abstractbaseDefinitioncopyrightdate- Values Differ
descriptionexperimentalfhirVersionjurisdiction
jurisdiction[0]kindnamepublisherpurposestatustitletypeurlversion- Values Differ
| Left: | Payer Insurance Plan (http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PayerInsurancePlan) |
| Right: | Payer Insurance Plan (http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PayerInsurancePlan) |
| Error | StructureDefinition.version | Values for version differ: '2.0.1' vs '2.1.0' |
| Information | StructureDefinition.date | Values for date differ: '2023-12-01T22:20:12+00:00' vs '2024-09-24T20:29:11+00:00' |
| Information | StructureDefinition.definition | Values for definition differ: 'A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.' vs 'A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R4/provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.' |
| Information | StructureDefinition.definition | Values for definition differ: 'A list of profiles (references to [StructureDefinition](structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](structuredefinition-definitions.html#StructureDefinition.url).' vs 'A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url).' |
| Name | Value | Comments | |
|---|---|---|---|
| abstract | false | ||
| baseDefinition | http://hl7.org/fhir/StructureDefinition/InsurancePlan | ||
| copyright | |||
| date | 2023-12-01T22:20:12+00:00 | 2024-09-24T20:29:11+00:00 |
|
| description | The Payer InsurancePlan that defines the health insurance product, which include coverage benefits that are offered, and additional information about the offering, such as a coverage area, contact information, brochure locations, etc. The health insurance product offers one or more types of coverage, each of which may define a plan of covered benefits with the particular cost sharing structure offered to a consumer. Health insurance plans that include drug coverage reference a formulary that provides details about drugs that are covered under the plan including requirements and limitations of the coverage specific to each drug. | ||
| experimental | |||
| fhirVersion | 4.0.1 | ||
| jurisdiction | |||
| jurisdiction[0] | urn:iso:std:iso:3166#US | ||
| kind | resource | ||
| name | PayerInsurancePlan | ||
| publisher | HL7 International / Pharmacy | ||
| purpose | |||
| status | active | ||
| title | Payer Insurance Plan | ||
| type | InsurancePlan | ||
| url | http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PayerInsurancePlan | ||
| version | 2.0.1 | 2.1.0 |
|
| Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
 InsurancePlan | C | 0..* | InsurancePlan | Details of a Health Insurance product/plan provided by an organization ipn-1: The organization SHALL at least have a name or an idendtifier, and possibly more than one | C | 0..* | InsurancePlan | Details of a Health Insurance product/plan provided by an organization ipn-1: The organization SHALL at least have a name or an idendtifier, and possibly more than one | |||||||||
 id | Σ | 0..1 | id | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact | |||||||||
 meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource | |||||||||
 id | 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 | |||||||||||
| versionId | Σ | 0..1 | id | Version specific identifier | Σ | 0..1 | id | Version specific identifier | |||||||||
| lastUpdated | SΣ | 1..1 | instant | When the resource version last changed | SΣ | 1..1 | instant | When the resource version last changed | |||||||||
| source | Σ | 0..1 | uri | Identifies where the resource comes from | Σ | 0..1 | uri | Identifies where the resource comes from | |||||||||
| profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | |||||||||
| security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: ?? (extensible): Security Labels from the Healthcare Privacy and Security Classification System. | Σ | 0..* | Coding | Security Labels applied to this resource Binding: ?? (extensible): Security Labels from the Healthcare Privacy and Security Classification System. | |||||||||
| tag | Σ | 0..* | Coding | Tags applied to this resource Binding: ?? (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". | Σ | 0..* | Coding | Tags applied to this resource Binding: ?? (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". | |||||||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created | |||||||||
| language | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| |||||||||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||||||||
