CARIN Digital Insurance Card
1.1.0 - STU 1.1 United States of America flag

CARIN Digital Insurance Card, published by HL7 International / Payer/Provider Information Exchange Work Group. This guide is not an authorized publication; it is the continuous build for version 1.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/carin-digital-insurance-card/ and changes regularly. See the Directory of published versions

Resource Profile: C4DIC Coverage

Official URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage Version: 1.1.0
Active as of 2024-04-16 Computable Name: C4DICCoverage

Data that reflect a payer’s coverage of the member.

Usage:

Formal Views of Profile Content

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

This structure is derived from Coverage

NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..* Coverage Insurance or medical plan or a payment agreement
... meta S 1..1 Meta Metadata about the resource
.... lastUpdated S 1..1 instant When the resource version last changed
.... Slices for profile 1..* canonical(StructureDefinition) Profiles this resource claims to conform to
Slice: Unordered, Open by pattern:$this
..... profile:supportedProfile 1..1 canonical(StructureDefinition) Profiles this resource claims to conform to
Required Pattern: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
... C4DIC-PlanBeneficiaries-extension 0..* (Complex) Plan Beneficiaries
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-PlanBeneficiaries-extension
... C4DIC-ColorPalette-extension 0..1 (Complex) Color Palette
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-ColorPalette-extension
... C4DIC-Logo-extension 0..1 (Complex) Logo
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Logo-extension
... C4DIC-QRCode-extension 0..* (Complex) QR Code
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-QRCode-extension
... C4DIC-Barcode-extension 0..* (Complex) Barcode
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Barcode-extension
... C4DIC-SupportingImage-extension 0..* (Complex) Supporting image
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension
... C4DIC-CardIssueDate-extension 0..1 date Card Issue Date
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-CardIssueDate-extension
... Slices for identifier S 1..* Identifier Business Identifier for the coverage
Slice: Unordered, Open by pattern:type
.... identifier:All Slices Content/Rules for all slices
..... type 0..1 CodeableConcept Description of identifier
Binding: C4DIC Coverage Identifier Type (extensible)
.... identifier:memberid S 1..1 Identifier Member ID
..... type 1..1 CodeableConcept Description of identifier
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: MB
..... system S 1..1 uri The namespace for the identifier value
..... value S 1..1 string The value that is unique
..... assigner S 1..1 Reference(Organization) Organization that issued id (may be just text)
... status S 1..1 code active | cancelled | draft | entered-in-error
... type S 1..1 CodeableConcept Coverage category such as medical or accident
... subscriber S 1..1 Reference(Patient | RelatedPerson) Subscriber to the policy
.... reference S 1..1 string Literal reference, Relative, internal or absolute URL
... subscriberId S 1..1 string ID assigned to the subscriber
... beneficiary S 1..1 Reference(C4DIC Patient) Plan beneficiary
.... reference S 1..1 string Literal reference, Relative, internal or absolute URL
... dependent S 0..1 string Dependent number
... relationship S 1..1 CodeableConcept Beneficiary relationship to the subscriber
Binding: SubscriberRelationshipCodes (required)
... period S 0..1 Period Coverage start and end dates
... payor S 1..1 Reference(C4DIC Organization) Issuer of the policy
... Slices for class S 0..* BackboneElement Additional coverage classifications
Slice: Unordered, Open by pattern:type
.... class:All Slices Content/Rules for all slices
..... type 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: C4DIC Coverage Class (required)
.... class:group S 0..1 BackboneElement Additional coverage classifications
..... type 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: group
..... value 1..1 string Value associated with the type
..... name 0..1 string Human readable description of the type and value
.... class:plan S 0..1 BackboneElement Additional coverage classifications
..... type 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: plan
..... value 1..1 string Value associated with the type
..... name 0..1 string Human readable description of the type and value
.... class:division S 0..1 BackboneElement Additional coverage classifications
..... type 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: division
.... class:network S 0..1 BackboneElement Additional coverage classifications
..... type 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: network
.... class:rxbin S 0..1 BackboneElement Additional coverage classifications
..... type 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: rxbin
.... class:rxpcn S 0..1 BackboneElement Additional coverage classifications
..... type 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: rxpcn
.... class:rxgroup S 0..1 BackboneElement Additional coverage classifications
..... type 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: rxgroup
.... class:rxid S 0..1 BackboneElement Additional coverage classifications
..... type 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: rxid
.... class:rxiin S 0..1 BackboneElement Additional coverage classifications
..... type 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: rxiin
... costToBeneficiary S 0..* BackboneElement Patient payments for services/products
.... type S 1..1 CodeableConcept Cost category
Binding: C4DIC Copay Type (extensible)
.... value[x] SC 1..1 Money The amount or percentage due from the beneficiary
ValueMoney-details-or-extension: costToBeneficiary SHALL have (value AND currency) OR Beneficiary Cost String extension, but not both
..... C4DIC-BeneficiaryCostString-extension S 0..1 string Beneficiary Cost as String
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BeneficiaryCostString-extension
..... value S 0..1 decimal Numerical value (with implicit precision)
..... currency S 0..1 code ISO 4217 Currency Code

