Da Vinci - Coverage Requirements Discovery
2.1.0-preview - STU 2 United States of America flag

Da Vinci - Coverage Requirements Discovery, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.0-preview built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-crd/ and changes regularly. See the Directory of published versions

Logical Model: CRDMetricData - Detailed Descriptions

Page standards status: Informative Maturity Level: 1

Definitions for the CRDMetricData logical model.

Guidance on how to interpret the contents of this table can be found here

0. CRDMetricData
Definition

A logical model describing the information that should be captured by CRD implementers about every CRD invocation to support measures evaluating CRD implementation

ShortCRD Metric Data
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. CRDMetricData.source
Definition

A code to indicate which type of system collected the metric data.

Shortprovider-src | payer-src
Comments

Each hook should have metric data capture by both the initiating provider and the responding payer.

Control1..1
BindingThe codes SHALL be taken from CRD Metric Data Source Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/metricDataSource)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
4. CRDMetricData.hookInstance
Definition

The unique id for this specific hook invocation.

ShortUnique hook invocation id
Comments

Used to link the statistics for a given hook call between provider and payer systems.

Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
6. CRDMetricData.hookType
Definition

The type of hook specified in the hook element in the CDS hooks request.

Shortorder-select | order-sign +
Control1..1
BindingUnless not suitable, these codes SHALL be taken from CDS Hook Types Value Set
(extensible to http://hl7.org/fhir/us/davinci-crd/ValueSet/cdsHookType)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
8. CRDMetricData.providerId
Definition

The NPI number of the user who initiated the hook request.

ShortUser invoking hook
Control1..1
TypeIdentifier
10. CRDMetricData.providerId.system
Pattern Valuehttp://hl7.org/fhir/sid/us-npi
12. CRDMetricData.providerId.value
Control1..?
14. CRDMetricData.groupId
Definition

The NPI of the hospital/clinic/other organization that initiated the hook request.

ShortHealthcare org of user
Control1..1
TypeIdentifier
16. CRDMetricData.groupId.system
Pattern Valuehttp://hl7.org/fhir/sid/us-npi
18. CRDMetricData.groupId.value
Control1..?
20. CRDMetricData.payerId
Definition

The identifier of the payer organization to whom the CRD call was made.

ShortPayer receiving hook
Control1..1
TypeIdentifier
22. CRDMetricData.payerId.system
Control1..?
24. CRDMetricData.payerId.value
Control1..?
26. CRDMetricData.requestTime
Definition

For providers, the time the hook call was made. For payers, the time the hook call was received.

ShortTime hook initiated
Control1..1
Typeinstant
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
28. CRDMetricData.responseTime
Definition

For providers, the time the hook response was received. For payers, the time the hook response was returned.

ShortTime of hook response
Control0..1
Typeinstant
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
30. CRDMetricData.httpResponse
Definition

What HTTP response code was returned for the hook invocation.

Shorte.g. 200
Control1..1
TypepositiveInt
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
32. CRDMetricData.issue
Definition

In the event of an HTTP error, if an OperationOutcome is returned, what were the issues?

ShortOperationOutcome info
Control0..*
TypeBackboneElement
34. CRDMetricData.issue.code
Definition

The issue.code value from the OperationOutcome for this issue.

ShortError code
Control1..1
BindingThe codes SHALL be taken from IssueType
(required to http://hl7.org/fhir/ValueSet/issue-type)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
36. CRDMetricData.issue.details
Definition

The issue.details value from the OperationOutcome for this issue.

ShortMore detailed error code
Control0..1
BindingFor example codes, see OperationOutcomeCodes
(example to http://hl7.org/fhir/ValueSet/operation-outcome)
TypeCodeableConcept
Requirements

Because these codes are not standardized, they will primarily only be useful for evaluation between communication partners, not for comparison across implementations

38. CRDMetricData.tokenUse
Definition

Indicates whether the provided access token was used to retrieve additional information. Rejected indicates that when used, the access failed.

