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Optum Fhir Explanation Of Benefit Structure
Optum Fhir Explanation Of Benefit Structure
FHIR R4 ExplanationOfBenefit resource representing a claim with adjudication details for UnitedHealth Group members
Type: object
Properties: 0
Healthcare Health Insurance FHIR Claims Interoperability Fortune 100
UnitedHealth Group FHIR ExplanationOfBenefit is a JSON Structure definition published by UnitedHealth Group. It conforms to the https://json-structure.org/meta/core/v0/# meta-schema.
Meta-schema: https://json-structure.org/meta/core/v0/#
JSON Structure
{
"$schema": "https://json-structure.org/meta/core/v0/#",
"$id": "https://raw.githubusercontent.com/api-evangelist/unitedhealth/refs/heads/main/json-structure/optum-fhir-explanation-of-benefit-structure.json",
"name": "UnitedHealth Group FHIR ExplanationOfBenefit",
"type": "object",
"description": "FHIR R4 ExplanationOfBenefit resource representing a claim with adjudication details for UnitedHealth Group members",
"fields": [
{
"name": "resourceType",
"type": "string",
"description": "FHIR resource type",
"enum": [
"ExplanationOfBenefit"
]
},
{
"name": "id",
"type": "string",
"description": "Resource ID"
},
{
"name": "status",
"type": "string",
"description": "EOB status",
"enum": [
"active",
"cancelled",
"draft",
"entered-in-error"
]
},
{
"name": "type",
"type": "object",
"description": "Claim type coding"
},
{
"name": "patient",
"type": "object",
"description": "Reference to Patient"
},
{
"name": "billablePeriod",
"type": "object",
"description": "Service period"
},
{
"name": "created",
"type": "datetime",
"description": "Creation date"
},
{
"name": "provider",
"type": "object",
"description": "Provider reference"
},
{
"name": "insurance",
"type": "array",
"description": "Insurance coverage",
"items": {
"type": "object"
}
},
{
"name": "item",
"type": "array",
"description": "Claim line items",
"items": {
"type": "object"
}
},
{
"name": "total",
"type": "array",
"description": "Adjudication totals",
"items": {
"type": "object"
}
}
]
}