Consolidated CDA (C-CDA)
4.0.0 - STU4 United States of America flag

This page is part of the CCDA: Consolidated CDA Release (v4.0.0: CCDA 4.0) generated with FHIR (HL7® FHIR® Standard) v5.0.0. This is the current published version. For a full list of available versions, see the Directory of published versions

Logical Model: Policy Activity

Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/PolicyActivity Version: 4.0.0
Draft as of 2025-06-20 Computable Name: PolicyActivity
Other Identifiers: urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#urn:hl7ii:2.16.840.1.113883.10.20.22.4.61:2024-05-01

A policy activity represents the policy or program providing the coverage. The person for whom payment is being provided (i.e., the patient) is the covered party. The subscriber of the policy or program is represented as a participant that is the holder of the coverage. The payer is represented as the performer of the policy activity. Note that the absence of a Policy Activity Act is not confirmation the patient does not have coverage. A Patient's coverage may not have been documented yet or not known to the healthcare provider.

  • Absence of a Policy Activity Act may mean that the patient has no coverage or the healthcare provider may not know it.
  • A self pay payer type MAY be used to imply that the patient has no coverage or that an individual or organization other than an insurer is taking responsibility for payment for a portion of the health care costs.

Templates Used

Although open templates may contain any valid CDA content, the following templates are specifically called out by this template:

Optional EntryRelationships: AuthorizationActivity

Usages:

Changes since version 3.0.0:

  • The resource metadata has changed (description)

    • Formal Views of Template Content

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

    This structure is derived from Act

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, 4537-17139
    ... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
    .... templateId:policy-activity 1..1 II
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.61
    ..... @extension 1..1 st Required Pattern: 2024-05-01
    ... @classCode 1..1 cs Fixed Value: ACT
    ... @moodCode 1..1 cs Fixed Value: EVN
    ... code 1..1 CD 𝗨𝗦𝗖𝗗𝗜: Coverage Type: Records the category of health care payers, insurance products, or benefits.
    Binding: Payer Type . (preferred)
    ... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    ... statusCode 1..1 CS
    .... @code 1..1 cs Fixed Value: completed
    ... Slices for performer 1..* Performer2 Slice: Unordered, Open by value:templateId.root
    .... performer:payer 1..1 Performer2 This performer represents the Payer.
    ..... templateId 1..1 II
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.87
    ...... @extension 0..0
    ..... @typeCode 1..1 cs
    ..... assignedEntity C 1..1 AssignedEntity Constraints: should-code, should-representedOrganization
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Payer Identifier: This is the Payer id. The root is a unique identifier to an openly available assigning authority, such as National Association of Insurance Commissioners (NAIC) (2.16.840.1.113883.6.300), and the extension identifiers the payer within that authority.
    ...... code 0..1 CE
    ....... @nullFlavor 0..0
    ....... @code 1..1 cs Binding: Financially Responsible Party Type Value Set . (preferred)
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... representedOrganization C 0..1 Organization Constraints: should-name
    ....... name 0..1 ON
    .... performer:guarantor C 0..* Performer2 This performer represents the Guarantor.
    Constraints: should-time
    ..... templateId 1..1 II
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.88
    ...... @extension 0..0
    ..... @typeCode 1..1 cs
    ..... time 0..1 IVL_TS
    ..... assignedEntity C 1..1 AssignedEntity Constraints: 4537-8967, should-addr, should-telecom
    ...... code 1..1 CE
    ....... @code 1..1 cs Required Pattern: GUAR
    ....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.110
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ... Slices for participant 1..* Participant2 Slice: Unordered, Open by value:typeCode
    .... participant:coverage-target C 1..1 Participant2 participant
    Constraints: should-time
    ..... templateId 1..1 II
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.89
    ...... @extension 0..0
    ..... @typeCode 1..1 cs Fixed Value: COV
    ..... time C 0..1 IVL_TS This records the policy coverage period or self-pay period.
    Constraints: should-low, should-high
    ...... low 0..1 IVXB_TS
    ...... high 0..1 IVXB_TS SHOULD contain high
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr, should-playingEntity
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Member Identifier: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
    ...... code C 1..1 CE 𝗨𝗦𝗖𝗗𝗜: Relationship to Subscriber: Records the relationship of a patient to the primary insured person.
    Constraints: should-code-attr
    ....... @code 0..1 cs Binding: Coverage Role Type Value Set . (preferred)
    ...... addr 0..1 USRealmAddress
    ...... playingEntity 0..1 PlayingEntity This playingEntity records the covered party name and birthTime as represented by the health plan. This could match the information in recordTarget, or be different due to marriage or other reasons.
    ....... name 1..1 PN
    ....... sdtcBirthTime 1..1 TS sdtc:birthTime
    .... participant:subscriber 0..1 Participant2 When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information.
    ..... templateId 1..1 II
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.90
    ...... @extension 0..0
    ..... @typeCode 1..1 cs Fixed Value: HLD
    ..... time 0..1 IVL_TS
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Subscriber Id: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
    ...... addr 0..1 USRealmAddress
    ... Slices for entryRelationship 0..* EntryRelationship Slice: Unordered, Open by value:act.moodCode
    .... entryRelationship:authorization 0..* EntryRelationship entryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... act 1..1 AuthorizationActivity
    ...... @moodCode 1..1 cs EVN
    .... entryRelationship:plan 0..* EntryRelationship Represents the Coverage Plan
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... act 1..1 Act
    ...... @classCode 1..1 cs Fixed Value: ACT
    ...... @moodCode 1..1 cs Fixed Value: DEF
    ...... id 1..* II Plan identifier
    ...... text 1..1 ED Name of the plan

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    Act.codepreferredPayerType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
    Act.performer:payer.assignedEntity.code.codepreferredFinanciallyResponsiblePartyTypeValueSet .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.10416
    Act.participant:coverage-target.participantRole.code.codepreferredCoverageRoleTypeValueSet .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.18877

