Extensions for Using Data Elements from FHIR STU3 in FHIR R4B - Downloaded Version null See the Directory of published versions

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Resource Profile: Profile_R3_Coverage_R4B

This cross-version profile allows STU3 Coverage content to be represented via FHIR R4B Coverage resources.

Usages:

• This Profile is not used by any profiles in this Implementation Guide

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
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Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage(4.3.0)	Insurance or medical plan or a payment agreement
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:sequence		0..1	string	STU3: The plan instance or sequence counter (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.sequence Constraints: ext-1
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
beneficiary	Σ	1..1	Reference(Patient)	Plan beneficiary
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:beneficiary		0..1	Reference(Resource)	STU3: Plan Beneficiary additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
payor	Σ	1..*	Reference(Organization | Patient | RelatedPerson)	Issuer of the policy
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:payor		0..1	Reference(Resource)	STU3: Identifier for the plan or agreement issuer URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.status	Base	required	Financial Resource Status Codes	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Coverage	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	contained.where(((id.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Coverage	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	Coverage.implicitRules, Coverage.extension, Coverage.extension:sequence, Coverage.modifierExtension, Coverage.status, Coverage.beneficiary, Coverage.beneficiary.extension, Coverage.beneficiary.extension:beneficiary, Coverage.payor, Coverage.payor.extension, Coverage.payor.extension:payor	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	Coverage.extension, Coverage.extension:sequence, Coverage.modifierExtension, Coverage.beneficiary.extension, Coverage.beneficiary.extension:beneficiary, Coverage.payor.extension, Coverage.payor.extension:payor	Must have either extensions or value[x], not both	extension.exists() != value.exists()

