Extensions for Using Data Elements from FHIR R4B in FHIR STU3
0.1.0 - STU
Extensions for Using Data Elements from FHIR R4B in FHIR STU3
0.1.0 - STU
Extensions for Using Data Elements from FHIR R4B in FHIR STU3 - Downloaded Version null See the Directory of published versions
| Page standards status: Trial-use | Maturity Level: 0 |
Definitions for the ext-R4B-InsurancePlan.coverage extension.
Guidance on how to interpret the contents of this table can be foundhere
| 0. Extension | |
| Definition | R4B: Optional Extension Element - found in all resources. |
| Short | R4B: Coverage details (new)Optional Extensions Element |
| Comments | Element |
| Control | 0..* This element is affected by the following invariants: ele-1 |
| Is Modifier | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists())ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 2. Extension.extension | |
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | ExtensionAdditional Content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 20..* |
| Type | Extension |
| Alternate Names | extensions, user content |
| Slicing | This element introduces a set of slices on Extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 4. Extension.extension:type | |
| Slice Name | type |
| Definition | R4B: |
| Short | R4B: Type of coverage (new)Additional Content defined by implementations |
| Comments | Element |
| Control | 10..1* |
| Type | Extension |
| Requirements | Element |
| 6. Extension.extension:type.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| Fixed Value | type |
| 8. Extension.extension:type.value[x] | |
| Definition | Type of coverage (Medical; Dental; Mental Health; Substance Abuse; Vision; Drug; Short Term; Long Term Care; Hospice; Home Health). Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). |
| Short | Type of coverageValue of extension |
| Control | 10..1 |
| Type | CodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 10. Extension.extension:network | |
| Slice Name | network |
| Definition | R4B: |
| Short | R4B: What networks provide coverage (new)Additional Content defined by implementations |
| Comments | Element |
| Control | 0..* |
| Type | Extension |
| Requirements | Element |
| 12. Extension.extension:network.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| Fixed Value | network |
| 14. Extension.extension:network.value[x] | |
| Definition | Reference to the network that providing the type of coverage. Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). |
| Short | What networks provide coverageValue of extension |
| Comments | Networks are represented as a hierarchy of organization resources. |
| Control | 0..1 |
| Type | Reference(Cross-version Profile for R4B.Organization for use in FHIR STU3, Organization), date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 16. Extension.extension:benefit | |
| Slice Name | benefit |
| Definition | R4B: |
| Short | R4B: List of benefits (new)Additional Content defined by implementations |
| Comments | Element |
| Control | 10..* |
| Type | Extension |
| Requirements | Element |
| 18. Extension.extension:benefit.extension | |
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | ExtensionAdditional Content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 10..* |
| Type | Extension |
| Alternate Names | extensions, user content |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 20. Extension.extension:benefit.extension:type | |
| Slice Name | type |
| Definition | R4B: |
| Short | R4B: Type of benefit (new)Additional Content defined by implementations |
| Comments | Element |
| Control | 10..1* |
| Type | Extension |
| Requirements | Element |
| 22. Extension.extension:benefit.extension:type.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| Fixed Value | type |
| 24. Extension.extension:benefit.extension:type.value[x] | |
| Definition | Type of benefit (primary care; speciality care; inpatient; outpatient). Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). |
| Short | Type of benefitValue of extension |
| Control | 10..1 |
| Type | CodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 26. Extension.extension:benefit.extension:requirement | |
| Slice Name | requirement |
| Definition | R4B: |
| Short | R4B: Referral requirements (new)Additional Content defined by implementations |
| Comments | Element |
| Control | 0..1* |
| Type | Extension |
| Requirements | Element |
| 28. Extension.extension:benefit.extension:requirement.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| Fixed Value | requirement |
| 30. Extension.extension:benefit.extension:requirement.value[x] | |
| Definition | The referral requirements to have access/coverage for this benefit. Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). |
| Short | Referral requirementsValue of extension |
| Control | 0..1 |
| Type | string, date, dateTime, Meta, code, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 32. Extension.extension:benefit.extension:limit | |
