![.](tbl_spacer.png) 0 Table of Contents |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 1 Home |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 2 Background |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 3 Use Case |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 4 Conformance Requirements |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 5 General Guidance |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 6 Common Payer Consumer Data Set (CPCDS) |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 7 Terminology Licensure |
![.](tbl_spacer.png) ![.](tbl_vjoin-open.png) 8 Artifacts Summary |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.1 C4BB CapabilityStatement |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.2 Coverage_Payor |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.3 ExplanationOfBenefit_BillablePeriodStart |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.4 ExplanationOfBenefit_Careteam |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.5 ExplanationOfBenefit_Coverage |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.6 ExplanationOfBenefit_Identifier |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.7 ExplanationOfBenefit_Insurer |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.8 ExplanationOfBenefit_Organization |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.9 ExplanationOfBenefit_Patient |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.10 ExplanationOfBenefit_Practitioner |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.11 ExplanationOfBenefit_Provider |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.12 ExplanationOfBenefit_ServiceDate |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.13 ExplanationOfBenefit_ServiceStartDate |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.14 ExplanationOfBenefit_Type |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.15 C4BB Explanation Of Benefit |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.16 C4BB Coverage |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.17 C4BB ExplanationOfBenefit Inpatient Institutional |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.18 C4BB ExplanationOfBenefit Inpatient Institutional Basis |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.19 C4BB ExplanationOfBenefit Oral |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.20 C4BB ExplanationOfBenefit Oral Basis |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.21 C4BB ExplanationOfBenefit Outpatient Institutional |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.22 C4BB ExplanationOfBenefit Outpatient Institutional Basis |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.23 C4BB ExplanationOfBenefit Pharmacy |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.24 C4BB ExplanationOfBenefit Pharmacy Basis |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.25 C4BB ExplanationOfBenefit Professional NonClinician |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.26 C4BB ExplanationOfBenefit Professional NonClinician Basis |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.27 C4BB Organization |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.28 C4BB Patient |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.29 C4BB Practitioner |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.30 C4BB RelatedPerson |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.31 ADA Code on Dental Procedures and Nomenclature Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.32 American Dental Association Universal Numbering Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.33 C4BB Adjudication Category Discriminator Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.34 C4BB Adjudication Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.35 C4BB Ambulance Transport Reasons Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.36 C4BB Claim Identifier Type Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.37 C4BB Claim Inpatient Institutional Diagnosis Type Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.38 C4BB Claim Institutional Care Team Role Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.39 C4BB Claim Outpatient Institutional Diagnosis Type Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.40 C4BB Claim Pharmacy CareTeam Role Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.41 C4BB Claim Procedure Type Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.42 C4BB Claim Professional And Non Clinician Care Team Role Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.43 C4BB Claim Professional And Non Clinician Diagnosis Type Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.44 C4BB Institutional Claim SubType Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.45 C4BB Organization Identifier Type Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.46 C4BB Patient Identifier Type Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.47 C4BB Payee Type Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.48 C4BB Payer Benefit Payment Status Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.49 C4BB Payer Claim Payment Status Code Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.50 C4BB Payer Provider Network Status Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.51 C4BB Practitioner Identifier Type Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.52 C4BB Professional And Non Clinician Claim SubType Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.53 C4BB Professional And Non Clinician Claim Type Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.54 C4BB Related Claim Relationship Codes Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.55 C4BB SupportingInfo Type Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.56 C4BB Total Category Discriminator Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.57 C4BB Transportation Services Categories Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.58 CMS Place of Service Codes (POS) Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.59 Diagnosis Codes - International Classification of Diseases, Clinical Modification (ICD-9-CM, ICD-10-CM) Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.60 MS-DRGs - AP-DRGs - APR-DRGs Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.61 National Drug Code (NDC) Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.62 NCPDP Brand Generic Indicator Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.63 NCPDP Compound Code Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.64 NCPDP Dispense As Written (DAW)/Product Selection Code Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.65 NCPDP Prescription Origin Code Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.66 NCPDP Reject Code Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.67 NDC or Compound Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.68 NUBC Patient Discharge Status Codes Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.69 NUBC Point Of Origin Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.70 NUBC Present On Admission Indicator Codes Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.71 NUBC Priority (Type) of Admission or Visit Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.72 NUBC Revenue Codes Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.73 NUBC Type of Bill Codes Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.74 Oral Body Site Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.75 Procedure Codes - AMA CPT - CMS HCPCS - CMS HIPPS Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.76 Procedure Codes - AMA CPT - CMS HCPCS Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.77 Procedure Codes - International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) - ICD-10 Procedure Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.78 Procedure Modifier Codes - AMA CPT - CMS HCPCS Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.79 US Surface Codes Set Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.80 X12 Claim Adjustment Reason Codes - Remittance Advice Remark Codes Value Set |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.81 C4BB Adjudication Code System |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.82 C4BB Adjudication Discriminator Code System |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.83 C4BB Claim Care Team Role Code System |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.84 C4BB Claim Diagnosis Type Code System |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.85 C4BB Claim Procedure Type Code System |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.86 C4BB Compound Literal Code System |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.87 C4BB Identifier Type Code System |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.88 C4BB Institutional Claim SubType Code System |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.89 C4BB Payee Type Code System |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.90 C4BB Payer Adjudication Status Code System |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.91 C4BB Related Claim Relationship Code System |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.92 C4BB Supporting Info Type Code System |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.93 NUBC Present On Admission Indicator Code System |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.94 US Surface Codes System |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.95 X12 Ambulance Transport Reason Codes Code System |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.96 BB-EOBOral1-nonfinancial |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.97 BB-EOBOral2-nonfinancial |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.98 BB-EOBPharmacy1-nonfinancial |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.99 Coverage Example 1 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.100 Coverage Example 2 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.101 Coverage Example 3 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.102 Dental Coverage Example1 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.103 Dental Payer1 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.104 Dental Provider 1 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.105 EOB Inpatient Example 2 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.106 EOB Inpatient Example1 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.107 EOB Inpatient Institutional - Example 1 - Nonfinancial |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.108 EOB Inpatient Institutional - Example 2 - Nonfinancial |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.109 EOB Oral Example 1 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.110 EOB Oral Example 2 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.111 EOB Outpatient Institutional - Example 1 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.112 EOB Outpatient Institutional - Example 1 - Nonfinancial |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.113 EOB Outpatient Institutional - Example 2 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.114 EOB Outpatient Institutional - Example 2 - Nonfinancial |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.115 EOB Pharmacy Example1 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.116 EOB Professional - Example 1 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.117 EOB Professional - Example 1 - Nonfinancial |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.118 EOB Professional - Example 2 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.119 EOB Professional - Example 2 - Nonfinancial |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.120 EOB Professional - Transportation 1 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.121 EOB Professional - Transportation 1 - Nonfinancial |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.122 Patient Example 1 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.123 Patient Example 2 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.124 Payer 1 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.125 Payer 2 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.126 Practitioner Example 1 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.127 Practitioner Example 2 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.128 Practitioner Example 3 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.129 Practitioner4 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.130 Provider Organization 1 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.131 Provider Organization 2 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.132 Provider Organization 3 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.133 Provider Organization 4 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.134 Provider Organization 5 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.135 Provider Organization 6 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 8.136 Provider Transportation Organization Example 1 |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin_end.png) 8.137 Related Person 1 |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 9 Search Parameters |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 10 Security and Privacy Considerations |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 11 Downloads |
![.](tbl_spacer.png) ![.](tbl_vjoin_end.png) 12 Change Notes |