Shortused | not-used | rejected
Control0..1
BindingFor example codes, see CRD Metric Token Use
(example to http://hl7.org/fhir/us/davinci-crd/ValueSet/metricTokenUse)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
40. CRDMetricData.orderDetail
Definition

The code or codes defining the type of product or service from the focal Request or

ShortService or product code(s)
Comments

Specifically, this corresponds to: Appointment.serviceType, CommunicationRequest.payload.valueCodeableConcept, DeviceRequest.codeCodeableConcept, DeviceRequest.codeReference.resolve().udiCarrier.deviceIdentifier (expressed as a CodeableConcept), Encounter.serviceType, MedicationRequest.medicationCodeableConcept, MedicationRequest.medicationReference.resolve().code, ServiceRequest.code, VisionPrescription.lensSpecification.productType

Control0..*
BindingUnless not suitable, these codes SHALL be taken from CRD Order Detail Codes Value Set
(extensible to http://hl7.org/fhir/us/davinci-crd/ValueSet/orderDetail)
TypeCodeableConcept
42. CRDMetricData.resources
Definition

Information other than the 'focal' resources (orders, encounter, appointment) for the hook that were accessed by the payer.

ShortResource types accessed
Control0..*
TypeBackboneElement
44. CRDMetricData.resources.type
Definition

What kind of resource was accessed.

ShortKind of resource
Control1..1
BindingThe codes SHALL be taken from ResourceType
(required to http://hl7.org/fhir/ValueSet/resource-types)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
46. CRDMetricData.resources.profile
Definition

Indicates the sub-type of data accessed in situations where multiple US-core profiles could apply (e.g. Observation). Note: This does not mean that the data received was actually valid against the profile, merely that the search criteria used were intended to retrieve data of this type.

ShortSolicited profile
Control0..1
Typecanonical(StructureDefinition)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
48. CRDMetricData.resources.count
Definition

How many resources of that type were accessed.

ShortNumber retrieved
Control1..1
TypepositiveInt
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
50. CRDMetricData.resources.prefetch
Definition

Was the data retrieved by prefetch or direct query. (If some resources of the same type were accessed both with and without prefetch, include two repetitions.)

ShortRetrieved by prefetch?
Control0..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
52. CRDMetricData.response
Definition

Summary information about each card or system action returned.

ShortReturned card/system action
Control0..*
TypeBackboneElement
54. CRDMetricData.response.type
Definition

The CRD code for the card. Mandatory if the card corresponds to a type defined by CRD, otherwise omit.

ShortType of CRD card
Control0..1
BindingThe codes SHALL be taken from CRD Card Types Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/cardType)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
56. CRDMetricData.response.focus
Definition

Indicates the type of resource(s) tied to the card.

ShortResource tied to card
Control0..*
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
58. CRDMetricData.response.engagement
Definition

Indicates if the user engaged with the card as per the CDS Hooks feedback mechanism.

Shortignore | accept | override
Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
60. CRDMetricData.response.coverageInfo
Definition

If the card is a coverage-information card, indicates additional information about the information provided in the coverage-information extension.

ShortCoverage information
Control0..*
TypeBackboneElement
62. CRDMetricData.response.coverageInfo.covered
Definition

Indicates whether the service is covered.

Shortcovered | not-covered | conditional
Control0..1
BindingThe codes SHALL be taken from CRD Coverage Information Covered Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageInfo)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
64. CRDMetricData.response.coverageInfo.paNeeded
Definition

Indicates whether prior authorization is necessary or not, as well as considerations about applying for prior authorization.

Shortauth-needed | no-auth | satisfied +
Control0..1
BindingThe codes SHALL be taken from CRD Coverage Information Prior Authorization Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/coveragePaDetail)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
66. CRDMetricData.response.coverageInfo.docNeeded
Definition

Indicates whether additional information is necessary (for prior auth, claims submission, or some other purpose).

Shortno-doc | clinical | admin | both +
Control0..1
BindingThe codes SHALL be taken from CRD Coverage Information Additional Documentation Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/AdditionalDocumentation)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
68. CRDMetricData.response.coverageInfo.infoNeeded
Definition

Indicates what additional inforamtion is necessary in order to determine authorization/coverage - which might be available on a later hook invocation.

Shortperformer | location | timeframe
Control0..1
BindingThe codes SHALL be taken from CRD Information Needed Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/informationNeeded)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
70. CRDMetricData.response.coverageInfo.questionnaire
Definition

Information about the Questionnaire(s) returned to gather additional information (e.g. through DTR).

ShortQuestionnaire(s) returned
Control0..*
TypeBackboneElement
Requirements

Allows linking metadata about forms identified 'to be filled out' in CRD with what is actually completed in DTR, and eventually submitted in CDex, PAS or claims

72. CRDMetricData.response.coverageInfo.questionnaire.reference
Definition

The official identifier of one of the Questionnaires provided to be filled out.

