This page is part of the CARIN Digital Insurance Card (v0.1.0: STU 1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions
Defining URL: | http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage |
Version: | 0.1.0 |
Name: | C4DICCoverage |
Title: | C4DIC Coverage |
Status: | Active as of 12/6/21 10:19 PM |
Definition: | Data that reflect a payer’s coverage of the member. |
Publisher: | HL7 Payer/Provider Information Exchange Working Group (PIE WG) |
Source Resource: | XML / JSON / Turtle |
The official URL for this profile is:
http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from Coverage
Summary
Mandatory: 16 elements (4 nested mandatory elements)
Must-Support: 33 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
This structure is derived from Coverage
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |
meta | S | 1..1 | Meta | Metadata about the resource |
lastUpdated | S | 1..1 | instant | When the resource version last changed |
Slices for profile | 1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to Slice: Unordered, Open by pattern:$this | |
profile:supportedProfile | 1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to Required Pattern: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage | |
Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
C4DIC-PlanBeneficiaries-extension | 0..* | (Complex) | Plan Beneficiaries URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-PlanBeneficiaries-extension | |
C4DIC-BeneficiaryCosts-extension | 0..1 | (Complex) | Beneficiary Costs URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BeneficiaryCosts-extension | |
C4DIC-AdditionalCardInformation-extension | 0..* | Annotation | Additional Insurance Card Information URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-AdditionalCardInformation-extension | |
C4DIC-BackgroundColor-extension | 0..1 | CodeableConcept | Background Color URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BackgroundColor-extension Binding: C4DIC ISO Color (required) | |
C4DIC-HighlightColor-extension | 0..1 | CodeableConcept | Highlight Color URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-HighlightColor-extension Binding: C4DIC ISO Color (required) | |
C4DIC-Logo-extension | 0..1 | (Complex) | Logo URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Logo-extension | |
C4DIC-QRCode-extension | 0..* | (Complex) | QR Code URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-QRCode-extension | |
C4DIC-Barcode-extension | 0..* | (Complex) | Barcode URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Barcode-extension | |
C4DIC-SupportingImage-extension | 0..* | (Complex) | Supporting image URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension | |
C4DIC-CardIssueDate-extension | 0..1 | date | Card Issue Date URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-CardIssueDate-extension | |
Slices for identifier | S | 1..* | Identifier | Business Identifier for the coverage Slice: Unordered, Open by pattern:type |
identifier:All Slices | Content/Rules for all slices | |||
type | 0..1 | CodeableConcept | Description of identifier Binding: C4DIC Coverage Identifier Type (extensible) | |
identifier:memberid | S | 1..1 | Identifier | Member ID |
type | 1..1 | CodeableConcept | Description of identifier Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203 | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: MB | |
system | S | 1..1 | uri | The namespace for the identifier value |
value | S | 1..1 | string | The value that is unique |
assigner | S | 1..1 | Reference(Organization) | Organization that issued id (may be just text) |
status | S | 1..1 | code | active | cancelled | draft | entered-in-error |
type | S | 1..1 | CodeableConcept | Coverage category such as medical or accident Required Pattern: At least the following |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: HIP | |
subscriber | S | 1..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy |
reference | S | 1..1 | string | Literal reference, Relative, internal or absolute URL |
subscriberId | S | 1..1 | string | ID assigned to the subscriber |
beneficiary | S | 1..1 | Reference(C4DIC Patient) | Plan beneficiary |
reference | S | 1..1 | string | Literal reference, Relative, internal or absolute URL |
dependent | S | 0..1 | string | Dependent number |
relationship | S | 1..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (required) |
period | S | 0..1 | Period | Coverage start and end dates |
payor | S | 1..1 | Reference(C4DIC Organization) | Issuer of the policy |
Slices for class | S | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by pattern:type |
class:All Slices | Content/Rules for all slices | |||
type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: C4DIC Coverage Class (required) | |
class:group | S | 0..1 | BackboneElement | Additional coverage classifications |
type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: group | |
value | 1..1 | string | Value associated with the type | |
name | 0..1 | string | Human readable description of the type and value | |
class:plan | S | 0..1 | BackboneElement | Additional coverage classifications |
type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: plan | |
value | 1..1 | string | Value associated with the type | |
name | 0..1 | string | Human readable description of the type and value | |
