ext-coverage-information
type: StructureDefinition
node role: treeRoot
id:
  v: ext-coverage-information
language:
  v: en
text:
  status:
    v: extensions
  div:
    v: Generated Narrative: StructureDefinition ext-coverage-information Name Flags Card. Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> Extension <a style="padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;; padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;" href="http://hl7.org/fhir/R4/conformance-rules.html#constraints" title="This element has or is affected by constraints ( crd-ci-q1, crd-ci-q2, crd-ci-q3, crd-ci-q4, crd-ci-q5, crd-ci-q6, crd-ci-q7, crd-ci-q8, crd-ci-q9 )">C 0..* Extension CoverageInfo Constraints: crd-ci-q1, crd-ci-q2, crd-ci-q3, crd-ci-q4, crd-ci-q5, crd-ci-q6, crd-ci-q7, crd-ci-q8, crd-ci-q9 #xD; extension 4..* Extension Extension #xD; Slices for extension Content/Rules for all slices #xD; extension:coverage S 1..1 Extension Reference to Coverage #xD; extension 0..0 Extension #xD; url 1..1 uri "coverage" #xD; value[x] 1..1 Reference(CRD Coverage) Value of extension #xD; <a href="StructureDefinition-ext-coverage-information-definitions.html#Extension.extension:covered" title="Slice covered: Indicates whether the ordered/requested service is covered under patient's plan. This includes checking whether the proposed service is a benefit under the patient's plan. It **MAY** also involve checking whether the patient has reached their limits under the current plan period but is not required to.">extension:covered S 1..1 Extension covered | not-covered | conditional | indeterminate #xD; extension 0..0 Extension #xD; url 1..1 uri "covered" #xD; value[x] 1..1 code Value of extension Binding: CRD Coverage Information Covered Value Set (required) #xD; extension:pa-needed S<a style="padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;; padding-left: 3px; padding-right: 3px; border: 1px maro…
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm
    l: structuredefinition-fmm
  value: Integer
    v: 1
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-wg
    l: structuredefinition-wg
  value: Code
    v: fm
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status
    l: structuredefinition-standards-status
  value: Code
    v: trial-use
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom
        l: structuredefinition-conformance-derivedFrom
      value: Canonical
        v: http://hl7.org/fhir/us/davinci-crd/ImplementationGuide/davinci-crd
        l: davinci-crd
url:
  v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
  l: ext-coverage-information
identifier:
  system:
    v: urn:ietf:rfc:3986
    l: 3986
  value:
    v: urn:oid:2.16.840.1.113883.4.642.40.18.42.2
version:
  v: 2.2.1
name:
  v: CRDCoverageInformation
title:
  v: Coverage Information
status:
  v: active
experimental:
  v: false
date:
  v: 2026-03-26T15:54:25+00:00
publisher:
  v: HL7 International / Financial Management
contact:
  telecom:
    system:
      v: url
    value:
      v: http://www.hl7.org/Special/committees/fm
description:
  v: Captures assertions from a payer about the coverage rules for a service - in particular, whether it is covered and/or requires prior authorization.
jurisdiction:
  coding:
    system:
      v: urn:iso:std:iso:3166
      l: 3166
    code:
      v: US
fhir version:
  v: 4.0.1
mapping:
  identity:
    v: rim
  uri:
    v: http://hl7.org/v3
    l: v3
  name:
    v: RIM Mapping
kind:
  v: complex-type
abstract:
  v: false
context:
  type:
    v: element
  expression:
    v: Appointment
context:
  type:
    v: element
  expression:
    v: CommunicationRequest
context:
  type:
    v: element
  expression:
    v: Encounter
context:
  type:
    v: element
  expression:
    v: DeviceRequest
context:
  type:
    v: element
  expression:
    v: MedicationRequest
context:
  type:
    v: element
  expression:
    v: NutritionOrder
context:
  type:
    v: element
  expression:
    v: QuestionnaireResponse
context:
  type:
    v: element
  expression:
    v: ServiceRequest
context:
  type:
    v: element
  expression:
    v: VisionPrescription
type:
  v: Extension
  l: Extension
base definition:
  v: http://hl7.org/fhir/StructureDefinition/Extension
  l: Extension
derivation:
  v: constraint
snapshot:
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version
      l: snapshot-base-version
    value: String
      v: 4.0.1
  element:
    id:
      v: Extension
    path:
      v: Extension
    short:
      v: CoverageInfo
    definition:
      v: Indicates coverage information.
    min:
      v: 0
    max:
      v: *
    base:
      path:
        v: Extension
      min:
        v: 0
      max:
        v: *
    condition:
      v: ele-1
    constraint:
      key:
        v: ele-1
      severity:
        v: error
      human:
        v: All FHIR elements must have a @value or children
      expression:
        v: hasValue() or (children().count() > id.count())
      xpath:
        v: @value|f:*|h:div
      source:
        v: http://hl7.org/fhir/StructureDefinition/Element
        l: Element
    constraint:
      key:
        v: ext-1
      severity:
        v: error
      human:
        v: Must have either extensions or value[x], not both
      expression:
        v: extension.exists() != value.exists()
      xpath:
        v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
      source:
        v: http://hl7.org/fhir/StructureDefinition/Extension
        l: Extension
    constraint:
      key:
        v: crd-ci-q1
      severity:
        v: error