| contained | 0..* | Resource | Contained, inline Resources | 0..* | Resource | Contained, inline Resources | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored | |||||||||
| identifier | SΣC | 1..* | Identifier | Business Identifier for Product | SΣC | 1..* | Identifier | Business Identifier for Product | |||||||||
| status | ?!SΣ | 1..1 | code | draft | active | retired | unknown Binding: ?? (required): The lifecycle status of an artifact. | ?!SΣ | 1..1 | code | draft | active | retired | unknown Binding: ?? (required): The lifecycle status of an artifact. | |||||||||
| type | SΣ | 1..1 | CodeableConcept | Product type Binding: ?? (extensible) | SΣ | 1..1 | CodeableConcept | Product type Binding: ?? (extensible) | |||||||||
| name | SΣC | 0..1 | string | Official name | SΣC | 0..1 | string | Official name | |||||||||
| alias | 0..* | string | Alternate names | 0..* | string | Alternate names | |||||||||||
| period | S | 0..1 | Period | When the product is available | S | 0..1 | Period | When the product is available | |||||||||
| ownedBy | Σ | 0..1 | Reference(Organization) | Plan issuer | Σ | 0..1 | Reference(Organization) | Plan issuer | |||||||||
| administeredBy | Σ | 0..1 | Reference(Organization) | Product administrator | Σ | 0..1 | Reference(Organization) | Product administrator | |||||||||
| coverageArea | SΣ | 0..* | Reference(Insurance Plan Location) | Where product applies | SΣ | 0..* | Reference(Insurance Plan Location) | Where product applies | |||||||||
| contact | 0..* | BackboneElement | Contact information for the Insurance Plan including URLs for brochure and formulary information | 0..* | BackboneElement | Contact information for the Insurance Plan including URLs for brochure and formulary information | |||||||||||
| id | 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 | |||||||||
| purpose | 0..1 | CodeableConcept | The type of contact Binding: ?? (extensible) | 0..1 | CodeableConcept | The type of contact Binding: ?? (extensible) | |||||||||||
| name | S | 0..1 | HumanName | A name associated with the contact | S | 0..1 | HumanName | A name associated with the contact | |||||||||
| id | 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 | usual | official | temp | nickname | anonymous | old | maiden Binding: ?? (required): The use of a human name. | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: ?? (required): The use of a human name. | |||||||||
| text | SΣ | 0..1 | string | Text representation of the full name | SΣ | 0..1 | string | Text representation of the full name | |||||||||
| family | Σ | 0..1 | string | Family name (often called 'Surname') | Σ | 0..1 | string | Family name (often called 'Surname') | |||||||||
| given | Σ | 0..* | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name | Σ | 0..* | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name | |||||||||
| prefix | Σ | 0..* | string | Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name | Σ | 0..* | string | Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name | |||||||||
| suffix | Σ | 0..* | string | Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name | Σ | 0..* | string | Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name | |||||||||
| period | Σ | 0..1 | Period | Time period when name was/is in use | Σ | 0..1 | Period | Time period when name was/is in use | |||||||||
| telecom | S | 0..* | ContactPoint | Contact details (telephone, email, etc.) for a contact | S | 0..* | ContactPoint | Contact details (telephone, email, etc.) for a contact | |||||||||
| id | 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 | |||||||||||
| system | SΣC | 0..1 | code | phone | fax | email | pager | url | sms | other Binding: ?? (required): Telecommunications form for contact point. | SΣC | 0..1 | code | phone | fax | email | pager | url | sms | other Binding: ?? (required): Telecommunications form for contact point. | |||||||||
| value | SΣ | 0..1 | string | The actual contact point details | SΣ | 0..1 | string | The actual contact point details | |||||||||
| use | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ?? (required): Use of contact point. | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ?? (required): Use of contact point. | |||||||||
| rank | Σ | 0..1 | positiveInt | Specify preferred order of use (1 = highest) | Σ | 0..1 | positiveInt | Specify preferred order of use (1 = highest) | |||||||||
| period | Σ | 0..1 | Period | Time period when the contact point was/is in use | Σ | 0..1 | Period | Time period when the contact point was/is in use | |||||||||
