This page is part of the US Drug Formulary (v0.1.0: STU 1 Draft) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions
<StructureDefinition xmlns="http://hl7.org/fhir"> <id value="usdf-CoveragePlan"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <p><b>CoveragePlan Profile</b></p> <p>A health plan which contains links to administrative information, a list of formulary drugs covered under that plan, and a definition of drug tiers and their associated cost-sharing models.</p> <p><b>Mapping Summary</b></p> <p><pre>usdf.CoveragePlan maps to List: PlanIdentifier maps to identifier CoveragePlanMode maps to mode CoveragePlanStatus maps to status MarketingName maps to title FormularyDrugEntry maps to entry.item DrugTierDefinition maps to extension Network maps to extension SummaryURL maps to extension FormularyURL maps to extension EmailPlanContact maps to extension MarketingURL maps to extension LastUpdatedOn maps to date </pre></p> </div> </text> <url value="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-CoveragePlan"/> <identifier> <system value="http://hl7.org/fhir/us/davinci-drug-formulary"/> <value value="usdf.CoveragePlan"/> </identifier> <version value="0.1.0"/> <name value="CoveragePlan"/> <title value="usdf-CoveragePlan"/> <status value="draft"/> <date value="2019-06-21T00:00:00-04:00"/> <publisher value="HL7 Pharmacy WG"/> <contact> <telecom> <system value="url"/> <value value="http://www.hl7.org/Special/committees/medication/"/> </telecom> </contact> <description value="A health plan which contains links to administrative information, a list of formulary drugs covered under that plan, and a definition of drug tiers and their associated cost-sharing models."/> <fhirVersion value="4.0.0"/> <mapping> <identity value="rim"/> <uri value="http://hl7.org/v3"/> <name value="RIM Mapping"/> </mapping> <mapping> <identity value="w5"/> <uri value="http://hl7.org/fhir/fivews"/> <name value="FiveWs Pattern Mapping"/> </mapping> <kind value="resource"/> <abstract value="false"/> <type value="List"/> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/List"/> <derivation value="constraint"/> <snapshot> <element id="List:usdf-CoveragePlan"> <path value="List"/> <short value="usdf-CoveragePlan"/> <definition value="A health plan which contains links to administrative information, a list of formulary drugs covered under that plan, and a definition of drug tiers and their associated cost-sharing models."/> <alias value="Collection"/> <alias value="WorkingList"/> <alias value="Organizer"/> <min value="0"/> <max value="*"/> <base> <path value="List"/> <min value="0"/> <max value="*"/> </base> <constraint> <key value="dom-2"/> <severity value="error"/> <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> <expression value="contained.contained.empty()"/> <xpath value="not(parent::f:contained and f:contained)"/> <source value="DomainResource"/> </constraint> <constraint> <key value="dom-4"/> <severity value="error"/> <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/> <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/> <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/> <source value="DomainResource"/> </constraint> <constraint> <key value="dom-3"/> <severity value="error"/> <human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource"/> <expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()"/> <xpath value="not(exists(for $contained in f:contained return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))"/> <source value="DomainResource"/> </constraint> <constraint> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation"> <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/> </extension> <key value="dom-6"/> <severity value="warning"/> <human value="A resource should have narrative for robust management"/> <expression value="text.div.exists()"/> <xpath value="exists(f:text/h:div)"/> <source value="DomainResource"/> </constraint> <constraint> <key value="dom-5"/> <severity value="error"/> <human value="If a resource is contained in another resource, it SHALL NOT have a security label"/> <expression value="contained.meta.security.empty()"/> <xpath value="not(exists(f:contained/*/f:meta/f:security))"/> <source value="DomainResource"/> </constraint> <constraint> <key value="lst-3"/> <severity value="error"/> <human value="An entry date can only be used if the mode of the list is "working""/> <expression value="mode = 'working' or entry.date.empty()"/> <xpath value="(f:mode/@value = 'working') or not(exists(f:entry/f:date))"/> </constraint> <constraint> <key value="lst-2"/> <severity value="error"/> <human value="The deleted flag can only be used if the mode of the list is "changes""/> <expression value="mode = 'changes' or entry.deleted.empty()"/> <xpath value="(f:mode/@value = 'changes') or not(exists(f:entry/f:deleted))"/> </constraint> <constraint> <key value="lst-1"/> <severity value="error"/> <human value="A list can only have an emptyReason if it is empty"/> <expression value="emptyReason.empty() or entry.empty()"/> <xpath value="not(exists(f:emptyReason) and exists(f:entry))"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Entity. Role, or Act"/> </mapping> <mapping> <identity value="rim"/> <map value="Act[classCode<ORG,moodCode=EVN]"/> </mapping> </element> <element id="List:usdf-CoveragePlan.id"> <path value="List.id"/> <short value="Logical id of this artifact"/> <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/> <comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="id"/> </type> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="List:usdf-CoveragePlan.meta"> <path value="List.meta"/> <short value="Metadata about the resource"/> <definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.meta"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Meta"/> </type> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="List:usdf-CoveragePlan.implicitRules"> <path value="List.implicitRules"/> <short value="A set of rules under which this content was created"/> <definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc."/> <comment value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.implicitRules"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <isModifier value="true"/> <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation"/> <isSummary value="true"/> </element> <element id="List:usdf-CoveragePlan.language"> <path value="List.language"/> <short value="Language of the resource content"/> <definition value="The base language in which the resource is written."/> <comment value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.language"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet"> <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Language"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="preferred"/> <description value="A human language."/> <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> </binding> </element> <element id="List:usdf-CoveragePlan.text"> <path value="List.text"/> <short value="Text summary of the resource, for human interpretation"/> <definition value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/> <comment value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later."/> <alias value="narrative"/> <alias value="html"/> <alias value="xhtml"/> <alias value="display"/> <min value="0"/> <max value="1"/> <base> <path value="DomainResource.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Narrative"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Act.text?"/> </mapping> </element> <element id="List:usdf-CoveragePlan.contained"> <path value="List.contained"/> <short value="Contained, inline Resources"/> <definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope."/> <comment value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels."/> <alias value="inline resources"/> <alias value="anonymous resources"/> <alias value="contained resources"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.contained"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Resource"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="List:usdf-CoveragePlan.extension"> <path value="List.extension"/> <slicing id="1"> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <ordered value="false"/> <rules value="open"/> </slicing> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="4"/> <max value="*"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="List:usdf-CoveragePlan.extension:drugtierdefinition"> <path value="List.extension"/> <sliceName value="drugtierdefinition"/> <definition value="A description of the drug tiers used by the formulary and how those tiers implement copay and coinsurance amounts. Drug tiers do not have any inherent meaning that is consistent across all formularies. Rather, each tier is defined using this element."/> <min value="1"/> <max value="*"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierDefinition-extension"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="List:usdf-CoveragePlan.extension:network"> <path value="List.extension"/> <sliceName value="network"/> <definition value="Array of Networks within a plan."/> <min value="1"/> <max value="*"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-Network-extension"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="List:usdf-CoveragePlan.extension:summaryurl"> <path value="List.extension"/> <sliceName value="summaryurl"/> <definition value="The URL that goes directly to the formulary brochure for the specific standard plan or plan variation."/> <min value="1"/> <max value="1"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-SummaryURL-extension"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="List:usdf-CoveragePlan.extension:formularyurl"> <path value="List.extension"/> <sliceName value="formularyurl"/> <definition value="The URL that goes directly to the formulary brochure for the specific standard plan or plan variation."/> <min value="0"/> <max value="1"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyURL-extension"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="List:usdf-CoveragePlan.extension:emailplancontact"> <path value="List.extension"/> <sliceName value="emailplancontact"/> <definition value="An email address for developers/public to report mistakes in the network and formulary data"/> <min value="0"/> <max value="1"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-EmailPlanContact-extension"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="List:usdf-CoveragePlan.extension:marketingurl"> <path value="List.extension"/> <sliceName value="marketingurl"/> <definition value="The URL that goes directly to the plan brochure for the specific standard plan or plan variation"/> <min value="0"/> <max value="1"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-MarketingURL-extension"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="List:usdf-CoveragePlan.extension:planidtype"> <path value="List.extension"/> <sliceName value="planidtype"/> <definition value="Type of Plan ID. For all Marketplace plans this should be: HIOS-PLAN-ID"/> <min value="1"/> <max value="1"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PlanIDType-extension"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="List:usdf-CoveragePlan.modifierExtension"> <path value="List.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="List:usdf-CoveragePlan.identifier"> <path value="List.identifier"/> <short value="Business identifier"/> <definition value="Identifier for the List assigned for business purposes outside the context of FHIR."