ShortQuestionnaire url & version
Control1..1
Typecanonical(Questionnaire)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
74. CRDMetricData.response.coverageInfo.questionnaire.adaptive
Definition

If true, indicates that the questionnaire is adaptive (i.e. uses the $next-question operation to determine questions).

ShortIs questionnaire adaptive?
Control1..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
76. CRDMetricData.response.coverageInfo.questionnaire.response
Definition

If true, indicates that the card included a partially populated QuestionnaireResponse with answers filled by the payer from pre-known data.

ShortPre-pop response provided?
Control1..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
78. CRDMetricData.response.coverageInfo.assertionId
Definition

Corresponds to the coverage-assertion-id from the coverage-information extension.

ShortId for coverage assertion
Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Requirements

Used to link the results of CRD to metric information captured for DTR and/or PAS.

80. CRDMetricData.response.coverageInfo.satisfiedId
Definition

Corresponds to the satisfied-pa-id from the coverage-information extension.

ShortId if PA is satisfied
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
82. CRDMetricData.response.coverageInfo.businessLine
Definition

A code that indicates which type of insurance this assertion applies to.

ShortE.g. MedicareAdvantage
Control0..1
TypeCodeableConcept

Guidance on how to interpret the contents of this table can be found here

0. CRDMetricData
Definition

A logical model describing the information that should be captured by CRD implementers about every CRD invocation to support measures evaluating CRD implementation

ShortCRD Metric Data
Control0..*
Is Modifierfalse
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. CRDMetricData.source
Definition

A code to indicate which type of system collected the metric data.

Shortprovider-src | payer-src
Comments

Each hook should have metric data capture by both the initiating provider and the responding payer.

Control1..1
BindingThe codes SHALL be taken from CRD Metric Data Source Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/metricDataSource)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
4. CRDMetricData.hookInstance
Definition

The unique id for this specific hook invocation.

ShortUnique hook invocation id
Comments

Used to link the statistics for a given hook call between provider and payer systems.

Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
6. CRDMetricData.hookType
Definition

The type of hook specified in the hook element in the CDS hooks request.

Shortorder-select | order-sign +
Control1..1
BindingUnless not suitable, these codes SHALL be taken from CDS Hook Types Value Set
(extensible to http://hl7.org/fhir/us/davinci-crd/ValueSet/cdsHookType)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
8. CRDMetricData.providerId
Definition

The NPI number of the user who initiated the hook request.

ShortUser invoking hook
Control1..1
TypeIdentifier
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. CRDMetricData.providerId.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. CRDMetricData.providerId.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control0..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Pattern Valuehttp://hl7.org/fhir/sid/us-npi
Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. CRDMetricData.providerId.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. CRDMetricData.groupId
Definition

The NPI of the hospital/clinic/other organization that initiated the hook request.

ShortHealthcare org of user
Control1..1
TypeIdentifier
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. CRDMetricData.groupId.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. CRDMetricData.groupId.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control0..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Pattern Valuehttp://hl7.org/fhir/sid/us-npi
Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. CRDMetricData.groupId.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. CRDMetricData.payerId
Definition

The identifier of the payer organization to whom the CRD call was made.

ShortPayer receiving hook
Control1..1
TypeIdentifier
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. CRDMetricData.payerId.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. CRDMetricData.payerId.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control10..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. CRDMetricData.payerId.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. CRDMetricData.requestTime
Definition

For providers, the time the hook call was made. For payers, the time the hook call was received.

ShortTime hook initiated
Control1..1
Typeinstant
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
34. CRDMetricData.responseTime
Definition

For providers, the time the hook response was received. For payers, the time the hook response was returned.

ShortTime of hook response
Control0..1
Typeinstant
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
36. CRDMetricData.httpResponse
Definition

What HTTP response code was returned for the hook invocation.

Shorte.g. 200
Control1..1
TypepositiveInt
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
38. CRDMetricData.issue
Definition

In the event of an HTTP error, if an OperationOutcome is returned, what were the issues?

ShortOperationOutcome info
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. CRDMetricData.issue.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
42. CRDMetricData.issue.code
Definition

The issue.code value from the OperationOutcome for this issue.

ShortError code
Control1..1
BindingThe codes SHALL be taken from IssueType
(required to http://hl7.org/fhir/ValueSet/issue-type)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
44. CRDMetricData.issue.details
Definition

The issue.details value from the OperationOutcome for this issue.