| address | 0..1 | Address | Visiting or postal addresses for the contact | 0..1 | Address | Visiting or postal addresses for the contact | |||||||||||
| endpoint | 0..* | Reference(Endpoint) | Technical endpoint | 0..* | Reference(Endpoint) | Technical endpoint | |||||||||||
| network | 0..* | Reference(Organization) | What networks are Included | 0..* | Reference(Organization) | What networks are Included | |||||||||||
| Slices for coverage | S | 1..* | BackboneElement | Coverage details Slice: Unordered, Open by pattern:type | S | 1..* | BackboneElement | Coverage details Slice: Unordered, Open by pattern:type | |||||||||
| id | 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 | S | 1..1 | CodeableConcept | Type of coverage | S | 1..1 | CodeableConcept | Type of coverage | |||||||||
| network | 0..* | Reference(Organization) | What networks provide coverage | 0..* | Reference(Organization) | What networks provide coverage | |||||||||||
 benefit | 1..* | BackboneElement | List of benefits | 1..* | BackboneElement | List of benefits | |||||||||||
 id | 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 | Type of benefit | 1..1 | CodeableConcept | Type of benefit | |||||||||||
| requirement | 0..1 | string | Referral requirements | 0..1 | string | Referral requirements | |||||||||||
| limit | 0..* | BackboneElement | Benefit limits | 0..* | BackboneElement | Benefit limits | |||||||||||
| id | 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 | |||||||||
| value | 0..1 | Quantity | Maximum value allowed | 0..1 | Quantity | Maximum value allowed | |||||||||||
| code | 0..1 | CodeableConcept | Benefit limit details | 0..1 | CodeableConcept | Benefit limit details | |||||||||||
| Slices for plan | S | 1..* | BackboneElement | Plan details Slice: Unordered, Open by pattern:type | S | 1..* | BackboneElement | Plan details Slice: Unordered, Open by pattern:type | |||||||||
| id | 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 | |||||||||
| identifier | Σ | 0..* | Identifier | Business Identifier for Product | Σ | 0..* | Identifier | Business Identifier for Product | |||||||||
| type | 0..1 | CodeableConcept | Type of plan Binding: ?? (extensible) | 0..1 | CodeableConcept | Type of plan Binding: ?? (extensible) | |||||||||||
| coverageArea | Σ | 0..* | Reference(Location) | Where product applies | Σ | 0..* | Reference(Location) | Where product applies | |||||||||
| network | 0..* | Reference(Organization) | What networks provide coverage | 0..* | Reference(Organization) | What networks provide coverage | |||||||||||
| generalCost | 0..* | BackboneElement | Overall costs | 0..* | BackboneElement | Overall costs | |||||||||||
| id | 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 | 0..1 | CodeableConcept | Type of cost | 0..1 | CodeableConcept | Type of cost | |||||||||||
| groupSize | 0..1 | positiveInt | Number of enrollees | 0..1 | positiveInt | Number of enrollees | |||||||||||
| cost | 0..1 | Money | Cost value | 0..1 | Money | Cost value | |||||||||||
| comment | 0..1 | string | Additional cost information | 0..1 | string | Additional cost information | |||||||||||
| specificCost | 0..* | BackboneElement | Specific costs | 0..* | BackboneElement | Specific costs | |||||||||||
| id | 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 | |||||||||
| category | 1..1 | CodeableConcept | General category of benefit | 1..1 | CodeableConcept | General category of benefit | |||||||||||
| benefit | 0..* | BackboneElement | Benefits list | 0..* | BackboneElement | Benefits list | |||||||||||
| id | 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 | Type of specific benefit | 1..1 | CodeableConcept | Type of specific benefit | |||||||||||
| cost | 0..* | BackboneElement | List of the costs | 0..* | BackboneElement | List of the costs | |||||||||||
| id | 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 | Type of cost | 1..1 | CodeableConcept | Type of cost | |||||||||||
| applicability | 0..1 | CodeableConcept | in-network | out-of-network | other Binding: ?? (required): Whether the cost applies to in-network or out-of-network providers. | 0..1 | CodeableConcept | in-network | out-of-network | other Binding: ?? (required): Whether the cost applies to in-network or out-of-network providers. | |||||||||||
| qualifiers | 0..* | CodeableConcept | Additional information about the cost | 0..* | CodeableConcept | Additional information about the cost | |||||||||||
| value | 0..1 | Quantity | The actual cost value | 0..1 | Quantity | The actual cost value | |||||||||||
| Documentation for this format | |||||||||||||||||