/> <min value="1"/> <max value="1"/> <base> <path value="List.identifier"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Identifier"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="w5"/> <map value="FiveWs.identifier"/> </mapping> <mapping> <identity value="rim"/> <map value=".id"/> </mapping> </element> <element id="List:usdf-CoveragePlan.status"> <path value="List.status"/> <short value="current | retired | entered-in-error"/> <definition value="Indicates the current state of this list."/> <comment value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid."/> <min value="1"/> <max value="1"/> <base> <path value="List.status"/> <min value="1"/> <max value="1"/> </base> <type> <code value="code"/> </type> <mustSupport value="true"/> <isModifier value="true"/> <isModifierReason value="This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ListStatus"/> </extension> <strength value="required"/> <description value="The current state of the list."/> <valueSet value="http://hl7.org/fhir/ValueSet/list-status|4.0.0"/> </binding> <mapping> <identity value="w5"/> <map value="FiveWs.status"/> </mapping> <mapping> <identity value="rim"/> <map value=".status[current=active;retired=obsolete;entered-in-error=nullified]"/> </mapping> </element> <element id="List:usdf-CoveragePlan.mode"> <path value="List.mode"/> <short value="working | snapshot | changes"/> <definition value="How this list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted."/> <comment value="This element is labeled as a modifier because a change list must not be misunderstood as a complete list."/> <requirements value="Lists are used in various ways, and it must be known in what way it is safe to use them."/> <min value="1"/> <max value="1"/> <base> <path value="List.mode"/> <min value="1"/> <max value="1"/> </base> <type> <code value="code"/> </type> <mustSupport value="true"/> <isModifier value="true"/> <isModifierReason value="If set to "changes", the list is considered incomplete, while the other two codes indicate the list is complete, which changes the understanding of the elements listed"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ListMode"/> </extension> <strength value="required"/> <description value="The processing mode that applies to this list."/> <valueSet value="http://hl7.org/fhir/ValueSet/list-mode|4.0.0"/> </binding> <mapping> <identity value="w5"/> <map value="FiveWs.class"/> </mapping> <mapping> <identity value="rim"/> <map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value"/> </mapping> </element> <element id="List:usdf-CoveragePlan.title"> <path value="List.title"/> <short value="Descriptive name for the list"/> <definition value="A label for the list assigned by the author."/> <requirements value="Allows customization beyond just the code identifying the kind of list."/> <min value="1"/> <max value="1"/> <base> <path value="List.title"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value=".title"/> </mapping> </element> <element id="List:usdf-CoveragePlan.code"> <path value="List.code"/> <short value="What the purpose of this list is"/> <definition value="This code defines the purpose of the list - why it was created."/> <comment value="If there is no code, the purpose of the list is implied where it is used, such as in a document section using Document.section.code."/> <requirements value="Lists often contain subsets of resources rather than an exhaustive list. The code identifies what type of subset is included."/> <min value="0"/> <max value="1"/> <base> <path value="List.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ListPurpose"/> </extension> <strength value="example"/> <description value="What the purpose of a list is."/> <valueSet value="http://hl7.org/fhir/ValueSet/list-example-codes"/> </binding> <mapping> <identity value="w5"/> <map value="FiveWs.what[x]"/> </mapping> <mapping> <identity value="rim"/> <map value=".code"/> </mapping> </element> <element id="List:usdf-CoveragePlan.subject"> <path value="List.subject"/> <short value="If all resources have the same subject"/> <definition value="The common subject (or patient) of the resources that are in the list if there is one."/> <comment value="Some purely arbitrary lists do not have a common subject, so this is optional."/> <requirements value="The primary purpose of listing the subject explicitly is to help with finding the right list."/> <min value="0"/> <max value="1"/> <base> <path value="List.subject"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/> </type> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="w5"/> <map value="FiveWs.subject[x]"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode<SUB].role (and sometimes .player)"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.subject"/> </mapping> </element> <element id="List:usdf-CoveragePlan.encounter"> <path value="List.encounter"/> <short value="Context in which list created"/> <definition value="The encounter that is the context in which this list was created."/> <min value="0"/> <max value="1"/> <base> <path value="List.encounter"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="w5"/> <map value="FiveWs.context"/> </mapping> <mapping> <identity value="rim"/> <map value="inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/> </mapping> </element> <element id="List:usdf-CoveragePlan.date"> <path value="List.date"/> <short value="When the list was prepared"/> <definition value="The date that the list was prepared."/> <comment value="The actual important date is the date of currency of the resources that were summarized, but it is usually assumed that these are current when the preparation occurs."/> <requirements value="Identifies how current the list is which affects relevance."/> <min value="0"/> <max value="1"/> <base> <path value="List.date"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="w5"/> <map value="FiveWs.recorded"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode<AUT].time[type=TS]"/> </mapping> </element> <element id="List:usdf-CoveragePlan.source"> <path value="List.source"/> <short value="Who and/or what defined the list contents (aka Author)"/> <definition value="The entity responsible for deciding what the contents of the list were. Where the list was created by a human, this is the same as the author of the list."