ShortMore detailed error code
Control0..1
BindingFor example codes, see OperationOutcomeCodes
(example to http://hl7.org/fhir/ValueSet/operation-outcome)
TypeCodeableConcept
Requirements

Because these codes are not standardized, they will primarily only be useful for evaluation between communication partners, not for comparison across implementations

46. CRDMetricData.tokenUse
Definition

Indicates whether the provided access token was used to retrieve additional information. Rejected indicates that when used, the access failed.

Shortused | not-used | rejected
Control0..1
BindingFor example codes, see CRD Metric Token Use
(example to http://hl7.org/fhir/us/davinci-crd/ValueSet/metricTokenUse)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
48. CRDMetricData.orderDetail
Definition

The code or codes defining the type of product or service from the focal Request or

ShortService or product code(s)
Comments

Specifically, this corresponds to: Appointment.serviceType, CommunicationRequest.payload.valueCodeableConcept, DeviceRequest.codeCodeableConcept, DeviceRequest.codeReference.resolve().udiCarrier.deviceIdentifier (expressed as a CodeableConcept), Encounter.serviceType, MedicationRequest.medicationCodeableConcept, MedicationRequest.medicationReference.resolve().code, ServiceRequest.code, VisionPrescription.lensSpecification.productType

Control0..*
BindingUnless not suitable, these codes SHALL be taken from CRD Order Detail Codes Value Set
(extensible to http://hl7.org/fhir/us/davinci-crd/ValueSet/orderDetail)
TypeCodeableConcept
50. CRDMetricData.resources
Definition

Information other than the 'focal' resources (orders, encounter, appointment) for the hook that were accessed by the payer.

ShortResource types accessed
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. CRDMetricData.resources.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
54. CRDMetricData.resources.type
Definition

What kind of resource was accessed.

ShortKind of resource
Control1..1
BindingThe codes SHALL be taken from ResourceType
(required to http://hl7.org/fhir/ValueSet/resource-types)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
56. CRDMetricData.resources.profile
Definition

Indicates the sub-type of data accessed in situations where multiple US-core profiles could apply (e.g. Observation). Note: This does not mean that the data received was actually valid against the profile, merely that the search criteria used were intended to retrieve data of this type.

ShortSolicited profile
Control0..1
Typecanonical(StructureDefinition)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
58. CRDMetricData.resources.count
Definition

How many resources of that type were accessed.

ShortNumber retrieved
Control1..1
TypepositiveInt
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
60. CRDMetricData.resources.prefetch
Definition

Was the data retrieved by prefetch or direct query. (If some resources of the same type were accessed both with and without prefetch, include two repetitions.)

ShortRetrieved by prefetch?
Control0..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
62. CRDMetricData.response
Definition

Summary information about each card or system action returned.

ShortReturned card/system action
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. CRDMetricData.response.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
66. CRDMetricData.response.type
Definition

The CRD code for the card. Mandatory if the card corresponds to a type defined by CRD, otherwise omit.

ShortType of CRD card
Control0..1
BindingThe codes SHALL be taken from CRD Card Types Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/cardType)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
68. CRDMetricData.response.focus
Definition

Indicates the type of resource(s) tied to the card.

ShortResource tied to card
Control0..*
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
70. CRDMetricData.response.engagement
Definition

Indicates if the user engaged with the card as per the CDS Hooks feedback mechanism.

Shortignore | accept | override
Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
72. CRDMetricData.response.coverageInfo
Definition

If the card is a coverage-information card, indicates additional information about the information provided in the coverage-information extension.

ShortCoverage information
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
74. CRDMetricData.response.coverageInfo.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
76. CRDMetricData.response.coverageInfo.covered
Definition

Indicates whether the service is covered.

Shortcovered | not-covered | conditional
Control0..1
BindingThe codes SHALL be taken from CRD Coverage Information Covered Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageInfo)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
78. CRDMetricData.response.coverageInfo.paNeeded
Definition

Indicates whether prior authorization is necessary or not, as well as considerations about applying for prior authorization.

Shortauth-needed | no-auth | satisfied +
Control0..1
BindingThe codes SHALL be taken from CRD Coverage Information Prior Authorization Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/coveragePaDetail)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
80. CRDMetricData.response.coverageInfo.docNeeded
Definition

Indicates whether additional information is necessary (for prior auth, claims submission, or some other purpose).

Shortno-doc | clinical | admin | both +
Control0..1
BindingThe codes SHALL be taken from CRD Coverage Information Additional Documentation Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/AdditionalDocumentation)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
82. CRDMetricData.response.coverageInfo.infoNeeded
Definition

Indicates what additional inforamtion is necessary in order to determine authorization/coverage - which might be available on a later hook invocation.

