Specialty Medication Enrollment
0.1.0 - STU1 Ballot

This page is part of the Specialty Medication Enrollment (v0.1.0: STU1 Ballot 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

Resource Profile: SpecialtyRxCoverage - Mappings

Mappings for the specialty-rx-coverage resource profile.

Mappings for Workflow Pattern (http://hl7.org/fhir/workflow)

SpecialtyRxCoverage
CoverageEvent
   identifierEvent.identifier
   statusEvent.status
   beneficiaryEvent.subject
   periodEvent.occurrence[x]

Mappings for RIM Mapping (http://hl7.org/v3)

SpecialtyRxCoverage
CoverageEntity. Role, or Act, Coverage
   textAct.text?
   containedN/A
   extensionN/A
   modifierExtensionN/A
   identifier.id
   statusAct.status
   periodAct.effectiveTime
   class
      idn/a
      extensionn/a
      modifierExtensionN/A
   class (bin)
      idn/a
      extensionn/a
      modifierExtensionN/A
   class (pcn)
      idn/a
      extensionn/a
      modifierExtensionN/A
   class (rxgroup-id)
      idn/a
      extensionn/a
      modifierExtensionN/A
   class (pbm-member-id)
      idn/a
      extensionn/a
      modifierExtensionN/A
   costToBeneficiary
      idn/a
      extensionn/a
      modifierExtensionN/A
      exception
         idn/a
         extensionn/a
         modifierExtensionN/A
   contractn/a

Mappings for FiveWs Pattern Mapping (http://hl7.org/fhir/fivews)

SpecialtyRxCoverage
Coverage
   identifierFiveWs.identifier
   statusFiveWs.status
   typeFiveWs.class
   policyHolderFiveWs.subject[x], FiveWs.subject
   subscriberFiveWs.subject[x], FiveWs.subject
   subscriberIdFiveWs.subject[x], FiveWs.subject
   beneficiaryFiveWs.subject[x], FiveWs.subject
   periodFiveWs.done[x]
   payorFiveWs.author

Mappings for Canadian Dental Association eclaims standard (http://www.cda-adc.ca/en/services/cdanet/)

SpecialtyRxCoverage
Coverage
   identifierC02
   policyHolderD01 through D09
   subscriberD01 through D09
   subscriberIdD01 through D09
   beneficiaryD01 through D09
   dependentC17
   relationshipC03
   payorA05
   class
      valueC11 (Division,Section)
      nameC11 (Division,Section)
   class (bin)
      valueC11 (Division,Section)
      nameC11 (Division,Section)
   class (pcn)
      valueC11 (Division,Section)
      nameC11 (Division,Section)
   class (rxgroup-id)
      valueC11 (Division,Section)
      nameC11 (Division,Section)
   class (pbm-member-id)
      valueC11 (Division,Section)
      nameC11 (Division,Section)
   networkD10
   costToBeneficiary
      value[x]C11 (Division,Section)
   contractD01 through D09

Mappings for HL7 v2 Mapping (http://hl7.org/v2)

SpecialtyRxCoverage
Coverage
   identifierIN1-2
   typeIN1-15
   policyHolderIN1-16, 18, 19-name of insured, address, date of birth
   subscriberIN1-16, 18, 19-name of insured, address, date of birth
   subscriberIdIN1-16, 18, 19-name of insured, address, date of birth
   beneficiaryIN1-16, 18, 19-name of insured, address, date of birth
   dependent- No exact HL7 v2 equivalent concept seems to exist;
   periodIN1-12 / IN1-13
   payorIN1-3
   class
      valueIN1-8
      nameIN1-8
   class (bin)
      valueIN1-8
      nameIN1-8
   class (pcn)
      valueIN1-8
      nameIN1-8
   class (rxgroup-id)
      valueIN1-8
      nameIN1-8
   class (pbm-member-id)
      valueIN1-8
      nameIN1-8
   order- No exact HL7 v2 equivalent concept seems to exist;
   costToBeneficiary
      value[x]IN1-8
   contractIN1-16, 18, 19

Mappings for Canadian Pharmacy Associaiton eclaims standard (http://www.pharmacists.ca/)

SpecialtyRxCoverage
Coverage
   identifierC.32, C.33, C.39
   policyHolderC.35
   subscriberC.35
   subscriberIdC.35
   beneficiaryC.35
   payorC.30
   class
      valueC.31
      nameC.31
   class (bin)
      valueC.31
      nameC.31
   class (pcn)
      valueC.31
      nameC.31
   class (rxgroup-id)
      valueC.31
      nameC.31
   class (pbm-member-id)
      valueC.31
      nameC.31
   costToBeneficiary
      value[x]C.31
   contractC.35