    Constraints

    IdGradePath(s)DetailsRequirements
    4537-8967warningAct.performer:guarantor.assignedEntity**SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
    : assignedPerson.name.exists() or representedOrganization.name.exists()
    4537-17139errorActWhen the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
    : participant.where(typeCode='COV').participantRole.code.where(code = 'SELF').exists() implies participant.where(typeCode='HLD').empty()
    should-addrwarningAct.performer:guarantor.assignedEntity, Act.participant:coverage-target.participantRole, Act.participant:subscriber.participantRoleSHOULD contain addr
    : addr.exists()
    should-codewarningAct.performer:payer.assignedEntitySHOULD contain code
    : code.exists()
    should-code-attrwarningAct.participant:coverage-target.participantRole.codeSHOULD contain @code
    : code.exists()
    should-highwarningAct.participant:coverage-target.timeSHOULD contain high
    : high.exists()
    should-lowwarningAct.participant:coverage-target.timeSHOULD contain low
    : low.exists()
    should-namewarningAct.performer:payer.assignedEntity.representedOrganizationSHOULD contain name
    : name.exists()
    should-playingEntitywarningAct.participant:coverage-target.participantRoleSHOULD contain playingEntity
    : playingEntity.exists()
    should-representedOrganizationwarningAct.performer:payer.assignedEntitySHOULD contain representedOrganization
    : representedOrganization.exists()
    should-telecomwarningAct.performer:guarantor.assignedEntitySHOULD contain telecom
    : telecom.exists()
    should-text-ref-valuewarningActSHOULD contain text/reference/@value
    : text.reference.value.exists()
    should-timewarningAct.performer:guarantor, Act.participant:coverage-targetSHOULD contain time
    : time.exists()
    value-starts-octothorpeerrorAct.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
    : value.exists() implies value.startsWith('#')
    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, 4537-17139
    ... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ... realmCode 0..* CS
    ... typeId C 0..1 II Constraints: II-1
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @assigningAuthorityName 0..1 st
    .... @displayable 0..1 bl
    .... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    .... @extension 1..1 st
    .... templateId:policy-activity 1..1 II
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... @assigningAuthorityName 0..1 st
    ..... @displayable 0..1 bl
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.61
    ..... @extension 1..1 st Required Pattern: 2024-05-01
    ... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ... @moodCode 1..1 cs Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: EVN
    ... @negationInd 0..1 bl
    ... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Group Identifier: This is the identifier (sent in the @extension attribute) used to uniquely refer to a specific health insurance plan.
    ... code 1..1 CD 𝗨𝗦𝗖𝗗𝗜: Coverage Type: Records the category of health care payers, insurance products, or benefits.
    Binding: Payer Type . (preferred)
    ... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
    .... @integrityCheck 0..1 bin
    .... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
    .... @language 0..1 cs
    .... @mediaType 0..1 cs Binding: MediaType (example)
    .... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
    .... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    .... thumbnail 0..1 ED
    ... statusCode 1..1 CS Binding: ActStatus (required)
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @code 1..1 cs Fixed Value: completed
    .... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
    XML: valueSet (urn:hl7-org:sdtc)
    .... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
    XML: valueSetVersion (urn:hl7-org:sdtc)
    ... effectiveTime 0..1 IVL_TS
    ... priorityCode 0..1 CE Binding: ActPriority (example)
    ... languageCode 0..1 CS Binding: AllLanguages (required)
    ... subject 0..1 Subject
    ... specimen 0..* Specimen
    ... Slices for performer 1..* Performer2 Slice: Unordered, Open by value:templateId.root
    .... performer:payer 1..1 Performer2 This performer represents the Payer.
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 1..1 II
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.87
    ..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
    Fixed Value: PRF
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... modeCode 0..1 CE
    ..... assignedEntity C 1..1 AssignedEntity Constraints: should-code, should-representedOrganization
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... templateId 0..* II
    ...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
    Fixed Value: ASSIGNED
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Payer Identifier: This is the Payer id. The root is a unique identifier to an openly available assigning authority, such as National Association of Insurance Commissioners (NAIC) (2.16.840.1.113883.6.300), and the extension identifiers the payer within that authority.
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 0..1 CE Binding: CDARoleCode (example)
    ....... @code 1..1 cs Binding: Financially Responsible Party Type Value Set . (preferred)
    ....... @codeSystem 0..1 oid, uuid, ruid
    ....... @codeSystemName 0..1 st
    ....... @codeSystemVersion 0..1 st
    ....... @displayName 0..1 st
    ....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
    XML: valueSet (urn:hl7-org:sdtc)
    ....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
    XML: valueSetVersion (urn:hl7-org:sdtc)
    ....... originalText 0..1 ED
    ....... translation 0..* CD
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... assignedPerson 0..1 Person
    ...... representedOrganization C 0..1 Organization Constraints: should-name
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... realmCode 0..* CS
    ....... typeId C 0..1 II Constraints: II-1
    ........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ........ @assigningAuthorityName 0..1 st
    ........ @displayable 0..1 bl
    ........ @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ........ @extension 1..1 st
    ....... templateId 0..* II
    ....... @classCode 0..1 cs Binding: EntityClassOrganization (required)
    Fixed Value: ORG
    ....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
    Fixed Value: INSTANCE
    ....... id 0..* II
    ....... name 0..1 ON
    ....... telecom 0..* TEL
    ....... addr 0..* AD
    ....... standardIndustryClassCode 0..1 CE Binding: OrganizationIndustryClassNAICS (example)
    ....... asOrganizationPartOf 0..1 OrganizationPartOf
    ...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
    XML: patient (urn:hl7-org:sdtc)
    ....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
    XML Namespace: urn:hl7-org:sdtc
    .... performer:guarantor C 0..* Performer2 This performer represents the Guarantor.
    Constraints: should-time
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 1..1 II
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.88
    ..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
    Fixed Value: PRF
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... modeCode 0..1 CE
    ..... assignedEntity C 1..1 AssignedEntity Constraints: 4537-8967, should-addr, should-telecom
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... templateId 0..* II
    ...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
    Fixed Value: ASSIGNED
    ...... id 1..* II
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 1..1 CE Binding: CDARoleCode (example)
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @code 1..1 cs Required Pattern: GUAR
    ....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.110
    ....... @codeSystemName 0..1 st
    ....... @codeSystemVersion 0..1 st
    ....... @displayName 0..1 st
    ....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
    XML: valueSet (urn:hl7-org:sdtc)
    ....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
    XML: valueSetVersion (urn:hl7-org:sdtc)
    ....... originalText 0..1 ED
    ....... translation 0..* CD
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... assignedPerson 0..1 Person
    ...... representedOrganization 0..1 Organization
    ...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
    XML: patient (urn:hl7-org:sdtc)
    ....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
    XML Namespace: urn:hl7-org:sdtc
    ... author 0..* Author
    ... informant 0..* Informant
    ... Slices for participant 1..* Participant2 Slice: Unordered, Open by value:typeCode
    .... participant:coverage-target C 1..1 Participant2 participant
    Constraints: should-time
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 1..1 II
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.89
    ..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
    Fixed Value: COV
    ..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
    Fixed Value: OP
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time C 0..1 IVL_TS This records the policy coverage period or self-pay period.
    Constraints: should-low, should-high
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @value 0..1 ts Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
    ...... @operator 0..1 cs Binding: CDASetOperator (required)
    ...... low 0..1 IVXB_TS
    ...... center 0..1 TS
    ...... width 0..1 PQ
    ...... high 0..1 IVXB_TS SHOULD contain high
    ..... awarenessCode 0..1 CE
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr, should-playingEntity
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... templateId 0..* II
    ...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Member Identifier: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code C 1..1 CE 𝗨𝗦𝗖𝗗𝗜: Relationship to Subscriber: Records the relationship of a patient to the primary insured person.
    Binding: CDARoleCode (example)
    Constraints: should-code-attr
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @code 0..1 cs Binding: Coverage Role Type Value Set . (preferred)
    ....... @codeSystem 0..1 oid, uuid, ruid
    ....... @codeSystemName 0..1 st
    ....... @codeSystemVersion 0..1 st
    ....... @displayName 0..1 st
    ....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
    XML: valueSet (urn:hl7-org:sdtc)
    ....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
    XML: valueSetVersion (urn:hl7-org:sdtc)
    ....... originalText 0..1 ED
    ....... translation 0..* CD
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... playingDevice 0..1 Device
    ...... playingEntity 0..1 PlayingEntity This playingEntity records the covered party name and birthTime as represented by the health plan. This could match the information in recordTarget, or be different due to marriage or other reasons.
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... realmCode 0..* CS
    ....... typeId C 0..1 II Constraints: II-1
    ........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ........ @assigningAuthorityName 0..1 st
    ........ @displayable 0..1 bl
    ........ @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ........ @extension 1..1 st
    ....... templateId 0..* II
    ....... @classCode 0..1 cs Binding: EntityClassRoot (required)
    ....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
    Fixed Value: INSTANCE
    ....... code 0..1 CE Binding: CDAEntityCode (example)
    ....... quantity 0..* PQ
    ....... name 1..1 PN
    ....... sdtcBirthTime 1..1 TS XML Namespace: urn:hl7-org:sdtc
    sdtc:birthTime
    XML: birthTime (urn:hl7-org:sdtc)
    ....... desc 0..1 ED
    ...... scopingEntity 0..1 Entity
    .... participant:subscriber 0..1 Participant2 When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information.
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 1..1 II
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.90
    ..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
    Fixed Value: HLD
    ..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
    Fixed Value: OP
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... awarenessCode 0..1 CE
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... templateId 0..* II
    ...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Subscriber Id: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 0..1 CE Binding: CDARoleCode (example)
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... playingDevice 0..1 Device
    ...... playingEntity 0..1 PlayingEntity
    ...... scopingEntity 0..1 Entity
    ... Slices for entryRelationship 0..* EntryRelationship Slice: Unordered, Open by value:act.moodCode
    .... entryRelationship:authorization 0..* EntryRelationship entryRelationship
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 AuthorizationActivity
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... Slices for templateId 1..* II Slice: Unordered, Open by value:root
    ....... templateId:authorization-activity 1..1 II
    ........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ........ @assigningAuthorityName 0..1 st
    ........ @displayable 0..1 bl
    ........ @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.1.19
    ...... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ...... @moodCode 1..1 cs EVN
    Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: EVN
    ...... @negationInd 0..1 bl
    ...... id 1..1 II
    ...... code 1..1 CD Binding: v3 Code System ActCode (example)
    ...... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
    ....... @integrityCheck 0..1 bin
    ....... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
    ....... @language 0..1 cs
    ....... @mediaType 0..1 cs Binding: MediaType (example)
    ....... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
    ....... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    ....... reference C 0..1 TEL Constraints: value-starts-octothorpe
    ....... thumbnail 0..1 ED
    ...... statusCode 0..1 CS Binding: ActStatus (required)
    ...... effectiveTime 0..1 IVL_TS
    ...... priorityCode 0..1 CE Binding: ActPriority (example)
    ...... languageCode 0..1 CS Binding: AllLanguages (required)
    ...... subject 0..1 Subject
    ...... specimen 0..* Specimen
    ...... performer 0..* Performer2
    ...... author 0..* Author
    ...... informant 0..* Informant
    ...... participant 0..* Participant2
    ...... Slices for entryRelationship 1..* EntryRelationship Slice: Unordered, Open by value:typeCode
    ....... entryRelationship:target C 1..* EntryRelationship The target of an authorization activity MAY contain one or more performer, to indicate the providers that have been authorized to provide treatment (CONF:81-8952).
    Constraints: 81-8951
    ........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ........ realmCode 0..* CS
    ........ typeId C 0..1 II Constraints: II-1
    ......... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ......... @assigningAuthorityName 0..1 st
    ......... @displayable 0..1 bl
    ......... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ......... @extension 1..1 st
    ........ templateId 0..* II
    ........ @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: SUBJ
    ........ @inversionInd 0..1 bl
    ........ @contextConductionInd 0..1 bl
    ........ @negationInd 0..1 bl
    ........ sequenceNumber 0..1 INT
    ........ seperatableInd 0..1 BL
    ........ act 0..1 Act
    ........ encounter 0..1 Encounter
    ........ observation 0..1 Observation
    ........ observationMedia 0..1 ObservationMedia
    ........ organizer 0..1 Organizer
    ........ procedure 0..1 Procedure
    ........ regionOfInterest 0..1 RegionOfInterest
    ........ substanceAdministration 0..1 SubstanceAdministration
    ........ supply 0..1 Supply
    ...... reference 0..* Reference
    ...... precondition 0..* Precondition
    ...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
    ..... encounter 0..1 Encounter
    ..... observation 0..1 Observation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:plan 0..* EntryRelationship Represents the Coverage Plan
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 Act
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... templateId 0..* II
    ...... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ...... @moodCode 1..1 cs Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: DEF
    ...... @negationInd 0..1 bl
    ...... id 1..* II Plan identifier
    ...... code 1..1 CD Binding: v3 Code System ActCode (example)
    ...... text 1..1 ED Name of the plan
    ...... statusCode 0..1 CS Binding: ActStatus (required)
    ...... effectiveTime 0..1 IVL_TS
    ...... priorityCode 0..1 CE Binding: ActPriority (example)
    ...... languageCode 0..1 CS Binding: AllLanguages (required)
    ...... subject 0..1 Subject
    ...... specimen 0..* Specimen
    ...... performer 0..* Performer2
    ...... author 0..* Author
    ...... informant 0..* Informant
    ...... participant 0..* Participant2
    ...... entryRelationship 0..* EntryRelationship
    ...... reference 0..* Reference
    ...... precondition 0..* Precondition
    ...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
    ..... encounter 0..1 Encounter
    ..... observation 0..1 Observation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    ... reference 0..* Reference
    ... precondition 0..* Precondition
    ... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Act.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.templateId:policy-activity.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.classCoderequiredFixed Value: ACT
    http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
    Act.moodCoderequiredFixed Value: EVN
    http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
    Act.codepreferredPayerType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
    Act.text.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.text.compressionrequiredCDACompressionAlgorithm
    http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
    Act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
    http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
    Act.text.mediaTypeexampleMediaType
    http://terminology.hl7.org/ValueSet/v3-MediaType
    Act.text.representationrequiredBinaryDataEncoding
    http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
    Act.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.statusCode.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.priorityCodeexampleActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard
    Act.performer:payer.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.templateId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.typeCoderequiredFixed Value: PRF
    http://terminology.hl7.org/ValueSet/v3-ParticipationPhysicalPerformer
    Act.performer:payer.assignedEntity.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.assignedEntity.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.assignedEntity.classCoderequiredFixed Value: ASSIGNED
    http://terminology.hl7.org/ValueSet/v3-RoleClassAssignedEntity
    Act.performer:payer.assignedEntity.codeexampleCDARoleCode
    http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
