbill).code
Bindings: https://www.nubc.org/CodeSystem/TypeOfBill |
Claim.BillClass
Domain: BillClass |
|
| supportingInfo.category
Bindings: ValueSet-C4BBSupportingInfoType |
Claim.ClaimSupportingInformation.Type
Domain: SupportingInformationType |
|
| supportingInfo.code |
Claim.ClaimSupportingInformation.Term
Domain: SupportingInformationCode |
|
| supportingInfo.reason |
Claim.ClaimSupportingInformation.Reason
Domain: SupportingInformationReason |
|
| supportingInfo.sequence | Claim.ClaimSupportingInformation.Sequence | |
| supportingInfo.timing | Claim.ClaimSupportingInformation.StartDate | |
| Claim.ClaimSupportingInformation.EndDate | ||
| supportingInfo.value | Claim.ClaimSupportingInformation.Value | |
| text | Claim.Comment | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount | Claim.TotalCoinsuranceAmount | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount | Claim.TotalPatientResponsibleAmount | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount | Claim.TotalNotCoveredAmount | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount | Claim.TotalPatientPaid | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount | Claim.TotalHsaPaidAmount | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount | Claim.TotalPaid | |
| total(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount | Claim.TotalAllowed | |
| total(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount | Claim.TotalCopayAmount | |
| total(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount | Claim.TotalDeductibleAmount | |
| total(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount | Claim.TotalCharges | |
| total.category
Bindings: ValueSet-C4BBPayerBenefitPaymentStatus |
Claim.InNetwork | |
| type
Bindings: valueset-claim-type |
Claim.ClaimType
Domain: ClaimType |
| FHIR | CareEvolution | |
|---|---|---|
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount | Claim.TotalCoinsuranceAmount | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount | Claim.TotalPatientResponsibleAmount | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount | Claim.TotalNotCoveredAmount | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount | Claim.TotalPatientPaid | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount | Claim.TotalHsaPaidAmount | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount | Claim.TotalPaid | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|adjustmentreason).reason
Bindings: https://x12.org/codes/remittance-advice-remark-codes https://x12.org/codes/claim-adjustment-reason-codes |
Claim.NonPaymentReason
Domain: NonPaymentReason |
|
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|benefitpaymentstatus).reason
Bindings: ValueSet-C4BBPayerBenefitPaymentStatus |
Claim.InNetwork | |
| adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount | Claim.TotalAllowed | |
| adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount | Claim.TotalCopayAmount | |
| adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount | Claim.TotalDeductibleAmount | |
| adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount | Claim.TotalCharges | |
| benefitBalance.financial.used | Claim.Properties | |
| billablePeriod | Claim.StartDate | |
| Claim.EndDate | ||
| careTeam.provider | Claim.CaregiverRelationships.CaregiverID | |
| Claim.Services.CaregiverRelationships.CaregiverID | ||
| careTeam.responsible | Claim.CaregiverRelationships.Responsible | |
| Claim.Services.CaregiverRelationships.Responsible | ||
| careTeam.role
Bindings: ValueSet-C4BBClaimInstitutionalCareTeamRole |
Claim.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType |
|
|
Claim.Services.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType |
||
| created | Claim.CreatedDate | |
| 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.Term
Domain: DiagnosisCode |
|
| diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate') | Claim.Problems.Date | |
| diagnosis.onAdmission |
Claim.Problems.OnAdmission
Domain: DiagnosisStatusOnAdmission |
|
| diagnosis.sequence | Claim.Problems.Sequence | |
| diagnosis.type
Bindings: CodeSystem-C4BBClaimDiagnosisType |
Claim.Problems.Type
Domain: DiagnosisType |
|
| disposition | Claim.Property('FHIRExplanationOfBenefitDisposition') | |
| extension | Claim.Properties | |
| extension('http://careevolution.com/fhirextensions#dataSource') | Claim.DataSource | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-adjudicationDate') | Claim.AdjudicationDate | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-claimRevision') | Claim.Revision | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-controlNumber') | Claim.ControlNumber | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-disposition') |
