{ "x-source": { "spec": "openapi/aetna-patient-access-api-openapi.yml", "operationId": "get_v2_patientaccess_ExplanationOfBenefit_id", "path": "/v2/patientaccess/ExplanationOfBenefit/{id}", "status": "200", "media_type": "application/json", "note": "Response example published verbatim by Aetna in its own Swagger document; extracted, not authored." }, "example": { "insurance": [ { "coverage": { "reference": "Coverage/0000000000000100327" }, "focal": true } ], "identifier": [ { "system": "https://sources.aetna.com/EOB/identifier/claimid/62", "type": { "coding": [ { "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType", "code": "uc", "display": "Unique Claim ID" } ] }, "value": "EPAB10914D87A" } ], "use": "claim", "created": "2021-02-25", "diagnosis": [ { "sequence": 1, "onAdmission": { "coding": [ { "system": "https://www.nubc.org/CodeSystem/PresentOnAdmissionIndicator", "code": "u", "display": "Unknown" } ] }, "type": [ { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype", "code": "principal", "display": "Principal Diagnosis" } ] } ], "diagnosisCodeableConcept": { "coding": [ { "code": "K92.2" } ] } } ], "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/claim-type", "code": "institutional", "display": "Institutional" } ] }, "payee": { "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/payeetype", "code": "provider", "display": "Provider" } ] }, "party": { "reference": "Organization/0000000000000100319" } }, "disposition": "Completed", "total": [ { "amount": { "value": 7559.2 }, "category": { "coding": [ { "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBPayerAdjudicationStatus", "code": "other", "display": "Other" } ] } } ], "supportingInfo": [ { "sequence": 1, "valueString": "35052599711", "category": { "coding": [ { "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType", "code": "patientaccountnumber" } ] } } ], "provider": { "reference": "Organization/0000000000000100319" }, "meta": { "lastUpdated": "2021-02-25T12:04:59.714+00:00", "profile": [ "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional" ] }, "patient": { "reference": "Patient/0000000000000100267" }, "insurer": { "display": "Aetna or it's Affiliates (collectively, 'Aetna')" }, "billablePeriod": { "start": "2021-06-01", "end": "3000-01-01" }, "subType": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/ex-claimsubtype" } ], "text": "Inpatient" }, "id": "02d44f7e-2b88-11ec-a2d4-9d79182d0000", "outcome": "complete", "careTeam": [ { "sequence": 1, "role": { "coding": [ { "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBClaimCareTeamRole", "code": "attending", "display": "Attending" } ] }, "provider": { "reference": "Practitioner/0000000000000100318" }, "responsible": true } ], "resourceType": "ExplanationOfBenefit", "status": "active" } }