    Act.performer:payer.assignedEntity.code.codepreferredFinanciallyResponsiblePartyTypeValueSet .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.10416
    Act.performer:payer.assignedEntity.representedOrganization.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.assignedEntity.representedOrganization.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.assignedEntity.representedOrganization.classCoderequiredFixed Value: ORG
    http://terminology.hl7.org/ValueSet/v3-EntityClassOrganization
    Act.performer:payer.assignedEntity.representedOrganization.determinerCoderequiredFixed Value: INSTANCE
    http://terminology.hl7.org/ValueSet/v3-EntityDeterminer
    Act.performer:payer.assignedEntity.representedOrganization.standardIndustryClassCodeexampleOrganizationIndustryClassNAICS
    http://terminology.hl7.org/ValueSet/v3-OrganizationIndustryClassNAICS
    Act.performer:guarantor.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:guarantor.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:guarantor.templateId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:guarantor.typeCoderequiredFixed Value: PRF
    http://terminology.hl7.org/ValueSet/v3-ParticipationPhysicalPerformer
    Act.performer:guarantor.assignedEntity.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:guarantor.assignedEntity.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:guarantor.assignedEntity.classCoderequiredFixed Value: ASSIGNED
    http://terminology.hl7.org/ValueSet/v3-RoleClassAssignedEntity
    Act.performer:guarantor.assignedEntity.codeexampleCDARoleCode
    http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
    Act.performer:guarantor.assignedEntity.code.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.templateId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.typeCoderequiredFixed Value: COV
    http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
    Act.participant:coverage-target.contextControlCoderequiredFixed Value: OP
    http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
    Act.participant:coverage-target.time.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.time.operatorrequiredCDASetOperator
    http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
    Act.participant:coverage-target.participantRole.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.participantRole.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.participantRole.classCoderequiredCDARoleClassRoot
    http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
    Act.participant:coverage-target.participantRole.codeexampleCDARoleCode
    http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
    Act.participant:coverage-target.participantRole.code.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.participantRole.code.codepreferredCoverageRoleTypeValueSet .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.18877
    Act.participant:coverage-target.participantRole.playingEntity.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.participantRole.playingEntity.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.participantRole.playingEntity.classCoderequiredEntityClassRoot
    http://terminology.hl7.org/ValueSet/v3-EntityClassRoot
    Act.participant:coverage-target.participantRole.playingEntity.determinerCoderequiredFixed Value: INSTANCE
    http://terminology.hl7.org/ValueSet/v3-EntityDeterminer
    Act.participant:coverage-target.participantRole.playingEntity.codeexampleCDAEntityCode
    http://hl7.org/cda/stds/core/ValueSet/CDAEntityCode
    Act.participant:subscriber.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:subscriber.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:subscriber.templateId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:subscriber.typeCoderequiredFixed Value: HLD
    http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
    Act.participant:subscriber.contextControlCoderequiredFixed Value: OP
    http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
    Act.participant:subscriber.participantRole.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:subscriber.participantRole.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:subscriber.participantRole.classCoderequiredCDARoleClassRoot
    http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
    Act.participant:subscriber.participantRole.codeexampleCDARoleCode
    http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
    Act.entryRelationship:authorization.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.typeCoderequiredFixed Value: REFR
    http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
    Act.entryRelationship:authorization.act.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.templateId:authorization-activity.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.classCoderequiredFixed Value: ACT
    http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
    Act.entryRelationship:authorization.act.moodCoderequiredFixed Value: EVN
    http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
    Act.entryRelationship:authorization.act.codeexampleActCode
    http://terminology.hl7.org/ValueSet/v3-ActCode
    Act.entryRelationship:authorization.act.text.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.text.compressionrequiredCDACompressionAlgorithm
    http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
    Act.entryRelationship:authorization.act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
    http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
    Act.entryRelationship:authorization.act.text.mediaTypeexampleMediaType
    http://terminology.hl7.org/ValueSet/v3-MediaType
    Act.entryRelationship:authorization.act.text.representationrequiredBinaryDataEncoding
    http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
    Act.entryRelationship:authorization.act.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.entryRelationship:authorization.act.priorityCodeexampleActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.entryRelationship:authorization.act.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard
    Act.entryRelationship:authorization.act.entryRelationship:target.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.entryRelationship:target.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.entryRelationship:target.typeCoderequiredFixed Value: SUBJ
    http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
    Act.entryRelationship:plan.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:plan.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:plan.typeCoderequiredFixed Value: REFR
    http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
    Act.entryRelationship:plan.act.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:plan.act.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:plan.act.classCoderequiredFixed Value: ACT
    http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
    Act.entryRelationship:plan.act.moodCoderequiredFixed Value: DEF
    http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
    Act.entryRelationship:plan.act.codeexampleActCode
    http://terminology.hl7.org/ValueSet/v3-ActCode
    Act.entryRelationship:plan.act.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.entryRelationship:plan.act.priorityCodeexampleActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.entryRelationship:plan.act.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    4537-8967warningAct.performer:guarantor.assignedEntity**SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
    : assignedPerson.name.exists() or representedOrganization.name.exists()
    4537-17139errorActWhen the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
    : participant.where(typeCode='COV').participantRole.code.where(code = 'SELF').exists() implies participant.where(typeCode='HLD').empty()
    81-8951errorAct.entryRelationship:authorization.act.entryRelationship:targetThe target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951).
    : (act | encounter | observation | observationMedia | organizer | procedure | regionOfInterest | substanceAdministration | supply).where(moodCode='PRMS').exists()
    II-1errorAct.typeId, Act.performer:payer.typeId, Act.performer:payer.assignedEntity.typeId, Act.performer:payer.assignedEntity.representedOrganization.typeId, Act.performer:guarantor.typeId, Act.performer:guarantor.assignedEntity.typeId, Act.participant:coverage-target.typeId, Act.participant:coverage-target.participantRole.typeId, Act.participant:coverage-target.participantRole.playingEntity.typeId, Act.participant:subscriber.typeId, Act.participant:subscriber.participantRole.typeId, Act.entryRelationship:authorization.typeId, Act.entryRelationship:authorization.act.typeId, Act.entryRelationship:authorization.act.entryRelationship:target.typeId, Act.entryRelationship:plan.typeId, Act.entryRelationship:plan.act.typeIdAn II instance must have either a root or an nullFlavor.
    : root.exists() or nullFlavor.exists()
    should-addrwarningAct.performer:guarantor.assignedEntity, Act.participant:coverage-target.participantRole, Act.participant:subscriber.participantRoleSHOULD contain addr
    : addr.exists()
    should-codewarningAct.performer:payer.assignedEntitySHOULD contain code
    : code.exists()
    should-code-attrwarningAct.participant:coverage-target.participantRole.codeSHOULD contain @code
    : code.exists()
    should-highwarningAct.participant:coverage-target.timeSHOULD contain high
    : high.exists()
    should-lowwarningAct.participant:coverage-target.timeSHOULD contain low
    : low.exists()
    should-namewarningAct.performer:payer.assignedEntity.representedOrganizationSHOULD contain name
    : name.exists()
    should-playingEntitywarningAct.participant:coverage-target.participantRoleSHOULD contain playingEntity
    : playingEntity.exists()
    should-representedOrganizationwarningAct.performer:payer.assignedEntitySHOULD contain representedOrganization
    : representedOrganization.exists()
    should-telecomwarningAct.performer:guarantor.assignedEntitySHOULD contain telecom
    : telecom.exists()
    should-text-ref-valuewarningActSHOULD contain text/reference/@value
    : text.reference.value.exists()
    should-timewarningAct.performer:guarantor, Act.participant:coverage-targetSHOULD contain time
    : time.exists()
    value-starts-octothorpeerrorAct.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
    : value.exists() implies value.startsWith('#')
    value-starts-octothorpeerrorAct.entryRelationship:authorization.act.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
    : value.exists() implies value.startsWith('#')
    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, 4537-17139
    ... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ... realmCode 0..* CS
    ... typeId C 0..1 II Constraints: II-1
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @assigningAuthorityName 0..1 st
    .... @displayable 0..1 bl
    .... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    .... @extension 1..1 st
    .... templateId:policy-activity 1..1 II
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... @assigningAuthorityName 0..1 st
    ..... @displayable 0..1 bl
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.61
    ..... @extension 1..1 st Required Pattern: 2024-05-01
    ... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ... @moodCode 1..1 cs Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: EVN
    ... @negationInd 0..1 bl
    ... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Group Identifier: This is the identifier (sent in the @extension attribute) used to uniquely refer to a specific health insurance plan.
    ... code 1..1 CD 𝗨𝗦𝗖𝗗𝗜: Coverage Type: Records the category of health care payers, insurance products, or benefits.
    Binding: Payer Type . (preferred)
    ... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
    .... @integrityCheck 0..1 bin
    .... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
    .... @language 0..1 cs
    .... @mediaType 0..1 cs Binding: MediaType (example)
    .... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
    .... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    .... thumbnail 0..1 ED
    ... statusCode 1..1 CS Binding: ActStatus (required)
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @code 1..1 cs Fixed Value: completed
    .... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
    XML: valueSet (urn:hl7-org:sdtc)
    .... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
    XML: valueSetVersion (urn:hl7-org:sdtc)
    ... effectiveTime 0..1 IVL_TS
    ... priorityCode 0..1 CE Binding: ActPriority (example)
    ... languageCode 0..1 CS Binding: AllLanguages (required)
    ... subject 0..1 Subject
    ... specimen 0..* Specimen
    ... Slices for performer 1..* Performer2 Slice: Unordered, Open by value:templateId.root
    .... performer:payer 1..1 Performer2 This performer represents the Payer.
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 1..1 II
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.87
    ..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
    Fixed Value: PRF
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... modeCode 0..1 CE
    ..... assignedEntity C 1..1 AssignedEntity Constraints: should-code, should-representedOrganization
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... templateId 0..* II
    ...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
    Fixed Value: ASSIGNED
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Payer Identifier: This is the Payer id. The root is a unique identifier to an openly available assigning authority, such as National Association of Insurance Commissioners (NAIC) (2.16.840.1.113883.6.300), and the extension identifiers the payer within that authority.
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 0..1 CE Binding: CDARoleCode (example)
    ....... @code 1..1 cs Binding: Financially Responsible Party Type Value Set . (preferred)
    ....... @codeSystem 0..1 oid, uuid, ruid
    ....... @codeSystemName 0..1 st
    ....... @codeSystemVersion 0..1 st
    ....... @displayName 0..1 st
    ....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
    XML: valueSet (urn:hl7-org:sdtc)
    ....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
    XML: valueSetVersion (urn:hl7-org:sdtc)
    ....... originalText 0..1 ED
    ....... translation 0..* CD
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... assignedPerson 0..1 Person
    ...... representedOrganization C 0..1 Organization Constraints: should-name
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... realmCode 0..* CS
    ....... typeId C 0..1 II Constraints: II-1
    ........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ........ @assigningAuthorityName 0..1 st
    ........ @displayable 0..1 bl
    ........ @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ........ @extension 1..1 st
    ....... templateId 0..* II
    ....... @classCode 0..1 cs Binding: EntityClassOrganization (required)
    Fixed Value: ORG
    ....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
    Fixed Value: INSTANCE
    ....... id 0..* II
    ....... name 0..1 ON
    ....... telecom 0..* TEL
    ....... addr 0..* AD
    ....... standardIndustryClassCode 0..1 CE Binding: OrganizationIndustryClassNAICS (example)
    ....... asOrganizationPartOf 0..1 OrganizationPartOf
    ...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
    XML: patient (urn:hl7-org:sdtc)
    ....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
    XML Namespace: urn:hl7-org:sdtc
    .... performer:guarantor C 0..* Performer2 This performer represents the Guarantor.
    Constraints: should-time
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 1..1 II
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.88
    ..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
    Fixed Value: PRF
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... modeCode 0..1 CE
    ..... assignedEntity C 1..1 AssignedEntity Constraints: 4537-8967, should-addr, should-telecom
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... templateId 0..* II
    ...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
    Fixed Value: ASSIGNED
    ...... id 1..* II
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 1..1 CE Binding: CDARoleCode (example)
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @code 1..1 cs Required Pattern: GUAR
    ....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.110
    ....... @codeSystemName 0..1 st
    ....... @codeSystemVersion 0..1 st
    ....... @displayName 0..1 st
    ....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
    XML: valueSet (urn:hl7-org:sdtc)
    ....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
    XML: valueSetVersion (urn:hl7-org:sdtc)
    ....... originalText 0..1 ED
    ....... translation 0..* CD
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... assignedPerson 0..1 Person
    ...... representedOrganization 0..1 Organization
    ...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
    XML: patient (urn:hl7-org:sdtc)
    ....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
    XML Namespace: urn:hl7-org:sdtc
    ... author 0..* Author
    ... informant 0..* Informant
    ... Slices for participant 1..* Participant2 Slice: Unordered, Open by value:typeCode
    .... participant:coverage-target C 1..1 Participant2 participant
    Constraints: should-time
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 1..1 II
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.89
    ..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
    Fixed Value: COV
    ..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
    Fixed Value: OP
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time C 0..1 IVL_TS This records the policy coverage period or self-pay period.
    Constraints: should-low, should-high
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @value 0..1 ts Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
    ...... @operator 0..1 cs Binding: CDASetOperator (required)
    ...... low 0..1 IVXB_TS
    ...... center 0..1 TS
    ...... width 0..1 PQ
    ...... high 0..1 IVXB_TS SHOULD contain high
    ..... awarenessCode 0..1 CE
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr, should-playingEntity
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... templateId 0..* II
    ...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Member Identifier: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code C 1..1 CE 𝗨𝗦𝗖𝗗𝗜: Relationship to Subscriber: Records the relationship of a patient to the primary insured person.
    Binding: CDARoleCode (example)
    Constraints: should-code-attr
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @code 0..1 cs Binding: Coverage Role Type Value Set . (preferred)
    ....... @codeSystem 0..1 oid, uuid, ruid
    ....... @codeSystemName 0..1 st
    ....... @codeSystemVersion 0..1 st
    ....... @displayName 0..1 st
    ....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
    XML: valueSet (urn:hl7-org:sdtc)
    ....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
    XML: valueSetVersion (urn:hl7-org:sdtc)
    ....... originalText 0..1 ED
    ....... translation 0..* CD