Shortperformer | location | timeframe
Control0..1
BindingThe codes SHALL be taken from CRD Information Needed Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/informationNeeded)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
84. CRDMetricData.response.coverageInfo.questionnaire
Definition

Information about the Questionnaire(s) returned to gather additional information (e.g. through DTR).

ShortQuestionnaire(s) returned
Control0..*
TypeBackboneElement
Requirements

Allows linking metadata about forms identified 'to be filled out' in CRD with what is actually completed in DTR, and eventually submitted in CDex, PAS or claims

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
86. CRDMetricData.response.coverageInfo.questionnaire.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
88. CRDMetricData.response.coverageInfo.questionnaire.reference
Definition

The official identifier of one of the Questionnaires provided to be filled out.

ShortQuestionnaire url & version
Control1..1
Typecanonical(Questionnaire)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
90. CRDMetricData.response.coverageInfo.questionnaire.adaptive
Definition

If true, indicates that the questionnaire is adaptive (i.e. uses the $next-question operation to determine questions).

ShortIs questionnaire adaptive?
Control1..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
92. CRDMetricData.response.coverageInfo.questionnaire.response
Definition

If true, indicates that the card included a partially populated QuestionnaireResponse with answers filled by the payer from pre-known data.

ShortPre-pop response provided?
Control1..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
94. CRDMetricData.response.coverageInfo.assertionId
Definition

Corresponds to the coverage-assertion-id from the coverage-information extension.

ShortId for coverage assertion
Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Requirements

Used to link the results of CRD to metric information captured for DTR and/or PAS.

96. CRDMetricData.response.coverageInfo.satisfiedId
Definition

Corresponds to the satisfied-pa-id from the coverage-information extension.

ShortId if PA is satisfied
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
98. CRDMetricData.response.coverageInfo.businessLine
Definition

A code that indicates which type of insurance this assertion applies to.

ShortE.g. MedicareAdvantage
Control0..1
TypeCodeableConcept

Guidance on how to interpret the contents of this table can be found here

0. CRDMetricData
Definition

A logical model describing the information that should be captured by CRD implementers about every CRD invocation to support measures evaluating CRD implementation

ShortCRD Metric Data
Control0..*
Is Modifierfalse
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. CRDMetricData.source
Definition

A code to indicate which type of system collected the metric data.

Shortprovider-src | payer-src
Comments

Each hook should have metric data capture by both the initiating provider and the responding payer.

Control1..1
BindingThe codes SHALL be taken from CRD Metric Data Source Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/metricDataSource)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
4. CRDMetricData.hookInstance
Definition

The unique id for this specific hook invocation.

ShortUnique hook invocation id
Comments

Used to link the statistics for a given hook call between provider and payer systems.

Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
6. CRDMetricData.hookType
Definition

The type of hook specified in the hook element in the CDS hooks request.

Shortorder-select | order-sign +
Control1..1
BindingUnless not suitable, these codes SHALL be taken from CDS Hook Types Value Set
(extensible to http://hl7.org/fhir/us/davinci-crd/ValueSet/cdsHookType)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
8. CRDMetricData.providerId
Definition

The NPI number of the user who initiated the hook request.

ShortUser invoking hook
Control1..1
TypeIdentifier
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. CRDMetricData.providerId.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
12. CRDMetricData.providerId.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on CRDMetricData.providerId.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 14. CRDMetricData.providerId.use
    Definition

    The purpose of this identifier.

    Shortusual | official | temp | secondary | old (If known)
    Comments

    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

    Control0..1
    BindingThe codes SHALL be taken from IdentifierUse
    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

    Identifies the purpose for this identifier, if known .

    Typecode
    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. CRDMetricData.providerId.type
    Definition

    A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

    ShortDescription of identifier
    Comments

    This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

    Control0..1
    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
    (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

    A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Requirements

    Allows users to make use of identifiers when the identifier system is not known.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. CRDMetricData.providerId.system
    Definition

    Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

    ShortThe namespace for the identifier value
    Comments

    Identifier.system is always case sensitive.

    Control0..1
    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

    Pattern Valuehttp://hl7.org/fhir/sid/us-npi
    Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. CRDMetricData.providerId.value
    Definition

    The portion of the identifier typically relevant to the user and which is unique within the context of the system.

    ShortThe value that is unique
    Comments

    If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

    Control1..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Example<br/><b>General</b>:123456
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. CRDMetricData.providerId.period
    Definition

    Time period during which identifier is/was valid for use.