This structure is derived from Coverage

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage(4.3.0)	Insurance or medical plan or a payment agreement
meta
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:meta		0..1	(Complex)	STU3: meta additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.meta
text
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:text		0..1	(Complex)	STU3: text additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.text
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:sequence		0..1	string	STU3: The plan instance or sequence counter (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.sequence
identifier
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:identifier		0..*	Identifier	STU3: The primary coverage ID additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.identifier
policyHolder
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:policyHolder		0..1	Reference(Resource)	STU3: policyHolder URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
subscriber
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:subscriber		0..1	Reference(Resource)	STU3: subscriber additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
beneficiary
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:beneficiary		0..1	Reference(Resource)	STU3: Plan Beneficiary additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
period
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:period		0..1	Period	STU3: period additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.period
payor
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:payor		0..*	Reference(Resource)	STU3: Identifier for the plan or agreement issuer URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
class
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:group		0..1	string	STU3: An identifier for the group (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.group
extension:groupDisplay		0..1	string	STU3: Display text for an identifier for the group (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.groupDisplay
extension:subGroup		0..1	string	STU3: An identifier for the subsection of the group (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subGroup
extension:subGroupDisplay		0..1	string	STU3: Display text for the subsection of the group (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subGroupDisplay
extension:plan		0..1	string	STU3: An identifier for the plan (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.plan
extension:planDisplay		0..1	string	STU3: Display text for the plan (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.planDisplay
extension:subPlan		0..1	string	STU3: An identifier for the subsection of the plan (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subPlan
extension:subPlanDisplay		0..1	string	STU3: Display text for the subsection of the plan (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subPlanDisplay
extension:class		0..1	string	STU3: An identifier for the class (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.class
extension:classDisplay		0..1	string	STU3: Display text for the class (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.classDisplay
extension:subClass		0..1	string	STU3: An identifier for the subsection of the class (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subClass
extension:subClassDisplay		0..1	string	STU3: Display text for the subsection of the subclass (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subClassDisplay
contract
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:contract		0..*	Reference(Resource)	STU3: contract additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage(4.3.0)	Insurance or medical plan or a payment agreement
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:meta		0..1	(Complex)	STU3: meta additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.meta Constraints: ext-1
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible)
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example)
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): IETF language tag Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:text		0..1	(Complex)	STU3: text additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.text Constraints: ext-1
status		1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required)
div	C	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
contained		0..*	Resource	Contained, inline Resources Constraints: dom-r4b
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:sequence		0..1	string	STU3: The plan instance or sequence counter (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.sequence Constraints: ext-1
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
identifier	Σ	0..*	Identifier	Business Identifier for the coverage
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:identifier		0..*	Identifier	STU3: The primary coverage ID additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.identifier Constraints: ext-1
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (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)
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	0..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.
policyHolder	Σ	0..1	Reference(Patient | RelatedPerson | Organization)	Owner of the policy
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:policyHolder		0..1	Reference(Resource)	STU3: policyHolder URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..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)
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
subscriber	Σ	0..1	Reference(Patient | RelatedPerson)	Subscriber to the policy
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:subscriber		0..1	Reference(Resource)	STU3: subscriber additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..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)
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
subscriberId	Σ	0..1	string	ID assigned to the subscriber
beneficiary	Σ	1..1	Reference(Patient)	Plan beneficiary
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:beneficiary		0..1	Reference(Resource)	STU3: Plan Beneficiary additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..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)
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
dependent	Σ	0..1	string	Dependent number
relationship		0..1	CodeableConcept	Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
period	Σ	0..1	Period	Coverage start and end dates
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:period		0..1	Period	STU3: period additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.period Constraints: ext-1
start	ΣC	0..1	dateTime	Starting time with inclusive boundary
end	ΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
payor	Σ	1..*	Reference(Organization | Patient | RelatedPerson)	Issuer of the policy
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:payor		0..1	Reference(Resource)	STU3: Identifier for the plan or agreement issuer URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..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)
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
class		0..*	BackboneElement	Additional coverage classifications
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:group		0..1	string	STU3: An identifier for the group (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.group Constraints: ext-1
extension:groupDisplay		0..1	string	STU3: Display text for an identifier for the group (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.groupDisplay Constraints: ext-1
extension:subGroup		0..1	string	STU3: An identifier for the subsection of the group (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subGroup Constraints: ext-1
extension:subGroupDisplay		0..1	string	STU3: Display text for the subsection of the group (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subGroupDisplay Constraints: ext-1
extension:plan		0..1	string	STU3: An identifier for the plan (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.plan Constraints: ext-1
extension:planDisplay		0..1	string	STU3: Display text for the plan (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.planDisplay Constraints: ext-1
