### ----------------------------------------------------
### -- FHIR
### -- Licenses: Artistic-2.0
### -- Authors: Hugh Simpson
### -- File: t/resources/structureDefinition/ExplanationOfBenefit.json
### ----------------------------------------------------
### -- Chunk 51 of 54
path" : "ExplanationOfBenefit.diagnosis.onAdmission",
      "short" : "Present on admission",
      "definition" : "Indication of whether the diagnosis was present on admission to a facility.",
      "requirements" : "Many systems need to understand for adjudication if the diagnosis was present a time of admission.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "DiagnosisOnAdmission"
        }],
        "strength" : "example",
        "description" : "Present on admission.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission"
      }
    },
    {
      "id" : "ExplanationOfBenefit.diagnosis.packageCode",
      "path" : "ExplanationOfBenefit.diagnosis.packageCode",
      "short" : "Package billing code",
      "definition" : "A package billing code or bundle code used to group products and services to a particular health condition (such as heart attack) which is based on a predetermined grouping code system.",
      "comment" : "For example, DRG (Diagnosis Related Group) or a bundled billing code. A patient may have a diagnosis of a Myocardio-infarction and a DRG for HeartAttack would assigned. The Claim item (and possible subsequent claims) would refer to the DRG for those line items that were for services related to the heart attack event.",
      "requirements" : "Required to relate the current  diagnosis to a package billing code that is then referenced on the individual claim items which are specific to the health condition covered by the package code.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "DiagnosisRelatedGroup"
        }],
        "strength" : "example",
        "description" : "The DRG codes associated with the diagnosis.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup"
      }
    },
    {
      "id" : "ExplanationOfBenefit.procedure",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "Procedure"
      }],
      "path" : "ExplanationOfBenefit.procedure",
      "short" : "Clinical procedures performed",
      "definition" : "Procedures performed on the patient relevant to the billing items with the claim.",
      "requirements" : "The specific clinical invention are sometimes required to be provided to justify billing a greater than customary amount for a service.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "BackboneElement"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.procedure.sequence",
      "path" : "ExplanationOfBenefit.procedure.sequence",
      "short" : "Procedure instance identifier",
      "definition" : "A number to uniquely identify procedure entries.",
      "requirements" : "Necessary to provide a mechanism to link to claim details.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "positiveInt"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.procedure.type",
      "path" : "ExplanationOfBenefit.procedure.type",
      "short" : "Category of Procedure",
      "definition" : "When the condition was observed or the relative ranking.",
      "requirements" : "Often required to capture a particular diagnosis, for example: primary or discharge.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "ProcedureType"
        }],
        "strength" : "example",
        "description" : "Example procedure type codes.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/ex-procedure-type"
      }
    },
    {
      "id" : "ExplanationOfBenefit.procedure.date",
      "path" : "ExplanationOfBenefit.procedure.date",
      "short" : "When the procedure was performed",
      "definition" : "Date and optionally time the procedure was performed.",
      "requirements" : "Required for auditing purposes.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "dateTime"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.procedure.procedure[x]",
      "path" : "ExplanationOfBenefit.procedure.procedure[x]",
      "short" : "Specific clinical procedure",
      "definition" : "The code or reference to a Procedure resource which identifies the clinical intervention performed.",
      "requirements" : "This identifies the actual clinical procedure.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      },
      {
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Procedure"]
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "ICD10_Procedures"
        }],
        "strength" : "example",
        "description" : "ICD10 Procedure codes.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/icd-10-procedures"
      }
    },
    {
      "id" : "ExplanationOfBenefit.procedure.udi",
      "path" : "ExplanationOfBenefit.procedure.udi",
      "short" : "Unique device identifier",
      "definition" : "Unique Device Identifiers associated with this line item.",
      "requirements" : "The UDI code allows the insurer to obtain device level information on the product supplied.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Device"]
      }]
    },
    {
      "id" : "ExplanationOfBenefit.precedence",
      "path" : "ExplanationOfBenefit.precedence",
      "short" : "Precedence (primary, secondary, etc.)",
      "definition" : "This indicates the relative order of a series of EOBs related to different coverages for the same suite of services.",
      "requirements" : "Needed to coordinate between multiple EOBs for the same suite of services.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "positiveInt"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.insurance",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "Insurance"
      }],
      "path" : "ExplanationOfBenefit.insurance",
      "short" : "Patient insurance information",
      "definition" : "Financial instruments for reimbursement for the health care products and services specified on the claim.",
      "comment" : "All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'Coverage.subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim.",
      "requirements" : "At least one insurer is required for a claim to be a claim.",
      "min" : 1,
      "max" : "*",
      "type" : [{
        "code" : "BackboneElement"