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Coverage.identifier.typeextensibleC4DICCoverageIdentifierType
http://hl7.org/fhir/us/insurance-card/ValueSet/C4DICCoverageIdentifierType
from this IG
Coverage.relationshiprequiredSubscriberRelationshipCodes
http://hl7.org/fhir/ValueSet/subscriber-relationship
from the FHIR Standard
Coverage.class.typerequiredC4DICCoverageClassVS
http://hl7.org/fhir/us/insurance-card/ValueSet/C4DICCoverageClassVS
from this IG
Coverage.costToBeneficiary.typeextensibleC4DICCopayTypeVS
http://hl7.org/fhir/us/insurance-card/ValueSet/C4DICCopayTypeVS
from this IG

Constraints

IdGradePath(s)DetailsRequirements
ValueMoney-details-or-extensionerrorCoverage.costToBeneficiary.value[x]costToBeneficiary SHALL have (value AND currency) OR Beneficiary Cost String extension, but not both
: ((value.exists() and currency.exists()) xor extension.where(url='http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BeneficiaryCostString-extension').exists()) and ((value.exists() xor currency.exists())).not()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..* Coverage Insurance or medical plan or a payment agreement
... meta SΣ 1..1 Meta Metadata about the resource
.... lastUpdated SΣ 1..1 instant When the resource version last changed
.... Slices for profile Σ 1..* canonical(StructureDefinition) Profiles this resource claims to conform to
Slice: Unordered, Open by pattern:$this
..... profile:supportedProfile Σ 1..1 canonical(StructureDefinition) Profiles this resource claims to conform to

Required Pattern: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
... C4DIC-AdditionalCardInformation-extension 0..* Annotation Additional Insurance Card Information
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-AdditionalCardInformation-extension
... C4DIC-ColorPalette-extension 0..1 (Complex) Color Palette
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-ColorPalette-extension
... C4DIC-Logo-extension 0..1 (Complex) Logo
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Logo-extension
... C4DIC-QRCode-extension 0..* (Complex) QR Code
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-QRCode-extension
... C4DIC-Barcode-extension 0..* (Complex) Barcode
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Barcode-extension
... C4DIC-SupportingImage-extension 0..* (Complex) Supporting image
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension
... C4DIC-CardIssueDate-extension 0..1 date Card Issue Date
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-CardIssueDate-extension
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier SΣ 1..* Identifier Business Identifier for the coverage
Slice: Unordered, Open by pattern:type
.... identifier:All Slices Content/Rules for all slices
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ 0..1 CodeableConcept Description of identifier
Binding: C4DIC Coverage Identifier Type (extensible)
.... identifier:memberid SΣ 1..1 Identifier Member ID
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ 1..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: MB
..... system SΣ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 1..1 string The value that is unique
Example General: 123456
..... assigner SΣ 1..1 Reference(Organization) Organization that issued id (may be just text)
... status ?!SΣ 1..1 code active | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.