extension:subPlan		0..1	string	STU3: An identifier for the subsection of the plan (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subPlan Constraints: ext-1
extension:subPlanDisplay		0..1	string	STU3: Display text for the subsection of the plan (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subPlanDisplay Constraints: ext-1
extension:class		0..1	string	STU3: An identifier for the class (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.class Constraints: ext-1
extension:classDisplay		0..1	string	STU3: Display text for the class (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.classDisplay Constraints: ext-1
extension:subClass		0..1	string	STU3: An identifier for the subsection of the class (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subClass Constraints: ext-1
extension:subClassDisplay		0..1	string	STU3: Display text for the subsection of the subclass (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subClassDisplay Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
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		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 Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
type	Σ	0..1	CodeableConcept	Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified.
value[x]	Σ	1..1		The amount or percentage due from the beneficiary
valueQuantity			Quantity(SimpleQuantity)
valueMoney			Money
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 Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
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
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:contract		0..1	Reference(Resource)	STU3: contract additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..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)
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.meta.security	Base	extensible	SecurityLabels	📍4.3.0	FHIR Std.
Coverage.meta.tag	Base	example	Common Tags	📍4.3.0	FHIR Std.
Coverage.language	Base	preferred	Common Languages	📍4.3.0	FHIR Std.
Coverage.text.status	Base	required	NarrativeStatus	📍4.3.0	FHIR Std.
Coverage.identifier.​use	Base	required	IdentifierUse	📍4.3.0	FHIR Std.
Coverage.identifier.​type	Base	extensible	IdentifierType	📍4.3.0	FHIR Std.
Coverage.status	Base	required	Financial Resource Status Codes	📍4.3.0	FHIR Std.
Coverage.type	Base	preferred	Coverage Type and Self-Pay Codes	📍4.3.0	FHIR Std.
Coverage.policyHolder.​type	Base	extensible	ResourceType	📍4.3.0	FHIR Std.
Coverage.subscriber.​type	Base	extensible	ResourceType	📍4.3.0	FHIR Std.
Coverage.beneficiary.​type	Base	extensible	ResourceType	📍4.3.0	FHIR Std.
Coverage.relationship	Base	extensible	SubscriberPolicyholder Relationship Codes	📍4.3.0	FHIR Std.
Coverage.payor.type	Base	extensible	ResourceType	📍4.3.0	FHIR Std.
Coverage.class.type	Base	extensible	Coverage Class Codes	📍4.3.0	FHIR Std.
Coverage.costToBeneficiary.​type	Base	extensible	Coverage Copay Type Codes	📍4.3.0	FHIR Std.
Coverage.costToBeneficiary.​exception.type	Base	example	Example Coverage Financial Exception Codes	📍4.3.0	FHIR Std.
Coverage.contract.type	Base	extensible	ResourceType	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Coverage	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	contained.where(((id.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Coverage	A resource should have narrative for robust management	text.`div`.exists()
dom-r4b	warning	Coverage.contained	Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems	($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
ele-1	error	Coverage.meta, Coverage.meta.extension, Coverage.meta.extension:meta, Coverage.meta.versionId, Coverage.meta.lastUpdated, Coverage.meta.source, Coverage.meta.profile, Coverage.meta.security, Coverage.meta.tag, Coverage.implicitRules, Coverage.language, Coverage.text, Coverage.text.extension, Coverage.text.extension:text, Coverage.text.status, Coverage.text.div, Coverage.extension, Coverage.extension:sequence, Coverage.modifierExtension, Coverage.identifier, Coverage.identifier.extension, Coverage.identifier.extension:identifier, Coverage.identifier.use, Coverage.identifier.type, Coverage.identifier.system, Coverage.identifier.value, Coverage.identifier.period, Coverage.identifier.assigner, Coverage.status, Coverage.type, Coverage.policyHolder, Coverage.policyHolder.extension, Coverage.policyHolder.extension:policyHolder, Coverage.policyHolder.reference, Coverage.policyHolder.type, Coverage.policyHolder.identifier, Coverage.policyHolder.display, Coverage.subscriber, Coverage.subscriber.extension, Coverage.subscriber.extension:subscriber, Coverage.subscriber.reference, Coverage.subscriber.type, Coverage.subscriber.identifier, Coverage.subscriber.display, Coverage.subscriberId, Coverage.beneficiary, Coverage.beneficiary.extension, Coverage.beneficiary.extension:beneficiary, Coverage.beneficiary.reference, Coverage.beneficiary.type, Coverage.beneficiary.identifier, Coverage.beneficiary.display, Coverage.dependent, Coverage.relationship, Coverage.period, Coverage.period.extension, Coverage.period.extension:period, Coverage.period.start, Coverage.period.end, Coverage.payor, Coverage.payor.extension, Coverage.payor.extension:payor, Coverage.payor.reference, Coverage.payor.type, Coverage.payor.identifier, Coverage.payor.display, Coverage.class, Coverage.class.extension, Coverage.class.extension:group, Coverage.class.extension:groupDisplay, Coverage.class.extension:subGroup, Coverage.class.extension:subGroupDisplay, Coverage.class.extension:plan, Coverage.class.extension:planDisplay, Coverage.class.extension:subPlan, Coverage.class.extension:subPlanDisplay, Coverage.class.extension:class, Coverage.class.extension:classDisplay, Coverage.class.extension:subClass, Coverage.class.extension:subClassDisplay, Coverage.class.modifierExtension, Coverage.class.type, Coverage.class.value, Coverage.class.name, Coverage.order, Coverage.network, Coverage.costToBeneficiary, Coverage.costToBeneficiary.extension, Coverage.costToBeneficiary.modifierExtension, Coverage.costToBeneficiary.type, Coverage.costToBeneficiary.value[x], Coverage.costToBeneficiary.exception, Coverage.costToBeneficiary.exception.extension, Coverage.costToBeneficiary.exception.modifierExtension, Coverage.costToBeneficiary.exception.type, Coverage.costToBeneficiary.exception.period, Coverage.subrogation, Coverage.contract, Coverage.contract.extension, Coverage.contract.extension:contract, Coverage.contract.reference, Coverage.contract.type, Coverage.contract.identifier, Coverage.contract.display	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	Coverage.meta.extension, Coverage.meta.extension:meta, Coverage.text.extension, Coverage.text.extension:text, Coverage.extension, Coverage.extension:sequence, Coverage.modifierExtension, Coverage.identifier.extension, Coverage.identifier.extension:identifier, Coverage.policyHolder.extension, Coverage.policyHolder.extension:policyHolder, Coverage.subscriber.extension, Coverage.subscriber.extension:subscriber, Coverage.beneficiary.extension, Coverage.beneficiary.extension:beneficiary, Coverage.period.extension, Coverage.period.extension:period, Coverage.payor.extension, Coverage.payor.extension:payor, Coverage.class.extension, Coverage.class.extension:group, Coverage.class.extension:groupDisplay, Coverage.class.extension:subGroup, Coverage.class.extension:subGroupDisplay, Coverage.class.extension:plan, Coverage.class.extension:planDisplay, Coverage.class.extension:subPlan, Coverage.class.extension:subPlanDisplay, Coverage.class.extension:class, Coverage.class.extension:classDisplay, Coverage.class.extension:subClass, Coverage.class.extension:subClassDisplay, Coverage.class.modifierExtension, Coverage.costToBeneficiary.extension, Coverage.costToBeneficiary.modifierExtension, Coverage.costToBeneficiary.exception.extension, Coverage.costToBeneficiary.exception.modifierExtension, Coverage.contract.extension, Coverage.contract.extension:contract	Must have either extensions or value[x], not both	extension.exists() != value.exists()
txt-1	error	Coverage.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes	htmlChecks()
txt-2	error	Coverage.text.div	The narrative SHALL have some non-whitespace content	htmlChecks()