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "v2",
        "map" : "Coverage"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.insurance.focal",
      "path" : "ExplanationOfBenefit.insurance.focal",
      "short" : "Coverage to be used for adjudication",
      "definition" : "A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true.",
      "comment" : "A patient may (will) have multiple insurance policies which provide reimbursement for healthcare services and products. For example, a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for adjudicating this claim. Other claims would be created to request adjudication against the other listed policies.",
      "requirements" : "To identify which coverage in the list is being used to adjudicate this claim.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "boolean"
      }],
      "isSummary" : true
    },
    {
      "id" : "ExplanationOfBenefit.insurance.coverage",
      "path" : "ExplanationOfBenefit.insurance.coverage",
      "short" : "Insurance information",
      "definition" : "Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system.",
      "requirements" : "Required to allow the adjudicator to locate the correct policy and history within their information system.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Coverage"]
      }],
      "isSummary" : true
    },
    {
      "id" : "ExplanationOfBenefit.insurance.preAuthRef",
      "path" : "ExplanationOfBenefit.insurance.preAuthRef",
      "short" : "Prior authorization reference number",
      "definition" : "Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.",
      "comment" : "This value is an alphanumeric string that may be provided over the phone, via text, via paper, or within a ClaimResponse resource and is not a FHIR Identifier.",
      "requirements" : "Providers must quote previously issued authorization reference numbers in order to obtain adjudication as previously advised on the Preauthorization.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "string"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.accident",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "Accident"
      }],
      "path" : "ExplanationOfBenefit.accident",
      "short" : "Details of the event",
      "definition" : "Details of a accident which resulted in injuries which required the products and services listed in the claim.",
      "requirements" : "When healthcare products and services are accident related, benefits may be payable under accident provisions of policies, such as automotive, etc before they are payable under normal health insurance.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "BackboneElement"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.accident.date",
      "path" : "ExplanationOfBenefit.accident.date",
      "short" : "When the incident occurred",
      "definition" : "Date of an accident event  related to the products and services contained in the claim.",
      "comment" : "The date of the accident has to precede the dates of the products and services but within a reasonable timeframe.",
      "requirements" : "Required for audit purposes and adjudication.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "date"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.accident.type",
      "path" : "ExplanationOfBenefit.accident.type",
      "short" : "The nature of the accident",
      "definition" : "The type or context of the accident event for the purposes of selection of potential insurance coverages and determination of coordination between insurers.",
      "requirements" : "Coverage may be dependant on the type of accident.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "AccidentType"
        }],
        "strength" : "extensible",
        "description" : "Type of accident: work place, auto, etc.",
        "valueSet" : "http://terminology.hl7.org/ValueSet/v3-ActIncidentCode"
      }
    },
    {
      "id" : "ExplanationOfBenefit.accident.location[x]",
      "path" : "ExplanationOfBenefit.accident.location[x]",
      "short" : "Where the event occurred",
      "definition" : "The physical location of the accident event.",
      "requirements" : "Required for audit purposes and determination of applicable insurance liability.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Address"
      },
      {
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Location"]
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "Item"
      }],
      "path" : "ExplanationOfBenefit.item",
      "short" : "Product or service provided",
      "definition" : "A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details.",
      "requirements" : "The items to be processed for adjudication.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "BackboneElement"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.sequence",
      "path" : "ExplanationOfBenefit.item.sequence",
      "short" : "Item instance identifier",
      "definition" : "A number to uniquely identify item entries.",
      "requirements" : "Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "positiveInt"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.careTeamSequence",
      "path" : "ExplanationOfBenefit.item.careTeamSequence",
      "short" : "Applicable care team members",
      "definition" : "Care team members related to this service or product.",
      "requirements" : "Need to identify the individuals and their roles in the provision of the product or service.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "positiveInt"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.diagnosisSequence",
      "path" : "ExplanationOfBenefit.item.diagnosisSequence",
      "short" : "Applicable diagnoses",
      "definition" : "Diagnoses applicable for this service or product.",
      "requirements" : "Need to related the product or service to the associated diagnoses.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "positiveInt"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.procedureSequence",
      "path" : "ExplanationOfBenefit.item.procedureSequence",
      "short" : "Applicable procedures",
      "definition" : "Procedures applicable for this service or product.",