| Slice Name | limit |
| Definition | R4B: |
| Short | R4B: Benefit limits (new)Additional Content defined by implementations |
| Comments | Element |
| Control | 0..* |
| Type | Extension |
| Requirements | Element |
| 34. Extension.extension:benefit.extension:limit.extension | |
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | ExtensionAdditional Content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Alternate Names | extensions, user content |
| Slicing | This element introduces a set of slices on Extension.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 36. Extension.extension:benefit.extension:limit.extension:value | |
| Slice Name | value |
| Definition | R4B: |
| Short | R4B: Maximum value allowed (new)Additional Content defined by implementations |
| Comments | Element |
| Control | 0..1* |
| Type | Extension |
| Requirements | Element |
| 38. Extension.extension:benefit.extension:limit.extension:value.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| Fixed Value | value |
| 40. Extension.extension:benefit.extension:limit.extension:value.value[x] | |
| Definition | The maximum amount of a service item a plan will pay for a covered benefit. For examples. wellness visits, or eyeglasses. Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). |
| Short | Maximum value allowedValue of extension |
| Comments | May also be called “eligible expense,” “payment allowance,” or “negotiated rate.”. |
| Control | 0..1 |
| Type | Quantity, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 42. Extension.extension:benefit.extension:limit.extension:code | |
| Slice Name | code |
| Definition | R4B: |
| Short | R4B: Benefit limit details (new)Additional Content defined by implementations |
| Comments | Element |
| Control | 0..1* |
| Type | Extension |
| Requirements | Element |
| 44. Extension.extension:benefit.extension:limit.extension:code.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| Fixed Value | code |
| 46. Extension.extension:benefit.extension:limit.extension:code.value[x] | |
| Definition | The specific limit on the benefit. Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). |
| Short | Benefit limit detailsValue of extension |
| Comments | Use |
| Control | 0..1 |
| Type | CodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 48. Extension.extension:benefit.extension:limit.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| Fixed Value | limit |
| 50. Extension.extension:benefit.extension:limit.value[x] | |
| Definition | Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). |
| Short | Value of extension |
| Control | 0..01 |
| Type | Choice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 52. Extension.extension:benefit.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| Fixed Value | benefit |
| 54. Extension.extension:benefit.value[x] | |
| Definition | Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). |
| Short | Value of extension |
| Control | 0..01 |
| Type | Choice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 56. Extension.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| Fixed Value | http://hl7.org/fhir/4.3/StructureDefinition/extension-InsurancePlan.coverage |
| 58. Extension.value[x] | |
| Definition | Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). |
| Short | Value of extension |
| Control | 0..01 |
| Type | Choice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Guidance on how to interpret the contents of this table can be foundhere
| 0. Extension | |
| Definition | R4B: |
| Short | R4B: Coverage details (new) |
| Comments | Element |
| Control | 0..* |
| Is Modifier | false |
| 2. Extension.extension | |
| Control | 2..* |
| Slicing | This element introduces a set of slices on Extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 4. Extension.extension:type | |
| Slice Name | type |
| Definition | R4B: |
| Short | R4B: Type of coverage (new) |
| Comments | Element |
| Control | 1..1 |
| Requirements | Element |
| 6. Extension.extension:type.url | |
| Control | 1..1 |
| Fixed Value | type |
| 8. Extension.extension:type.value[x] | |
| Definition | Type of coverage (Medical; Dental; Mental Health; Substance Abuse; Vision; Drug; Short Term; Long Term Care; Hospice; Home Health). |
| Short | Type of coverage |
| Control | 1..1 |
| Type | CodeableConcept |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 10. Extension.extension:network | |
| Slice Name | network |
| Definition | R4B: |
| Short | R4B: What networks provide coverage (new) |
| Comments | Element |
| Control | 0..* |
| Requirements | Element |
| 12. Extension.extension:network.url | |
| Control | 1..1 |
| Fixed Value | network |
| 14. Extension.extension:network.value[x] | |
| Definition | Reference to the network that providing the type of coverage. |
| Short | What networks provide coverage |