... type SΣ 1..1 CodeableConcept Coverage category such as medical or accident
Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.

... subscriber SΣ 1..1 Reference(Patient | RelatedPerson) Subscriber to the policy
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
... subscriberId SΣ 1..1 string ID assigned to the subscriber
... beneficiary SΣ 1..1 Reference(C4DIC Patient) Plan beneficiary
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
... dependent SΣ 0..1 string Dependent number
... relationship S 1..1 CodeableConcept Beneficiary relationship to the subscriber
Binding: SubscriberRelationshipCodes (required)
... period SΣ 0..1 Period Coverage start and end dates
... payor SΣ 1..1 Reference(C4DIC Organization) Issuer of the policy
... Slices for class S 0..* BackboneElement Additional coverage classifications
Slice: Unordered, Open by pattern:type
.... class:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: C4DIC Coverage Class (required)
..... value Σ 1..1 string Value associated with the type
.... class:group S 0..1 BackboneElement Additional coverage classifications
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.


Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: group
..... value Σ 1..1 string Value associated with the type
..... name Σ 0..1 string Human readable description of the type and value
.... class:plan S 0..1 BackboneElement Additional coverage classifications
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.


Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: plan
..... value Σ 1..1 string Value associated with the type
..... name Σ 0..1 string Human readable description of the type and value
.... class:division S 0..1 BackboneElement Additional coverage classifications
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.


Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: division
..... value Σ 1..1 string Value associated with the type
.... class:network S 0..1 BackboneElement Additional coverage classifications
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.


Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: network
..... value Σ 1..1 string Value associated with the type
.... class:rxbin S 0..1 BackboneElement Additional coverage classifications
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.


Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: rxbin
..... value Σ 1..1 string Value associated with the type
.... class:rxpcn S 0..1 BackboneElement Additional coverage classifications
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.


Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: rxpcn
..... value Σ 1..1 string Value associated with the type
.... class:rxgroup S 0..1 BackboneElement Additional coverage classifications
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.


Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: rxgroup
..... value Σ 1..1 string Value associated with the type
.... class:rxid S 0..1 BackboneElement Additional coverage classifications
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.


Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: rxid
..... value Σ 1..1 string Value associated with the type
.... class:rxiin S 0..1 BackboneElement Additional coverage classifications
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.


Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: rxiin
..... value Σ 1..1 string Value associated with the type
... costToBeneficiary S 0..* BackboneElement Patient payments for services/products
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type SΣ 1..1 CodeableConcept Cost category
Binding: C4DIC Copay Type (extensible)
.... value[x] SΣC 1..1 Money The amount or percentage due from the beneficiary
ValueMoney-details-or-extension: costToBeneficiary SHALL have (value AND currency) OR Beneficiary Cost String extension, but not both
..... C4DIC-BeneficiaryCostString-extension S 0..1 string Beneficiary Cost as String
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BeneficiaryCostString-extension
..... value SΣ 0..1 decimal Numerical value (with implicit precision)
..... currency SΣ 0..1 code ISO 4217 Currency Code
Binding: Currencies (required): A code indicating the currency, taken from ISO 4217.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Coverage.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Coverage.identifier.typeextensibleC4DICCoverageIdentifierType
http://hl7.org/fhir/us/insurance-card/ValueSet/C4DICCoverageIdentifierType
from this IG
Coverage.identifier:memberid.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Coverage.identifier:memberid.typeextensiblePattern: MB
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Coverage.statusrequiredFinancialResourceStatusCodes
http://hl7.org/fhir/ValueSet/fm-status|4.0.1
from the FHIR Standard
Coverage.typepreferredCoverageTypeAndSelf-PayCodes
http://hl7.org/fhir/ValueSet/coverage-type
from the FHIR Standard
Coverage.relationshiprequiredSubscriberRelationshipCodes
http://hl7.org/fhir/ValueSet/subscriber-relationship
from the FHIR Standard
Coverage.class.typerequiredC4DICCoverageClassVS
http://hl7.org/fhir/us/insurance-card/ValueSet/C4DICCoverageClassVS
from this IG
Coverage.class:group.typeextensiblePattern: group
http://hl7.org/fhir/ValueSet/coverage-class
from the FHIR Standard
Coverage.class:plan.typeextensiblePattern: plan
http://hl7.org/fhir/ValueSet/coverage-class
from the FHIR Standard
Coverage.class:division.typeextensiblePattern: division
http://hl7.org/fhir/ValueSet/coverage-class
from the FHIR Standard
Coverage.class:network.typeextensiblePattern: network
http://hl7.org/fhir/ValueSet/coverage-class
from the FHIR Standard
Coverage.class:rxbin.typeextensiblePattern: rxbin
http://hl7.org/fhir/ValueSet/coverage-class
from the FHIR Standard
Coverage.class:rxpcn.typeextensiblePattern: rxpcn
http://hl7.org/fhir/ValueSet/coverage-class
from the FHIR Standard
Coverage.class:rxgroup.typeextensiblePattern: rxgroup
http://hl7.org/fhir/ValueSet/coverage-class
from the FHIR Standard
Coverage.class:rxid.typeextensiblePattern: rxid
http://hl7.org/fhir/ValueSet/coverage-class
from the FHIR Standard
Coverage.class:rxiin.typeextensiblePattern: rxiin
http://hl7.org/fhir/ValueSet/coverage-class
from the FHIR Standard
Coverage.costToBeneficiary.typeextensibleC4DICCopayTypeVS
http://hl7.org/fhir/us/insurance-card/ValueSet/C4DICCopayTypeVS
from this IG
Coverage.costToBeneficiary.value[x].currencyrequiredCurrencies (a valid code from urn:iso:std:iso:4217)
http://hl7.org/fhir/ValueSet/currencies|4.0.1
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ValueMoney-details-or-extensionerrorCoverage.costToBeneficiary.value[x]costToBeneficiary SHALL have (value AND currency) OR Beneficiary Cost String extension, but not both
: ((value.exists() and currency.exists()) xor extension.where(url='http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BeneficiaryCostString-extension').exists()) and ((value.exists() xor currency.exists())).not()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..* Coverage Insurance or medical plan or a payment agreement
... id Σ 0..1 id Logical id of this artifact
... meta SΣ 1..1 Meta Metadata about the resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated SΣ 1..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... Slices for profile Σ 1..* canonical(StructureDefinition) Profiles this resource claims to conform to
Slice: Unordered, Open by pattern:$this
..... profile:supportedProfile Σ 1..1 canonical(StructureDefinition) Profiles this resource claims to conform to

Required Pattern: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage
.... security Σ 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (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
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
... C4DIC-PlanBeneficiaries-extension 0..* (Complex) Plan Beneficiaries
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-PlanBeneficiaries-extension
... C4DIC-AdditionalCardInformation-extension 0..* Annotation Additional Insurance Card Information
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-AdditionalCardInformation-extension
... C4DIC-ColorPalette-extension 0..1 (Complex) Color Palette
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-ColorPalette-extension
... C4DIC-Logo-extension 0..1 (Complex) Logo
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Logo-extension
... C4DIC-QRCode-extension 0..* (Complex) QR Code
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-QRCode-extension
... C4DIC-Barcode-extension 0..* (Complex) Barcode
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Barcode-extension
... C4DIC-SupportingImage-extension 0..* (Complex) Supporting image
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension
... C4DIC-CardIssueDate-extension 0..1 date Card Issue Date
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-CardIssueDate-extension
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier SΣ 1..* Identifier Business Identifier for the coverage
Slice: Unordered, Open by pattern:type
.... identifier:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ 0..1 CodeableConcept Description of identifier
Binding: C4DIC Coverage Identifier Type (extensible)
..... system Σ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ 0..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:memberid SΣ 1..1 Identifier Member ID
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ 1..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: MB
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... system SΣ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 1..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner SΣ 1..1 Reference(Organization) Organization that issued id (may be just text)
... status ?!SΣ 1..1 code active | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.