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... playingDevice 0..1 Device
    ...... playingEntity 0..1 PlayingEntity This playingEntity records the covered party name and birthTime as represented by the health plan. This could match the information in recordTarget, or be different due to marriage or other reasons.
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... realmCode 0..* CS
    ....... typeId C 0..1 II Constraints: II-1
    ........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ........ @assigningAuthorityName 0..1 st
    ........ @displayable 0..1 bl
    ........ @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ........ @extension 1..1 st
    ....... templateId 0..* II
    ....... @classCode 0..1 cs Binding: EntityClassRoot (required)
    ....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
    Fixed Value: INSTANCE
    ....... code 0..1 CE Binding: CDAEntityCode (example)
    ....... quantity 0..* PQ
    ....... name 1..1 PN
    ....... sdtcBirthTime 1..1 TS XML Namespace: urn:hl7-org:sdtc
    sdtc:birthTime
    XML: birthTime (urn:hl7-org:sdtc)
    ....... desc 0..1 ED
    ...... scopingEntity 0..1 Entity
    .... participant:subscriber 0..1 Participant2 When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information.
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 1..1 II
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.90
    ..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
    Fixed Value: HLD
    ..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
    Fixed Value: OP
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... awarenessCode 0..1 CE
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... templateId 0..* II
    ...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Subscriber Id: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 0..1 CE Binding: CDARoleCode (example)
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... playingDevice 0..1 Device
    ...... playingEntity 0..1 PlayingEntity
    ...... scopingEntity 0..1 Entity
    ... Slices for entryRelationship 0..* EntryRelationship Slice: Unordered, Open by value:act.moodCode
    .... entryRelationship:authorization 0..* EntryRelationship entryRelationship
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 AuthorizationActivity
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... Slices for templateId 1..* II Slice: Unordered, Open by value:root
    ....... templateId:authorization-activity 1..1 II
    ........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ........ @assigningAuthorityName 0..1 st
    ........ @displayable 0..1 bl
    ........ @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.1.19
    ...... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ...... @moodCode 1..1 cs EVN
    Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: EVN
    ...... @negationInd 0..1 bl
    ...... id 1..1 II
    ...... code 1..1 CD Binding: v3 Code System ActCode (example)
    ...... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
    ....... @integrityCheck 0..1 bin
    ....... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
    ....... @language 0..1 cs
    ....... @mediaType 0..1 cs Binding: MediaType (example)
    ....... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
    ....... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    ....... reference C 0..1 TEL Constraints: value-starts-octothorpe
    ....... thumbnail 0..1 ED
    ...... statusCode 0..1 CS Binding: ActStatus (required)
    ...... effectiveTime 0..1 IVL_TS
    ...... priorityCode 0..1 CE Binding: ActPriority (example)
    ...... languageCode 0..1 CS Binding: AllLanguages (required)
    ...... subject 0..1 Subject
    ...... specimen 0..* Specimen
    ...... performer 0..* Performer2
    ...... author 0..* Author
    ...... informant 0..* Informant
    ...... participant 0..* Participant2
    ...... Slices for entryRelationship 1..* EntryRelationship Slice: Unordered, Open by value:typeCode
    ....... entryRelationship:target C 1..* EntryRelationship The target of an authorization activity MAY contain one or more performer, to indicate the providers that have been authorized to provide treatment (CONF:81-8952).
    Constraints: 81-8951
    ........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ........ realmCode 0..* CS
    ........ typeId C 0..1 II Constraints: II-1
    ......... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ......... @assigningAuthorityName 0..1 st
    ......... @displayable 0..1 bl
    ......... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ......... @extension 1..1 st
    ........ templateId 0..* II
    ........ @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: SUBJ
    ........ @inversionInd 0..1 bl
    ........ @contextConductionInd 0..1 bl
    ........ @negationInd 0..1 bl
    ........ sequenceNumber 0..1 INT
    ........ seperatableInd 0..1 BL
    ........ act 0..1 Act
    ........ encounter 0..1 Encounter
    ........ observation 0..1 Observation
    ........ observationMedia 0..1 ObservationMedia
    ........ organizer 0..1 Organizer
    ........ procedure 0..1 Procedure
    ........ regionOfInterest 0..1 RegionOfInterest
    ........ substanceAdministration 0..1 SubstanceAdministration
    ........ supply 0..1 Supply
    ...... reference 0..* Reference
    ...... precondition 0..* Precondition
    ...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
    ..... encounter 0..1 Encounter
    ..... observation 0..1 Observation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:plan 0..* EntryRelationship Represents the Coverage Plan
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 Act
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... templateId 0..* II
    ...... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ...... @moodCode 1..1 cs Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: DEF
    ...... @negationInd 0..1 bl
    ...... id 1..* II Plan identifier
    ...... code 1..1 CD Binding: v3 Code System ActCode (example)
    ...... text 1..1 ED Name of the plan
    ...... statusCode 0..1 CS Binding: ActStatus (required)
    ...... effectiveTime 0..1 IVL_TS
    ...... priorityCode 0..1 CE Binding: ActPriority (example)
    ...... languageCode 0..1 CS Binding: AllLanguages (required)
    ...... subject 0..1 Subject
    ...... specimen 0..* Specimen
    ...... performer 0..* Performer2
    ...... author 0..* Author
    ...... informant 0..* Informant
    ...... participant 0..* Participant2
    ...... entryRelationship 0..* EntryRelationship
    ...... reference 0..* Reference
    ...... precondition 0..* Precondition
    ...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
    ..... encounter 0..1 Encounter
    ..... observation 0..1 Observation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    ... reference 0..* Reference
    ... precondition 0..* Precondition
    ... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Act.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.templateId:policy-activity.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.classCoderequiredFixed Value: ACT
    http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
    Act.moodCoderequiredFixed Value: EVN
    http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
    Act.codepreferredPayerType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
    Act.text.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.text.compressionrequiredCDACompressionAlgorithm
    http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
    Act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
    http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
    Act.text.mediaTypeexampleMediaType
    http://terminology.hl7.org/ValueSet/v3-MediaType
    Act.text.representationrequiredBinaryDataEncoding
    http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
    Act.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.statusCode.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.priorityCodeexampleActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard
    Act.performer:payer.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.templateId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.typeCoderequiredFixed Value: PRF
    http://terminology.hl7.org/ValueSet/v3-ParticipationPhysicalPerformer
    Act.performer:payer.assignedEntity.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.assignedEntity.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.assignedEntity.classCoderequiredFixed Value: ASSIGNED
    http://terminology.hl7.org/ValueSet/v3-RoleClassAssignedEntity
    Act.performer:payer.assignedEntity.codeexampleCDARoleCode
    http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
    Act.performer:payer.assignedEntity.code.codepreferredFinanciallyResponsiblePartyTypeValueSet .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.10416
    Act.performer:payer.assignedEntity.representedOrganization.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.assignedEntity.representedOrganization.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.assignedEntity.representedOrganization.classCoderequiredFixed Value: ORG
    http://terminology.hl7.org/ValueSet/v3-EntityClassOrganization
    Act.performer:payer.assignedEntity.representedOrganization.determinerCoderequiredFixed Value: INSTANCE
    http://terminology.hl7.org/ValueSet/v3-EntityDeterminer
    Act.performer:payer.assignedEntity.representedOrganization.standardIndustryClassCodeexampleOrganizationIndustryClassNAICS
    http://terminology.hl7.org/ValueSet/v3-OrganizationIndustryClassNAICS
    Act.performer:guarantor.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:guarantor.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:guarantor.templateId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:guarantor.typeCoderequiredFixed Value: PRF
    http://terminology.hl7.org/ValueSet/v3-ParticipationPhysicalPerformer
    Act.performer:guarantor.assignedEntity.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:guarantor.assignedEntity.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:guarantor.assignedEntity.classCoderequiredFixed Value: ASSIGNED
    http://terminology.hl7.org/ValueSet/v3-RoleClassAssignedEntity
    Act.performer:guarantor.assignedEntity.codeexampleCDARoleCode
    http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
    Act.performer:guarantor.assignedEntity.code.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.templateId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.typeCoderequiredFixed Value: COV
    http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
    Act.participant:coverage-target.contextControlCoderequiredFixed Value: OP
    http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
    Act.participant:coverage-target.time.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.time.operatorrequiredCDASetOperator
    http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
    Act.participant:coverage-target.participantRole.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.participantRole.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.participantRole.classCoderequiredCDARoleClassRoot
    http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
    Act.participant:coverage-target.participantRole.codeexampleCDARoleCode
    http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
    Act.participant:coverage-target.participantRole.code.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.participantRole.code.codepreferredCoverageRoleTypeValueSet .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.18877
    Act.participant:coverage-target.participantRole.playingEntity.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.participantRole.playingEntity.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.participantRole.playingEntity.classCoderequiredEntityClassRoot
    http://terminology.hl7.org/ValueSet/v3-EntityClassRoot
    Act.participant:coverage-target.participantRole.playingEntity.determinerCoderequiredFixed Value: INSTANCE
    http://terminology.hl7.org/ValueSet/v3-EntityDeterminer
    Act.participant:coverage-target.participantRole.playingEntity.codeexampleCDAEntityCode
    http://hl7.org/cda/stds/core/ValueSet/CDAEntityCode
    Act.participant:subscriber.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:subscriber.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:subscriber.templateId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:subscriber.typeCoderequiredFixed Value: HLD
    http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
    Act.participant:subscriber.contextControlCoderequiredFixed Value: OP
    http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
    Act.participant:subscriber.participantRole.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:subscriber.participantRole.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:subscriber.participantRole.classCoderequiredCDARoleClassRoot
    http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
    Act.participant:subscriber.participantRole.codeexampleCDARoleCode
    http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
    Act.entryRelationship:authorization.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.typeCoderequiredFixed Value: REFR
    http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
    Act.entryRelationship:authorization.act.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.templateId:authorization-activity.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.classCoderequiredFixed Value: ACT
    http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
    Act.entryRelationship:authorization.act.moodCoderequiredFixed Value: EVN
    http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
    Act.entryRelationship:authorization.act.codeexampleActCode
    http://terminology.hl7.org/ValueSet/v3-ActCode
    Act.entryRelationship:authorization.act.text.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.text.compressionrequiredCDACompressionAlgorithm
    http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
    Act.entryRelationship:authorization.act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
    http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
    Act.entryRelationship:authorization.act.text.mediaTypeexampleMediaType
    http://terminology.hl7.org/ValueSet/v3-MediaType
    Act.entryRelationship:authorization.act.text.representationrequiredBinaryDataEncoding
    http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
    Act.entryRelationship:authorization.act.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.entryRelationship:authorization.act.priorityCodeexampleActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.entryRelationship:authorization.act.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard
    Act.entryRelationship:authorization.act.entryRelationship:target.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.entryRelationship:target.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.entryRelationship:target.typeCoderequiredFixed Value: SUBJ
    http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
    Act.entryRelationship:plan.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:plan.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:plan.typeCoderequiredFixed Value: REFR
    http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
    Act.entryRelationship:plan.act.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:plan.act.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:plan.act.classCoderequiredFixed Value: ACT
    http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
    Act.entryRelationship:plan.act.moodCoderequiredFixed Value: DEF
    http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
    Act.entryRelationship:plan.act.codeexampleActCode
    http://terminology.hl7.org/ValueSet/v3-ActCode
    Act.entryRelationship:plan.act.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.entryRelationship:plan.act.priorityCodeexampleActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.entryRelationship:plan.act.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    4537-8967warningAct.performer:guarantor.assignedEntity**SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
    : assignedPerson.name.exists() or representedOrganization.name.exists()
    4537-17139errorActWhen the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
    : participant.where(typeCode='COV').participantRole.code.where(code = 'SELF').exists() implies participant.where(typeCode='HLD').empty()
    81-8951errorAct.entryRelationship:authorization.act.entryRelationship:targetThe target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951).
    : (act | encounter | observation | observationMedia | organizer | procedure | regionOfInterest | substanceAdministration | supply).where(moodCode='PRMS').exists()
    II-1errorAct.typeId, Act.performer:payer.typeId, Act.performer:payer.assignedEntity.typeId, Act.performer:payer.assignedEntity.representedOrganization.typeId, Act.performer:guarantor.typeId, Act.performer:guarantor.assignedEntity.typeId, Act.participant:coverage-target.typeId, Act.participant:coverage-target.participantRole.typeId, Act.participant:coverage-target.participantRole.playingEntity.typeId, Act.participant:subscriber.typeId, Act.participant:subscriber.participantRole.typeId, Act.entryRelationship:authorization.typeId, Act.entryRelationship:authorization.act.typeId, Act.entryRelationship:authorization.act.entryRelationship:target.typeId, Act.entryRelationship:plan.typeId, Act.entryRelationship:plan.act.typeIdAn II instance must have either a root or an nullFlavor.
    : root.exists() or nullFlavor.exists()
    should-addrwarningAct.performer:guarantor.assignedEntity, Act.participant:coverage-target.participantRole, Act.participant:subscriber.participantRoleSHOULD contain addr
    : addr.exists()
    should-codewarningAct.performer:payer.assignedEntitySHOULD contain code
    : code.exists()
    should-code-attrwarningAct.participant:coverage-target.participantRole.codeSHOULD contain @code
    : code.exists()
    should-highwarningAct.participant:coverage-target.timeSHOULD contain high
    : high.exists()
    should-lowwarningAct.participant:coverage-target.timeSHOULD contain low
    : low.exists()
    should-namewarningAct.performer:payer.assignedEntity.representedOrganizationSHOULD contain name
    : name.exists()
    should-playingEntitywarningAct.participant:coverage-target.participantRoleSHOULD contain playingEntity
    : playingEntity.exists()
    should-representedOrganizationwarningAct.performer:payer.assignedEntitySHOULD contain representedOrganization
    : representedOrganization.exists()
    should-telecomwarningAct.performer:guarantor.assignedEntitySHOULD contain telecom
    : telecom.exists()
    should-text-ref-valuewarningActSHOULD contain text/reference/@value
    : text.reference.value.exists()
    should-timewarningAct.performer:guarantor, Act.participant:coverage-targetSHOULD contain time
    : time.exists()
    value-starts-octothorpeerrorAct.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
    : value.exists() implies value.startsWith('#')
    value-starts-octothorpeerrorAct.entryRelationship:authorization.act.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
    : value.exists() implies value.startsWith('#')