      "requirements" : "Need to provide any listed specific procedures to support the product or service being claimed.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "positiveInt"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.informationSequence",
      "path" : "ExplanationOfBenefit.item.informationSequence",
      "short" : "Applicable exception and supporting information",
      "definition" : "Exceptions, special conditions and supporting information applicable for this service or product.",
      "requirements" : "Need to reference the supporting information items that relate directly to this product or service.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "positiveInt"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.revenue",
      "path" : "ExplanationOfBenefit.item.revenue",
      "short" : "Revenue or cost center code",
      "definition" : "The type of revenue or cost center providing the product and/or service.",
      "requirements" : "Needed in the processing of institutional claims.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "RevenueCenter"
        }],
        "strength" : "example",
        "description" : "Codes for the revenue or cost centers supplying the service and/or products.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/ex-revenue-center"
      }
    },
    {
      "id" : "ExplanationOfBenefit.item.category",
      "path" : "ExplanationOfBenefit.item.category",
      "short" : "Benefit classification",
      "definition" : "Code to identify the general type of benefits under which products and services are provided.",
      "comment" : "Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.",
      "requirements" : "Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "BenefitCategory"
        }],
        "strength" : "example",
        "description" : "Benefit categories such as: oral, medical, vision, oral-basic etc.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/ex-benefitcategory"
      }
    },
    {
      "id" : "ExplanationOfBenefit.item.productOrService",
      "path" : "ExplanationOfBenefit.item.productOrService",
      "short" : "Billing, service, product, or drug code",
      "definition" : "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.",
      "comment" : "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.",
      "requirements" : "Necessary to state what was provided or done.",
      "alias" : ["Drug Code",
      "Bill Code",
      "Service Code"],
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "ServiceProduct"
        }],
        "strength" : "example",
        "description" : "Allowable service and product codes.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/service-uscls"
      }
    },
    {
      "id" : "ExplanationOfBenefit.item.modifier",
      "path" : "ExplanationOfBenefit.item.modifier",
      "short" : "Product or service billing modifiers",
      "definition" : "Item typification or modifiers codes to convey additional context for the product or service.",
      "comment" : "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.",
      "requirements" : "To support inclusion of the item for adjudication or to charge an elevated fee.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "Modifiers"
        }],
        "strength" : "example",
        "description" : "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/claim-modifiers"
      }
    },
    {
      "id" : "ExplanationOfBenefit.item.programCode",
      "path" : "ExplanationOfBenefit.item.programCode",
      "short" : "Program the product or service is provided under",
      "definition" : "Identifies the program under which this may be recovered.",
      "comment" : "For example: Neonatal program, child dental program or drug users recovery program.",
      "requirements" : "Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "ProgramCode"
        }],
        "strength" : "example",
        "description" : "Program specific reason codes.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/ex-program-code"
      }
    },
    {
      "id" : "ExplanationOfBenefit.item.serviced[x]",
      "path" : "ExplanationOfBenefit.item.serviced[x]",
      "short" : "Date or dates of service or product delivery",
      "definition" : "The date or dates when the service or product was supplied, performed or completed.",
      "requirements" : "Needed to determine whether the  service or product was provided during the term of the insurance coverage.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "date"
      },
      {
        "code" : "Period"
      }],
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.done[x]"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.location[x]",
      "path" : "ExplanationOfBenefit.item.location[x]",
      "short" : "Place of service or where product was supplied",
      "definition" : "Where the product or service was provided.",
      "requirements" : "The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      },
      {
        "code" : "Address"
      },
      {
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Location"]
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "ServicePlace"
        }],
        "strength" : "example",
        "description" : "Place where the service is rendered.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/service-place"
      },
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.where[x]"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.quantity",
      "path" : "ExplanationOfBenefit.item.quantity",
      "short" : "Count of products or services",
      "definition" : "The number of repetitions of a service or product.",
      "requirements" : "Required when the product or service code does not convey the quantity provided.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Quantity",
        "profile" : ["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.unitPrice",
      "path" : "ExplanationOfBenefit.item.unitPrice",
      "short" : "Fee, charge or cost per item",
      "definition" : "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.",
      "requirements" : "The amount charged to the patient by the provider for a single unit.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Money"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.factor",
      "path" : "ExplanationOfBenefit.item.factor",