class:division | S | 0..1 | BackboneElement | Additional coverage classifications |
type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: division | |
class:network | S | 0..1 | BackboneElement | Additional coverage classifications |
type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: network | |
class:rxbin | S | 0..1 | BackboneElement | Additional coverage classifications |
type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: rxbin | |
class:rxpcn | S | 0..1 | BackboneElement | Additional coverage classifications |
type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: rxpcn | |
class:rxgroup | S | 0..1 | BackboneElement | Additional coverage classifications |
type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: rxgroup | |
class:rxid | S | 0..1 | BackboneElement | Additional coverage classifications |
type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: rxid | |
class:rxiin | S | 0..1 | BackboneElement | Additional coverage classifications |
type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: rxiin | |
costToBeneficiary | S | 0..* | BackboneElement | Patient payments for services/products |
type | S | 1..1 | CodeableConcept | Cost category Binding: C4DIC Copay Type (extensible) |
Slices for value[x] | 1..1 | Money | The amount or percentage due from the beneficiary Slice: Unordered, Open by type:$this | |
valueMoney | S | 1..1 | Money | The amount or percentage due from the beneficiary |
value | S | 1..1 | decimal | Numerical value (with implicit precision) |
currency | S | 1..1 | code | ISO 4217 Currency Code |
Documentation for this format |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |
id | Σ | 0..1 | string | Logical id of this artifact |
meta | SΣ | 1..1 | Meta | Metadata about the resource |
id | 0..1 | string | Unique id for inter-element referencing | |
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
versionId | Σ | 0..1 | id | Version specific identifier |
lastUpdated | SΣ | 1..1 | instant | When the resource version last changed |
source | Σ | 0..1 | uri | Identifies where the resource comes from |
Slices for profile | Σ | 1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to Slice: Unordered, Open by pattern:$this |
profile:supportedProfile | Σ | 1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to Required Pattern: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage |
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System. |
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. | |
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
contained | 0..* | Resource | Contained, inline Resources | |
Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
C4DIC-PlanBeneficiaries-extension | 0..* | (Complex) | Plan Beneficiaries URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-PlanBeneficiaries-extension | |
C4DIC-BeneficiaryCosts-extension | 0..1 | (Complex) | Beneficiary Costs URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BeneficiaryCosts-extension | |
C4DIC-AdditionalCardInformation-extension | 0..* | Annotation | Additional Insurance Card Information URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-AdditionalCardInformation-extension | |
C4DIC-BackgroundColor-extension | 0..1 | CodeableConcept | Background Color URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BackgroundColor-extension Binding: C4DIC ISO Color (required) | |
C4DIC-HighlightColor-extension | 0..1 | CodeableConcept | Highlight Color URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-HighlightColor-extension Binding: C4DIC ISO Color (required) | |
C4DIC-Logo-extension | 0..1 | (Complex) | Logo URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Logo-extension | |
C4DIC-QRCode-extension | 0..* | (Complex) | QR Code URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-QRCode-extension | |
C4DIC-Barcode-extension | 0..* | (Complex) | Barcode URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Barcode-extension | |
C4DIC-SupportingImage-extension | 0..* | (Complex) | Supporting image URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension | |
C4DIC-CardIssueDate-extension | 0..1 | date | Card Issue Date URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-CardIssueDate-extension | |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
Slices for identifier | SΣ | 1..* | Identifier | Business Identifier for the coverage Slice: Unordered, Open by pattern:type |
identifier:All Slices | Content/Rules for all slices | |||
id | 0..1 | string | Unique id for inter-element referencing | |
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: C4DIC Coverage Identifier Type (extensible) |
system | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient |
value | Σ | 0..1 | string | The value that is unique Example General: 123456 |
period | Σ | 0..1 | Period | Time period when id is/was valid for use |
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
identifier:memberid | SΣ | 1..1 | Identifier | Member ID |
id | 0..1 | string | Unique id for inter-element referencing | |
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203 | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: MB | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
system | SΣ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient |
value | SΣ | 1..1 | string | The value that is unique Example General: 123456 |
period | Σ | 0..1 | Period | Time period when id is/was valid for use |
assigner | SΣ | 1..1 | Reference(Organization) | Organization that issued id (may be just text) |
status | ?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. |
type | SΣ | 1..1 | CodeableConcept | Coverage category such as medical or accident Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: HIP | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
policyHolder | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy |
subscriber | SΣ | 1..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy |
id | 0..1 | string | Unique id for inter-element referencing | |
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
reference | SΣI | 1..1 | string | Literal reference, Relative, internal or absolute URL |
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). |
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known |
display | Σ | 0..1 | string | Text alternative for the resource |
subscriberId | SΣ | 1..1 | string | ID assigned to the subscriber |
beneficiary | SΣ | 1..1 | Reference(C4DIC Patient) | Plan beneficiary |
id | 0..1 | string | Unique id for inter-element referencing | |
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
reference | SΣI | 1..1 | string | Literal reference, Relative, internal or absolute URL |
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). |
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known |
display | Σ | 0..1 | string | Text alternative for the resource |
dependent | SΣ | 0..1 | string | Dependent number |
relationship | S | 1..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (required) |
period | SΣ | 0..1 | Period | Coverage start and end dates |
payor | SΣ | 1..1 | Reference(C4DIC Organization) | Issuer of the policy |
Slices for class | S | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by pattern:type |
class:All Slices | Content/Rules for all slices | |||
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: C4DIC Coverage Class (required) |
value | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value |
class:group | S | 0..1 | BackboneElement | Additional coverage classifications |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: group | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
value | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value |
class:plan | S | 0..1 | BackboneElement | Additional coverage classifications |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: plan | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
value | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value |
class:division | S | 0..1 | BackboneElement | Additional coverage classifications |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: division | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
value | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value |
class:network | S | 0..1 | BackboneElement | Additional coverage classifications |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: network | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
value | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value |
class:rxbin | S | 0..1 | BackboneElement | Additional coverage classifications |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: rxbin | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
value | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value |
class:rxpcn | S | 0..1 | BackboneElement | Additional coverage classifications |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: rxpcn | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
value | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value |
class:rxgroup | S | 0..1 | BackboneElement | Additional coverage classifications |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: rxgroup | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
value | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value |
class:rxid | S | 0..1 | BackboneElement | Additional coverage classifications |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: rxid | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
value | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value |
class:rxiin | S | 0..1 | BackboneElement | Additional coverage classifications |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: rxiin | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
value | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value |
order | Σ | 0..1 | positiveInt | Relative order of the coverage |
network | Σ | 0..1 | string | Insurer network |
costToBeneficiary | S | 0..* | BackboneElement | Patient payments for services/products |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | SΣ | 1..1 | CodeableConcept | Cost category Binding: C4DIC Copay Type (extensible) |
Slices for value[x] | Σ | 1..1 | Money | The amount or percentage due from the beneficiary Slice: Unordered, Closed by type:$this |
value[x]:valueMoney | SΣ | 1..1 | Money | The amount or percentage due from the beneficiary |
id | 0..1 | string | Unique id for inter-element referencing | |
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
value | SΣ | 1..1 | decimal | Numerical value (with implicit precision) |
