<?xml version="1.0" encoding="UTF-8"?>

<ValueSet xmlns="http://hl7.org/fhir">
  <id value="R5-v3-ActCoverageLimitCode-for-R4"/>
  <text>
    <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ValueSet R5-v3-ActCoverageLimitCode-for-R4</b></p><a name="R5-v3-ActCoverageLimitCode-for-R4"> </a><a name="hcR5-v3-ActCoverageLimitCode-for-R4"> </a><p>This value set expansion contains 10 concepts.</p><table class="codes"><tr><td><b>System</b></td><td><b>Version</b></td><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a name="R5-v3-ActCoverageLimitCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-COVMX"> </a><code>http://terminology.hl7.org/CodeSystem/v3-ActCode</code></td><td>8.0.0</td><td style="white-space:nowrap">  <a href="CodeSystem-v3-ActCode.html#v3-ActCode-COVMX">COVMX</a></td><td>coverage maximum</td><td><div><p><strong>Definition:</strong> Codes representing the maximum coverate or financial participation requirements.</p>
</div></td></tr><tr><td><a name="R5-v3-ActCoverageLimitCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-COVPRD"> </a><code>http://terminology.hl7.org/CodeSystem/v3-ActCode</code></td><td>8.0.0</td><td style="white-space:nowrap">  <a href="CodeSystem-v3-ActCode.html#v3-ActCode-COVPRD">COVPRD</a></td><td>coverage period</td><td><div><p>Codes representing the time period during which coverage is available; or financial participation requirements are in effect.</p>
</div></td></tr><tr><td><a name="R5-v3-ActCoverageLimitCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-LFEMX"> </a><code>http://terminology.hl7.org/CodeSystem/v3-ActCode</code></td><td>8.0.0</td><td style="white-space:nowrap">  <a href="CodeSystem-v3-ActCode.html#v3-ActCode-LFEMX">LFEMX</a></td><td>life time maximum</td><td><div><p><strong>Definition:</strong> Maximum amount paid by payer or covered party; or maximum number of services or products covered under the policy or program during a covered party's lifetime.</p>
</div></td></tr><tr><td><a name="R5-v3-ActCoverageLimitCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-NETAMT"> </a><code>http://terminology.hl7.org/CodeSystem/v3-ActCode</code></td><td>8.0.0</td><td style="white-space:nowrap">  <a href="CodeSystem-v3-ActCode.html#v3-ActCode-NETAMT">NETAMT</a></td><td>Net Amount</td><td><div><p>Maximum net amount that will be covered for the product or service specified.</p>
</div></td></tr><tr><td><a name="R5-v3-ActCoverageLimitCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-PRDMX"> </a><code>http://terminology.hl7.org/CodeSystem/v3-ActCode</code></td><td>8.0.0</td><td style="white-space:nowrap">  <a href="CodeSystem-v3-ActCode.html#v3-ActCode-PRDMX">PRDMX</a></td><td>period maximum</td><td><div><p><strong>Definition:</strong> Maximum amount paid by payer or covered party; or maximum number of services/products covered under the policy or program by time period specified by the effective time on the act.</p>
</div></td></tr><tr><td><a name="R5-v3-ActCoverageLimitCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-UNITPRICE"> </a><code>http://terminology.hl7.org/CodeSystem/v3-ActCode</code></td><td>8.0.0</td><td style="white-space:nowrap">  <a href="CodeSystem-v3-ActCode.html#v3-ActCode-UNITPRICE">UNITPRICE</a></td><td>Unit Price</td><td><div><p>Maximum unit price that will be covered for the authorized product or service.</p>
</div></td></tr><tr><td><a name="R5-v3-ActCoverageLimitCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-UNITQTY"> </a><code>http://terminology.hl7.org/CodeSystem/v3-ActCode</code></td><td>8.0.0</td><td style="white-space:nowrap">  <a href="CodeSystem-v3-ActCode.html#v3-ActCode-UNITQTY">UNITQTY</a></td><td>Unit Quantity</td><td><div><p>Maximum number of items that will be covered of the product or service specified.</p>
</div></td></tr><tr><td><a name="R5-v3-ActCoverageLimitCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-_ActCoveragePartyLimitGroupCode"> </a><code>http://terminology.hl7.org/CodeSystem/v3-ActCode</code></td><td>8.0.0</td><td style="white-space:nowrap">  <a href="CodeSystem-v3-ActCode.html#v3-ActCode-_ActCoveragePartyLimitGroupCode">_ActCoveragePartyLimitGroupCode</a></td><td>ActCoveragePartyLimitGroupCode</td><td><div><p>Codes representing the level of coverage provided under the policy or program in terms of the types of entities that may play covered parties based on their personal relationships or employment status.</p>
</div></td></tr><tr><td><a name="R5-v3-ActCoverageLimitCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-_ActCoverageQuantityLimitCode"> </a><code>http://terminology.hl7.org/CodeSystem/v3-ActCode</code></td><td>8.0.0</td><td style="white-space:nowrap">  <a href="CodeSystem-v3-ActCode.html#v3-ActCode-_ActCoverageQuantityLimitCode">_ActCoverageQuantityLimitCode</a></td><td>ActCoverageQuantityLimitCode</td><td><div><p>Maximum amount paid or maximum number of services/products covered; or maximum amount or number covered during a specified time period under the policy or program.</p>
</div></td></tr><tr><td><a name="R5-v3-ActCoverageLimitCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-_ActCoveredPartyLimitCode"> </a><code>http://terminology.hl7.org/CodeSystem/v3-ActCode</code></td><td>8.0.0</td><td style="white-space:nowrap">  <a href="CodeSystem-v3-ActCode.html#v3-ActCode-_ActCoveredPartyLimitCode">_ActCoveredPartyLimitCode</a></td><td>ActCoveredPartyLimitCode</td><td><div><p>Codes representing the types of covered parties that may receive covered benefits under a policy or program.</p>
</div></td></tr></table></div>
  </text>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="fhir"/>