    This structure is derived from Act

    Summary

    Mandatory: 18 elements(16 nested mandatory elements)
    Fixed: 9 elements
    Prohibited: 5 elements

    Structures

    This structure refers to these other structures:

    Slices

    This structure defines the following Slices:

    • The element 2 is sliced based on the values of Act.templateId
    • The element 1 is sliced based on the value of Act.performer
    • The element 1 is sliced based on the value of Act.participant
    • The element 1 is sliced based on the value of Act.entryRelationship

    Differential View

    This structure is derived from Act

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, 4537-17139
    ... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
    .... templateId:policy-activity 1..1 II
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.61
    ..... @extension 1..1 st Required Pattern: 2024-05-01
    ... @classCode 1..1 cs Fixed Value: ACT
    ... @moodCode 1..1 cs Fixed Value: EVN
    ... code 1..1 CD 𝗨𝗦𝗖𝗗𝗜: Coverage Type: Records the category of health care payers, insurance products, or benefits.
    Binding: Payer Type . (preferred)
    ... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    ... statusCode 1..1 CS
    .... @code 1..1 cs Fixed Value: completed
    ... Slices for performer 1..* Performer2 Slice: Unordered, Open by value:templateId.root
    .... performer:payer 1..1 Performer2 This performer represents the Payer.
    ..... templateId 1..1 II
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.87
    ...... @extension 0..0
    ..... @typeCode 1..1 cs
    ..... assignedEntity C 1..1 AssignedEntity Constraints: should-code, should-representedOrganization
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Payer Identifier: This is the Payer id. The root is a unique identifier to an openly available assigning authority, such as National Association of Insurance Commissioners (NAIC) (2.16.840.1.113883.6.300), and the extension identifiers the payer within that authority.
    ...... code 0..1 CE
    ....... @nullFlavor 0..0
    ....... @code 1..1 cs Binding: Financially Responsible Party Type Value Set . (preferred)
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... representedOrganization C 0..1 Organization Constraints: should-name
    ....... name 0..1 ON
    .... performer:guarantor C 0..* Performer2 This performer represents the Guarantor.
    Constraints: should-time
    ..... templateId 1..1 II
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.88
    ...... @extension 0..0
    ..... @typeCode 1..1 cs
    ..... time 0..1 IVL_TS
    ..... assignedEntity C 1..1 AssignedEntity Constraints: 4537-8967, should-addr, should-telecom
    ...... code 1..1 CE
    ....... @code 1..1 cs Required Pattern: GUAR
    ....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.110
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ... Slices for participant 1..* Participant2 Slice: Unordered, Open by value:typeCode
    .... participant:coverage-target C 1..1 Participant2 participant
    Constraints: should-time
    ..... templateId 1..1 II
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.89
    ...... @extension 0..0
    ..... @typeCode 1..1 cs Fixed Value: COV
    ..... time C 0..1 IVL_TS This records the policy coverage period or self-pay period.
    Constraints: should-low, should-high
    ...... low 0..1 IVXB_TS
    ...... high 0..1 IVXB_TS SHOULD contain high
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr, should-playingEntity
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Member Identifier: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
    ...... code C 1..1 CE 𝗨𝗦𝗖𝗗𝗜: Relationship to Subscriber: Records the relationship of a patient to the primary insured person.
    Constraints: should-code-attr
    ....... @code 0..1 cs Binding: Coverage Role Type Value Set . (preferred)
    ...... addr 0..1 USRealmAddress
    ...... playingEntity 0..1 PlayingEntity This playingEntity records the covered party name and birthTime as represented by the health plan. This could match the information in recordTarget, or be different due to marriage or other reasons.
    ....... name 1..1 PN
    ....... sdtcBirthTime 1..1 TS sdtc:birthTime
    .... participant:subscriber 0..1 Participant2 When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information.
    ..... templateId 1..1 II
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.90
    ...... @extension 0..0
    ..... @typeCode 1..1 cs Fixed Value: HLD
    ..... time 0..1 IVL_TS
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Subscriber Id: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
    ...... addr 0..1 USRealmAddress
    ... Slices for entryRelationship 0..* EntryRelationship Slice: Unordered, Open by value:act.moodCode
    .... entryRelationship:authorization 0..* EntryRelationship entryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... act 1..1 AuthorizationActivity
    ...... @moodCode 1..1 cs EVN
    .... entryRelationship:plan 0..* EntryRelationship Represents the Coverage Plan
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... act 1..1 Act
    ...... @classCode 1..1 cs Fixed Value: ACT
    ...... @moodCode 1..1 cs Fixed Value: DEF
    ...... id 1..* II Plan identifier
    ...... text 1..1 ED Name of the plan

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    Act.codepreferredPayerType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
    Act.performer:payer.assignedEntity.code.codepreferredFinanciallyResponsiblePartyTypeValueSet .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.10416
    Act.participant:coverage-target.participantRole.code.codepreferredCoverageRoleTypeValueSet .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.18877

    Constraints

    IdGradePath(s)DetailsRequirements
    4537-8967warningAct.performer:guarantor.assignedEntity**SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
    : assignedPerson.name.exists() or representedOrganization.name.exists()
    4537-17139errorActWhen the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
    : participant.where(typeCode='COV').participantRole.code.where(code = 'SELF').exists() implies participant.where(typeCode='HLD').empty()
    should-addrwarningAct.performer:guarantor.assignedEntity, Act.participant:coverage-target.participantRole, Act.participant:subscriber.participantRoleSHOULD contain addr
    : addr.exists()
    should-codewarningAct.performer:payer.assignedEntitySHOULD contain code
    : code.exists()
    should-code-attrwarningAct.participant:coverage-target.participantRole.codeSHOULD contain @code
    : code.exists()
    should-highwarningAct.participant:coverage-target.timeSHOULD contain high
    : high.exists()
    should-lowwarningAct.participant:coverage-target.timeSHOULD contain low
    : low.exists()
    should-namewarningAct.performer:payer.assignedEntity.representedOrganizationSHOULD contain name
    : name.exists()
    should-playingEntitywarningAct.participant:coverage-target.participantRoleSHOULD contain playingEntity
    : playingEntity.exists()
    should-representedOrganizationwarningAct.performer:payer.assignedEntitySHOULD contain representedOrganization
    : representedOrganization.exists()
    should-telecomwarningAct.performer:guarantor.assignedEntitySHOULD contain telecom
    : telecom.exists()
    should-text-ref-valuewarningActSHOULD contain text/reference/@value
    : text.reference.value.exists()
    should-timewarningAct.performer:guarantor, Act.participant:coverage-targetSHOULD contain time
    : time.exists()
    value-starts-octothorpeerrorAct.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
    : value.exists() implies value.startsWith('#')

