davinci-pct-gfe-institutional vs davinci-pct-gfe-institutional

Target

SΣ

0..1

Required if insured estimate

Elements differ in definition for mustSupport: 'false' vs 'true'
Element minimum cardinalities differ: '1' vs '0'

provider

1..1

Billing provider - party responsible for the GFE

1..1

Billing provider - party responsible for the GFE

0..1

string

Unique id for inter-element referencing

0..1

string

Unique id for inter-element referencing

Slices for extension

1..*

Extension

Extension
Slice: Unordered, Open by value:url

1..*

Extension

Extension
Slice: Unordered, Open by value:url

reference

ΣC

0..1

string

Literal reference, Relative, internal or absolute URL

ΣC

0..1

string

Literal reference, Relative, internal or absolute URL

type

0..1

uri

Type the reference refers to (e.g. "Patient")
Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).

0..1

uri

Type the reference refers to (e.g. "Patient")
Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).

identifier

0..1

Identifier

Logical reference, when literal reference is not known

0..1

Identifier

Logical reference, when literal reference is not known

display

0..1

string

Text alternative for the resource

0..1

string

Text alternative for the resource

priority

1..1

CodeableConcept

Desired processing ugency
Binding: ?? (required)

1..1

CodeableConcept

Desired processing ugency
Binding: ?? (required)

fundsReserve

0..1

CodeableConcept

For whom to reserve funds
Binding: ?? (example): For whom funds are to be reserved: (Patient, Provider, None).

0..1

CodeableConcept

For whom to reserve funds
Binding: ?? (example): For whom funds are to be reserved: (Patient, Provider, None).

0..*

BackboneElement

Prior or corollary claims

0..*

BackboneElement

Prior or corollary claims

0..1

string

Unique id for inter-element referencing

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

claim

0..1

Reference(Claim)

Reference to the related claim

0..1

Reference(Claim)

Reference to the related claim

relationship

0..1

CodeableConcept

How the reference claim is related
Binding: ?? (example): Relationship of this claim to a related Claim.

0..1

CodeableConcept

How the reference claim is related
Binding: ?? (example): Relationship of this claim to a related Claim.

reference

0..1

Identifier

File or case reference

0..1

Identifier

File or case reference

prescription

0..1

Reference(DeviceRequest | MedicationRequest | VisionPrescription)

Prescription authorizing services and products

0..1

Reference(DeviceRequest | MedicationRequest | VisionPrescription)

Prescription authorizing services and products

originalPrescription

0..1

Reference(DeviceRequest | MedicationRequest | VisionPrescription)

Original prescription if superseded by fulfiller

0..1

Reference(DeviceRequest | MedicationRequest | VisionPrescription)

Original prescription if superseded by fulfiller

payee

0..1

BackboneElement

Recipient of benefits payable

0..1

BackboneElement

Recipient of benefits payable

0..1

string

Unique id for inter-element referencing

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

type

1..1

CodeableConcept

Category of recipient
Binding: ?? (example): A code for the party to be reimbursed.

1..1

CodeableConcept

Category of recipient
Binding: ?? (example): A code for the party to be reimbursed.

party

0..1

Recipient reference

0..1

Reference(ServiceRequest)

Recipient reference

referral

0..1

Treatment referral

0..1

Reference(ServiceRequest)

Treatment referral

0..1

string

Unique id for inter-element referencing

0..1

string

Unique id for inter-element referencing

Slices for extension

1..*

Extension

Extension
Slice: Unordered, Open by value:url

1..*

Extension

Extension
Slice: Unordered, Open by value:url

reference

ΣC

0..1

string

Literal reference, Relative, internal or absolute URL

ΣC

0..1

string

Literal reference, Relative, internal or absolute URL

type

0..1

uri

Type the reference refers to (e.g. "Patient")
Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).

0..1

uri

Type the reference refers to (e.g. "Patient")
Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).

identifier

0..1

Identifier

Logical reference, when literal reference is not known

0..1

Identifier

Logical reference, when literal reference is not known

display

0..1

string

Text alternative for the resource

0..1

string

Text alternative for the resource

facility

0..1

Reference(Location)

Servicing facility

0..1

Reference(Location)

Servicing facility

Slices for careTeam

0..*

BackboneElement

Members of the care team
Slice: Unordered, Open by pattern:role

0..*

BackboneElement

Members of the care team
Slice: Unordered, Open by pattern:role

0..1

string

Unique id for inter-element referencing

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

positiveInt

Order of care team

1..1

positiveInt

Order of care team

provider

1..1

Practitioner or organization

1..1

Practitioner or organization

responsible

0..1

boolean

Indicator of the lead practitioner

0..1

boolean

Indicator of the lead practitioner

role

1..1

CodeableConcept

Function within the team
Binding: ?? (required)