| Comments | Networks are represented as a hierarchy of organization resources. |
| Control | 0..1 |
| Type | Reference(Cross-version Profile for R4B.Organization for use in FHIR STU3, Organization) |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 16. Extension.extension:benefit | |
| Slice Name | benefit |
| Definition | R4B: |
| Short | R4B: List of benefits (new) |
| Comments | Element |
| Control | 1..* |
| Requirements | Element |
| 18. Extension.extension:benefit.extension | |
| Control | 1..* |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 20. Extension.extension:benefit.extension:type | |
| Slice Name | type |
| Definition | R4B: |
| Short | R4B: Type of benefit (new) |
| Comments | Element |
| Control | 1..1 |
| Requirements | Element |
| 22. Extension.extension:benefit.extension:type.url | |
| Control | 1..1 |
| Fixed Value | type |
| 24. Extension.extension:benefit.extension:type.value[x] | |
| Definition | Type of benefit (primary care; speciality care; inpatient; outpatient). |
| Short | Type of benefit |
| Control | 1..1 |
| Type | CodeableConcept |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 26. Extension.extension:benefit.extension:requirement | |
| Slice Name | requirement |
| Definition | R4B: |
| Short | R4B: Referral requirements (new) |
| Comments | Element |
| Control | 0..1 |
| Requirements | Element |
| 28. Extension.extension:benefit.extension:requirement.url | |
| Control | 1..1 |
| Fixed Value | requirement |
| 30. Extension.extension:benefit.extension:requirement.value[x] | |
| Definition | The referral requirements to have access/coverage for this benefit. |
| Short | Referral requirements |
| Control | 0..1 |
| Type | string |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 32. Extension.extension:benefit.extension:limit | |
| Slice Name | limit |
| Definition | R4B: |
| Short | R4B: Benefit limits (new) |
| Comments | Element |
| Control | 0..* |
| Requirements | Element |
| 34. Extension.extension:benefit.extension:limit.extension | |
| Control | 0..* |
| Slicing | This element introduces a set of slices on Extension.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 36. Extension.extension:benefit.extension:limit.extension:value | |
| Slice Name | value |
| Definition | R4B: |
| Short | R4B: Maximum value allowed (new) |
| Comments | Element |
| Control | 0..1 |
| Requirements | Element |
| 38. Extension.extension:benefit.extension:limit.extension:value.url | |
| Control | 1..1 |
| Fixed Value | value |
| 40. Extension.extension:benefit.extension:limit.extension:value.value[x] | |
| Definition | The maximum amount of a service item a plan will pay for a covered benefit. For examples. wellness visits, or eyeglasses. |
| Short | Maximum value allowed |
| Comments | May also be called “eligible expense,” “payment allowance,” or “negotiated rate.”. |
| Control | 0..1 |
| Type | Quantity |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 42. Extension.extension:benefit.extension:limit.extension:code | |
| Slice Name | code |
| Definition | R4B: |
| Short | R4B: Benefit limit details (new) |
| Comments | Element |
| Control | 0..1 |
| Requirements | Element |
| 44. Extension.extension:benefit.extension:limit.extension:code.url | |
| Control | 1..1 |
| Fixed Value | code |
| 46. Extension.extension:benefit.extension:limit.extension:code.value[x] | |
| Definition | The specific limit on the benefit. |
| Short | Benefit limit details |
| Comments | Use |
| Control | 0..1 |
| Type | CodeableConcept |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 48. Extension.extension:benefit.extension:limit.url | |
| Control | 1..1 |
| Fixed Value | limit |
| 50. Extension.extension:benefit.extension:limit.value[x] | |
| Control | 0..0 |
| 52. Extension.extension:benefit.url | |
| Control | 1..1 |
| Fixed Value | benefit |
| 54. Extension.extension:benefit.value[x] | |
| Control | 0..0 |
| 56. Extension.url | |
| Control | 1..1 |
| Fixed Value | http://hl7.org/fhir/4.3/StructureDefinition/extension-InsurancePlan.coverage |
| 58. Extension.value[x] | |
| Control | 0..0 |
Guidance on how to interpret the contents of this table can be foundhere
| 0. Extension | |
| Definition | R4B: |
| Short | R4B: Coverage details (new) |
| Comments | Element |
| Control | 0..* This element is affected by the following invariants: ele-1 |
| Is Modifier | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| 2. Extension.id | |
| Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | xml:id (or equivalent in JSON) |
| Control | 0..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| 4. Extension.extension | |
| Definition | An Extension |
| Short | Extension |
| Control | 2..* |
| Type | Extension |
| Slicing | This element introduces a set of slices on Extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 6. Extension.extension:type | |
| Slice Name | type |
| Definition | R4B: |
| Short | R4B: Type of coverage (new) |