Claim.Disposition
Domain: ClaimDisposition |
|
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-encounterID') | Claim.EncounterID | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-mrn') | Claim.Mrn | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-referralReference') | Claim.ReferralID | |
| extension('http://careevolution.com/fhirextensions#properties') | Claim.Properties | |
| facility.identifier | Claim.Property('FacilityNpi') | |
| id | Claim.Identifier | |
| identifier | Claim.Identifier | |
| Claim.AlternateIdentifier | ||
| insurance.coverage | Claim.InsuranceID | |
| Claim.InsuranceIdentifier | ||
| insurer | Claim.InsuranceID | |
| Claim.InsuranceIdentifier | ||
| item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount | Claim.Services.CoinsuranceAmount | |
| item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount | Claim.Services.PatientResponsibleAmount | |
| item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount | Claim.Services.NotCoveredAmount | |
| item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount | Claim.Services.PatientPaid | |
| item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount | Claim.Services.HsaPaidAmount | |
| item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount | Medications.AmountPaid | |
| Claim.Services.AmountPaid | ||
| item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|adjustmentreason).reason
Bindings: https://x12.org/codes/remittance-advice-remark-codes https://x12.org/codes/claim-adjustment-reason-codes |
Claim.Services.NonPaymentReason
Domain: NonPaymentReason |
|
| item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount | Claim.Services.AllowedAmount | |
| item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount | Claim.Services.CopayAmount | |
| item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount | Claim.Services.DeductibleAmount | |
| item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount | Medications.AmountBilled | |
| Claim.Services.AmountClaimed | ||
| item.detail.productOrService.coding.display | Medications.Comment | |
| item.encounter | Medications.EncounterID | |
| item.extension | Claim.Services.Properties | |
| item.extension('http://careevolution.com/fhirextensions#dataSource') | Medications.DataSource | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-alternateIdentifier') | Medications.AlternateIdentifier | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-caregiverReference') | Medications.CaregiverID | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-comment') | Claim.Services.Comment | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-dose') | Medications.Dose | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-doseUnits')
Bindings: http://unitsofmeasure.org |
Medications.DoseUnits
Domain: MedicationProfileDoseUnits |
|
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-filledBy') | Medications.FilledByID | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-frequency') |
Medications.Frequency
Domain: MedicationProfileFrequency |
|
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-isGeneric') | Medications.IsGeneric | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-prescribedDate') | Medications.PrescribedDate | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-problems')
Bindings: http://snomed.info/sct http://hl7.org/fhir/sid/icd-10-cm http://hl7.org/fhir/sid/icd-9-cm |
Claim.Services.Problem1
Domain: DiagnosisCode |
|
|
Claim.Services.Problem2
Domain: DiagnosisCode |
||
|
Claim.Services.Problem3
Domain: DiagnosisCode |
||
|
Claim.Services.Problem4
Domain: DiagnosisCode |
||
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-reconcileStatus') |
Medications.ReconcileStatus
Domain: ReconcileStatus |
|
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-refills') | Medications.Refills | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-status') |
Medications.Status
Domain: MedicationStatus |
|
|
Claim.Services.Status
Domain: ClaimServiceStatus |
||
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-strength') | Medications.Strength | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-therapeuticClass') |
Medications.TherapeuticClass
Domain: TherapeuticClass |
|
| item.extension('http://careevolution.com/fhirextensions#properties') | Medications.Properties | |
| Claim.Services.Properties | ||
| item.location
