UnitedHealth Group · JSON 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
HealthcareHealth InsuranceFHIRClaimsInteroperabilityFortune 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

Raw ↑
{
  "$schema": "https://json-structure.org/meta/core/v0/#",
  "$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"
      }
    }
  ]
}

Work with this as data

Every JSON Structure here is available over the APIs.io API and to AI agents over MCP.

MCP server

One button, every client — Claude, Cursor, VS Code and the rest.

https://apis.io/mcp

Tools for json structure

4 MCP tools reach this
  • find_json_structuresBrowse and filter every JSON Structure in the catalog.
  • apis_io_searchSTART HERE — APIs, providers and tags for one query, each with its total.
  • resolveTurn a domain, URL or GitHub org into the provider it belongs to.
  • find_cohortsEvery scored population of providers in the catalog.
All 92 tools

Call it yourself

curl for this page
This JSON Structure
curl "https://apis.io/api/v1/json-structures/optum-fhir-explanation-of-benefit-structure"
All json structure
curl "https://apis.io/api/v1/json-structures?limit=25"

Discovery needs no key. Ratings and market analysis are Pro.

Get an API key

Free tier, no email required.

A second provider on the same verified email joins the account you already have.