This structure is derived from Coverage

Summary

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.meta|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.text|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.sequence|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.identifier|0.1.0
• http://hl7.org/fhir/StructureDefinition/alternate-reference|5.2.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.period|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.group|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.groupDisplay|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subGroup|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subGroupDisplay|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.plan|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.planDisplay|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subPlan|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subPlanDisplay|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.class|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.classDisplay|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subClass|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subClassDisplay|0.1.0

Maturity: 0

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage(4.3.0)	Insurance or medical plan or a payment agreement
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:sequence		0..1	string	STU3: The plan instance or sequence counter (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.sequence Constraints: ext-1
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
beneficiary	Σ	1..1	Reference(Patient)	Plan beneficiary
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:beneficiary		0..1	Reference(Resource)	STU3: Plan Beneficiary additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
payor	Σ	1..*	Reference(Organization | Patient | RelatedPerson)	Issuer of the policy
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:payor		0..1	Reference(Resource)	STU3: Identifier for the plan or agreement issuer URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.status	Base	required	Financial Resource Status Codes	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Coverage	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	contained.where(((id.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Coverage	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	Coverage.implicitRules, Coverage.extension, Coverage.extension:sequence, Coverage.modifierExtension, Coverage.status, Coverage.beneficiary, Coverage.beneficiary.extension, Coverage.beneficiary.extension:beneficiary, Coverage.payor, Coverage.payor.extension, Coverage.payor.extension:payor	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	Coverage.extension, Coverage.extension:sequence, Coverage.modifierExtension, Coverage.beneficiary.extension, Coverage.beneficiary.extension:beneficiary, Coverage.payor.extension, Coverage.payor.extension:payor	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Differential View