Bindings: https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set http://terminology.hl7.org/CodeSystem/v3-ActCode https://rosetta.careevolution.com/UBFacilityType |
Claim.Services.LocationType
Domain: ServiceLocation |
|
| item.modifier
Bindings: https://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.net | Medications.AmountBilled | |
| Claim.Services.AmountClaimed | ||
| item.productOrService
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.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 |
Medications.Term
Domain: MedicationType |
|
|
Claim.Services.ServiceCode
Domain: ServiceCode |
||
| item.quantity
Bindings: http://unitsofmeasure.org |
Medications.Quantity | |
|
Medications.Units
Domain: MedicationUnits |
||
| Claim.Services.Units | ||
| item.revenue
Bindings: https://www.nubc.org/CodeSystem/RevenueCodes |
Claim.Services.RevenueCode
Domain: RevenueCode |
|
| item.sequence | Medications.Identifier | |
| Medications.Sequence | ||
| Claim.Services.Sequence | ||
| item.serviced | Medications.Date | |
| Claim.Services.StartDate | ||
| Claim.Services.EndDate | ||
| patient | Claim.PatientID | |
| payee | Claim.CaregiverRelationships | Maps CaregiverRelationships with RelationshipType=PayToProvider |
| payment.amount | Claim.TotalPaid | |
| payment.date | Claim.PaidDate | |
| preAuthRef | Claim.AuthorizationNumber | |
| priority |
Claim.Priority
Domain: ClaimPriority |
|
|
Claim.PriorityAlternateTerms
Domain: ClaimPriority |
||
| Claim.PriorityText | ||
| procedure.date | Claim.Procedures.Date | |
| 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.Term
Domain: ProcedureCode |
|
| procedure.sequence | Claim.Procedures.Sequence | |
| procedure.type
Bindings: ValueSet-C4BBClaimProcedureType |
Claim.Procedures.Type
Domain: ProcedureType |
|
| provider | Claim.CaregiverRelationships | Maps CaregiverRelationships with RelationshipType=ClaimProvider |
| related | Claim.Property('OriginalClaimNumber') | |
| status
Bindings: valueset-explanationofbenefit-status |
Claim.Status
Domain: ClaimStatus |
|
| supportingInfo(category=http://careevolution.com/fhir/SupportingInfo|placeofservice).code
Bindings: https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set http://terminology.hl7.org/CodeSystem/v3-ActCode https://rosetta.careevolution.com/UBFacilityType |
Claim.FacilityType
Domain: FacilityType |
|
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admissionperiod).timing | Claim.AdmitDate | |
| Claim.DischargeDate | ||
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admtype).code
Bindings: https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set https://rosetta.careevolution.com/UBFacilityType http://terminology.hl7.org/CodeSystem/v3-ActCode |
Claim.AdmitType
Domain: AdmissionType |
|
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|dawcode).code |
Medications.DawCode
Domain: DispenseAsWritten |
|
| Medications.DispenseAsWritten | ||
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|dayssupply).value | Medications.DaysSupplied | |
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|discharge-status).code |
Claim.PatientStatus
Domain: PatientStatus |
|
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|drg).code
Bindings: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software |
Claim.Drg
Domain: ClaimDrg |
|
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|pointoforigin).code
Bindings: https://www.nubc.org/CodeSystem/PointOfOrigin https://www.nubc.org/CodeSystem/PointOfOriginNewBorn |
Claim.AdmitSource
Domain: AdmitSource |
|
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|refillnum).value | Medications.RefillNumber | |
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|refillsauthorized).value | Medications.Refills | |
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|typeofbill).code
Bindings: https://www.nubc.org/CodeSystem/TypeOfBill |
Claim.BillClass
Domain: BillClass |
|
| supportingInfo.category
Bindings: ValueSet-C4BBSupportingInfoType |
Claim.ClaimSupportingInformation.Type
Domain: SupportingInformationType |
|
| supportingInfo.code |
Claim.ClaimSupportingInformation.Term
Domain: SupportingInformationCode |
|
| supportingInfo.reason |
Claim.ClaimSupportingInformation.Reason
Domain: SupportingInformationReason |
|
| supportingInfo.sequence | Claim.ClaimSupportingInformation.Sequence | |
| supportingInfo.timing | Claim.ClaimSupportingInformation.StartDate | |
| Claim.ClaimSupportingInformation.EndDate | ||
| supportingInfo.value | Claim.ClaimSupportingInformation.Value | |