... type SΣ 1..1 CodeableConcept Coverage category such as medical or accident
Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.

... policyHolder Σ 0..1 Reference(Patient | RelatedPerson | Organization) Owner of the policy
... subscriber SΣ 1..1 Reference(Patient | RelatedPerson) Subscriber to the policy
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... subscriberId SΣ 1..1 string ID assigned to the subscriber
... beneficiary SΣ 1..1 Reference(C4DIC Patient) Plan beneficiary
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... dependent SΣ 0..1 string Dependent number
... relationship S 1..1 CodeableConcept Beneficiary relationship to the subscriber
Binding: SubscriberRelationshipCodes (required)
... period SΣ 0..1 Period Coverage start and end dates
... payor SΣ 1..1 Reference(C4DIC Organization) Issuer of the policy
... Slices for class S 0..* BackboneElement Additional coverage classifications
Slice: Unordered, Open by pattern:type
.... class:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: C4DIC Coverage Class (required)
..... value Σ 1..1 string Value associated with the type
..... name Σ 0..1 string Human readable description of the type and value
.... class:group S 0..1 BackboneElement Additional coverage classifications
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: group
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... value Σ 1..1 string Value associated with the type
..... name Σ 0..1 string Human readable description of the type and value
.... class:plan S 0..1 BackboneElement Additional coverage classifications
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: plan
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... value Σ 1..1 string Value associated with the type
..... name Σ 0..1 string Human readable description of the type and value
.... class:division S 0..1 BackboneElement Additional coverage classifications
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: division
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... value Σ 1..1 string Value associated with the type
..... name Σ 0..1 string Human readable description of the type and value
.... class:network S 0..1 BackboneElement Additional coverage classifications
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: network
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... value Σ 1..1 string Value associated with the type
..... name Σ 0..1 string Human readable description of the type and value
.... class:rxbin S 0..1 BackboneElement Additional coverage classifications
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: rxbin
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... value Σ 1..1 string Value associated with the type
..... name Σ 0..1 string Human readable description of the type and value
.... class:rxpcn S 0..1 BackboneElement Additional coverage classifications
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: rxpcn
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... value Σ 1..1 string Value associated with the type
..... name Σ 0..1 string Human readable description of the type and value
.... class:rxgroup S 0..1 BackboneElement Additional coverage classifications
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: rxgroup
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... value Σ 1..1 string Value associated with the type
..... name Σ 0..1 string Human readable description of the type and value
.... class:rxid S 0..1 BackboneElement Additional coverage classifications
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: rxid
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... value Σ 1..1 string Value associated with the type
..... name Σ 0..1 string Human readable description of the type and value
.... class:rxiin S 0..1 BackboneElement Additional coverage classifications
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCoverageClassCS
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: rxiin
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... value Σ 1..1 string Value associated with the type
..... name Σ 0..1 string Human readable description of the type and value
... order Σ 0..1 positiveInt Relative order of the coverage
... network Σ 0..1 string Insurer network
... costToBeneficiary S 0..* BackboneElement Patient payments for services/products
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type SΣ 1..1 CodeableConcept Cost category
Binding: C4DIC Copay Type (extensible)
.... value[x] SΣC 1..1 Money The amount or percentage due from the beneficiary
ValueMoney-details-or-extension: costToBeneficiary SHALL have (value AND currency) OR Beneficiary Cost String extension, but not both
..... id 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
..... C4DIC-BeneficiaryCostString-extension S 0..1 string Beneficiary Cost as String
URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BeneficiaryCostString-extension
..... value SΣ 0..1 decimal Numerical value (with implicit precision)
..... currency SΣ 0..1 code ISO 4217 Currency Code
Binding: Currencies (required): A code indicating the currency, taken from ISO 4217.

