Left: | RTPBC Coverage (http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-coverage) |
Right: | RTPBC Coverage (http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-coverage) |
Error | StructureDefinition.version | Values for version differ: '1.0.0' vs '2.0.0' |
Information | StructureDefinition.publisher | Values for publisher differ: 'HL7 International - Pharmacy' vs 'HL7 International / Pharmacy' |
Name | Value | Comments | |
---|---|---|---|
![]() | false | ||
![]() | http://hl7.org/fhir/StructureDefinition/Coverage | ||
![]() | |||
![]() | 2020-05-23T00:00:00-05:00 | ||
![]() | This profile constrains the Coverage resource for carrying the pharmacy benefit information required in the consumer real-time pharmacy benefit check process | ||
![]() | false | ||
![]() | 4.0.1 | ||
![]() | |||
![]() ![]() | urn:iso:std:iso:3166#US | ||
![]() | resource | ||
![]() | RtpbcCoverage | ||
![]() | HL7 International - Pharmacy | HL7 International / Pharmacy |
|
![]() | |||
![]() | active | ||
![]() | RTPBC Coverage | ||
![]() | Coverage | ||
![]() | http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-coverage | ||
![]() | 1.0.0 | 2.0.0 |
|
Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments![]() | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
![]() ![]() | 0..* | Coverage | Insurance or medical plan or a payment agreement | 0..* | Coverage | Insurance or medical plan or a payment agreement | |||||||||||
![]() ![]() ![]() | Σ | 0..1 | string | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact | |||||||||
![]() ![]() ![]() | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource | |||||||||
![]() ![]() ![]() | ?!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 | |||||||||
![]() ![]() ![]() | 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.
| |||||||||||
![]() ![]() ![]() | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||||||||
![]() ![]() ![]() | 0..* | Resource | Contained, inline Resources | 0..* | Resource | Contained, inline Resources | |||||||||||
![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
![]() ![]() ![]() | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored | |||||||||
![]() ![]() ![]() | Σ | 0..* | Identifier | Business Identifier for the coverage | Σ | 0..* | Identifier | Business Identifier for the coverage | |||||||||
![]() ![]() ![]() | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | |||||||||
![]() ![]() ![]() | Σ | 0..1 | CodeableConcept | Coverage category such as medical or accident Binding: ?? (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization. | Σ | 0..1 | CodeableConcept | Coverage category such as medical or accident Binding: ?? (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization. | |||||||||
![]() ![]() ![]() | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy | |||||||||
![]() ![]() ![]() | Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy | Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy | |||||||||
![]() ![]() ![]() | SΣ | 0..1 | string | Health Plan Cardholder ID | SΣ | 0..1 | string | Health Plan Cardholder ID | |||||||||
![]() ![]() ![]() | SΣ | 1..1 | Reference(Patient) | Plan beneficiary | SΣ | 1..1 | Reference(Patient) | Plan beneficiary | |||||||||
![]() ![]() ![]() | Σ | 0..1 | string | Dependent number | Σ | 0..1 | string | Dependent number | |||||||||
![]() ![]() ![]() | 0..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: ?? (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). | 0..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: ?? (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). | |||||||||||
![]() ![]() ![]() | Σ | 0..1 | Period | Coverage start and end dates | Σ | 0..1 | Period | Coverage start and end dates | |||||||||
![]() ![]() ![]() | SΣ | 1..1 | Reference(Organization | Patient | RelatedPerson) | Payer ID | SΣ | 1..1 | Reference(Organization | Patient | RelatedPerson) | Payer ID | |||||||||
![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
![]() ![]() ![]() ![]() | 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 | |||||||||||
![]() ![]() ![]() ![]() | ΣC | 0..1 | string | Literal reference, Relative, internal or absolute URL | ΣC | 0..1 | string | Literal reference, Relative, internal or absolute URL | |||||||||