1..1

CodeableConcept

Function within the team
Binding: ?? (required)

qualification

0..1

CodeableConcept

Practitioner credential or specialization
Binding: ?? (required)

0..1

CodeableConcept

Practitioner credential or specialization
Binding: ?? (required)

Slices for supportingInfo

1..*

BackboneElement

Supporting information
Slice: Unordered, Open by pattern:category

1..*

BackboneElement

Supporting information
Slice: Unordered, Open by pattern:category

0..1

string

Unique id for inter-element referencing

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

positiveInt

Information instance identifier

1..1

positiveInt

Information instance identifier

category

1..1

CodeableConcept

Classification of the supplied information
Binding: ?? (extensible)

1..1

CodeableConcept

Classification of the supplied information
Binding: ?? (extensible)

code

0..1

CodeableConcept

Type of information
Binding: ?? (example): The valuset used for additional information codes.

0..1

CodeableConcept

Type of information
Binding: ?? (example): The valuset used for additional information codes.

timing[x]

0..1

date, Period

When it occurred

0..1

date, Period

When it occurred

value[x]

0..1

boolean, string, Quantity, Attachment, Reference(Resource)

Data to be provided

0..1

boolean, string, Quantity, Attachment, Reference(Resource)

Data to be provided

reason

0..1

CodeableConcept

Explanation for the information
Binding: ?? (example): Reason codes for the missing teeth.

0..1

CodeableConcept

Explanation for the information
Binding: ?? (example): Reason codes for the missing teeth.

Slices for diagnosis

1..*

BackboneElement

Pertinent diagnosis information
Slice: Unordered, Open by pattern:type

1..*

BackboneElement

Pertinent diagnosis information
Slice: Unordered, Open by pattern:type

0..1

string

Unique id for inter-element referencing

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

positiveInt

Diagnosis instance identifier

1..1

positiveInt

Diagnosis instance identifier

diagnosis[x]

1..1

CodeableConcept, Reference(Condition)

Nature of illness or problem
Binding: ?? (example): Example ICD10 Diagnostic codes.

1..1

CodeableConcept, Reference(Condition)

Nature of illness or problem
Binding: ?? (example): Example ICD10 Diagnostic codes.

type

0..*

CodeableConcept

Timing or nature of the diagnosis
Binding: ?? (required)

0..*

CodeableConcept

Timing or nature of the diagnosis
Binding: ?? (required)

onAdmission

0..1

CodeableConcept

Present on admission
Binding: ?? (example): Present on admission.

0..1

CodeableConcept

Present on admission
Binding: ?? (example): Present on admission.

packageCode

0..1

CodeableConcept

Package billing code
Binding: ?? (example): The DRG codes associated with the diagnosis.

0..1

CodeableConcept

Package billing code
Binding: ?? (example): The DRG codes associated with the diagnosis.

Slices for procedure

0..*

BackboneElement

Clinical procedures performed
Slice: Unordered, Open by pattern:type

0..*

BackboneElement

Clinical procedures performed
Slice: Unordered, Open by pattern:type

0..1

string

Unique id for inter-element referencing

0..1

string

Unique id for inter-element referencing

Slices for extension

1..*

Extension

Extension
Slice: Unordered, Open by value:url

1..*

Extension

Extension
Slice: Unordered, Open by value:url

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

positiveInt

Procedure instance identifier

1..1

positiveInt

Procedure instance identifier

type

0..*

CodeableConcept

Category of Procedure
Binding: ?? (required)

0..*

CodeableConcept

Category of Procedure
Binding: ?? (required)

date

0..1

dateTime

When the procedure was performed

0..1

dateTime

When the procedure was performed

procedure[x]

1..1

CodeableConcept, Reference(Procedure)

Specific clinical procedure
Binding: ?? (example): Example ICD10 Procedure codes.

1..1

CodeableConcept, Reference(Procedure)

Specific clinical procedure
Binding: ?? (example): Example ICD10 Procedure codes.

udi

0..*

Unique device identifier

0..*

Unique device identifier

insurance

1..*

BackboneElement

Patient insurance information

1..*

BackboneElement

Patient insurance information

0..1

string

Unique id for inter-element referencing

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

positiveInt

Insurance instance identifier

1..1

positiveInt

Insurance instance identifier

focal

1..1

boolean

Coverage to be used for adjudication

1..1

boolean

Coverage to be used for adjudication

identifier

0..1

Identifier

Pre-assigned Claim number

0..1

Identifier

Pre-assigned Claim number

coverage

1..1

Reference(PCT Coverage)

Insurance information

1..1

Reference(PCT Coverage)

Insurance information

0..1

string

Unique id for inter-element referencing

Added this element

Slices for extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

Added this element

reference

ΣC

0..1

string

Literal reference, Relative, internal or absolute URL

Added this element

type

0..1

uri

Type the reference refers to (e.g. "Patient")
Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).