| text | Claim.Comment | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount | Claim.TotalCoinsuranceAmount | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount | Claim.TotalPatientResponsibleAmount | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount | Claim.TotalNotCoveredAmount | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount | Claim.TotalPatientPaid | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount | Claim.TotalHsaPaidAmount | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount | Claim.TotalPaid | |
| total(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount | Claim.TotalAllowed | |
| total(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount | Claim.TotalCopayAmount | |
| total(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount | Claim.TotalDeductibleAmount | |
| total(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount | Claim.TotalCharges | |
| total.category
Bindings: ValueSet-C4BBPayerBenefitPaymentStatus |
Claim.InNetwork | |
| type
Bindings: valueset-claim-type |
Claim.ClaimType
Domain: ClaimType |
| FHIR | CareEvolution | |
|---|---|---|
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount | Claim.TotalCoinsuranceAmount | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount | Claim.TotalPatientResponsibleAmount | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount | Claim.TotalNotCoveredAmount | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount | Claim.TotalPatientPaid | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount | Claim.TotalHsaPaidAmount | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount | Claim.TotalPaid | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|benefitpaymentstatus).reason
Bindings: ValueSet-C4BBPayerBenefitPaymentStatus |
Claim.InNetwork | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|denialreason).reason
Bindings: https://x12.org/codes/remittance-advice-remark-codes https://x12.org/codes/claim-adjustment-reason-codes |
Claim.NonPaymentReason
Domain: NonPaymentReason |
|
| adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount | Claim.TotalAllowed | |
| adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount | Claim.TotalCopayAmount | |
| adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount | Claim.TotalDeductibleAmount | |
| adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount | Claim.TotalCharges | |
| billablePeriod | Claim.StartDate | |
| Claim.EndDate | ||
| careTeam.provider | Claim.CaregiverRelationships.CaregiverID | Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider |
| Claim.Services.CaregiverRelationships.CaregiverID | ||
| careTeam.responsible | Claim.CaregiverRelationships.Responsible | Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider |
| Claim.Services.CaregiverRelationships.Responsible | ||
| careTeam.role
Bindings: ValueSet-C4BBClaimInstitutionalCareTeamRole |
Claim.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType |
Excludes CaregiverRelationships with RelationshipType equal to ClaimProvider or PayToProvider |
|
Claim.Services.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType |
||
| created | Claim.CreatedDate | |
| Claim.AdjudicationDate | ||
| 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.Term
Domain: DiagnosisCode |
|
| diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate') | Claim.Problems.Date | |
| diagnosis.extension('http://careevolution.com/fhirextensions#derived') | Claim.Problems.ID | |
| diagnosis.onAdmission |
Claim.Problems.OnAdmission
Domain: DiagnosisStatusOnAdmission |
|
| diagnosis.sequence | Claim.Problems.Sequence | |
| diagnosis.type
Bindings: CodeSystem-C4BBClaimDiagnosisType |
Claim.Problems.Type
Domain: DiagnosisType |
|
| disposition | Claim.Property('FHIRExplanationOfBenefitDisposition') | |
| extension('http://careevolution.com/fhirextensions#dataSource') | Claim.DataSource | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-adjudicationDate') | Claim.AdjudicationDate | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-claimRevision') | Claim.Revision | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-controlNumber') | Claim.ControlNumber | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-disposition') |
Claim.Disposition
Domain: ClaimDisposition |
|
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-encounterID') | Claim.EncounterID | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-mrn') | Claim.Mrn | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-referralReference') | Claim.ReferralID | |
| extension('http://careevolution.com/fhirextensions#properties') | Claim.Properties | |
| facility.identifier | Claim.Property('FacilityNpi') | |