![]() ![]() ![]() ![]() | Σ | 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). | Σ | 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). | |||||||||
![]() ![]() ![]() ![]() | SΣ | 0..1 | Identifier | Payer ID | SΣ | 0..1 | Identifier | Payer ID | |||||||||
![]() ![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
![]() ![]() ![]() ![]() ![]() | 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 | |||||||||||
![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: ?? (required): Identifies the purpose for this identifier, if known . | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: ?? (required): Identifies the purpose for this identifier, if known . | |||||||||
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | CodeableConcept | Description of identifier Binding: ?? (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | Σ | 0..1 | CodeableConcept | Description of identifier Binding: ?? (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | |||||||||
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | |||||||||
![]() ![]() ![]() ![]() ![]() | SΣ | 1..1 | string | Payer ID Value Example General: 123456 | SΣ | 1..1 | string | Payer ID Value Example General: 123456 | |||||||||
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | Period | Time period when id is/was valid for use | Σ | 0..1 | Period | Time period when id is/was valid for use | |||||||||
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | |||||||||
![]() ![]() ![]() ![]() | Σ | 0..1 | string | Text alternative for the resource | Σ | 0..1 | string | Text alternative for the resource | |||||||||
![]() ![]() ![]() | S | 0..* | BackboneElement | Pharmacy coverage identifiers Slice: Unordered, Open by value:type | S | 0..* | BackboneElement | Pharmacy coverage identifiers Slice: Unordered, Open by value:type | |||||||||
![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
![]() ![]() ![]() ![]() | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: ?? (extensible): Coverage Class Codes | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: ?? (extensible): Coverage Class Codes | |||||||||
![]() ![]() ![]() ![]() | Σ | 1..1 | string | Value associated with the type | Σ | 1..1 | string | Value associated with the type | |||||||||
![]() ![]() ![]() ![]() | Σ | 0..1 | string | Human readable description of the type and value | Σ | 0..1 | string | Human readable description of the type and value | |||||||||
![]() ![]() ![]() | Σ | 0..1 | positiveInt | Relative order of the coverage | Σ | 0..1 | positiveInt | Relative order of the coverage | |||||||||
![]() ![]() ![]() | Σ | 0..1 | string | Insurer network | Σ | 0..1 | string | Insurer network | |||||||||
![]() ![]() ![]() | 0..* | BackboneElement | Patient payments for services/products | 0..* | BackboneElement | Patient payments for services/products | |||||||||||
![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
![]() ![]() ![]() ![]() | Σ | 0..1 | CodeableConcept | Cost category Binding: ?? (extensible): The types of services to which patient copayments are specified. | Σ | 0..1 | CodeableConcept | Cost category Binding: ?? (extensible): The types of services to which patient copayments are specified. | |||||||||
![]() ![]() ![]() ![]() | Σ | 1..1 | ??, Money | The amount or percentage due from the beneficiary | Σ | 1..1 | ??, Money | The amount or percentage due from the beneficiary | |||||||||
![]() ![]() ![]() ![]() | 0..* | BackboneElement | Exceptions for patient payments | 0..* | BackboneElement | Exceptions for patient payments | |||||||||||
![]() ![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
![]() ![]() ![]() ![]() ![]() | Σ | 1..1 | CodeableConcept | Exception category Binding: ?? (example): The types of exceptions from the part or full value of financial obligations such as copays. | Σ | 1..1 | CodeableConcept | Exception category Binding: ?? (example): The types of exceptions from the part or full value of financial obligations such as copays. | |||||||||
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | Period | The effective period of the exception | Σ | 0..1 | Period | The effective period of the exception | |||||||||
![]() ![]() ![]() | 0..1 | boolean | Reimbursement to insurer | 0..1 | boolean | Reimbursement to insurer | |||||||||||
![]() ![]() ![]() | 0..* | Reference(Contract) | Contract details | 0..* | Reference(Contract) | Contract details | |||||||||||
![]() |