Coverage.profile.xml

StructureDefinition for coverage

Raw XML

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="Coverage"/>
  <meta>
    <lastUpdated value="2015-04-03T14:24:32.000+11:00"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><!-- Snipped for brevity --></div>
  </text>
  <url value="http://hl7.org/fhir/StructureDefinition/Coverage"/>
  <name value="Coverage"/>
  <publisher value="HL7 FHIR Project (Financial Management)"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://hl7.org/fhir"/>
    </telecom>
  </contact>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/fm/index.cfm"/>
    </telecom>
  </contact>
  <description value="Base StructureDefinition for Coverage Resource"/>
  <status value="draft"/>
  <date value="2015-04-03T14:24:32+11:00"/>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM"/>
  </mapping>
  <mapping>
    <identity value="cpha3pharm"/>
    <uri value="http://www.pharmacists.ca/"/>
    <name value="Canadian Pharmacy Associaiton eclaims standard"/>
  </mapping>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2"/>
  </mapping>
  <mapping>
    <identity value="cdanetv4"/>
    <uri value="http://www.cda-adc.ca/en/services/cdanet/"/>
    <name value="Canadian Dental Association eclaims standard"/>
  </mapping>
  <type value="resource"/>
  <abstract value="true"/>
  <snapshot>
    <element>
      <path value="Coverage"/>
      <short value="Insurance or medical plan"/>
      <definition value="Financial instrument which may be used to pay for or reimburse for health care products
       and services."/>
      <requirements value="Health care programs and insurers are significant payors of health service costs."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="DomainResource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="Coverage"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.id"/>
      <short value="Logical id of this artefact"/>
      <definition value="The logical id of the resource, as used in the url for the resoure. Once assigned, this
       value never changes."/>
      <comments value="The only time that a resource does not have an id is when it is being submitted to the
       server using a create operation. Bundles always have an id, though it is usually a generated
       UUID."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
    </element>
    <element>
      <path value="Coverage.meta"/>
      <short value="Metadata about the resource"/>
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.
       Changes to the content may not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Meta"/>
      </type>
    </element>
    <element>
      <path value="Coverage.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition value="A reference to a set of rules that were followed when the resource was constructed, and
       which must be understood when processing the content."/>
      <comments value="Asserting this rule set restricts the content to be only understood by a limited set of
       trading partners. This inherently limits the usefulness of the data in the long term.
       However the existing health eco-system is highly fractured, and not yet ready to define,
       collect, and exchange data in a generally computable sense. Wherever possible, implementers
       and/or specification writers should avoid using this element as much as possible."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
    </element>
    <element>
      <path value="Coverage.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comments value="Language is provided to support indexing and accessibility (typically, services such as
       text to speech use the language tag). The html language tag in the narrative applies 
       to the narrative. The language tag on the resource may be used to specify the language
       of other presentations generated from the data in the resource  Not all the content has
       to be in the base language. The Resource.language should not be assumed to apply to the
       narrative automatically. If a language is specified, it should it also be specified on
       the div element in the html (see rules in HTML5 for information about the relationship
       between xml:lang and the html lang attribute)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <name value="Language"/>
        <strength value="required"/>
        <description value="A human language"/>
        <valueSetUri value="http://tools.ietf.org/html/bcp47"/>
      </binding>
    </element>
    <element>
      <path value="Coverage.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition value="A human-readable narrative that contains a summary of the resource, and may be used to
       represent the content of the resource to a human. The narrative need not encode all the
       structured data, but is required to contain sufficient detail to make it &quot;clinically
       safe&quot; for a human to just read the narrative. Resource definitions may define what
       content should be represented in the narrative to ensure clinical safety."/>
      <comments value="Contained resources do not have narrative. Resources that are not contained SHOULD have
       a narrative."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.contained"/>
      <short value="Contained, inline Resources"/>
      <definition value="These resources do not have an independent existence apart from the resource that contains
       them - they cannot be identified independently, and nor can they have their own independent
       transaction scope."/>
      <comments value="This should never be done when the content can be identified properly, as once identification
       is lost, it is extremely difficult (and context dependent) to restore it again."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. 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."/>
      <comments value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource, and that modifies the understanding of the element that contains it.
       Usually modifier elements provide negation or qualification. 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.