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/package-source">
    <extension url="packageId">
      <valueId value="hl7.fhir.uv.xver-r5.r4"/>
    </extension>
    <extension url="version">
      <valueString value="0.1.0"/>
    </extension>
    <extension url="uri">
      <valueUri value="http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r4"/>
    </extension>
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="0">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
        <valueCanonical value="http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r4"/>
      </extension>
    </valueInteger>
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
        <valueCanonical value="http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r4"/>
      </extension>
    </valueCode>
  </extension>
  <url value="http://hl7.org/fhir/uv/xver/ValueSet/R5-v3-ActCoverageLimitCode-for-R4"/>
  <version value="0.1.0"/>
  <name value="R5V3ActCoverageLimitCodeForR4"/>
  <title value="Cross-version ValueSet R5.ActCoverageLimitCode for use in FHIR R4"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2026-03-17T21:02:03.8104715+00:00"/>
  <publisher value="FHIR Infrastructure"/>
  <contact>
    <name value="FHIR Infrastructure"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/fiwg"/>
    </telecom>
  </contact>
  <description value="This cross-version ValueSet represents content from `http://terminology.hl7.org/ValueSet/v3-ActCoverageLimitCode|2.0.0` for use in FHIR R4."/>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="001"/>
      <display value="World"/>
    </coding>
  </jurisdiction>
  <purpose value="This value set is part of the cross-version definitions generated to enable use of the&#xD;&#xA;value set `http://terminology.hl7.org/ValueSet/v3-ActCoverageLimitCode|2.0.0` as defined in FHIR R5&#xD;&#xA;in FHIR R4.&#xD;&#xA;&#xD;&#xA;The source value set is bound to the following FHIR R5 elements:&#xD;&#xA;* &#xD;&#xA;&#xD;&#xA;Note that all concepts are included in this cross-version definition because no concepts have compatible representations&#xD;&#xA;&#xD;&#xA;Following are the generation technical comments:&#xD;&#xA;&#xA;FHIR ValueSet `http://terminology.hl7.org/ValueSet/v3-ActCoverageLimitCode|2.0.0`, defined in FHIR R5 does not have any mapping to FHIR R4"/>
  <compose>
    <include>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
      <version value="8.0.0"/>
      <concept>
        <code value="COVMX"/>
        <display value="coverage maximum"/>
      </concept>
      <concept>
        <code value="COVPRD"/>
        <display value="coverage period"/>
      </concept>
      <concept>
        <code value="LFEMX"/>
        <display value="life time maximum"/>
      </concept>
      <concept>
        <code value="NETAMT"/>
        <display value="Net Amount"/>
      </concept>
      <concept>
        <code value="PRDMX"/>
        <display value="period maximum"/>
      </concept>
      <concept>
        <code value="UNITPRICE"/>
        <display value="Unit Price"/>
      </concept>
      <concept>
        <code value="UNITQTY"/>
        <display value="Unit Quantity"/>
      </concept>
      <concept>
        <code value="_ActCoveragePartyLimitGroupCode"/>
        <display value="ActCoveragePartyLimitGroupCode"/>
      </concept>
      <concept>
        <code value="_ActCoverageQuantityLimitCode"/>
        <display value="ActCoverageQuantityLimitCode"/>
      </concept>
      <concept>
        <code value="_ActCoveredPartyLimitCode"/>
        <display value="ActCoveredPartyLimitCode"/>
      </concept>
    </include>
  </compose>
  <expansion>
    <timestamp value="2026-03-17T21:02:03.8104715+00:00"/>
    <contains>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
      <version value="8.0.0"/>
      <code value="COVMX"/>
      <display value="coverage maximum"/>
    </contains>
    <contains>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
      <version value="8.0.0"/>
      <code value="COVPRD"/>
      <display value="coverage period"/>
    </contains>
    <contains>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
      <version value="8.0.0"/>
      <code value="LFEMX"/>
      <display value="life time maximum"/>
    </contains>
    <contains>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
      <version value="8.0.0"/>
      <code value="NETAMT"/>
      <display value="Net Amount"/>
    </contains>
    <contains>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
      <version value="8.0.0"/>
      <code value="PRDMX"/>
      <display value="period maximum"/>
    </contains>
    <contains>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
      <version value="8.0.0"/>
      <code value="UNITPRICE"/>
      <display value="Unit Price"/>
    </contains>
    <contains>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
      <version value="8.0.0"/>
      <code value="UNITQTY"/>
      <display value="Unit Quantity"/>
    </contains>
    <contains>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
      <version value="8.0.0"/>
      <code value="_ActCoveragePartyLimitGroupCode"/>
      <display value="ActCoveragePartyLimitGroupCode"/>
    </contains>
    <contains>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
      <version value="8.0.0"/>
      <code value="_ActCoverageQuantityLimitCode"/>
      <display value="ActCoverageQuantityLimitCode"/>
    </contains>
    <contains>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
      <version value="8.0.0"/>
      <code value="_ActCoveredPartyLimitCode"/>
      <display value="ActCoveredPartyLimitCode"/>
    </contains>
  </expansion>
</ValueSet>