| Comments | Element |
| Control | 1..1 |
| Type | Extension |
| Requirements | Element |
| 8. Extension.extension:type.id | |
| Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | xml:id (or equivalent in JSON) |
| Control | 0..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| 10. Extension.extension:type.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | Additional Content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Alternate Names | extensions, user content |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 12. Extension.extension:type.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| Fixed Value | type |
| 14. Extension.extension:type.value[x] | |
| Definition | Type of coverage (Medical; Dental; Mental Health; Substance Abuse; Vision; Drug; Short Term; Long Term Care; Hospice; Home Health). |
| Short | Type of coverage |
| Control | 1..1 |
| Type | CodeableConcept |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 16. Extension.extension:network | |
| Slice Name | network |
| Definition | R4B: |
| Short | R4B: What networks provide coverage (new) |
| Comments | Element |
| Control | 0..* |
| Type | Extension |
| Requirements | Element |
| 18. Extension.extension:network.id | |
| Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | xml:id (or equivalent in JSON) |
| Control | 0..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| 20. Extension.extension:network.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | Additional Content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Alternate Names | extensions, user content |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 22. Extension.extension:network.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| Fixed Value | network |
| 24. Extension.extension:network.value[x] | |
| Definition | Reference to the network that providing the type of coverage. |
| Short | What networks provide coverage |
| Comments | Networks are represented as a hierarchy of organization resources. |
| Control | 0..1 |
| Type | Reference(Cross-version Profile for R4B.Organization for use in FHIR STU3, Organization) |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 26. Extension.extension:benefit | |
| Slice Name | benefit |
| Definition | R4B: |
| Short | R4B: List of benefits (new) |
| Comments | Element |
| Control | 1..* |
| Type | Extension |
| Requirements | Element |
| 28. Extension.extension:benefit.id | |
| Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | xml:id (or equivalent in JSON) |
| Control | 0..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| 30. Extension.extension:benefit.extension | |
| Definition | An Extension |
| Short | Extension |
| Control | 1..* |
| Type | Extension |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 32. Extension.extension:benefit.extension:type | |
| Slice Name | type |
| Definition | R4B: |
| Short | R4B: Type of benefit (new) |
| Comments | Element |
| Control | 1..1 |
| Type | Extension |
| Requirements | Element |
| 34. Extension.extension:benefit.extension:type.id | |
| Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | xml:id (or equivalent in JSON) |
| Control | 0..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| 36. Extension.extension:benefit.extension:type.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | Additional Content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Alternate Names | extensions, user content |
| Slicing | This element introduces a set of slices on Extension.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 38. Extension.extension:benefit.extension:type.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| Fixed Value | type |
| 40. Extension.extension:benefit.extension:type.value[x] | |
| Definition | Type of benefit (primary care; speciality care; inpatient; outpatient). |
| Short | Type of benefit |
| Control | 1..1 |
| Type | CodeableConcept |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 42. Extension.extension:benefit.extension:requirement | |
| Slice Name | requirement |
| Definition | R4B: |
| Short | R4B: Referral requirements (new) |
| Comments | Element |
| Control | 0..1 |
| Type | Extension |
| Requirements | Element |
| 44. Extension.extension:benefit.extension:requirement.id | |
| Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | xml:id (or equivalent in JSON) |
| Control | 0..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| 46. Extension.extension:benefit.extension:requirement.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | Additional Content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Alternate Names | extensions, user content |
| Slicing | This element introduces a set of slices on Extension.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 48. Extension.extension:benefit.extension:requirement.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| Fixed Value | requirement |