       Applications processing a resource are required to check for modifier extensions."/>
      <comments value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.issuer"/>
      <short value="An identifier for the plan issuer"/>
      <definition value="The program or plan underwriter or payor."/>
      <requirements value="Need to identify the issuer to target for processing and for coordination of benefit processing."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Organization"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cpha3pharm"/>
        <map value="C.30"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-3-insurance company ID"/>
      </mapping>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="A05"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.bin"/>
      <short value="BIN Number"/>
      <definition value="Business Identification Number (BIN number) used to identify the routing  of eclaims if
       the insurer themselves don't have a BIN number for all of their business."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Identifier"/>
      </type>
    </element>
    <element>
      <path value="Coverage.period"/>
      <short value="Coverage start and end dates"/>
      <definition value="Time period during which the coverage is in force. A missing start date indicates the
       start date isn't known, a missing end date means the coverage is continuing to be in force."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Period"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-12-plan effective date / IN1-13-plan expiration date"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.type"/>
      <short value="Type of coverage"/>
      <definition value="The type of coverage: social program, medical plan, accident coverage (workers compensation,
       auto), group health."/>
      <requirements value="The order of application of coverages is dependent on the types of coverage."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Coding"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <name value="CoverageType"/>
        <strength value="example"/>
        <description value="The type of insurance: public health, worker compensation; private accident, auto, private
         health, etc.)"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/v3/vs/ActCoverageTypeCode"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-15-plan type"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.subscriberId"/>
      <short value="Subscriber ID"/>
      <definition value="The id issued to the subscriber."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="Coverage.identifier"/>
      <short value="The primary coverage ID"/>
      <definition value="The main (and possibly only) identifier for the coverage - often referred to as a Member
       Id, Subscriber Id, Certificate number or Personal Health Number or Case ID."/>
      <requirements value="This value may uniquely identify the coverage or it may be used in conjunction with the
       additional identifiers below."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cpha3pharm"/>
        <map value="C.32, C.33, C.39"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-2-health plan ID"/>
      </mapping>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="C02"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.group"/>
      <short value="An identifier for the group"/>
      <definition value="Identifies a style or collective of coverage issues by the underwriter, for example may
       be used to identify a class of coverage or employer group. May also be referred to as
       a Policy or Group ID."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cpha3pharm"/>
        <map value="C.31"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-8-group number"/>
      </mapping>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="C11 (Division,Section)"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.plan"/>
      <short value="An identifier for the plan"/>
      <definition value="Identifies a style or collective of coverage issues by the underwriter, for example may
       be used to identify a class of coverage or employer group. May also be referred to as
       a Policy or Group ID."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-35-company plan code"/>
      </mapping>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="C01"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.subPlan"/>
      <short value="An identifier for the subsection of the plan"/>
      <definition value="Identifies a sub-style or sub-collective of coverage issues by the underwriter, for example
       may be used to identify a specific employer group within a class of employers. May be
       referred to as a Section or Division ID."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-10-insured's group emp ID"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.dependent"/>
      <short value="The dependent number"/>
      <definition value="A unique identifier for a dependent under the coverage."/>
      <requirements value="For some coverage a single identifier is issued to the PolicyHolder and dependent number
       issues to each to each of their dependents to track and manage the plan."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="positiveInt"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="- No exact V2.x equivalent concept seems to exist; instance relationship can be inferred
         if ( ( PID-3-patient ID list ??? IN1-49-insured's ID number ) &amp; ( ?? IN2-72-patient's
         relationship to insured ) )"/>
      </mapping>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="C17"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.sequence"/>
      <short value="The plan instance or sequence counter"/>
      <definition value="An optional counter for a particular instance of the identified coverage which increments
       upon each renewal."/>
      <requirements value="Some coverage, for example social plans, may be offered in short time increments, for
       example for a week or a month at a time, so while the rest of the plan details and identifiers
       may remain constant over time, the instance is incremented with each renewal and provided
       to the covered party on their 'card'."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="positiveInt"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="No V2.x equivalent concept seems to exist"/>
      </mapping>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="D11"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.subscriber"/>
      <short value="Plan holder information"/>
      <definition value="The party who 'owns' the insurance contractual relationship to the policy or to whom the
       benefit of the policy is due."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="cpha3pharm"/>
        <map value="C.35"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-16, 18,  19-name of insured, address, date of birth"/>
      </mapping>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="D01 through D09"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.network"/>
      <short value="Insurer network"/>
      <definition value="The identifier for a community of providers."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="D10"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.contract"/>
      <short value="Contract details"/>
      <definition value="The policy(s) which constitute this insurance coverage."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Contract"/>
      </type>
      <mapping>
        <identity value="cpha3pharm"/>
        <map value="C.35"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-16, 18,  19-name of insured, address, date of birth"/>
      </mapping>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="D01 through D09"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element>
      <path value="Coverage"/>
      <short value="Insurance or medical plan"/>
      <definition value="Financial instrument which may be used to pay for or reimburse for health care products