| identifier | Claim.Identifier | |
| Claim.AlternateIdentifier | ||
| insurance.coverage | Claim.InsuranceID | |
| Claim.InsuranceIdentifier | ||
| insurer | Claim.InsuranceID | |
| Claim.InsuranceIdentifier | ||
| item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount | Medications.AmountPaid | |
| item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount | Medications.AmountBilled | |
| item.detail.productOrService.coding.display | Medications.Comment | |
| item.encounter | Medications.EncounterID | |
| item.extension('http://careevolution.com/fhirextensions#dataSource') | Medications.DataSource | |
| item.extension('http://careevolution.com/fhirextensions#derived') | Medications.ID | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-alternateIdentifier') | Medications.AlternateIdentifier | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-caregiverReference') | Medications.CaregiverID | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-dose') | Medications.Dose | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-doseUnits')
Bindings: http://unitsofmeasure.org |
Medications.DoseUnits
Domain: MedicationProfileDoseUnits |
|
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-filledBy') | Medications.FilledByID | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-frequency') |
Medications.Frequency
Domain: MedicationProfileFrequency |
|
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-isGeneric') | Medications.IsGeneric | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-prescribedDate') | Medications.PrescribedDate | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-reconcileStatus') |
Medications.ReconcileStatus
Domain: ReconcileStatus |
|
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-refills') | Medications.Refills | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-status') |
Medications.Status
Domain: MedicationStatus |
|
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-strength') | Medications.Strength | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-therapeuticClass') |
Medications.TherapeuticClass
Domain: TherapeuticClass |
|
| item.extension('http://careevolution.com/fhirextensions#properties') | Medications.Properties | |
| item.net | Medications.AmountBilled | |
| item.productOrService
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.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 |
Medications.Term
Domain: MedicationType |
|
| item.quantity
Bindings: http://unitsofmeasure.org |
Medications.Quantity | |
|
Medications.Units
Domain: MedicationUnits |
||
|
Medications.Term
Domain: MedicationType |
||
| item.sequence | Medications.Identifier | |
| Medications.Sequence | ||
| item.serviced | Medications.Date | |
| patient | Claim.PatientID | |
| payee | Claim.CaregiverRelationships | Maps CaregiverRelationships with RelationshipType=PayToProvider |
| payment.amount | Claim.TotalPaid | |
| payment.date | Claim.PaidDate | |
| payment.type
Bindings: ValueSet-C4BBPayerClaimPaymentStatusCode |
Claim.Status | |
| preAuthRef | Claim.AuthorizationNumber | |
| priority |
Claim.Priority
Domain: ClaimPriority |
|
|
Claim.PriorityAlternateTerms
Domain: ClaimPriority |
||
| Claim.PriorityText | ||
| procedure.date | Claim.Procedures.Date | |
| procedure.extension('http://careevolution.com/fhirextensions#derived') | Claim.Procedures.ID | |
| 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.Term
Domain: ProcedureCode |
|
| procedure.sequence | Claim.Procedures.Sequence | |
| procedure.type
Bindings: ValueSet-C4BBClaimProcedureType |
Claim.Procedures.Type
Domain: ProcedureType |
|
| provider | Claim.CaregiverRelationships | Maps CaregiverRelationships with RelationshipType=ClaimProvider |
| related | Claim.Property('OriginalClaimNumber') | |
| status
Bindings: valueset-explanationofbenefit-status |
Claim.Status
Domain: ClaimStatus |
|
| supportingInfo(category=http://careevolution.com/fhir/SupportingInfo|placeofservice).code
Bindings: https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set http://terminology.hl7.org/CodeSystem/v3-ActCode https://rosetta.careevolution.com/UBFacilityType |
Claim.FacilityType
Domain: FacilityType |
|
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admissionperiod).timing | Claim.AdmitDate | |
| Claim.DischargeDate | ||
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admtype).code
Bindings: https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set https://rosetta.careevolution.com/UBFacilityType http://terminology.hl7.org/CodeSystem/v3-ActCode |
Claim.AdmitType