Added this element

identifier

0..1

Identifier

Logical reference, when literal reference is not known

Added this element

display

0..1

string

Text alternative for the resource

Added this element

businessArrangement

0..1

string

Additional provider contract number

0..1

string

Additional provider contract number

preAuthRef

0..1

string

Prior authorization reference number

0..1

string

Prior authorization reference number

claimResponse

0..1

Reference(ClaimResponse)

Adjudication results

0..1

Reference(ClaimResponse)

Adjudication results

accident

0..1

BackboneElement

Details of the event

0..1

BackboneElement

Details of the event

0..1

string

Unique id for inter-element referencing

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

date

1..1

date

When the incident occurred

1..1

date

When the incident occurred

type

0..1

CodeableConcept

The nature of the accident
Binding: ?? (extensible): Type of accident: work place, auto, etc.

0..1

CodeableConcept

The nature of the accident
Binding: ?? (extensible): Type of accident: work place, auto, etc.

location[x]

0..1

Address

Where the event occurred

0..1

Address

Where the event occurred

0..1

string

Unique id for inter-element referencing

0..1

string

Unique id for inter-element referencing

Slices for extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

use

?!Σ

0..1

code

home | work | temp | old | billing - purpose of this address
Binding: ?? (required): The use of an address.

Example General: home

?!Σ

0..1

code

home | work | temp | old | billing - purpose of this address
Binding: ?? (required): The use of an address.

Example General: home

type

0..1

code

postal | physical | both
Binding: ?? (required): The type of an address (physical / postal).

Example General: both

0..1

code

postal | physical | both
Binding: ?? (required): The type of an address (physical / postal).

Example General: both

text

0..1

string

Text representation of the address
Example General: 137 Nowhere Street, Erewhon 9132

0..1

string

Text representation of the address
Example General: 137 Nowhere Street, Erewhon 9132

line

0..*

string

Street name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street

0..*

string

Street name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street

city

0..1

string

Name of city, town etc.
Example General: Erewhon

0..1

string

Name of city, town etc.
Example General: Erewhon

district

0..1

string

District name (aka county)
Example General: Madison

0..1

string

District name (aka county)
Example General: Madison

state

0..1

string

Sub-unit of country (abbreviations ok)

0..1

string

Sub-unit of country (abbreviations ok)

postalCode

0..1

string

Postal code for area
Example General: 9132

0..1

string

Postal code for area
Example General: 9132

country

0..1

string

Country (e.g. can be ISO 3166 2 or 3 letter code)
Binding: ?? (required)

0..1

string

Country (e.g. can be ISO 3166 2 or 3 letter code)
Binding: ?? (required)

period

0..1

Period

Time period when address was/is in use
Example General: {"start":"2010-03-23","end":"2010-07-01"}

0..1

Period

Time period when address was/is in use
Example General: {"start":"2010-03-23","end":"2010-07-01"}

item

1..999

BackboneElement

Product or service provided

1..999

BackboneElement

Product or service provided

0..1

string

Unique id for inter-element referencing

0..1

string

Unique id for inter-element referencing

Slices for extension

1..*

Extension

Extension
Slice: Unordered, Open by value:url

1..*

Extension

Extension
Slice: Unordered, Open by value:url

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

positiveInt

Item instance identifier

1..1

positiveInt

Item instance identifier

careTeamSequence

0..*

positiveInt

Applicable careTeam members

0..*

positiveInt

Applicable careTeam members

diagnosisSequence

0..*

positiveInt

Applicable diagnoses

0..*

positiveInt

Applicable diagnoses

procedureSequence

0..*

positiveInt

Applicable procedures

0..*

positiveInt

Applicable procedures

informationSequence

0..*

positiveInt

Applicable exception and supporting information

0..*

positiveInt

Applicable exception and supporting information

revenue

1..1

CodeableConcept

Revenue or cost center code - must provide a value for the Institutional case
Binding: ?? (required)

1..1

CodeableConcept

Revenue or cost center code - must provide a value for the Institutional case
Binding: ?? (required)

category

0..1

CodeableConcept

Benefit classification
Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses.

0..1

CodeableConcept

Benefit classification
Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses.

productOrService

1..1

CodeableConcept

Billing, service, product, or drug code
Binding: ?? (required)

1..1

CodeableConcept

Billing, service, product, or drug code
Binding: ?? (required)

modifier

0..4

CodeableConcept

Product or service billing modifiers
Binding: ?? (required)

0..4

CodeableConcept

Product or service billing modifiers
Binding: ?? (required)

programCode

0..*

CodeableConcept

Program the product or service is provided under
Binding: ?? (example): Program specific reason codes.