    Key Elements View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, 4537-17139
    ... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ... realmCode 0..* CS
    ... typeId C 0..1 II Constraints: II-1
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @assigningAuthorityName 0..1 st
    .... @displayable 0..1 bl
    .... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    .... @extension 1..1 st
    .... templateId:policy-activity 1..1 II
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... @assigningAuthorityName 0..1 st
    ..... @displayable 0..1 bl
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.61
    ..... @extension 1..1 st Required Pattern: 2024-05-01
    ... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ... @moodCode 1..1 cs Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: EVN
    ... @negationInd 0..1 bl
    ... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Group Identifier: This is the identifier (sent in the @extension attribute) used to uniquely refer to a specific health insurance plan.
    ... code 1..1 CD 𝗨𝗦𝗖𝗗𝗜: Coverage Type: Records the category of health care payers, insurance products, or benefits.
    Binding: Payer Type . (preferred)
    ... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
    .... @integrityCheck 0..1 bin
    .... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
    .... @language 0..1 cs
    .... @mediaType 0..1 cs Binding: MediaType (example)
    .... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
    .... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    .... thumbnail 0..1 ED
    ... statusCode 1..1 CS Binding: ActStatus (required)
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @code 1..1 cs Fixed Value: completed
    .... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
    XML: valueSet (urn:hl7-org:sdtc)
    .... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
    XML: valueSetVersion (urn:hl7-org:sdtc)
    ... effectiveTime 0..1 IVL_TS
    ... priorityCode 0..1 CE Binding: ActPriority (example)
    ... languageCode 0..1 CS Binding: AllLanguages (required)
    ... subject 0..1 Subject
    ... specimen 0..* Specimen
    ... Slices for performer 1..* Performer2 Slice: Unordered, Open by value:templateId.root
    .... performer:payer 1..1 Performer2 This performer represents the Payer.
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 1..1 II
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.87
    ..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
    Fixed Value: PRF
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... modeCode 0..1 CE
    ..... assignedEntity C 1..1 AssignedEntity Constraints: should-code, should-representedOrganization
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... templateId 0..* II
    ...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
    Fixed Value: ASSIGNED
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Payer Identifier: This is the Payer id. The root is a unique identifier to an openly available assigning authority, such as National Association of Insurance Commissioners (NAIC) (2.16.840.1.113883.6.300), and the extension identifiers the payer within that authority.
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 0..1 CE Binding: CDARoleCode (example)
    ....... @code 1..1 cs Binding: Financially Responsible Party Type Value Set . (preferred)
    ....... @codeSystem 0..1 oid, uuid, ruid
    ....... @codeSystemName 0..1 st
    ....... @codeSystemVersion 0..1 st
    ....... @displayName 0..1 st
    ....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
    XML: valueSet (urn:hl7-org:sdtc)
    ....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
    XML: valueSetVersion (urn:hl7-org:sdtc)
    ....... originalText 0..1 ED
    ....... translation 0..* CD
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... assignedPerson 0..1 Person
    ...... representedOrganization C 0..1 Organization Constraints: should-name
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... realmCode 0..* CS
    ....... typeId C 0..1 II Constraints: II-1
    ........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ........ @assigningAuthorityName 0..1 st
    ........ @displayable 0..1 bl
    ........ @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ........ @extension 1..1 st
    ....... templateId 0..* II
    ....... @classCode 0..1 cs Binding: EntityClassOrganization (required)
    Fixed Value: ORG
    ....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
    Fixed Value: INSTANCE
    ....... id 0..* II
    ....... name 0..1 ON
    ....... telecom 0..* TEL
    ....... addr 0..* AD
    ....... standardIndustryClassCode 0..1 CE Binding: OrganizationIndustryClassNAICS (example)
    ....... asOrganizationPartOf 0..1 OrganizationPartOf
    ...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
    XML: patient (urn:hl7-org:sdtc)
    ....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
    XML Namespace: urn:hl7-org:sdtc
    .... performer:guarantor C 0..* Performer2 This performer represents the Guarantor.
    Constraints: should-time
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 1..1 II
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.88
    ..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
    Fixed Value: PRF
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... modeCode 0..1 CE
    ..... assignedEntity C 1..1 AssignedEntity Constraints: 4537-8967, should-addr, should-telecom
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... templateId 0..* II
    ...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
    Fixed Value: ASSIGNED
    ...... id 1..* II
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 1..1 CE Binding: CDARoleCode (example)
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @code 1..1 cs Required Pattern: GUAR
    ....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.110
    ....... @codeSystemName 0..1 st
    ....... @codeSystemVersion 0..1 st
    ....... @displayName 0..1 st
    ....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
    XML: valueSet (urn:hl7-org:sdtc)
    ....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
    XML: valueSetVersion (urn:hl7-org:sdtc)
    ....... originalText 0..1 ED
    ....... translation 0..* CD
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... assignedPerson 0..1 Person
    ...... representedOrganization 0..1 Organization
    ...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
    XML: patient (urn:hl7-org:sdtc)
    ....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
    XML Namespace: urn:hl7-org:sdtc
    ... author 0..* Author
    ... informant 0..* Informant
    ... Slices for participant 1..* Participant2 Slice: Unordered, Open by value:typeCode
    .... participant:coverage-target C 1..1 Participant2 participant
    Constraints: should-time
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 1..1 II
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.89
    ..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
    Fixed Value: COV
    ..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
    Fixed Value: OP
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time C 0..1 IVL_TS This records the policy coverage period or self-pay period.
    Constraints: should-low, should-high
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @value 0..1 ts Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
    ...... @operator 0..1 cs Binding: CDASetOperator (required)
    ...... low 0..1 IVXB_TS
    ...... center 0..1 TS
    ...... width 0..1 PQ
    ...... high 0..1 IVXB_TS SHOULD contain high
    ..... awarenessCode 0..1 CE
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr, should-playingEntity
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... templateId 0..* II
    ...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Member Identifier: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code C 1..1 CE 𝗨𝗦𝗖𝗗𝗜: Relationship to Subscriber: Records the relationship of a patient to the primary insured person.
    Binding: CDARoleCode (example)
    Constraints: should-code-attr
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @code 0..1 cs Binding: Coverage Role Type Value Set . (preferred)
    ....... @codeSystem 0..1 oid, uuid, ruid
    ....... @codeSystemName 0..1 st
    ....... @codeSystemVersion 0..1 st
    ....... @displayName 0..1 st
    ....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
    XML: valueSet (urn:hl7-org:sdtc)
    ....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
    XML: valueSetVersion (urn:hl7-org:sdtc)
    ....... originalText 0..1 ED
    ....... translation 0..* CD
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... playingDevice 0..1 Device
    ...... playingEntity 0..1 PlayingEntity This playingEntity records the covered party name and birthTime as represented by the health plan. This could match the information in recordTarget, or be different due to marriage or other reasons.
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... realmCode 0..* CS
    ....... typeId C 0..1 II Constraints: II-1
    ........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ........ @assigningAuthorityName 0..1 st
    ........ @displayable 0..1 bl
    ........ @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ........ @extension 1..1 st
    ....... templateId 0..* II
    ....... @classCode 0..1 cs Binding: EntityClassRoot (required)
    ....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
    Fixed Value: INSTANCE
    ....... code 0..1 CE Binding: CDAEntityCode (example)
    ....... quantity 0..* PQ
    ....... name 1..1 PN
    ....... sdtcBirthTime 1..1 TS XML Namespace: urn:hl7-org:sdtc
    sdtc:birthTime
    XML: birthTime (urn:hl7-org:sdtc)
    ....... desc 0..1 ED
    ...... scopingEntity 0..1 Entity
    .... participant:subscriber 0..1 Participant2 When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information.
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 1..1 II
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.90
    ..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
    Fixed Value: HLD
    ..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
    Fixed Value: OP
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... awarenessCode 0..1 CE
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... templateId 0..* II
    ...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Subscriber Id: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 0..1 CE Binding: CDARoleCode (example)
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... playingDevice 0..1 Device
    ...... playingEntity 0..1 PlayingEntity
    ...... scopingEntity 0..1 Entity
    ... Slices for entryRelationship 0..* EntryRelationship Slice: Unordered, Open by value:act.moodCode
    .... entryRelationship:authorization 0..* EntryRelationship entryRelationship
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 AuthorizationActivity
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... Slices for templateId 1..* II Slice: Unordered, Open by value:root
    ....... templateId:authorization-activity 1..1 II
    ........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ........ @assigningAuthorityName 0..1 st
    ........ @displayable 0..1 bl
    ........ @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.1.19
    ...... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ...... @moodCode 1..1 cs EVN
    Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: EVN
    ...... @negationInd 0..1 bl
    ...... id 1..1 II
    ...... code 1..1 CD Binding: v3 Code System ActCode (example)
    ...... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
    ....... @integrityCheck 0..1 bin
    ....... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
    ....... @language 0..1 cs
    ....... @mediaType 0..1 cs Binding: MediaType (example)
    ....... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
    ....... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    ....... reference C 0..1 TEL Constraints: value-starts-octothorpe
    ....... thumbnail 0..1 ED
    ...... statusCode 0..1 CS Binding: ActStatus (required)
    ...... effectiveTime 0..1 IVL_TS
    ...... priorityCode 0..1 CE Binding: ActPriority (example)
    ...... languageCode 0..1 CS Binding: AllLanguages (required)
    ...... subject 0..1 Subject
    ...... specimen 0..* Specimen
    ...... performer 0..* Performer2
    ...... author 0..* Author
    ...... informant 0..* Informant
    ...... participant 0..* Participant2
    ...... Slices for entryRelationship 1..* EntryRelationship Slice: Unordered, Open by value:typeCode
    ....... entryRelationship:target C 1..* EntryRelationship The target of an authorization activity MAY contain one or more performer, to indicate the providers that have been authorized to provide treatment (CONF:81-8952).
    Constraints: 81-8951
    ........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ........ realmCode 0..* CS
    ........ typeId C 0..1 II Constraints: II-1
    ......... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ......... @assigningAuthorityName 0..1 st
    ......... @displayable 0..1 bl
    ......... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ......... @extension 1..1 st
    ........ templateId 0..* II
    ........ @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: SUBJ
    ........ @inversionInd 0..1 bl
    ........ @contextConductionInd 0..1 bl
    ........ @negationInd 0..1 bl
    ........ sequenceNumber 0..1 INT
    ........ seperatableInd 0..1 BL
    ........ act 0..1 Act
    ........ encounter 0..1 Encounter
    ........ observation 0..1 Observation
    ........ observationMedia 0..1 ObservationMedia
    ........ organizer 0..1 Organizer
    ........ procedure 0..1 Procedure
    ........ regionOfInterest 0..1 RegionOfInterest
    ........ substanceAdministration 0..1 SubstanceAdministration
    ........ supply 0..1 Supply
    ...... reference 0..* Reference
    ...... precondition 0..* Precondition
    ...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
    ..... encounter 0..1 Encounter
    ..... observation 0..1 Observation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:plan 0..* EntryRelationship Represents the Coverage Plan
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 Act
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... templateId 0..* II
    ...... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ...... @moodCode 1..1 cs Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: DEF
    ...... @negationInd 0..1 bl
    ...... id 1..* II Plan identifier
    ...... code 1..1 CD Binding: v3 Code System ActCode (example)
    ...... text 1..1 ED Name of the plan
    ...... statusCode 0..1 CS Binding: ActStatus (required)
    ...... effectiveTime 0..1 IVL_TS
    ...... priorityCode 0..1 CE Binding: ActPriority (example)
    ...... languageCode 0..1 CS Binding: AllLanguages (required)
    ...... subject 0..1 Subject
    ...... specimen 0..* Specimen
    ...... performer 0..* Performer2
    ...... author 0..* Author
    ...... informant 0..* Informant
    ...... participant 0..* Participant2
    ...... entryRelationship 0..* EntryRelationship
    ...... reference 0..* Reference
    ...... precondition 0..* Precondition
    ...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
    ..... encounter 0..1 Encounter
    ..... observation 0..1 Observation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    ... reference 0..* Reference
    ... precondition 0..* Precondition
    ... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Act.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.templateId:policy-activity.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.classCoderequiredFixed Value: ACT
    http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
    Act.moodCoderequiredFixed Value: EVN
    http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
    Act.codepreferredPayerType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
    Act.text.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.text.compressionrequiredCDACompressionAlgorithm
    http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
    Act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
    http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
    Act.text.mediaTypeexampleMediaType
    http://terminology.hl7.org/ValueSet/v3-MediaType
    Act.text.representationrequiredBinaryDataEncoding
    http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
    Act.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.statusCode.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.priorityCodeexampleActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard
    Act.performer:payer.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.templateId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.typeCoderequiredFixed Value: PRF
    http://terminology.hl7.org/ValueSet/v3-ParticipationPhysicalPerformer
    Act.performer:payer.assignedEntity.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.assignedEntity.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.assignedEntity.classCoderequiredFixed Value: ASSIGNED
    http://terminology.hl7.org/ValueSet/v3-RoleClassAssignedEntity
    Act.performer:payer.assignedEntity.codeexampleCDARoleCode
    http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
    Act.performer:payer.assignedEntity.code.codepreferredFinanciallyResponsiblePartyTypeValueSet .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.10416
    Act.performer:payer.assignedEntity.representedOrganization.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.assignedEntity.representedOrganization.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.assignedEntity.representedOrganization.classCoderequiredFixed Value: ORG
    http://terminology.hl7.org/ValueSet/v3-EntityClassOrganization
    Act.performer:payer.assignedEntity.representedOrganization.determinerCoderequiredFixed Value: INSTANCE
    http://terminology.hl7.org/ValueSet/v3-EntityDeterminer
    Act.performer:payer.assignedEntity.representedOrganization.standardIndustryClassCodeexampleOrganizationIndustryClassNAICS
    http://terminology.hl7.org/ValueSet/v3-OrganizationIndustryClassNAICS
    Act.performer:guarantor.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:guarantor.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:guarantor.templateId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:guarantor.typeCoderequiredFixed Value: PRF
    http://terminology.hl7.org/ValueSet/v3-ParticipationPhysicalPerformer
    Act.performer:guarantor.assignedEntity.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:guarantor.assignedEntity.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:guarantor.assignedEntity.classCoderequiredFixed Value: ASSIGNED
    http://terminology.hl7.org/ValueSet/v3-RoleClassAssignedEntity
    Act.performer:guarantor.assignedEntity.codeexampleCDARoleCode
    http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
    Act.performer:guarantor.assignedEntity.code.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.templateId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.typeCoderequiredFixed Value: COV
    http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
    Act.participant:coverage-target.contextControlCoderequiredFixed Value: OP
    http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
    Act.participant:coverage-target.time.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.time.operatorrequiredCDASetOperator
    http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
    Act.participant:coverage-target.participantRole.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.participantRole.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.participantRole.classCoderequiredCDARoleClassRoot
    http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
    Act.participant:coverage-target.participantRole.codeexampleCDARoleCode
    http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
    Act.participant:coverage-target.participantRole.code.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.participantRole.code.codepreferredCoverageRoleTypeValueSet .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.18877
    Act.participant:coverage-target.participantRole.playingEntity.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.participantRole.playingEntity.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.participantRole.playingEntity.classCoderequiredEntityClassRoot
    http://terminology.hl7.org/ValueSet/v3-EntityClassRoot
    Act.participant:coverage-target.participantRole.playingEntity.determinerCoderequiredFixed Value: INSTANCE
    http://terminology.hl7.org/ValueSet/v3-EntityDeterminer
    Act.participant:coverage-target.participantRole.playingEntity.codeexampleCDAEntityCode
    http://hl7.org/cda/stds/core/ValueSet/CDAEntityCode
    Act.participant:subscriber.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:subscriber.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:subscriber.templateId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:subscriber.typeCoderequiredFixed Value: HLD
    http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
    Act.participant:subscriber.contextControlCoderequiredFixed Value: OP
    http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
    Act.participant:subscriber.participantRole.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:subscriber.participantRole.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:subscriber.participantRole.classCoderequiredCDARoleClassRoot
    http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
    Act.participant:subscriber.participantRole.codeexampleCDARoleCode
    http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
    Act.entryRelationship:authorization.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.typeCoderequiredFixed Value: REFR
    http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
    Act.entryRelationship:authorization.act.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.templateId:authorization-activity.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.classCoderequiredFixed Value: ACT
    http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
    Act.entryRelationship:authorization.act.moodCoderequiredFixed Value: EVN
    http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
    Act.entryRelationship:authorization.act.codeexampleActCode
    http://terminology.hl7.org/ValueSet/v3-ActCode
    Act.entryRelationship:authorization.act.text.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.text.compressionrequiredCDACompressionAlgorithm
    http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
    Act.entryRelationship:authorization.act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
    http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
    Act.entryRelationship:authorization.act.text.mediaTypeexampleMediaType
    http://terminology.hl7.org/ValueSet/v3-MediaType
    Act.entryRelationship:authorization.act.text.representationrequiredBinaryDataEncoding
    http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
    Act.entryRelationship:authorization.act.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.entryRelationship:authorization.act.priorityCodeexampleActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.entryRelationship:authorization.act.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard
    Act.entryRelationship:authorization.act.entryRelationship:target.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.entryRelationship:target.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.entryRelationship:target.typeCoderequiredFixed Value: SUBJ
    http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
    Act.entryRelationship:plan.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:plan.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:plan.typeCoderequiredFixed Value: REFR
    http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
    Act.entryRelationship:plan.act.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:plan.act.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:plan.act.classCoderequiredFixed Value: ACT
    http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
    Act.entryRelationship:plan.act.moodCoderequiredFixed Value: DEF
    http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
    Act.entryRelationship:plan.act.codeexampleActCode
    http://terminology.hl7.org/ValueSet/v3-ActCode
    Act.entryRelationship:plan.act.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.entryRelationship:plan.act.priorityCodeexampleActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.entryRelationship:plan.act.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    4537-8967warningAct.performer:guarantor.assignedEntity**SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
    : assignedPerson.name.exists() or representedOrganization.name.exists()
    4537-17139errorActWhen the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
    : participant.where(typeCode='COV').participantRole.code.where(code = 'SELF').exists() implies participant.where(typeCode='HLD').empty()
    81-8951errorAct.entryRelationship:authorization.act.entryRelationship:targetThe target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951).
    : (act | encounter | observation | observationMedia | organizer | procedure | regionOfInterest | substanceAdministration | supply).where(moodCode='PRMS').exists()
    II-1errorAct.typeId, Act.performer:payer.typeId, Act.performer:payer.assignedEntity.typeId, Act.performer:payer.assignedEntity.representedOrganization.typeId, Act.performer:guarantor.typeId, Act.performer:guarantor.assignedEntity.typeId, Act.participant:coverage-target.typeId, Act.participant:coverage-target.participantRole.typeId, Act.participant:coverage-target.participantRole.playingEntity.typeId, Act.participant:subscriber.typeId, Act.participant:subscriber.participantRole.typeId, Act.entryRelationship:authorization.typeId, Act.entryRelationship:authorization.act.typeId, Act.entryRelationship:authorization.act.entryRelationship:target.typeId, Act.entryRelationship:plan.typeId, Act.entryRelationship:plan.act.typeIdAn II instance must have either a root or an nullFlavor.
    : root.exists() or nullFlavor.exists()
    should-addrwarningAct.performer:guarantor.assignedEntity, Act.participant:coverage-target.participantRole, Act.participant:subscriber.participantRoleSHOULD contain addr
    : addr.exists()
    should-codewarningAct.performer:payer.assignedEntitySHOULD contain code
    : code.exists()
    should-code-attrwarningAct.participant:coverage-target.participantRole.codeSHOULD contain @code
    : code.exists()
    should-highwarningAct.participant:coverage-target.timeSHOULD contain high
    : high.exists()
    should-lowwarningAct.participant:coverage-target.timeSHOULD contain low
    : low.exists()
    should-namewarningAct.performer:payer.assignedEntity.representedOrganizationSHOULD contain name
    : name.exists()
    should-playingEntitywarningAct.participant:coverage-target.participantRoleSHOULD contain playingEntity
    : playingEntity.exists()
    should-representedOrganizationwarningAct.performer:payer.assignedEntitySHOULD contain representedOrganization
    : representedOrganization.exists()
    should-telecomwarningAct.performer:guarantor.assignedEntitySHOULD contain telecom
    : telecom.exists()
    should-text-ref-valuewarningActSHOULD contain text/reference/@value
    : text.reference.value.exists()
    should-timewarningAct.performer:guarantor, Act.participant:coverage-targetSHOULD contain time
    : time.exists()
    value-starts-octothorpeerrorAct.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
    : value.exists() implies value.startsWith('#')
    value-starts-octothorpeerrorAct.entryRelationship:authorization.act.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
    : value.exists() implies value.startsWith('#')