currency | SΣ | 1..1 | code | ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. |
exception | 0..* | BackboneElement | Exceptions for patient payments | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Exception category Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays. |
period | Σ | 0..1 | Period | The effective period of the exception |
subrogation | 0..1 | boolean | Reimbursement to insurer | |
contract | 0..* | Reference(Contract) | Contract details | |
Documentation for this format |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |
meta | Σ | 1..1 | Meta | Metadata about the resource |
lastUpdated | Σ | 1..1 | instant | When the resource version last changed |
Slices for identifier | Σ | 1..* | Identifier | Business Identifier for the coverage Slice: Unordered, Open by pattern:type |
identifier:memberid | Σ | 1..1 | Identifier | Member ID |
system | Σ | 1..1 | uri | The namespace for the identifier value |
value | Σ | 1..1 | string | The value that is unique |
assigner | Σ | 1..1 | Reference(Organization) | Organization that issued id (may be just text) |
status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. |
type | Σ | 1..1 | CodeableConcept | Coverage category such as medical or accident Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization. Required Pattern: At least the following |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: HIP | |
subscriber | Σ | 1..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy |
reference | ΣI | 1..1 | string | Literal reference, Relative, internal or absolute URL |
subscriberId | Σ | 1..1 | string | ID assigned to the subscriber |
beneficiary | Σ | 1..1 | Reference(C4DIC Patient) | Plan beneficiary |
reference | ΣI | 1..1 | string | Literal reference, Relative, internal or absolute URL |
dependent | Σ | 0..1 | string | Dependent number |
relationship | 1..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (required) | |
period | Σ | 0..1 | Period | Coverage start and end dates |
payor | Σ | 1..1 | Reference(C4DIC Organization) | Issuer of the policy |
Slices for class | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by pattern:type | |
class:group | 0..1 | BackboneElement | Additional coverage classifications | |
class:plan | 0..1 | BackboneElement | Additional coverage classifications | |
class:division | 0..1 | BackboneElement | Additional coverage classifications | |
class:network | 0..1 | BackboneElement | Additional coverage classifications | |
class:rxbin | 0..1 | BackboneElement | Additional coverage classifications | |
class:rxpcn | 0..1 | BackboneElement | Additional coverage classifications | |
class:rxgroup | 0..1 | BackboneElement | Additional coverage classifications | |
class:rxid | 0..1 | BackboneElement | Additional coverage classifications | |
class:rxiin | 0..1 | BackboneElement | Additional coverage classifications | |
costToBeneficiary | 0..* | BackboneElement | Patient payments for services/products | |
type | Σ | 1..1 | CodeableConcept | Cost category Binding: C4DIC Copay Type (extensible) |
value[x]:valueMoney | Σ | 1..1 | Money | The amount or percentage due from the beneficiary |
value | Σ | 1..1 | decimal | Numerical value (with implicit precision) |
currency | Σ | 1..1 | code | ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. |
Documentation for this format |
This structure is derived from Coverage
Summary
Mandatory: 16 elements (4 nested mandatory elements)
Must-Support: 33 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
Differential View
This structure is derived from Coverage
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |
meta | S | 1..1 | Meta | Metadata about the resource |
lastUpdated | S | 1..1 | instant | When the resource version last changed |
Slices for profile | 1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to Slice: Unordered, Open by pattern:$this | |
profile:supportedProfile | 1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to Required Pattern: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage | |
Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
C4DIC-PlanBeneficiaries-extension | 0..* | (Complex) | Plan Beneficiaries URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-PlanBeneficiaries-extension | |
C4DIC-BeneficiaryCosts-extension | 0..1 | (Complex) | Beneficiary Costs URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BeneficiaryCosts-extension | |
C4DIC-AdditionalCardInformation-extension | 0..* | Annotation | Additional Insurance Card Information URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-AdditionalCardInformation-extension | |
C4DIC-BackgroundColor-extension | 0..1 | CodeableConcept | Background Color URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BackgroundColor-extension Binding: C4DIC ISO Color (required) | |
C4DIC-HighlightColor-extension | 0..1 | CodeableConcept | Highlight Color URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-HighlightColor-extension Binding: C4DIC ISO Color (required) | |
C4DIC-Logo-extension | 0..1 | (Complex) | Logo URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Logo-extension | |
C4DIC-QRCode-extension | 0..* | (Complex) | QR Code URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-QRCode-extension | |
C4DIC-Barcode-extension | 0..* | (Complex) | Barcode URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Barcode-extension | |