    ShortTime period when id is/was valid for use
    Control0..1
    TypePeriod
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. CRDMetricData.providerId.assigner
    Definition

    Organization that issued/manages the identifier.

    ShortOrganization that issued id (may be just text)
    Comments

    The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

    Control0..1
    TypeReference(Organization)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. CRDMetricData.groupId
    Definition

    The NPI of the hospital/clinic/other organization that initiated the hook request.

    ShortHealthcare org of user
    Control1..1
    TypeIdentifier
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. CRDMetricData.groupId.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    ShortUnique id for inter-element referencing
    Control0..1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    30. CRDMetricData.groupId.extension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on CRDMetricData.groupId.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 32. CRDMetricData.groupId.use
      Definition

      The purpose of this identifier.

      Shortusual | official | temp | secondary | old (If known)
      Comments

      Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

      Control0..1
      BindingThe codes SHALL be taken from IdentifierUse
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

      Identifies the purpose for this identifier, if known .

      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. CRDMetricData.groupId.type
      Definition

      A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

      ShortDescription of identifier
      Comments

      This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

      Control0..1
      BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
      (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

      A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Requirements

      Allows users to make use of identifiers when the identifier system is not known.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. CRDMetricData.groupId.system
      Definition

      Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

      ShortThe namespace for the identifier value
      Comments

      Identifier.system is always case sensitive.

      Control0..1
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

      Pattern Valuehttp://hl7.org/fhir/sid/us-npi
      Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. CRDMetricData.groupId.value
      Definition

      The portion of the identifier typically relevant to the user and which is unique within the context of the system.

      ShortThe value that is unique
      Comments

      If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

      Control1..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Example<br/><b>General</b>:123456
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. CRDMetricData.groupId.period
      Definition

      Time period during which identifier is/was valid for use.

      ShortTime period when id is/was valid for use
      Control0..1
      TypePeriod
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. CRDMetricData.groupId.assigner
      Definition

      Organization that issued/manages the identifier.

      ShortOrganization that issued id (may be just text)
      Comments

      The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

      Control0..1
      TypeReference(Organization)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      44. CRDMetricData.payerId
      Definition

      The identifier of the payer organization to whom the CRD call was made.

      ShortPayer receiving hook
      Control1..1
      TypeIdentifier
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. CRDMetricData.payerId.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      ShortUnique id for inter-element referencing
      Control0..1
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      48. CRDMetricData.payerId.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on CRDMetricData.payerId.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 50. CRDMetricData.payerId.use
        Definition

        The purpose of this identifier.

        Shortusual | official | temp | secondary | old (If known)
        Comments

        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

        Control0..1
        BindingThe codes SHALL be taken from IdentifierUse
        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

        Identifies the purpose for this identifier, if known .

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. CRDMetricData.payerId.type
        Definition

        A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

        ShortDescription of identifier
        Comments

        This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

        Control0..1
        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
        (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

        A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

        Allows users to make use of identifiers when the identifier system is not known.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. CRDMetricData.payerId.system
        Definition

        Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

        ShortThe namespace for the identifier value
        Comments

        Identifier.system is always case sensitive.

        Control1..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

        Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. CRDMetricData.payerId.value
        Definition

        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

        ShortThe value that is unique
        Comments

        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

        Control1..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Example<br/><b>General</b>:123456
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. CRDMetricData.payerId.period
        Definition

        Time period during which identifier is/was valid for use.

        ShortTime period when id is/was valid for use
        Control0..1
        TypePeriod
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. CRDMetricData.payerId.assigner
        Definition

        Organization that issued/manages the identifier.

        ShortOrganization that issued id (may be just text)
        Comments

        The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

        Control0..1
        TypeReference(Organization)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. CRDMetricData.requestTime
        Definition

        For providers, the time the hook call was made. For payers, the time the hook call was received.

        ShortTime hook initiated
        Control1..1
        Typeinstant
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        64. CRDMetricData.responseTime
        Definition

        For providers, the time the hook response was received. For payers, the time the hook response was returned.

        ShortTime of hook response
        Control0..1
        Typeinstant
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        66. CRDMetricData.httpResponse
        Definition

        What HTTP response code was returned for the hook invocation.

        Shorte.g. 200
        Control1..1
        TypepositiveInt
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        68. CRDMetricData.issue
        Definition

        In the event of an HTTP error, if an OperationOutcome is returned, what were the issues?