    Snapshot View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, 4537-17139
    ... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ... realmCode 0..* CS
    ... typeId C 0..1 II Constraints: II-1
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @assigningAuthorityName 0..1 st
    .... @displayable 0..1 bl
    .... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    .... @extension 1..1 st
    .... templateId:policy-activity 1..1 II
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... @assigningAuthorityName 0..1 st
    ..... @displayable 0..1 bl
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.61
    ..... @extension 1..1 st Required Pattern: 2024-05-01
    ... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ... @moodCode 1..1 cs Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: EVN
    ... @negationInd 0..1 bl
    ... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Group Identifier: This is the identifier (sent in the @extension attribute) used to uniquely refer to a specific health insurance plan.
    ... code 1..1 CD 𝗨𝗦𝗖𝗗𝗜: Coverage Type: Records the category of health care payers, insurance products, or benefits.
    Binding: Payer Type . (preferred)
    ... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
    .... @integrityCheck 0..1 bin
    .... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
    .... @language 0..1 cs
    .... @mediaType 0..1 cs Binding: MediaType (example)
    .... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
    .... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    .... thumbnail 0..1 ED
    ... statusCode 1..1 CS Binding: ActStatus (required)
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @code 1..1 cs Fixed Value: completed
    .... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
    XML: valueSet (urn:hl7-org:sdtc)
    .... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
    XML: valueSetVersion (urn:hl7-org:sdtc)
    ... effectiveTime 0..1 IVL_TS
    ... priorityCode 0..1 CE Binding: ActPriority (example)
    ... languageCode 0..1 CS Binding: AllLanguages (required)
    ... subject 0..1 Subject
    ... specimen 0..* Specimen
    ... Slices for performer 1..* Performer2 Slice: Unordered, Open by value:templateId.root
    .... performer:payer 1..1 Performer2 This performer represents the Payer.
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 1..1 II
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.87
    ..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
    Fixed Value: PRF
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... modeCode 0..1 CE
    ..... assignedEntity C 1..1 AssignedEntity Constraints: should-code, should-representedOrganization
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... templateId 0..* II
    ...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
    Fixed Value: ASSIGNED
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Payer Identifier: This is the Payer id. The root is a unique identifier to an openly available assigning authority, such as National Association of Insurance Commissioners (NAIC) (2.16.840.1.113883.6.300), and the extension identifiers the payer within that authority.
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 0..1 CE Binding: CDARoleCode (example)
    ....... @code 1..1 cs Binding: Financially Responsible Party Type Value Set . (preferred)
    ....... @codeSystem 0..1 oid, uuid, ruid
    ....... @codeSystemName 0..1 st
    ....... @codeSystemVersion 0..1 st
    ....... @displayName 0..1 st
    ....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
    XML: valueSet (urn:hl7-org:sdtc)
    ....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
    XML: valueSetVersion (urn:hl7-org:sdtc)
    ....... originalText 0..1 ED
    ....... translation 0..* CD
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... assignedPerson 0..1 Person
    ...... representedOrganization C 0..1 Organization Constraints: should-name
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... realmCode 0..* CS
    ....... typeId C 0..1 II Constraints: II-1
    ........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ........ @assigningAuthorityName 0..1 st
    ........ @displayable 0..1 bl
    ........ @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ........ @extension 1..1 st
    ....... templateId 0..* II
    ....... @classCode 0..1 cs Binding: EntityClassOrganization (required)
    Fixed Value: ORG
    ....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
    Fixed Value: INSTANCE
    ....... id 0..* II
    ....... name 0..1 ON
    ....... telecom 0..* TEL
    ....... addr 0..* AD
    ....... standardIndustryClassCode 0..1 CE Binding: OrganizationIndustryClassNAICS (example)
    ....... asOrganizationPartOf 0..1 OrganizationPartOf
    ...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
    XML: patient (urn:hl7-org:sdtc)
    ....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
    XML Namespace: urn:hl7-org:sdtc
    .... performer:guarantor C 0..* Performer2 This performer represents the Guarantor.
    Constraints: should-time
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 1..1 II
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.88
    ..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
    Fixed Value: PRF
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... modeCode 0..1 CE
    ..... assignedEntity C 1..1 AssignedEntity Constraints: 4537-8967, should-addr, should-telecom
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... templateId 0..* II
    ...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
    Fixed Value: ASSIGNED
    ...... id 1..* II
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 1..1 CE Binding: CDARoleCode (example)
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @code 1..1 cs Required Pattern: GUAR
    ....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.110
    ....... @codeSystemName 0..1 st
    ....... @codeSystemVersion 0..1 st
    ....... @displayName 0..1 st
    ....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
    XML: valueSet (urn:hl7-org:sdtc)
    ....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
    XML: valueSetVersion (urn:hl7-org:sdtc)
    ....... originalText 0..1 ED
    ....... translation 0..* CD
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... assignedPerson 0..1 Person
    ...... representedOrganization 0..1 Organization
    ...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
    XML: patient (urn:hl7-org:sdtc)
    ....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
    XML Namespace: urn:hl7-org:sdtc
    ... author 0..* Author
    ... informant 0..* Informant
    ... Slices for participant 1..* Participant2 Slice: Unordered, Open by value:typeCode
    .... participant:coverage-target C 1..1 Participant2 participant
    Constraints: should-time
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 1..1 II
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.89
    ..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
    Fixed Value: COV
    ..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
    Fixed Value: OP
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time C 0..1 IVL_TS This records the policy coverage period or self-pay period.
    Constraints: should-low, should-high
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @value 0..1 ts Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
    ...... @operator 0..1 cs Binding: CDASetOperator (required)
    ...... low 0..1 IVXB_TS
    ...... center 0..1 TS
    ...... width 0..1 PQ
    ...... high 0..1 IVXB_TS SHOULD contain high
    ..... awarenessCode 0..1 CE
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr, should-playingEntity
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... templateId 0..* II
    ...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Member Identifier: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code C 1..1 CE 𝗨𝗦𝗖𝗗𝗜: Relationship to Subscriber: Records the relationship of a patient to the primary insured person.
    Binding: CDARoleCode (example)
    Constraints: should-code-attr
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @code 0..1 cs Binding: Coverage Role Type Value Set . (preferred)
    ....... @codeSystem 0..1 oid, uuid, ruid
    ....... @codeSystemName 0..1 st
    ....... @codeSystemVersion 0..1 st
    ....... @displayName 0..1 st
    ....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
    XML: valueSet (urn:hl7-org:sdtc)
    ....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
    XML: valueSetVersion (urn:hl7-org:sdtc)
    ....... originalText 0..1 ED
    ....... translation 0..* CD
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... playingDevice 0..1 Device
    ...... playingEntity 0..1 PlayingEntity This playingEntity records the covered party name and birthTime as represented by the health plan. This could match the information in recordTarget, or be different due to marriage or other reasons.
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... realmCode 0..* CS
    ....... typeId C 0..1 II Constraints: II-1
    ........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ........ @assigningAuthorityName 0..1 st
    ........ @displayable 0..1 bl
    ........ @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ........ @extension 1..1 st
    ....... templateId 0..* II
    ....... @classCode 0..1 cs Binding: EntityClassRoot (required)
    ....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
    Fixed Value: INSTANCE
    ....... code 0..1 CE Binding: CDAEntityCode (example)
    ....... quantity 0..* PQ
    ....... name 1..1 PN
    ....... sdtcBirthTime 1..1 TS XML Namespace: urn:hl7-org:sdtc
    sdtc:birthTime
    XML: birthTime (urn:hl7-org:sdtc)
    ....... desc 0..1 ED
    ...... scopingEntity 0..1 Entity
    .... participant:subscriber 0..1 Participant2 When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information.
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 1..1 II
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.90
    ..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
    Fixed Value: HLD
    ..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
    Fixed Value: OP
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... awarenessCode 0..1 CE
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... templateId 0..* II
    ...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Subscriber Id: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 0..1 CE Binding: CDARoleCode (example)
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... playingDevice 0..1 Device
    ...... playingEntity 0..1 PlayingEntity
    ...... scopingEntity 0..1 Entity
    ... Slices for entryRelationship 0..* EntryRelationship Slice: Unordered, Open by value:act.moodCode
    .... entryRelationship:authorization 0..* EntryRelationship entryRelationship
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 AuthorizationActivity
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... Slices for templateId 1..* II Slice: Unordered, Open by value:root
    ....... templateId:authorization-activity 1..1 II
    ........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ........ @assigningAuthorityName 0..1 st
    ........ @displayable 0..1 bl
    ........ @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.1.19
    ...... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ...... @moodCode 1..1 cs EVN
    Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: EVN
    ...... @negationInd 0..1 bl
    ...... id 1..1 II
    ...... code 1..1 CD Binding: v3 Code System ActCode (example)
    ...... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
    ....... @integrityCheck 0..1 bin
    ....... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
    ....... @language 0..1 cs
    ....... @mediaType 0..1 cs Binding: MediaType (example)
    ....... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
    ....... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    ....... reference C 0..1 TEL Constraints: value-starts-octothorpe
    ....... thumbnail 0..1 ED
    ...... statusCode 0..1 CS Binding: ActStatus (required)
    ...... effectiveTime 0..1 IVL_TS
    ...... priorityCode 0..1 CE Binding: ActPriority (example)
    ...... languageCode 0..1 CS Binding: AllLanguages (required)
    ...... subject 0..1 Subject
    ...... specimen 0..* Specimen
    ...... performer 0..* Performer2
    ...... author 0..* Author
    ...... informant 0..* Informant
    ...... participant 0..* Participant2
    ...... Slices for entryRelationship 1..* EntryRelationship Slice: Unordered, Open by value:typeCode
    ....... entryRelationship:target C 1..* EntryRelationship The target of an authorization activity MAY contain one or more performer, to indicate the providers that have been authorized to provide treatment (CONF:81-8952).
    Constraints: 81-8951
    ........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ........ realmCode 0..* CS
    ........ typeId C 0..1 II Constraints: II-1
    ......... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ......... @assigningAuthorityName 0..1 st
    ......... @displayable 0..1 bl
    ......... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ......... @extension 1..1 st
    ........ templateId 0..* II
    ........ @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: SUBJ
    ........ @inversionInd 0..1 bl
    ........ @contextConductionInd 0..1 bl
    ........ @negationInd 0..1 bl
    ........ sequenceNumber 0..1 INT
    ........ seperatableInd 0..1 BL
    ........ act 0..1 Act
    ........ encounter 0..1 Encounter
    ........ observation 0..1 Observation
    ........ observationMedia 0..1 ObservationMedia
    ........ organizer 0..1 Organizer
    ........ procedure 0..1 Procedure
    ........ regionOfInterest 0..1 RegionOfInterest
    ........ substanceAdministration 0..1 SubstanceAdministration
    ........ supply 0..1 Supply
    ...... reference 0..* Reference
    ...... precondition 0..* Precondition
    ...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
    ..... encounter 0..1 Encounter
    ..... observation 0..1 Observation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:plan 0..* EntryRelationship Represents the Coverage Plan
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 Act
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @assigningAuthorityName 0..1 st
    ....... @displayable 0..1 bl