This structure is derived from Coverage

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage(4.3.0)	Insurance or medical plan or a payment agreement
meta
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:meta		0..1	(Complex)	STU3: meta additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.meta
text
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:text		0..1	(Complex)	STU3: text additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.text
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:sequence		0..1	string	STU3: The plan instance or sequence counter (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.sequence
identifier
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:identifier		0..*	Identifier	STU3: The primary coverage ID additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.identifier
policyHolder
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:policyHolder		0..1	Reference(Resource)	STU3: policyHolder URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
subscriber
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:subscriber		0..1	Reference(Resource)	STU3: subscriber additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
beneficiary
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:beneficiary		0..1	Reference(Resource)	STU3: Plan Beneficiary additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
period
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:period		0..1	Period	STU3: period additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.period
payor
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:payor		0..*	Reference(Resource)	STU3: Identifier for the plan or agreement issuer URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
class
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:group		0..1	string	STU3: An identifier for the group (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.group
extension:groupDisplay		0..1	string	STU3: Display text for an identifier for the group (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.groupDisplay
extension:subGroup		0..1	string	STU3: An identifier for the subsection of the group (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subGroup
extension:subGroupDisplay		0..1	string	STU3: Display text for the subsection of the group (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subGroupDisplay
extension:plan		0..1	string	STU3: An identifier for the plan (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.plan
extension:planDisplay		0..1	string	STU3: Display text for the plan (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.planDisplay
extension:subPlan		0..1	string	STU3: An identifier for the subsection of the plan (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subPlan
extension:subPlanDisplay		0..1	string	STU3: Display text for the subsection of the plan (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subPlanDisplay
extension:class		0..1	string	STU3: An identifier for the class (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.class
extension:classDisplay		0..1	string	STU3: Display text for the class (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.classDisplay
extension:subClass		0..1	string	STU3: An identifier for the subsection of the class (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subClass
extension:subClassDisplay		0..1	string	STU3: Display text for the subsection of the subclass (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subClassDisplay
contract
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:contract		0..*	Reference(Resource)	STU3: contract additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage(4.3.0)	Insurance or medical plan or a payment agreement
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:meta		0..1	(Complex)	STU3: meta additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.meta Constraints: ext-1
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible)
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example)
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): IETF language tag Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:text		0..1	(Complex)	STU3: text additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.text Constraints: ext-1
status		1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required)
div	C	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
contained		0..*	Resource	Contained, inline Resources Constraints: dom-r4b
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:sequence		0..1	string	STU3: The plan instance or sequence counter (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.sequence Constraints: ext-1
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
identifier	Σ	0..*	Identifier	Business Identifier for the coverage
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:identifier		0..*	Identifier	STU3: The primary coverage ID additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.identifier Constraints: ext-1
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (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)
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	0..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.
policyHolder	Σ	0..1	Reference(Patient | RelatedPerson | Organization)	Owner of the policy
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:policyHolder		0..1	Reference(Resource)	STU3: policyHolder URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..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)
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
subscriber	Σ	0..1	Reference(Patient | RelatedPerson)	Subscriber to the policy
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:subscriber		0..1	Reference(Resource)	STU3: subscriber additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..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)
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