.... exception 0..* BackboneElement Exceptions for patient payments
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type Σ 1..1 CodeableConcept Exception category
Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays.

..... period Σ 0..1 Period The effective period of the exception
... subrogation 0..1 boolean Reimbursement to insurer
... contract 0..* Reference(Contract) Contract details

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Coverage.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Coverage.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Coverage.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Coverage.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Coverage.identifier.typeextensibleC4DICCoverageIdentifierType
http://hl7.org/fhir/us/insurance-card/ValueSet/C4DICCoverageIdentifierType
from this IG
Coverage.identifier:memberid.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Coverage.identifier:memberid.typeextensiblePattern: MB
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Coverage.statusrequiredFinancialResourceStatusCodes
http://hl7.org/fhir/ValueSet/fm-status|4.0.1
from the FHIR Standard
Coverage.typepreferredCoverageTypeAndSelf-PayCodes
http://hl7.org/fhir/ValueSet/coverage-type
from the FHIR Standard
Coverage.subscriber.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
Coverage.beneficiary.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
Coverage.relationshiprequiredSubscriberRelationshipCodes
http://hl7.org/fhir/ValueSet/subscriber-relationship
from the FHIR Standard
Coverage.class.typerequiredC4DICCoverageClassVS
http://hl7.org/fhir/us/insurance-card/ValueSet/C4DICCoverageClassVS
from this IG
Coverage.class:group.typeextensiblePattern: group
http://hl7.org/fhir/ValueSet/coverage-class
from the FHIR Standard
Coverage.class:plan.typeextensiblePattern: plan
http://hl7.org/fhir/ValueSet/coverage-class
from the FHIR Standard
Coverage.class:division.typeextensiblePattern: division
http://hl7.org/fhir/ValueSet/coverage-class
from the FHIR Standard
Coverage.class:network.typeextensiblePattern: network
http://hl7.org/fhir/ValueSet/coverage-class
from the FHIR Standard
Coverage.class:rxbin.typeextensiblePattern: rxbin
http://hl7.org/fhir/ValueSet/coverage-class
from the FHIR Standard
Coverage.class:rxpcn.typeextensiblePattern: rxpcn
http://hl7.org/fhir/ValueSet/coverage-class
from the FHIR Standard
Coverage.class:rxgroup.typeextensiblePattern: rxgroup
http://hl7.org/fhir/ValueSet/coverage-class
from the FHIR Standard
Coverage.class:rxid.typeextensiblePattern: rxid
http://hl7.org/fhir/ValueSet/coverage-class
from the FHIR Standard
Coverage.class:rxiin.typeextensiblePattern: rxiin
http://hl7.org/fhir/ValueSet/coverage-class
from the FHIR Standard
Coverage.costToBeneficiary.typeextensibleC4DICCopayTypeVS
http://hl7.org/fhir/us/insurance-card/ValueSet/C4DICCopayTypeVS
from this IG
Coverage.costToBeneficiary.value[x].currencyrequiredCurrencies (a valid code from urn:iso:std:iso:4217)
http://hl7.org/fhir/ValueSet/currencies|4.0.1
from the FHIR Standard
Coverage.costToBeneficiary.exception.typeexampleExampleCoverageFinancialExceptionCodes
http://hl7.org/fhir/ValueSet/coverage-financial-exception
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ValueMoney-details-or-extensionerrorCoverage.costToBeneficiary.value[x]costToBeneficiary SHALL have (value AND currency) OR Beneficiary Cost String extension, but not both
: ((value.exists() and currency.exists()) xor extension.where(url='http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BeneficiaryCostString-extension').exists()) and ((value.exists() xor currency.exists())).not()