        ShortOperationOutcome info
        Control0..*
        TypeBackboneElement
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        70. CRDMetricData.issue.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        72. CRDMetricData.issue.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on CRDMetricData.issue.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 74. CRDMetricData.issue.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          76. CRDMetricData.issue.code
          Definition

          The issue.code value from the OperationOutcome for this issue.

          ShortError code
          Control1..1
          BindingThe codes SHALL be taken from IssueType
          (required to http://hl7.org/fhir/ValueSet/issue-type)
          Typecode
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          78. CRDMetricData.issue.details
          Definition

          The issue.details value from the OperationOutcome for this issue.

          ShortMore detailed error code
          Control0..1
          BindingFor example codes, see OperationOutcomeCodes
          (example to http://hl7.org/fhir/ValueSet/operation-outcome)
          TypeCodeableConcept
          Requirements

          Because these codes are not standardized, they will primarily only be useful for evaluation between communication partners, not for comparison across implementations

          80. CRDMetricData.tokenUse
          Definition

          Indicates whether the provided access token was used to retrieve additional information. Rejected indicates that when used, the access failed.

          Shortused | not-used | rejected
          Control0..1
          BindingFor example codes, see CRD Metric Token Use
          (example to http://hl7.org/fhir/us/davinci-crd/ValueSet/metricTokenUse)
          Typecode
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          82. CRDMetricData.orderDetail
          Definition

          The code or codes defining the type of product or service from the focal Request or

          ShortService or product code(s)
          Comments

          Specifically, this corresponds to: Appointment.serviceType, CommunicationRequest.payload.valueCodeableConcept, DeviceRequest.codeCodeableConcept, DeviceRequest.codeReference.resolve().udiCarrier.deviceIdentifier (expressed as a CodeableConcept), Encounter.serviceType, MedicationRequest.medicationCodeableConcept, MedicationRequest.medicationReference.resolve().code, ServiceRequest.code, VisionPrescription.lensSpecification.productType

          Control0..*
          BindingUnless not suitable, these codes SHALL be taken from CRD Order Detail Codes Value Set
          (extensible to http://hl7.org/fhir/us/davinci-crd/ValueSet/orderDetail)
          TypeCodeableConcept
          84. CRDMetricData.resources
          Definition

          Information other than the 'focal' resources (orders, encounter, appointment) for the hook that were accessed by the payer.

          ShortResource types accessed
          Control0..*
          TypeBackboneElement
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          86. CRDMetricData.resources.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          88. CRDMetricData.resources.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on CRDMetricData.resources.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 90. CRDMetricData.resources.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            92. CRDMetricData.resources.type
            Definition

            What kind of resource was accessed.

            ShortKind of resource
            Control1..1
            BindingThe codes SHALL be taken from ResourceType
            (required to http://hl7.org/fhir/ValueSet/resource-types)
            Typecode
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            94. CRDMetricData.resources.profile
            Definition

            Indicates the sub-type of data accessed in situations where multiple US-core profiles could apply (e.g. Observation). Note: This does not mean that the data received was actually valid against the profile, merely that the search criteria used were intended to retrieve data of this type.

            ShortSolicited profile
            Control0..1
            Typecanonical(StructureDefinition)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            96. CRDMetricData.resources.count
            Definition

            How many resources of that type were accessed.

            ShortNumber retrieved
            Control1..1
            TypepositiveInt
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            98. CRDMetricData.resources.prefetch
            Definition

            Was the data retrieved by prefetch or direct query. (If some resources of the same type were accessed both with and without prefetch, include two repetitions.)

            ShortRetrieved by prefetch?
            Control0..1
            Typeboolean
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            100. CRDMetricData.response
            Definition

            Summary information about each card or system action returned.

            ShortReturned card/system action
            Control0..*
            TypeBackboneElement
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            102. CRDMetricData.response.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            104. CRDMetricData.response.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on CRDMetricData.response.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 106. CRDMetricData.response.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              108. CRDMetricData.response.type
              Definition

              The CRD code for the card. Mandatory if the card corresponds to a type defined by CRD, otherwise omit.

              ShortType of CRD card
              Control0..1
              BindingThe codes SHALL be taken from CRD Card Types Value Set
              (required to http://hl7.org/fhir/us/davinci-crd/ValueSet/cardType)
              Typecode
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              110. CRDMetricData.response.focus
              Definition

              Indicates the type of resource(s) tied to the card.

              ShortResource tied to card
              Control0..*
              Typecode
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              112. CRDMetricData.response.engagement
              Definition

              Indicates if the user engaged with the card as per the CDS Hooks feedback mechanism.