subscriberId	Σ	0..1	string	ID assigned to the subscriber
beneficiary	Σ	1..1	Reference(Patient)	Plan beneficiary
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:beneficiary		0..1	Reference(Resource)	STU3: Plan Beneficiary additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..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)
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
dependent	Σ	0..1	string	Dependent number
relationship		0..1	CodeableConcept	Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
period	Σ	0..1	Period	Coverage start and end dates
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:period		0..1	Period	STU3: period additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.period Constraints: ext-1
start	ΣC	0..1	dateTime	Starting time with inclusive boundary
end	ΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
payor	Σ	1..*	Reference(Organization | Patient | RelatedPerson)	Issuer of the policy
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:payor		0..1	Reference(Resource)	STU3: Identifier for the plan or agreement issuer URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..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)
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
class		0..*	BackboneElement	Additional coverage classifications
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:group		0..1	string	STU3: An identifier for the group (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.group Constraints: ext-1
extension:groupDisplay		0..1	string	STU3: Display text for an identifier for the group (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.groupDisplay Constraints: ext-1
extension:subGroup		0..1	string	STU3: An identifier for the subsection of the group (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subGroup Constraints: ext-1
extension:subGroupDisplay		0..1	string	STU3: Display text for the subsection of the group (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subGroupDisplay Constraints: ext-1
extension:plan		0..1	string	STU3: An identifier for the plan (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.plan Constraints: ext-1
extension:planDisplay		0..1	string	STU3: Display text for the plan (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.planDisplay Constraints: ext-1
extension:subPlan		0..1	string	STU3: An identifier for the subsection of the plan (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subPlan Constraints: ext-1
extension:subPlanDisplay		0..1	string	STU3: Display text for the subsection of the plan (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subPlanDisplay Constraints: ext-1
extension:class		0..1	string	STU3: An identifier for the class (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.class Constraints: ext-1
extension:classDisplay		0..1	string	STU3: Display text for the class (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.classDisplay Constraints: ext-1
extension:subClass		0..1	string	STU3: An identifier for the subsection of the class (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subClass Constraints: ext-1
extension:subClassDisplay		0..1	string	STU3: Display text for the subsection of the subclass (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subClassDisplay Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
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		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 Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
type	Σ	0..1	CodeableConcept	Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified.
value[x]	Σ	1..1		The amount or percentage due from the beneficiary
valueQuantity			Quantity(SimpleQuantity)
valueMoney			Money
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 Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
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
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:contract		0..1	Reference(Resource)	STU3: contract additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..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)
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.meta.security	Base	extensible	SecurityLabels	📍4.3.0	FHIR Std.
Coverage.meta.tag	Base	example	Common Tags	📍4.3.0	FHIR Std.
Coverage.language	Base	preferred	Common Languages	📍4.3.0	FHIR Std.
Coverage.text.status	Base	required	NarrativeStatus	📍4.3.0	FHIR Std.
Coverage.identifier.​use	Base	required	IdentifierUse	📍4.3.0	FHIR Std.
Coverage.identifier.​type	Base	extensible	IdentifierType	📍4.3.0	FHIR Std.
Coverage.status	Base	required	Financial Resource Status Codes	📍4.3.0	FHIR Std.
Coverage.type	Base	preferred	Coverage Type and Self-Pay Codes	📍4.3.0	FHIR Std.
Coverage.policyHolder.​type	Base	extensible	ResourceType	📍4.3.0	FHIR Std.
Coverage.subscriber.​type	Base	extensible	ResourceType	📍4.3.0	FHIR Std.
Coverage.beneficiary.​type	Base	extensible	ResourceType	📍4.3.0	FHIR Std.
Coverage.relationship	Base	extensible	SubscriberPolicyholder Relationship Codes	📍4.3.0	FHIR Std.
Coverage.payor.type	Base	extensible	ResourceType	📍4.3.0	FHIR Std.
Coverage.class.type	Base	extensible	Coverage Class Codes	📍4.3.0	FHIR Std.
Coverage.costToBeneficiary.​type	Base	extensible	Coverage Copay Type Codes	📍4.3.0	FHIR Std.
Coverage.costToBeneficiary.​exception.type	Base	example	Example Coverage Financial Exception Codes	📍4.3.0	FHIR Std.
Coverage.contract.type	Base	extensible	ResourceType	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Coverage	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	contained.where(((id.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Coverage	A resource should have narrative for robust management	text.`div`.exists()
dom-r4b	warning	Coverage.contained	Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems	($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