| 50. Extension.extension:benefit.extension:requirement.value[x] | |
| Definition | The referral requirements to have access/coverage for this benefit. |
| Short | Referral requirements |
| Control | 0..1 |
| Type | string |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 52. Extension.extension:benefit.extension:limit | |
| Slice Name | limit |
| Definition | R4B: |
| Short | R4B: Benefit limits (new) |
| Comments | Element |
| Control | 0..* |
| Type | Extension |
| Requirements | Element |
| 54. Extension.extension:benefit.extension:limit.id | |
| Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | xml:id (or equivalent in JSON) |
| Control | 0..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| 56. Extension.extension:benefit.extension:limit.extension | |
| Definition | An Extension |
| Short | Extension |
| Control | 0..* |
| Type | Extension |
| Slicing | This element introduces a set of slices on Extension.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 58. Extension.extension:benefit.extension:limit.extension:value | |
| Slice Name | value |
| Definition | R4B: |
| Short | R4B: Maximum value allowed (new) |
| Comments | Element |
| Control | 0..1 |
| Type | Extension |
| Requirements | Element |
| 60. Extension.extension:benefit.extension:limit.extension:value.id | |
| Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | xml:id (or equivalent in JSON) |
| Control | 0..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| 62. Extension.extension:benefit.extension:limit.extension:value.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | Additional Content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Alternate Names | extensions, user content |
| Slicing | This element introduces a set of slices on Extension.extension.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 64. Extension.extension:benefit.extension:limit.extension:value.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| Fixed Value | value |
| 66. Extension.extension:benefit.extension:limit.extension:value.value[x] | |
| Definition | The maximum amount of a service item a plan will pay for a covered benefit. For examples. wellness visits, or eyeglasses. |
| Short | Maximum value allowed |
| Comments | May also be called “eligible expense,” “payment allowance,” or “negotiated rate.”. |
| Control | 0..1 |
| Type | Quantity |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 68. Extension.extension:benefit.extension:limit.extension:code | |
| Slice Name | code |
| Definition | R4B: |
| Short | R4B: Benefit limit details (new) |
| Comments | Element |
| Control | 0..1 |
| Type | Extension |
| Requirements | Element |
| 70. Extension.extension:benefit.extension:limit.extension:code.id | |
| Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | xml:id (or equivalent in JSON) |
| Control | 0..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| 72. Extension.extension:benefit.extension:limit.extension:code.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | Additional Content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Alternate Names | extensions, user content |
| Slicing | This element introduces a set of slices on Extension.extension.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 74. Extension.extension:benefit.extension:limit.extension:code.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| Fixed Value | code |
| 76. Extension.extension:benefit.extension:limit.extension:code.value[x] | |
| Definition | The specific limit on the benefit. |
| Short | Benefit limit details |
| Comments | Use |
| Control | 0..1 |
| Type | CodeableConcept |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 78. Extension.extension:benefit.extension:limit.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| Fixed Value | limit |
| 80. Extension.extension:benefit.extension:limit.value[x] | |
| Definition | Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). |
| Short | Value of extension |
| Control | 0..0 |
| Type | Choice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 82. Extension.extension:benefit.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| Fixed Value | benefit |
| 84. Extension.extension:benefit.value[x] | |
| Definition | Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). |
| Short | Value of extension |
| Control | 0..0 |
| Type | Choice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 86. Extension.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| Fixed Value | http://hl7.org/fhir/4.3/StructureDefinition/extension-InsurancePlan.coverage |
| 88. Extension.value[x] | |
| Definition | Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). |
| Short | Value of extension |
| Control | 0..0 |
| Type | Choice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
IG © 2025+ FHIR Infrastructure. Package hl7.fhir.uv.xver-r4b.r3#0.1.0 based on FHIR 3.0.2. Generated 2026-03-20
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