Domain: AdmissionType |
|
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|dawcode).code |
Medications.DawCode
Domain: DispenseAsWritten |
|
| Medications.DispenseAsWritten | ||
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|dayssupply).value | Medications.DaysSupplied | |
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|discharge-status).code |
Claim.PatientStatus
Domain: PatientStatus |
|
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|drg).code
Bindings: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software |
Claim.Drg
Domain: ClaimDrg |
|
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|pointoforigin).code
Bindings: https://www.nubc.org/CodeSystem/PointOfOrigin https://www.nubc.org/CodeSystem/PointOfOriginNewBorn |
Claim.AdmitSource
Domain: AdmitSource |
|
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|refillnum).value | Medications.RefillNumber | |
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|refillsauthorized).value | Medications.Refills | |
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|typeofbill).code
Bindings: https://www.nubc.org/CodeSystem/TypeOfBill |
Claim.BillClass
Domain: BillClass |
|
| supportingInfo.category
Bindings: ValueSet-C4BBSupportingInfoType |
Claim.ClaimSupportingInformation.Type
Domain: SupportingInformationType |
|
| supportingInfo.code |
Claim.ClaimSupportingInformation.Term
Domain: SupportingInformationCode |
|
| supportingInfo.reason |
Claim.ClaimSupportingInformation.Reason
Domain: SupportingInformationReason |
|
| supportingInfo.sequence | Claim.ClaimSupportingInformation.Sequence | |
| supportingInfo.timing | Claim.ClaimSupportingInformation.StartDate | |
| Claim.ClaimSupportingInformation.EndDate | ||
| supportingInfo.value | Claim.ClaimSupportingInformation.Value | |
| text | Claim.Comment | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount | Claim.TotalCoinsuranceAmount | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount | Claim.TotalPatientResponsibleAmount | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount | Claim.TotalNotCoveredAmount | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount | Claim.TotalPatientPaid | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount | Claim.TotalHsaPaidAmount | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount | Claim.TotalPaid | |
| total(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount | Claim.TotalAllowed | |
| total(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount | Claim.TotalCopayAmount | |
| total(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount | Claim.TotalDeductibleAmount | |
| total(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount | Claim.TotalCharges | |
| total.category
Bindings: ValueSet-C4BBPayerBenefitPaymentStatus |
Claim.InNetwork | |
| type
Bindings: valueset-claim-type |
Claim.ClaimType
Domain: ClaimType |
| FHIR | CareEvolution | |
|---|---|---|
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount | Claim.TotalCoinsuranceAmount | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount | Claim.TotalPatientResponsibleAmount | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount | Claim.TotalNotCoveredAmount | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount | Claim.TotalPatientPaid | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount | Claim.TotalHsaPaidAmount | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount | Claim.TotalPaid | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|benefitpaymentstatus).reason
Bindings: ValueSet-C4BBPayerBenefitPaymentStatus |
Claim.InNetwork | |
| adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator|denialreason).reason
Bindings: https://x12.org/codes/remittance-advice-remark-codes https://x12.org/codes/claim-adjustment-reason-codes |
Claim.NonPaymentReason
Domain: NonPaymentReason |
|
| adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount | Claim.TotalAllowed | |
| adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount | Claim.TotalCopayAmount | |
| adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount | Claim.TotalDeductibleAmount | |
| adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount | Claim.TotalCharges | |
| benefitBalance.financial.used | Claim.Properties | |
| billablePeriod | Claim.StartDate | |
| Claim.EndDate | ||
| careTeam.provider | Claim.CaregiverRelationships.CaregiverID | |
| Claim.Services.CaregiverRelationships.CaregiverID | ||
| careTeam.responsible | Claim.CaregiverRelationships.Responsible | |
| Claim.Services.CaregiverRelationships.Responsible | ||