    ....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ....... @extension 1..1 st
    ...... templateId 0..* II
    ...... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ...... @moodCode 1..1 cs Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: DEF
    ...... @negationInd 0..1 bl
    ...... id 1..* II Plan identifier
    ...... code 1..1 CD Binding: v3 Code System ActCode (example)
    ...... text 1..1 ED Name of the plan
    ...... statusCode 0..1 CS Binding: ActStatus (required)
    ...... effectiveTime 0..1 IVL_TS
    ...... priorityCode 0..1 CE Binding: ActPriority (example)
    ...... languageCode 0..1 CS Binding: AllLanguages (required)
    ...... subject 0..1 Subject
    ...... specimen 0..* Specimen
    ...... performer 0..* Performer2
    ...... author 0..* Author
    ...... informant 0..* Informant
    ...... participant 0..* Participant2
    ...... entryRelationship 0..* EntryRelationship
    ...... reference 0..* Reference
    ...... precondition 0..* Precondition
    ...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
    ..... encounter 0..1 Encounter
    ..... observation 0..1 Observation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    ... reference 0..* Reference
    ... precondition 0..* Precondition
    ... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Act.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.templateId:policy-activity.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.classCoderequiredFixed Value: ACT
    http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
    Act.moodCoderequiredFixed Value: EVN
    http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
    Act.codepreferredPayerType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
    Act.text.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.text.compressionrequiredCDACompressionAlgorithm
    http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
    Act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
    http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
    Act.text.mediaTypeexampleMediaType
    http://terminology.hl7.org/ValueSet/v3-MediaType
    Act.text.representationrequiredBinaryDataEncoding
    http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
    Act.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.statusCode.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.priorityCodeexampleActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard
    Act.performer:payer.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.templateId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.typeCoderequiredFixed Value: PRF
    http://terminology.hl7.org/ValueSet/v3-ParticipationPhysicalPerformer
    Act.performer:payer.assignedEntity.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.assignedEntity.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.assignedEntity.classCoderequiredFixed Value: ASSIGNED
    http://terminology.hl7.org/ValueSet/v3-RoleClassAssignedEntity
    Act.performer:payer.assignedEntity.codeexampleCDARoleCode
    http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
    Act.performer:payer.assignedEntity.code.codepreferredFinanciallyResponsiblePartyTypeValueSet .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.10416
    Act.performer:payer.assignedEntity.representedOrganization.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.assignedEntity.representedOrganization.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:payer.assignedEntity.representedOrganization.classCoderequiredFixed Value: ORG
    http://terminology.hl7.org/ValueSet/v3-EntityClassOrganization
    Act.performer:payer.assignedEntity.representedOrganization.determinerCoderequiredFixed Value: INSTANCE
    http://terminology.hl7.org/ValueSet/v3-EntityDeterminer
    Act.performer:payer.assignedEntity.representedOrganization.standardIndustryClassCodeexampleOrganizationIndustryClassNAICS
    http://terminology.hl7.org/ValueSet/v3-OrganizationIndustryClassNAICS
    Act.performer:guarantor.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:guarantor.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:guarantor.templateId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:guarantor.typeCoderequiredFixed Value: PRF
    http://terminology.hl7.org/ValueSet/v3-ParticipationPhysicalPerformer
    Act.performer:guarantor.assignedEntity.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:guarantor.assignedEntity.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.performer:guarantor.assignedEntity.classCoderequiredFixed Value: ASSIGNED
    http://terminology.hl7.org/ValueSet/v3-RoleClassAssignedEntity
    Act.performer:guarantor.assignedEntity.codeexampleCDARoleCode
    http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
    Act.performer:guarantor.assignedEntity.code.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.templateId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.typeCoderequiredFixed Value: COV
    http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
    Act.participant:coverage-target.contextControlCoderequiredFixed Value: OP
    http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
    Act.participant:coverage-target.time.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.time.operatorrequiredCDASetOperator
    http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
    Act.participant:coverage-target.participantRole.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.participantRole.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.participantRole.classCoderequiredCDARoleClassRoot
    http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
    Act.participant:coverage-target.participantRole.codeexampleCDARoleCode
    http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
    Act.participant:coverage-target.participantRole.code.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.participantRole.code.codepreferredCoverageRoleTypeValueSet .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.18877
    Act.participant:coverage-target.participantRole.playingEntity.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.participantRole.playingEntity.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:coverage-target.participantRole.playingEntity.classCoderequiredEntityClassRoot
    http://terminology.hl7.org/ValueSet/v3-EntityClassRoot
    Act.participant:coverage-target.participantRole.playingEntity.determinerCoderequiredFixed Value: INSTANCE
    http://terminology.hl7.org/ValueSet/v3-EntityDeterminer
    Act.participant:coverage-target.participantRole.playingEntity.codeexampleCDAEntityCode
    http://hl7.org/cda/stds/core/ValueSet/CDAEntityCode
    Act.participant:subscriber.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:subscriber.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:subscriber.templateId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:subscriber.typeCoderequiredFixed Value: HLD
    http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
    Act.participant:subscriber.contextControlCoderequiredFixed Value: OP
    http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
    Act.participant:subscriber.participantRole.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:subscriber.participantRole.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant:subscriber.participantRole.classCoderequiredCDARoleClassRoot
    http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
    Act.participant:subscriber.participantRole.codeexampleCDARoleCode
    http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
    Act.entryRelationship:authorization.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.typeCoderequiredFixed Value: REFR
    http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
    Act.entryRelationship:authorization.act.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.templateId:authorization-activity.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.classCoderequiredFixed Value: ACT
    http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
    Act.entryRelationship:authorization.act.moodCoderequiredFixed Value: EVN
    http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
    Act.entryRelationship:authorization.act.codeexampleActCode
    http://terminology.hl7.org/ValueSet/v3-ActCode
    Act.entryRelationship:authorization.act.text.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.text.compressionrequiredCDACompressionAlgorithm
    http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
    Act.entryRelationship:authorization.act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
    http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
    Act.entryRelationship:authorization.act.text.mediaTypeexampleMediaType
    http://terminology.hl7.org/ValueSet/v3-MediaType
    Act.entryRelationship:authorization.act.text.representationrequiredBinaryDataEncoding
    http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
    Act.entryRelationship:authorization.act.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.entryRelationship:authorization.act.priorityCodeexampleActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.entryRelationship:authorization.act.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard
    Act.entryRelationship:authorization.act.entryRelationship:target.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.entryRelationship:target.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:authorization.act.entryRelationship:target.typeCoderequiredFixed Value: SUBJ
    http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
    Act.entryRelationship:plan.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:plan.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:plan.typeCoderequiredFixed Value: REFR
    http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
    Act.entryRelationship:plan.act.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:plan.act.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:plan.act.classCoderequiredFixed Value: ACT
    http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
    Act.entryRelationship:plan.act.moodCoderequiredFixed Value: DEF
    http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
    Act.entryRelationship:plan.act.codeexampleActCode
    http://terminology.hl7.org/ValueSet/v3-ActCode
    Act.entryRelationship:plan.act.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.entryRelationship:plan.act.priorityCodeexampleActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.entryRelationship:plan.act.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    4537-8967warningAct.performer:guarantor.assignedEntity**SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
    : assignedPerson.name.exists() or representedOrganization.name.exists()
    4537-17139errorActWhen the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
    : participant.where(typeCode='COV').participantRole.code.where(code = 'SELF').exists() implies participant.where(typeCode='HLD').empty()
    81-8951errorAct.entryRelationship:authorization.act.entryRelationship:targetThe target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951).
    : (act | encounter | observation | observationMedia | organizer | procedure | regionOfInterest | substanceAdministration | supply).where(moodCode='PRMS').exists()
    II-1errorAct.typeId, Act.performer:payer.typeId, Act.performer:payer.assignedEntity.typeId, Act.performer:payer.assignedEntity.representedOrganization.typeId, Act.performer:guarantor.typeId, Act.performer:guarantor.assignedEntity.typeId, Act.participant:coverage-target.typeId, Act.participant:coverage-target.participantRole.typeId, Act.participant:coverage-target.participantRole.playingEntity.typeId, Act.participant:subscriber.typeId, Act.participant:subscriber.participantRole.typeId, Act.entryRelationship:authorization.typeId, Act.entryRelationship:authorization.act.typeId, Act.entryRelationship:authorization.act.entryRelationship:target.typeId, Act.entryRelationship:plan.typeId, Act.entryRelationship:plan.act.typeIdAn II instance must have either a root or an nullFlavor.
    : root.exists() or nullFlavor.exists()
    should-addrwarningAct.performer:guarantor.assignedEntity, Act.participant:coverage-target.participantRole, Act.participant:subscriber.participantRoleSHOULD contain addr
    : addr.exists()
    should-codewarningAct.performer:payer.assignedEntitySHOULD contain code
    : code.exists()
    should-code-attrwarningAct.participant:coverage-target.participantRole.codeSHOULD contain @code
    : code.exists()
    should-highwarningAct.participant:coverage-target.timeSHOULD contain high
    : high.exists()
    should-lowwarningAct.participant:coverage-target.timeSHOULD contain low
    : low.exists()
    should-namewarningAct.performer:payer.assignedEntity.representedOrganizationSHOULD contain name
    : name.exists()
    should-playingEntitywarningAct.participant:coverage-target.participantRoleSHOULD contain playingEntity
    : playingEntity.exists()
    should-representedOrganizationwarningAct.performer:payer.assignedEntitySHOULD contain representedOrganization
    : representedOrganization.exists()
    should-telecomwarningAct.performer:guarantor.assignedEntitySHOULD contain telecom
    : telecom.exists()
    should-text-ref-valuewarningActSHOULD contain text/reference/@value
    : text.reference.value.exists()
    should-timewarningAct.performer:guarantor, Act.participant:coverage-targetSHOULD contain time
    : time.exists()
    value-starts-octothorpeerrorAct.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
    : value.exists() implies value.startsWith('#')
    value-starts-octothorpeerrorAct.entryRelationship:authorization.act.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
    : value.exists() implies value.startsWith('#')

    This structure is derived from Act

    Summary

    Mandatory: 18 elements(16 nested mandatory elements)
    Fixed: 9 elements
    Prohibited: 5 elements

    Structures

    This structure refers to these other structures:

    Slices

    This structure defines the following Slices:

    • The element 2 is sliced based on the values of Act.templateId
    • The element 1 is sliced based on the value of Act.performer
    • The element 1 is sliced based on the value of Act.participant
    • The element 1 is sliced based on the value of Act.entryRelationship

     

    Other representations of profile: CSV, Excel