/> <comment value="The primary source is the entity that made the decisions what items are in the list. This may be software or user."/> <requirements value="Allows follow-up as well as context."/> <alias value="Author"/> <min value="0"/> <max value="1"/> <base> <path value="List.source"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> </type> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="w5"/> <map value="FiveWs.author"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode<AUT].role[classCode=REL].player[classCode=PSN,determinerCode=INST] or .participation[typeCode<AUT].role[classCode=REL].player[classCode=DEV,determinerCode=INST]"/> </mapping> </element> <element id="List:usdf-CoveragePlan.orderedBy"> <path value="List.orderedBy"/> <short value="What order the list has"/> <definition value="What order applies to the items in the list."/> <comment value="Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order."/> <requirements value="Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries."/> <min value="0"/> <max value="1"/> <base> <path value="List.orderedBy"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ListOrder"/> </extension> <strength value="preferred"/> <description value="What order applies to the items in a list."/> <valueSet value="http://hl7.org/fhir/ValueSet/list-order"/> </binding> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=COMP].sequenceNumber > 1"/> </mapping> </element> <element id="List:usdf-CoveragePlan.note"> <path value="List.note"/> <short value="Comments about the list"/> <definition value="Comments that apply to the overall list."/> <min value="0"/> <max value="*"/> <base> <path value="List.note"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Annotation"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".inboundRelationship[typeCode=SUBJ].act.text"/> </mapping> </element> <element id="List:usdf-CoveragePlan.entry"> <path value="List.entry"/> <short value="Entries in the list"/> <definition value="Entries in this list."/> <comment value="If there are no entries in the list, an emptyReason SHOULD be provided."/> <min value="0"/> <max value="*"/> <base> <path value="List.entry"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <condition value="lst-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="Element"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"/> </mapping> </element> <element id="List:usdf-CoveragePlan.entry.id"> <path value="List.entry.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="List:usdf-CoveragePlan.entry.extension"> <path value="List.entry.extension"/> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="List:usdf-CoveragePlan.entry.modifierExtension"> <path value="List.entry.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="List:usdf-CoveragePlan.entry.flag"> <path value="List.entry.flag"/> <short value="Status/Workflow information about this item"/> <definition value="The flag allows the system constructing the list to indicate the role and significance of the item in the list."/> <comment value="The flag can only be understood in the context of the List.code. If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. Deleted can only be used if the List.mode is "changes"."/> <requirements value="This field is present to support various clinical uses of lists, such as a discharge summary medication list, where flags specify whether the medication was added, modified, or deleted from the list."/> <min value="0"/> <max value="1"/> <base> <path value="List.entry.flag"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ListItemFlag"/> </extension> <strength value="example"/> <description value="Codes that provide further information about the reason and meaning of the item in the list."/> <valueSet value="http://hl7.org/fhir/ValueSet/list-item-flag"/> </binding> <mapping> <identity value="rim"/> <map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value"/> </mapping> </element> <element id="List:usdf-CoveragePlan.entry.deleted"> <path value="List.entry.deleted"/> <short value="If this item is actually marked as deleted"/> <definition value="True if this item is marked as deleted in the list."/> <comment value="If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. Both flag and deleted can only be used if the List.mode is "changes". A deleted entry should be displayed in narrative as deleted. This element is labeled as a modifier because it indicates that an item is (to be) no longer in the list."/> <requirements value="The flag element may contain codes that an application processing the list does not understand. However there can be no ambiguity if a list item is actually marked as "deleted"."/> <min value="0"/> <max value="1"/> <base> <path value="List.entry.deleted"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <meaningWhenMissing value="List items are generally only treated as deleted when this element explicitly carries a value of true. Systems SHOULD always populate this value when mode is 'changes'"/> <condition value="lst-2"/> <isModifier value="true"/> <isModifierReason value="If deleted is true, then the item included in the list isn't actually part of the list anymore"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="added: .updateMode=("A","AR") retained: .updateMode="NC" updated: .updateMode="R" deleted: .updateMode="D""/> </mapping> </element> <element id="List:usdf-CoveragePlan.entry.date"> <path value="List.entry.date"/> <short value="When item added to list"/> <definition value="When this item was added to the list."/> <requirements value="The date may be significant for understanding the meaning of items in a working list."