| careTeam.role
Bindings: ValueSet-C4BBClaimInstitutionalCareTeamRole |
Claim.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType |
|
|
Claim.Services.CaregiverRelationships.RelationshipType
Domain: CaregiverRelationshipType |
||
| created | Claim.CreatedDate | |
| 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.Term
Domain: DiagnosisCode |
|
| diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate') | Claim.Problems.Date | |
| diagnosis.onAdmission |
Claim.Problems.OnAdmission
Domain: DiagnosisStatusOnAdmission |
|
| diagnosis.sequence | Claim.Problems.Sequence | |
| diagnosis.type
Bindings: CodeSystem-C4BBClaimDiagnosisType |
Claim.Problems.Type
Domain: DiagnosisType |
|
| disposition | Claim.Property('FHIRExplanationOfBenefitDisposition') | |
| extension | Claim.Properties | |
| extension('http://careevolution.com/fhirextensions#dataSource') | Claim.DataSource | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-adjudicationDate') | Claim.AdjudicationDate | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-claimRevision') | Claim.Revision | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-controlNumber') | Claim.ControlNumber | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-disposition') |
Claim.Disposition
Domain: ClaimDisposition |
|
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-encounterID') | Claim.EncounterID | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-mrn') | Claim.Mrn | |
| extension('http://careevolution.com/fhirextensions#explanationOfBenefit-referralReference') | Claim.ReferralID | |
| extension('http://careevolution.com/fhirextensions#properties') | Claim.Properties | |
| facility.identifier | Claim.Property('FacilityNpi') | |
| id | Claim.Identifier | |
| identifier | Claim.Identifier | |
| Claim.AlternateIdentifier | ||
| insurance.coverage | Claim.InsuranceID | |
| Claim.InsuranceIdentifier | ||
| insurer | Claim.InsuranceID | |
| Claim.InsuranceIdentifier | ||
| item.adjudication(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount | Medications.AmountPaid | |
| item.adjudication(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount | Medications.AmountBilled | |
| item.detail.productOrService.coding.display | Medications.Comment | |
| item.encounter | Medications.EncounterID | |
| item.extension('http://careevolution.com/fhirextensions#dataSource') | Medications.DataSource | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-alternateIdentifier') | Medications.AlternateIdentifier | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-caregiverReference') | Medications.CaregiverID | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-dose') | Medications.Dose | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-doseUnits')
Bindings: http://unitsofmeasure.org |
Medications.DoseUnits
Domain: MedicationProfileDoseUnits |
|
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-filledBy') | Medications.FilledByID | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-frequency') |
Medications.Frequency
Domain: MedicationProfileFrequency |
|
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-isGeneric') | Medications.IsGeneric | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-prescribedDate') | Medications.PrescribedDate | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-reconcileStatus') |
Medications.ReconcileStatus
Domain: ReconcileStatus |
|
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-refills') | Medications.Refills | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-status') |
Medications.Status
Domain: MedicationStatus |
|
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-strength') | Medications.Strength | |
| item.extension('http://careevolution.com/fhirextensions#explanationOfBenefitItem-therapeuticClass') |
Medications.TherapeuticClass
Domain: TherapeuticClass |
|
| item.extension('http://careevolution.com/fhirextensions#properties') | Medications.Properties | |
| item.net | Medications.AmountBilled | |
| item.productOrService
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.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 |
Medications.Term
Domain: MedicationType |
|
| item.quantity
Bindings: http://unitsofmeasure.org |
Medications.Quantity | |
|
Medications.Units
Domain: MedicationUnits |
||
| item.sequence | Medications.Identifier | |
| Medications.Sequence | ||
| item.serviced | Medications.Date | |
| patient | Claim.PatientID | |
| payee | Claim.CaregiverRelationships | Maps CaregiverRelationships with RelationshipType=PayToProvider |
| payment.amount | Claim.TotalPaid | |