0..*

CodeableConcept

Program the product or service is provided under
Binding: ?? (example): Program specific reason codes.

serviced[x]

1..1

date, Period

This is the planned or estimated date(s)s of service

1..1

date, Period

This is the planned or estimated date(s)s of service

Slices for location[x]

0..1

CodeableConcept, Address, Reference(Location)

Place of service or where product was supplied
Slice: Unordered, Open by type:$this
Binding: ?? (example): Place of service: pharmacy, school, prison, etc.

0..1

CodeableConcept, Address, Reference(Location)

Place of service or where product was supplied
Slice: Unordered, Open by type:$this
Binding: ?? (example): Place of service: pharmacy, school, prison, etc.

quantity

1..1

Count of products or services

1..1

Count of products or services

unitPrice

0..1

Money

Fee, charge or cost per item

0..1

Money

Fee, charge or cost per item

factor

0..1

decimal

Price scaling factor

0..1

decimal

Price scaling factor

net

1..1

Money

Total charge amount for the service line

1..1

Money

Total charge amount for the service line

udi

0..*

Unique device identifier

0..*

Unique device identifier

bodySite

0..1

CodeableConcept

Anatomical location
Binding: ?? (example): The code for the teeth, quadrant, sextant and arch.

0..1

CodeableConcept

Anatomical location
Binding: ?? (example): The code for the teeth, quadrant, sextant and arch.

subSite

0..*

CodeableConcept

Anatomical sub-location
Binding: ?? (example): The code for the tooth surface and surface combinations.

0..*

CodeableConcept

Anatomical sub-location
Binding: ?? (example): The code for the tooth surface and surface combinations.

encounter

0..*

Reference(Encounter)

Encounters related to this billed item

0..*

Reference(Encounter)

Encounters related to this billed item

detail

0..*

BackboneElement

Drug Identification Information

0..*

BackboneElement

Drug Identification Information

0..1

string

Unique id for inter-element referencing

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

positiveInt

Item instance identifier

1..1

positiveInt

Item instance identifier

revenue

0..1

CodeableConcept

Revenue or cost center code
Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products.

0..1

CodeableConcept

Revenue or cost center code
Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products.

category

0..1

CodeableConcept

Benefit classification
Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses.

0..1

CodeableConcept

Benefit classification
Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses.

productOrService

1..1

CodeableConcept

Billing, service, product, or drug code
Binding: ?? (required)

1..1

CodeableConcept

Billing, service, product, or drug code
Binding: ?? (required)

modifier

0..*

CodeableConcept

Service/Product billing modifiers
Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

0..*

CodeableConcept

Service/Product billing modifiers
Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

programCode

0..*

CodeableConcept

Program the product or service is provided under
Binding: ?? (example): Program specific reason codes.

0..*

CodeableConcept

Program the product or service is provided under
Binding: ?? (example): Program specific reason codes.

quantity

0..1

Count of products or services

0..1

Count of products or services

unitPrice

0..1

Money

Fee, charge or cost per item

0..1

Money

Fee, charge or cost per item

factor

0..1

decimal

Price scaling factor

0..1

decimal

Price scaling factor

net

0..1

Money

Total item cost

0..1

Money

Total item cost

udi

0..*

Unique device identifier

0..*

Unique device identifier

subDetail

0..*

BackboneElement

Product or service provided

0..*

BackboneElement

Product or service provided

0..1

string

Unique id for inter-element referencing

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

positiveInt

Item instance identifier

1..1

positiveInt

Item instance identifier

revenue

0..1

CodeableConcept

Revenue or cost center code
Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products.

0..1

CodeableConcept

Revenue or cost center code
Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products.

category

0..1

CodeableConcept

Benefit classification
Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses.

0..1

CodeableConcept

Benefit classification
Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses.

productOrService

1..1

CodeableConcept

Billing, service, product, or drug code
Binding: ?? (example): Allowable service and product codes.

1..1

CodeableConcept

Billing, service, product, or drug code
Binding: ?? (example): Allowable service and product codes.

modifier

0..*

CodeableConcept

Service/Product billing modifiers
Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

0..*

CodeableConcept

Service/Product billing modifiers
Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

programCode

0..*

CodeableConcept

Program the product or service is provided under
Binding: ?? (example): Program specific reason codes.

0..*

CodeableConcept

Program the product or service is provided under
Binding: ?? (example): Program specific reason codes.

quantity

0..1

Count of products or services

0..1

Count of products or services

unitPrice

0..1

Money

Fee, charge or cost per item

0..1

Money

Fee, charge or cost per item

factor

0..1

decimal

Price scaling factor

0..1

decimal

Price scaling factor

net

0..1

Money

Total item cost

0..1

Money

Total item cost

udi

0..*

Unique device identifier

0..*