API end point: https://nchess.careevolution.com/WebClient/api/Clover-PostData.

Resource ExplanationOfBenefit (STU3)

Maps CareEvolution Claim and contained Medication concepts with a Claim DataSource code containing the value 'ExplanationOfBenefit'

• 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

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

From FHIR mappings

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

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