/> <min value="0"/> <max value="1"/> <base> <path value="List.entry.date"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".availabilityTime"/> </mapping> </element> <element id="List:usdf-CoveragePlan.entry.item"> <path value="List.entry.item"/> <short value="Actual entry"/> <definition value="A reference to the actual resource from which data was derived."/> <min value="1"/> <max value="1"/> <base> <path value="List.entry.item"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyDrug"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".target or .role or .role.entity"/> </mapping> </element> <element id="List:usdf-CoveragePlan.emptyReason"> <path value="List.emptyReason"/> <short value="Why list is empty"/> <definition value="If the list is empty, why the list is empty."/> <comment value="The various reasons for an empty list make a significant interpretation to its interpretation. Note that this code is for use when the entire list has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases."/> <requirements value="Allows capturing things like "none exist" or "not asked" which can be important for most lists."/> <min value="0"/> <max value="1"/> <base> <path value="List.emptyReason"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <condition value="lst-1"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ListEmptyReason"/> </extension> <strength value="preferred"/> <description value="If a list is empty, why it is empty."/> <valueSet value="http://hl7.org/fhir/ValueSet/list-empty-reason"/> </binding> <mapping> <identity value="rim"/> <map value=".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]"/> </mapping> </element> </snapshot> <differential> <element id="List:usdf-CoveragePlan"> <path value="List"/> <short value="usdf-CoveragePlan"/> <definition value="A health plan which contains links to administrative information, a list of formulary drugs covered under that plan, and a definition of drug tiers and their associated cost-sharing models."/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="List:usdf-CoveragePlan.extension"> <path value="List.extension"/> <slicing id="1"> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <ordered value="false"/> <rules value="open"/> </slicing> <min value="4"/> <max value="*"/> </element> <element id="List:usdf-CoveragePlan.extension:drugtierdefinition"> <path value="List.extension"/> <sliceName value="drugtierdefinition"/> <definition value="A description of the drug tiers used by the formulary and how those tiers implement copay and coinsurance amounts. Drug tiers do not have any inherent meaning that is consistent across all formularies. Rather, each tier is defined using this element."/> <min value="1"/> <max value="*"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierDefinition-extension"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="List:usdf-CoveragePlan.extension:network"> <path value="List.extension"/> <sliceName value="network"/> <definition value="Array of Networks within a plan."/> <min value="1"/> <max value="*"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-Network-extension"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="List:usdf-CoveragePlan.extension:summaryurl"> <path value="List.extension"/> <sliceName value="summaryurl"/> <definition value="The URL that goes directly to the formulary brochure for the specific standard plan or plan variation."/> <min value="1"/> <max value="1"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-SummaryURL-extension"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="List:usdf-CoveragePlan.extension:formularyurl"> <path value="List.extension"/> <sliceName value="formularyurl"/> <definition value="The URL that goes directly to the formulary brochure for the specific standard plan or plan variation."/> <min value="0"/> <max value="1"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyURL-extension"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="List:usdf-CoveragePlan.extension:emailplancontact"> <path value="List.extension"/> <sliceName value="emailplancontact"/> <definition value="An email address for developers/public to report mistakes in the network and formulary data"/> <min value="0"/> <max value="1"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-EmailPlanContact-extension"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="List:usdf-CoveragePlan.extension:marketingurl"> <path value="List.extension"/> <sliceName value="marketingurl"/> <definition value="The URL that goes directly to the plan brochure for the specific standard plan or plan variation"/> <min value="0"/> <max value="1"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-MarketingURL-extension"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="List:usdf-CoveragePlan.extension:planidtype"> <path value="List.extension"/> <sliceName value="planidtype"/> <definition value="Type of Plan ID. For all Marketplace plans this should be: HIOS-PLAN-ID"/> <min value="1"/> <max value="1"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PlanIDType-extension"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="List:usdf-CoveragePlan.identifier"> <path value="List.identifier"/> <min value="1"/> <max value="1"/> <mustSupport value="true"/> </element> <element id="List:usdf-CoveragePlan.status"> <path value="List.status"/> <mustSupport value="true"/> </element> <element id="List:usdf-CoveragePlan.mode"> <path value="List.mode"/> <mustSupport value="true"/> </element> <element id="List:usdf-CoveragePlan.title"> <path value="List.title"/> <min value="1"/> <max value="1"/> </element> <element id="List:usdf-CoveragePlan.entry"> <path value="List.entry"/> </element> <element id="List:usdf-CoveragePlan.entry.item"> <path value="List.entry.item"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyDrug"/> </type> </element> </differential> </StructureDefinition>