| payment.date | Claim.PaidDate | |
| preAuthRef | Claim.AuthorizationNumber | |
| priority |
Claim.Priority
Domain: ClaimPriority |
|
|
Claim.PriorityAlternateTerms
Domain: ClaimPriority |
||
| Claim.PriorityText | ||
| procedure.date | Claim.Procedures.Date | |
| 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.Term
Domain: ProcedureCode |
|
| procedure.sequence | Claim.Procedures.Sequence | |
| procedure.type
Bindings: ValueSet-C4BBClaimProcedureType |
Claim.Procedures.Type
Domain: ProcedureType |
|
| provider | Claim.CaregiverRelationships | Maps CaregiverRelationships with RelationshipType=ClaimProvider |
| related | Claim.Property('OriginalClaimNumber') | |
| status
Bindings: valueset-explanationofbenefit-status |
Claim.Status
Domain: ClaimStatus |
|
| supportingInfo(category=http://careevolution.com/fhir/SupportingInfo|placeofservice).code
Bindings: https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set http://terminology.hl7.org/CodeSystem/v3-ActCode https://rosetta.careevolution.com/UBFacilityType |
Claim.FacilityType
Domain: FacilityType |
|
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admissionperiod).timing | Claim.AdmitDate | |
| Claim.DischargeDate | ||
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|admtype).code
Bindings: https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set https://rosetta.careevolution.com/UBFacilityType http://terminology.hl7.org/CodeSystem/v3-ActCode |
Claim.AdmitType
Domain: AdmissionType |
|
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|dawcode).code |
Medications.DawCode
Domain: DispenseAsWritten |
|
| Medications.DispenseAsWritten | ||
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|dayssupply).value | Medications.DaysSupplied | |
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|discharge-status).code |
Claim.PatientStatus
Domain: PatientStatus |
|
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|drg).code
Bindings: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software |
Claim.Drg
Domain: ClaimDrg |
|
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|pointoforigin).code
Bindings: https://www.nubc.org/CodeSystem/PointOfOrigin https://www.nubc.org/CodeSystem/PointOfOriginNewBorn |
Claim.AdmitSource
Domain: AdmitSource |
|
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|refillnum).value | Medications.RefillNumber | |
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|refillsauthorized).value | Medications.Refills | |
| supportingInfo(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType|typeofbill).code
Bindings: https://www.nubc.org/CodeSystem/TypeOfBill |
Claim.BillClass
Domain: BillClass |
|
| supportingInfo.category
Bindings: ValueSet-C4BBSupportingInfoType |
Claim.ClaimSupportingInformation.Type
Domain: SupportingInformationType |
|
| supportingInfo.code |
Claim.ClaimSupportingInformation.Term
Domain: SupportingInformationCode |
|
| supportingInfo.reason |
Claim.ClaimSupportingInformation.Reason
Domain: SupportingInformationReason |
|
| supportingInfo.sequence | Claim.ClaimSupportingInformation.Sequence | |
| supportingInfo.timing | Claim.ClaimSupportingInformation.StartDate | |
| Claim.ClaimSupportingInformation.EndDate | ||
| supportingInfo.value | Claim.ClaimSupportingInformation.Value | |
| text | Claim.Comment | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|coinsurance).amount | Claim.TotalCoinsuranceAmount | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|memberliability).amount | Claim.TotalPatientResponsibleAmount | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|noncovered).amount | Claim.TotalNotCoveredAmount | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatient).amount | Claim.TotalPatientPaid | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidbypatienthealthaccount).amount | Claim.TotalHsaPaidAmount | |
| total(category=http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication|paidtoprovider).amount | Claim.TotalPaid | |
| total(category=http://terminology.hl7.org/CodeSystem/adjudication|benefit).amount | Claim.TotalAllowed | |
| total(category=http://terminology.hl7.org/CodeSystem/adjudication|copay).amount | Claim.TotalCopayAmount | |
| total(category=http://terminology.hl7.org/CodeSystem/adjudication|deductible).amount | Claim.TotalDeductibleAmount | |
| total(category=http://terminology.hl7.org/CodeSystem/adjudication|submitted).amount | Claim.TotalCharges | |
| total.category
Bindings: ValueSet-C4BBPayerBenefitPaymentStatus |
Claim.InNetwork | |
| type
Bindings: valueset-claim-type |
Claim.ClaimType
Domain: ClaimType |