ele-1	error	Coverage.meta, Coverage.meta.extension, Coverage.meta.extension:meta, Coverage.meta.versionId, Coverage.meta.lastUpdated, Coverage.meta.source, Coverage.meta.profile, Coverage.meta.security, Coverage.meta.tag, Coverage.implicitRules, Coverage.language, Coverage.text, Coverage.text.extension, Coverage.text.extension:text, Coverage.text.status, Coverage.text.div, Coverage.extension, Coverage.extension:sequence, Coverage.modifierExtension, Coverage.identifier, Coverage.identifier.extension, Coverage.identifier.extension:identifier, Coverage.identifier.use, Coverage.identifier.type, Coverage.identifier.system, Coverage.identifier.value, Coverage.identifier.period, Coverage.identifier.assigner, Coverage.status, Coverage.type, Coverage.policyHolder, Coverage.policyHolder.extension, Coverage.policyHolder.extension:policyHolder, Coverage.policyHolder.reference, Coverage.policyHolder.type, Coverage.policyHolder.identifier, Coverage.policyHolder.display, Coverage.subscriber, Coverage.subscriber.extension, Coverage.subscriber.extension:subscriber, Coverage.subscriber.reference, Coverage.subscriber.type, Coverage.subscriber.identifier, Coverage.subscriber.display, Coverage.subscriberId, Coverage.beneficiary, Coverage.beneficiary.extension, Coverage.beneficiary.extension:beneficiary, Coverage.beneficiary.reference, Coverage.beneficiary.type, Coverage.beneficiary.identifier, Coverage.beneficiary.display, Coverage.dependent, Coverage.relationship, Coverage.period, Coverage.period.extension, Coverage.period.extension:period, Coverage.period.start, Coverage.period.end, Coverage.payor, Coverage.payor.extension, Coverage.payor.extension:payor, Coverage.payor.reference, Coverage.payor.type, Coverage.payor.identifier, Coverage.payor.display, Coverage.class, Coverage.class.extension, Coverage.class.extension:group, Coverage.class.extension:groupDisplay, Coverage.class.extension:subGroup, Coverage.class.extension:subGroupDisplay, Coverage.class.extension:plan, Coverage.class.extension:planDisplay, Coverage.class.extension:subPlan, Coverage.class.extension:subPlanDisplay, Coverage.class.extension:class, Coverage.class.extension:classDisplay, Coverage.class.extension:subClass, Coverage.class.extension:subClassDisplay, Coverage.class.modifierExtension, Coverage.class.type, Coverage.class.value, Coverage.class.name, Coverage.order, Coverage.network, Coverage.costToBeneficiary, Coverage.costToBeneficiary.extension, Coverage.costToBeneficiary.modifierExtension, Coverage.costToBeneficiary.type, Coverage.costToBeneficiary.value[x], Coverage.costToBeneficiary.exception, Coverage.costToBeneficiary.exception.extension, Coverage.costToBeneficiary.exception.modifierExtension, Coverage.costToBeneficiary.exception.type, Coverage.costToBeneficiary.exception.period, Coverage.subrogation, Coverage.contract, Coverage.contract.extension, Coverage.contract.extension:contract, Coverage.contract.reference, Coverage.contract.type, Coverage.contract.identifier, Coverage.contract.display	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	Coverage.meta.extension, Coverage.meta.extension:meta, Coverage.text.extension, Coverage.text.extension:text, Coverage.extension, Coverage.extension:sequence, Coverage.modifierExtension, Coverage.identifier.extension, Coverage.identifier.extension:identifier, Coverage.policyHolder.extension, Coverage.policyHolder.extension:policyHolder, Coverage.subscriber.extension, Coverage.subscriber.extension:subscriber, Coverage.beneficiary.extension, Coverage.beneficiary.extension:beneficiary, Coverage.period.extension, Coverage.period.extension:period, Coverage.payor.extension, Coverage.payor.extension:payor, Coverage.class.extension, Coverage.class.extension:group, Coverage.class.extension:groupDisplay, Coverage.class.extension:subGroup, Coverage.class.extension:subGroupDisplay, Coverage.class.extension:plan, Coverage.class.extension:planDisplay, Coverage.class.extension:subPlan, Coverage.class.extension:subPlanDisplay, Coverage.class.extension:class, Coverage.class.extension:classDisplay, Coverage.class.extension:subClass, Coverage.class.extension:subClassDisplay, Coverage.class.modifierExtension, Coverage.costToBeneficiary.extension, Coverage.costToBeneficiary.modifierExtension, Coverage.costToBeneficiary.exception.extension, Coverage.costToBeneficiary.exception.modifierExtension, Coverage.contract.extension, Coverage.contract.extension:contract	Must have either extensions or value[x], not both	extension.exists() != value.exists()
txt-1	error	Coverage.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes	htmlChecks()
txt-2	error	Coverage.text.div	The narrative SHALL have some non-whitespace content	htmlChecks()

This structure is derived from Coverage

Summary

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.meta|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.text|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.sequence|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.identifier|0.1.0
• http://hl7.org/fhir/StructureDefinition/alternate-reference|5.2.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.period|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.group|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.groupDisplay|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subGroup|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subGroupDisplay|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.plan|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.planDisplay|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subPlan|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subPlanDisplay|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.class|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.classDisplay|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subClass|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Coverage.grouping.subClassDisplay|0.1.0

Maturity: 0

Other representations of profile: CSV, Excel, Schematron