UnitedHealth Group FHIR ExplanationOfBenefit

{
  "$schema": "https://json-schema.org/draft/2020-12/schema",
  "$id": "https://raw.githubusercontent.com/api-evangelist/unitedhealth/refs/heads/main/json-schema/optum-fhir-explanation-of-benefit-schema.json",
  "title": "UnitedHealth Group FHIR ExplanationOfBenefit",
  "description": "FHIR R4 ExplanationOfBenefit resource representing a claim with adjudication details for UnitedHealth Group members",
  "type": "object",
  "properties": {
    "resourceType": {
      "type": "string",
      "enum": [
        "ExplanationOfBenefit"
      ],
      "description": "FHIR resource type"
    },
    "id": {
      "type": "string",
      "description": "Resource ID"
    },
    "status": {
      "type": "string",
      "enum": [
        "active",
        "cancelled",
        "draft",
        "entered-in-error"
      ],
      "description": "EOB status"
    },
    "type": {
      "type": "object",
      "description": "Claim type coding"
    },
    "patient": {
      "type": "object",
      "description": "Reference to Patient"
    },
    "billablePeriod": {
      "type": "object",
      "description": "Service period",
      "properties": {
        "start": {
          "type": "string",
          "format": "date"
        },
        "end": {
          "type": "string",
          "format": "date"
        }
      }
    },
    "created": {
      "type": "string",
      "format": "date-time",
      "description": "Creation date"
    },
    "provider": {
      "type": "object",
      "description": "Provider reference"
    },
    "insurance": {
      "type": "array",
      "description": "Insurance coverage",
      "items": {
        "type": "object"
      }
    },
    "item": {
      "type": "array",
      "description": "Claim line items",
      "items": {
        "type": "object"
      }
    },
    "total": {
      "type": "array",
      "description": "Adjudication totals",
      "items": {
        "type": "object",
        "properties": {
          "category": {
            "type": "object"
          },
          "amount": {
            "type": "object",
            "properties": {
              "value": {
                "type": "number"
              },
              "currency": {
                "type": "string"
              }
            }
          }
        }
      }
    }
  }
}