{ "$schema": "https://json-schema.org/draft/2020-12/schema", "$id": "https://raw.githubusercontent.com/api-evangelist/amerihealth-caritas/refs/heads/main/json-schema/amerihealth-caritas-explanation-of-benefit-schema.json", "title": "AmeriHealthCaritasExplanationOfBenefit", "description": "JSON Schema mirroring the FHIR R4 ExplanationOfBenefit resource as profiled by CARIN Blue Button and exposed via AmeriHealth Caritas Patient Access. EOB describes claim adjudication results for AmeriHealth Caritas Medicaid, CHIP, D-SNP, LTSS, and Marketplace members.", "type": "object", "required": ["resourceType", "status", "type", "use", "patient", "created", "insurer", "provider", "outcome"], "properties": { "resourceType": { "type": "string", "const": "ExplanationOfBenefit" }, "id": { "type": "string" }, "meta": { "type": "object" }, "identifier": { "type": "array", "items": { "type": "object" } }, "status": { "type": "string", "enum": ["active", "cancelled", "draft", "entered-in-error"] }, "type": { "type": "object" }, "subType": { "type": "object" }, "use": { "type": "string", "enum": ["claim", "preauthorization", "predetermination"] }, "patient": { "type": "object", "description": "Reference(Patient)" }, "billablePeriod": { "type": "object", "properties": { "start": { "type": "string", "format": "date" }, "end": { "type": "string", "format": "date" } } }, "created": { "type": "string", "format": "date-time" }, "insurer": { "type": "object", "description": "Reference(Organization)" }, "provider": { "type": "object", "description": "Reference(Practitioner|PractitionerRole|Organization)" }, "outcome": { "type": "string", "enum": ["queued", "complete", "error", "partial"] }, "disposition": { "type": "string" }, "insurance": { "type": "array", "items": { "type": "object", "properties": { "focal": { "type": "boolean" }, "coverage": { "type": "object", "description": "Reference(Coverage)" } } } }, "item": { "type": "array", "items": { "type": "object", "properties": { "sequence": { "type": "integer" }, "productOrService": { "type": "object" }, "servicedDate": { "type": "string", "format": "date" }, "servicedPeriod": { "type": "object" }, "quantity": { "type": "object" }, "unitPrice": { "type": "object" }, "net": { "type": "object" }, "adjudication": { "type": "array", "items": { "type": "object" } } } } }, "total": { "type": "array", "items": { "type": "object" } }, "payment": { "type": "object" } } }