       and services."/>
      <requirements value="Health care programs and insurers are significant payors of health service costs."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="DomainResource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="Coverage"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.issuer"/>
      <short value="An identifier for the plan issuer"/>
      <definition value="The program or plan underwriter or payor."/>
      <requirements value="Need to identify the issuer to target for processing and for coordination of benefit processing."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Organization"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cpha3pharm"/>
        <map value="C.30"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-3-insurance company ID"/>
      </mapping>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="A05"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.bin"/>
      <short value="BIN Number"/>
      <definition value="Business Identification Number (BIN number) used to identify the routing  of eclaims if
       the insurer themselves don't have a BIN number for all of their business."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Identifier"/>
      </type>
    </element>
    <element>
      <path value="Coverage.period"/>
      <short value="Coverage start and end dates"/>
      <definition value="Time period during which the coverage is in force. A missing start date indicates the
       start date isn't known, a missing end date means the coverage is continuing to be in force."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Period"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-12-plan effective date / IN1-13-plan expiration date"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.type"/>
      <short value="Type of coverage"/>
      <definition value="The type of coverage: social program, medical plan, accident coverage (workers compensation,
       auto), group health."/>
      <requirements value="The order of application of coverages is dependent on the types of coverage."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Coding"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <name value="CoverageType"/>
        <strength value="example"/>
        <description value="The type of insurance: public health, worker compensation; private accident, auto, private
         health, etc.)"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/v3/vs/ActCoverageTypeCode"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-15-plan type"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.subscriberId"/>
      <short value="Subscriber ID"/>
      <definition value="The id issued to the subscriber."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="Coverage.identifier"/>
      <short value="The primary coverage ID"/>
      <definition value="The main (and possibly only) identifier for the coverage - often referred to as a Member
       Id, Subscriber Id, Certificate number or Personal Health Number or Case ID."/>
      <requirements value="This value may uniquely identify the coverage or it may be used in conjunction with the
       additional identifiers below."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cpha3pharm"/>
        <map value="C.32, C.33, C.39"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-2-health plan ID"/>
      </mapping>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="C02"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.group"/>
      <short value="An identifier for the group"/>
      <definition value="Identifies a style or collective of coverage issues by the underwriter, for example may
       be used to identify a class of coverage or employer group. May also be referred to as
       a Policy or Group ID."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cpha3pharm"/>
        <map value="C.31"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-8-group number"/>
      </mapping>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="C11 (Division,Section)"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.plan"/>
      <short value="An identifier for the plan"/>
      <definition value="Identifies a style or collective of coverage issues by the underwriter, for example may
       be used to identify a class of coverage or employer group. May also be referred to as
       a Policy or Group ID."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-35-company plan code"/>
      </mapping>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="C01"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.subPlan"/>
      <short value="An identifier for the subsection of the plan"/>
      <definition value="Identifies a sub-style or sub-collective of coverage issues by the underwriter, for example
       may be used to identify a specific employer group within a class of employers. May be
       referred to as a Section or Division ID."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-10-insured's group emp ID"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.dependent"/>
      <short value="The dependent number"/>
      <definition value="A unique identifier for a dependent under the coverage."/>
      <requirements value="For some coverage a single identifier is issued to the PolicyHolder and dependent number
       issues to each to each of their dependents to track and manage the plan."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="positiveInt"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="- No exact V2.x equivalent concept seems to exist; instance relationship can be inferred
         if ( ( PID-3-patient ID list ??? IN1-49-insured's ID number ) &amp; ( ?? IN2-72-patient's
         relationship to insured ) )"/>
      </mapping>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="C17"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.sequence"/>
      <short value="The plan instance or sequence counter"/>
      <definition value="An optional counter for a particular instance of the identified coverage which increments
       upon each renewal."/>
      <requirements value="Some coverage, for example social plans, may be offered in short time increments, for
       example for a week or a month at a time, so while the rest of the plan details and identifiers
       may remain constant over time, the instance is incremented with each renewal and provided
       to the covered party on their 'card'."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="positiveInt"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="No V2.x equivalent concept seems to exist"/>
      </mapping>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="D11"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.subscriber"/>
      <short value="Plan holder information"/>
      <definition value="The party who 'owns' the insurance contractual relationship to the policy or to whom the
       benefit of the policy is due."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="cpha3pharm"/>
        <map value="C.35"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-16, 18,  19-name of insured, address, date of birth"/>
      </mapping>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="D01 through D09"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.network"/>
      <short value="Insurer network"/>
      <definition value="The identifier for a community of providers."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="D10"/>
      </mapping>
    </element>
    <element>
      <path value="Coverage.contract"/>
      <short value="Contract details"/>
      <definition value="The policy(s) which constitute this insurance coverage."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Contract"/>
      </type>
      <mapping>
        <identity value="cpha3pharm"/>
        <map value="C.35"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-16, 18,  19-name of insured, address, date of birth"/>
      </mapping>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="D01 through D09"/>
      </mapping>
    </element>
  </differential>
</StructureDefinition>