C4DIC-SupportingImage-extension | 0..* | (Complex) | Supporting image URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension | |
C4DIC-CardIssueDate-extension | 0..1 | date | Card Issue Date URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-CardIssueDate-extension | |
Slices for identifier | S | 1..* | Identifier | Business Identifier for the coverage Slice: Unordered, Open by pattern:type |
identifier:All Slices | Content/Rules for all slices | |||
type | 0..1 | CodeableConcept | Description of identifier Binding: C4DIC Coverage Identifier Type (extensible) | |
identifier:memberid | S | 1..1 | Identifier | Member ID |
type | 1..1 | CodeableConcept | Description of identifier Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203 | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: MB | |
system | S | 1..1 | uri | The namespace for the identifier value |
value | S | 1..1 | string | The value that is unique |
assigner | S | 1..1 | Reference(Organization) | Organization that issued id (may be just text) |
status | S | 1..1 | code | active | cancelled | draft | entered-in-error |
type | S | 1..1 | CodeableConcept | Coverage category such as medical or accident Required Pattern: At least the following |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: HIP | |
subscriber | S | 1..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy |
reference | S | 1..1 | string | Literal reference, Relative, internal or absolute URL |
subscriberId | S | 1..1 | string | ID assigned to the subscriber |
beneficiary | S | 1..1 | Reference(C4DIC Patient) | Plan beneficiary |
reference | S | 1..1 | string | Literal reference, Relative, internal or absolute URL |
dependent | S | 0..1 | string | Dependent number |
relationship | S | 1..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (required) |
period | S | 0..1 | Period | Coverage start and end dates |
payor | S | 1..1 | Reference(C4DIC Organization) | Issuer of the policy |
Slices for class | S | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by pattern:type |
class:All Slices | Content/Rules for all slices | |||
type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: C4DIC Coverage Class (required) | |
class:group | S | 0..1 | BackboneElement | Additional coverage classifications |
type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: group | |
value | 1..1 | string | Value associated with the type | |
name | 0..1 | string | Human readable description of the type and value | |
class:plan | S | 0..1 | BackboneElement | Additional coverage classifications |
type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: plan | |
value | 1..1 | string | Value associated with the type | |
name | 0..1 | string | Human readable description of the type and value | |
class:division | S | 0..1 | BackboneElement | Additional coverage classifications |
type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: division | |
class:network | S | 0..1 | BackboneElement | Additional coverage classifications |
type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: network | |
class:rxbin | S | 0..1 | BackboneElement | Additional coverage classifications |
type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: rxbin | |
class:rxpcn | S | 0..1 | BackboneElement | Additional coverage classifications |
type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: rxpcn | |
class:rxgroup | S | 0..1 | BackboneElement | Additional coverage classifications |
type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: rxgroup | |
class:rxid | S | 0..1 | BackboneElement | Additional coverage classifications |
type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: rxid | |
class:rxiin | S | 0..1 | BackboneElement | Additional coverage classifications |
type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Required Pattern: At least the following | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: rxiin | |
costToBeneficiary | S | 0..* | BackboneElement | Patient payments for services/products |
type | S | 1..1 | CodeableConcept | Cost category Binding: C4DIC Copay Type (extensible) |
Slices for value[x] | 1..1 | Money | The amount or percentage due from the beneficiary Slice: Unordered, Open by type:$this | |
valueMoney | S | 1..1 | Money | The amount or percentage due from the beneficiary |
value | S | 1..1 | decimal | Numerical value (with implicit precision) |
currency | S | 1..1 | code | ISO 4217 Currency Code |
Documentation for this format |
Snapshot View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |
id | Σ | 0..1 | string | Logical id of this artifact |
meta | SΣ | 1..1 | Meta | Metadata about the resource |
id | 0..1 | string | Unique id for inter-element referencing | |
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
versionId | Σ | 0..1 | id | Version specific identifier |
lastUpdated | SΣ | 1..1 | instant | When the resource version last changed |
source | Σ | 0..1 | uri | Identifies where the resource comes from |
Slices for profile | Σ | 1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to Slice: Unordered, Open by pattern:$this |
profile:supportedProfile | Σ | 1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to Required Pattern: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage |
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System. |