              Shortignore | accept | override
              Control0..1
              Typecode
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              114. CRDMetricData.response.coverageInfo
              Definition

              If the card is a coverage-information card, indicates additional information about the information provided in the coverage-information extension.

              ShortCoverage information
              Control0..*
              TypeBackboneElement
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              116. CRDMetricData.response.coverageInfo.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              118. CRDMetricData.response.coverageInfo.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on CRDMetricData.response.coverageInfo.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 120. CRDMetricData.response.coverageInfo.modifierExtension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                Summarytrue
                Requirements

                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                Alternate Namesextensions, user content, modifiers
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                122. CRDMetricData.response.coverageInfo.covered
                Definition

                Indicates whether the service is covered.

                Shortcovered | not-covered | conditional
                Control0..1
                BindingThe codes SHALL be taken from CRD Coverage Information Covered Value Set
                (required to http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageInfo)
                Typecode
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                124. CRDMetricData.response.coverageInfo.paNeeded
                Definition

                Indicates whether prior authorization is necessary or not, as well as considerations about applying for prior authorization.

                Shortauth-needed | no-auth | satisfied +
                Control0..1
                BindingThe codes SHALL be taken from CRD Coverage Information Prior Authorization Value Set
                (required to http://hl7.org/fhir/us/davinci-crd/ValueSet/coveragePaDetail)
                Typecode
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                126. CRDMetricData.response.coverageInfo.docNeeded
                Definition

                Indicates whether additional information is necessary (for prior auth, claims submission, or some other purpose).

                Shortno-doc | clinical | admin | both +
                Control0..1
                BindingThe codes SHALL be taken from CRD Coverage Information Additional Documentation Value Set
                (required to http://hl7.org/fhir/us/davinci-crd/ValueSet/AdditionalDocumentation)
                Typecode
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                128. CRDMetricData.response.coverageInfo.infoNeeded
                Definition

                Indicates what additional inforamtion is necessary in order to determine authorization/coverage - which might be available on a later hook invocation.

                Shortperformer | location | timeframe
                Control0..1
                BindingThe codes SHALL be taken from CRD Information Needed Value Set
                (required to http://hl7.org/fhir/us/davinci-crd/ValueSet/informationNeeded)
                Typecode
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                130. CRDMetricData.response.coverageInfo.questionnaire
                Definition

                Information about the Questionnaire(s) returned to gather additional information (e.g. through DTR).

                ShortQuestionnaire(s) returned
                Control0..*
                TypeBackboneElement
                Requirements

                Allows linking metadata about forms identified 'to be filled out' in CRD with what is actually completed in DTR, and eventually submitted in CDex, PAS or claims

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                132. CRDMetricData.response.coverageInfo.questionnaire.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                134. CRDMetricData.response.coverageInfo.questionnaire.extension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                ShortAdditional content defined by implementations
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on CRDMetricData.response.coverageInfo.questionnaire.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 136. CRDMetricData.response.coverageInfo.questionnaire.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  138. CRDMetricData.response.coverageInfo.questionnaire.reference
                  Definition

                  The official identifier of one of the Questionnaires provided to be filled out.

                  ShortQuestionnaire url & version
                  Control1..1
                  Typecanonical(Questionnaire)
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  140. CRDMetricData.response.coverageInfo.questionnaire.adaptive
                  Definition

                  If true, indicates that the questionnaire is adaptive (i.e. uses the $next-question operation to determine questions).

                  ShortIs questionnaire adaptive?
                  Control1..1
                  Typeboolean
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  142. CRDMetricData.response.coverageInfo.questionnaire.response
                  Definition

                  If true, indicates that the card included a partially populated QuestionnaireResponse with answers filled by the payer from pre-known data.

                  ShortPre-pop response provided?
                  Control1..1
                  Typeboolean
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  144. CRDMetricData.response.coverageInfo.assertionId
                  Definition

                  Corresponds to the coverage-assertion-id from the coverage-information extension.

                  ShortId for coverage assertion
                  Control1..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Requirements

                  Used to link the results of CRD to metric information captured for DTR and/or PAS.

                  146. CRDMetricData.response.coverageInfo.satisfiedId
                  Definition

                  Corresponds to the satisfied-pa-id from the coverage-information extension.

                  ShortId if PA is satisfied
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  148. CRDMetricData.response.coverageInfo.businessLine
                  Definition

                  A code that indicates which type of insurance this assertion applies to.

                  ShortE.g. MedicareAdvantage
                  Control0..1
                  TypeCodeableConcept