      "short" : "Price scaling factor",
      "definition" : "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
      "comment" : "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).",
      "requirements" : "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "decimal"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.net",
      "path" : "ExplanationOfBenefit.item.net",
      "short" : "Total item cost",
      "definition" : "The quantity times the unit price for an additional service or product or charge.",
      "comment" : "For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.",
      "requirements" : "Provides the total amount claimed  for the group (if a grouper) or the line item.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Money"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.udi",
      "path" : "ExplanationOfBenefit.item.udi",
      "short" : "Unique device identifier",
      "definition" : "Unique Device Identifiers associated with this line item.",
      "requirements" : "The UDI code allows the insurer to obtain device level information on the product supplied.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Device"]
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.bodySite",
      "path" : "ExplanationOfBenefit.item.bodySite",
      "short" : "Anatomical location",
      "definition" : "Physical service site on the patient (limb, tooth, etc.).",
      "comment" : "For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.",
      "requirements" : "Allows insurer to validate specific procedures.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "OralSites"
        }],
        "strength" : "example",
        "description" : "The code for the teeth, quadrant, sextant and arch.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/tooth"
      }
    },
    {
      "id" : "ExplanationOfBenefit.item.subSite",
      "path" : "ExplanationOfBenefit.item.subSite",
      "short" : "Anatomical sub-location",
      "definition" : "A region or surface of the bodySite, e.g. limb region or tooth surface(s).",
      "requirements" : "Allows insurer to validate specific procedures.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "Surface"
        }],
        "strength" : "example",
        "description" : "The code for the tooth surface and surface combinations.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/surface"
      }
    },
    {
      "id" : "ExplanationOfBenefit.item.encounter",
      "path" : "ExplanationOfBenefit.item.encounter",
      "short" : "Encounters related to this billed item",
      "definition" : "A billed item may include goods or services provided in multiple encounters.",
      "requirements" : "Used in some jurisdictions to link clinical events to claim items.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"]
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.noteNumber",
      "path" : "ExplanationOfBenefit.item.noteNumber",
      "short" : "Applicable note numbers",
      "definition" : "The numbers associated with notes below which apply to the adjudication of this item.",
      "requirements" : "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "positiveInt"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.adjudication",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "Adjudication"
      }],
      "path" : "ExplanationOfBenefit.item.adjudication",
      "short" : "Adjudication details",
      "definition" : "If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item.",
      "requirements" : "The adjudication results conveys the insurer's assessment of the item provided in the claim under the terms of the patient's insurance coverage.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "BackboneElement"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.adjudication.category",
      "path" : "ExplanationOfBenefit.item.adjudication.category",
      "short" : "Type of adjudication information",
      "definition" : "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in-aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
      "comment" : "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
      "requirements" : "Needed to enable understanding of the context of the other information in the adjudication.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "Adjudication"
        }],
        "strength" : "example",
        "description" : "The adjudication codes.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/adjudication"
      }
    },
    {
      "id" : "ExplanationOfBenefit.item.adjudication.reason",
      "path" : "ExplanationOfBenefit.item.adjudication.reason",
      "short" : "Explanation of adjudication outcome",
      "definition" : "A code supporting the understanding of the adjudication result and explaining variance from expected amount.",
      "comment" : "For example, may indicate that the funds for this benefit type have been exhausted.",
      "requirements" : "To support understanding of variance from adjudication expectations.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "AdjudicationReason"
        }],
        "strength" : "example",
        "description" : "Adjudication reason codes.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/adjudication-reason"
      }
    },
    {
      "id" : "ExplanationOfBenefit.item.adjudication.amount",
      "path" : "ExplanationOfBenefit.item.adjudication.amount",
      "short" : "Monetary amount",
      "definition" : "Monetary amount associated with the category.",
      "comment" : "For example, amount submitted, eligible amount, co-payment, and benefit payable.",
      "requirements" : "Most adjuciation categories convey a monetary amount.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Money"
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.adjudication.value",
      "path" : "ExplanationOfBenefit.item.adjudication.value",
      "short" : "Non-monitary value",
      "definition" : "A non-monetary value associated with the category. Mutually exclusive to the amount element above.",
      "comment" : "For example: eligible percentage or co-payment percentage.",
      "requirements" : "Some adjudication categories convey a percentage or a fixed value.",
      "min" : 0,
      "max" : "1",
      "type