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. | |
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
contained | 0..* | Resource | Contained, inline Resources | |
Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
C4DIC-PlanBeneficiaries-extension | 0..* | (Complex) | Plan Beneficiaries URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-PlanBeneficiaries-extension | |
C4DIC-BeneficiaryCosts-extension | 0..1 | (Complex) | Beneficiary Costs URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BeneficiaryCosts-extension | |
C4DIC-AdditionalCardInformation-extension | 0..* | Annotation | Additional Insurance Card Information URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-AdditionalCardInformation-extension | |
C4DIC-BackgroundColor-extension | 0..1 | CodeableConcept | Background Color URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BackgroundColor-extension Binding: C4DIC ISO Color (required) | |
C4DIC-HighlightColor-extension | 0..1 | CodeableConcept | Highlight Color URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-HighlightColor-extension Binding: C4DIC ISO Color (required) | |
C4DIC-Logo-extension | 0..1 | (Complex) | Logo URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Logo-extension | |
C4DIC-QRCode-extension | 0..* | (Complex) | QR Code URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-QRCode-extension | |
C4DIC-Barcode-extension | 0..* | (Complex) | Barcode URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Barcode-extension | |
C4DIC-SupportingImage-extension | 0..* | (Complex) | Supporting image URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension | |
C4DIC-CardIssueDate-extension | 0..1 | date | Card Issue Date URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-CardIssueDate-extension | |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
Slices for identifier | SΣ | 1..* | Identifier | Business Identifier for the coverage Slice: Unordered, Open by pattern:type |
identifier:All Slices | Content/Rules for all slices | |||
id | 0..1 | string | Unique id for inter-element referencing | |
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: C4DIC Coverage Identifier Type (extensible) |
system | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient |
value | Σ | 0..1 | string | The value that is unique Example General: 123456 |
period | Σ | 0..1 | Period | Time period when id is/was valid for use |
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
identifier:memberid | SΣ | 1..1 | Identifier | Member ID |
id | 0..1 | string | Unique id for inter-element referencing | |
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203 | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: MB | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
system | SΣ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient |
value | SΣ | 1..1 | string | The value that is unique Example General: 123456 |
period | Σ | 0..1 | Period | Time period when id is/was valid for use |
assigner | SΣ | 1..1 | Reference(Organization) | Organization that issued id (may be just text) |
status | ?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. |
type | SΣ | 1..1 | CodeableConcept | Coverage category such as medical or accident Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: HIP | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
policyHolder | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy |
subscriber | SΣ | 1..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy |
id | 0..1 | string | Unique id for inter-element referencing | |
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
reference | SΣI | 1..1 | string | Literal reference, Relative, internal or absolute URL |
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). |
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known |
display | Σ | 0..1 | string | Text alternative for the resource |
subscriberId | SΣ | 1..1 | string | ID assigned to the subscriber |
beneficiary | SΣ | 1..1 | Reference(C4DIC Patient) | Plan beneficiary |
id | 0..1 | string | Unique id for inter-element referencing | |
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
reference | SΣI | 1..1 | string | Literal reference, Relative, internal or absolute URL |
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). |
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known |
display | Σ | 0..1 | string | Text alternative for the resource |
dependent | SΣ | 0..1 | string | Dependent number |
relationship | S | 1..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (required) |
period | SΣ | 0..1 | Period | Coverage start and end dates |
payor | SΣ | 1..1 | Reference(C4DIC Organization) | Issuer of the policy |
Slices for class | S | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by pattern:type |
class:All Slices | Content/Rules for all slices | |||
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: C4DIC Coverage Class (required) |
value | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value |
class:group | S | 0..1 | BackboneElement | Additional coverage classifications |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: group | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
value | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value |
class:plan | S | 0..1 | BackboneElement | Additional coverage classifications |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: plan | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
value | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value |
class:division | S | 0..1 | BackboneElement | Additional coverage classifications |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: division | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
value | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value |
class:network | S | 0..1 | BackboneElement | Additional coverage classifications |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: network | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
value | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value |
class:rxbin | S | 0..1 | BackboneElement | Additional coverage classifications |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: rxbin | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
value | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value |
class:rxpcn | S | 0..1 | BackboneElement | Additional coverage classifications |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: rxpcn | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
value | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value |
class:rxgroup | S | 0..1 | BackboneElement | Additional coverage classifications |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: rxgroup | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
value | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value |
class:rxid | S | 0..1 | BackboneElement | Additional coverage classifications |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: rxid | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
value | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value |
class:rxiin | S | 0..1 | BackboneElement | Additional coverage classifications |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. Required Pattern: At least the following |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS | |
version | 0..1 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: rxiin | |
display | 0..1 | string | Representation defined by the system | |
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |
text | 0..1 | string | Plain text representation of the concept | |
value | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value |
order | Σ | 0..1 | positiveInt | Relative order of the coverage |
network | Σ | 0..1 | string | Insurer network |
costToBeneficiary | S | 0..* | BackboneElement | Patient payments for services/products |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | SΣ | 1..1 | CodeableConcept | Cost category Binding: C4DIC Copay Type (extensible) |
Slices for value[x] | Σ | 1..1 | Money | The amount or percentage due from the beneficiary Slice: Unordered, Closed by type:$this |
value[x]:valueMoney | SΣ | 1..1 | Money | The amount or percentage due from the beneficiary |
id | 0..1 | string | Unique id for inter-element referencing | |
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
value | SΣ | 1..1 | decimal | Numerical value (with implicit precision) |
currency | SΣ | 1..1 | code | ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. |
exception | 0..* | BackboneElement | Exceptions for patient payments | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 1..1 | CodeableConcept | Exception category Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays. |
period | Σ | 0..1 | Period | The effective period of the exception |
subrogation | 0..1 | boolean | Reimbursement to insurer | |
contract | 0..* | Reference(Contract) | Contract details | |
Documentation for this format |
Other representations of profile: CSV, Excel, Schematron
Path | Conformance | ValueSet / Code |
Coverage.meta.security | extensible | All Security Labels |
Coverage.meta.tag | example | CommonTags |
Coverage.language | preferred | CommonLanguages Max Binding: AllLanguages |
Coverage.identifier.use | required | IdentifierUse |
Coverage.identifier.type | extensible | C4DICCoverageIdentifierType |
Coverage.identifier:memberid.use | required | IdentifierUse |
Coverage.identifier:memberid.type | extensible | Pattern: MB |
Coverage.status | required | FinancialResourceStatusCodes |
Coverage.type | preferred | Pattern: HIP |
Coverage.subscriber.type | extensible | ResourceType |
Coverage.beneficiary.type | extensible | ResourceType |
Coverage.relationship | required | SubscriberRelationshipCodes |
Coverage.class.type | required | C4DICCoverageClassVS |
Coverage.class:group.type | extensible | Pattern: group |
Coverage.class:plan.type | extensible | Pattern: plan |
Coverage.class:division.type | extensible | Pattern: division |
Coverage.class:network.type | extensible | Pattern: network |
Coverage.class:rxbin.type | extensible | Pattern: rxbin |
Coverage.class:rxpcn.type | extensible | Pattern: rxpcn |
Coverage.class:rxgroup.type | extensible | Pattern: rxgroup |
Coverage.class:rxid.type | extensible | Pattern: rxid |
Coverage.class:rxiin.type | extensible | Pattern: rxiin |
Coverage.costToBeneficiary.type | extensible | C4DICCopayTypeVS |
Coverage.costToBeneficiary.value[x]:valueMoney.currency | required | Currencies |
Coverage.costToBeneficiary.exception.type | example | ExampleCoverageFinancialExceptionCodes |