v: Questionnaire is only allowed when doc-needed exists

v: extension.where(url='questionnaire').exists() implies extension.where(url = 'doc-needed').exists()

key:
  v: crd-ci-q2
severity:
  v: error
human:
  v: If covered is set to 'not-covered', then 'pa-needed' must not exist.
expression:
  v: extension.where(url = 'covered' and value = 'not-covered').exists() implies extension.where(url = 'pa-needed').exists().not()
source:
  v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
  l: ext-coverage-information

key:
  v: crd-ci-q3
severity:
  v: error
human:
  v: 'info-needed' SHALL exist if and only if at least one of 'covered', 'pa-needed', or 'doc-needed' is set to 'conditional'.
expression:
  v: extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'conditional').count() >= 1 implies extension.where(url = 'info-needed').exists()
source:
  v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
  l: ext-coverage-information

key:
  v: crd-ci-q4
severity:
  v: error
human:
  v: If 'pa-needed' is 'satisfied', 'noauth', or 'not-covered', then 'Doc-purpose' cannot be 'withpa'.
expression:
  v: extension.where(url = 'pa-needed' and (value = 'satisfied' or value = 'noauth' or value = 'not-covered')) and extension.where(url = 'doc-purpose').exists() implies extension.where(url = 'doc-purpose').all(value != 'withpa')
source:
  v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
  l: ext-coverage-information

key:
  v: crd-ci-q5
severity:
  v: error
human:
  v: 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'.
expression:
  v: extension.where(url = 'pa-needed' and value = 'satisfied').exists() = extension.where(url = 'satisfied-pa-id').exists()
source:
  v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
  l: ext-coverage-information

key:
  v: crd-ci-q6
severity:
  v: error
human:
  v: If 'info-needed' is OTH, then reason must be specified
expression:
  v: extension.where(url = 'info-needed' and value = 'OTH').exists() implies extension.where(url = 'reason').exists()
source:
  v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
  l: ext-coverage-information

key:
  v: crd-ci-q7
severity:
  v: error
human:
  v: If reason.coding is present and is not from the extensible value set, then reason.text must be present
expression:
  v: extension.where(url = 'reason').empty() or extension.where(url = 'reason').value.text.exists() or extension.where(url = 'reason').value.memberOf('http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons')
source:
  v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
  l: ext-coverage-information

key:
  v: crd-ci-q8
severity:
  v: error
human:
  v: If doc-purpose is present with a value other than 'conditional', then reason must be present
expression:
  v: extension.where(url = 'doc-purpose' and value != 'conditional').exists() implies extension.where(url = 'reason').exists()
source:
  v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
  l: ext-coverage-information

key:
  v: crd-ci-q9
severity:
  v: error
human:
  v: If any of 'covered', 'pa-needed', or 'doc-needed' is set to 'indeterminate', then reason must be present to explain the issue that is preventing the payer from making a coverage determination.
expression:
  v: extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'indeterminate').count() >= 1 implies extension.where(url = 'reason').exists()
source:
  v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
  l: ext-coverage-information

v: false

id:
  v: Extension.id
path:
  v: Extension.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Extension.extension
path:
  v: Extension.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 4
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:coverage
path:
  v: Extension.extension
slice name:
  v: coverage
short:
  v: Reference to Coverage
definition:
  v: Reference to Coverage that assertion applies to.
comment:
  v: This will always be a link to a Coverage resource on the CRD client's system - typically accessed via prefetch or direct query using the CDS-Hooks token. If no coverage instance is available, the coverage-information extension cannot be returned.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
must support:
  v: true
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:coverage.id
path:
  v: Extension.extension.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Extension.extension:coverage.extension
path:
  v: Extension.extension.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: 0
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:coverage.url
path:
  v: Extension.extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: coverage
  l: coverage
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:coverage.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-coverage
    l: profile-coverage
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:covered
path:
  v: Extension.extension
slice name:
  v: covered
short:
  v: covered | not-covered | conditional | indeterminate
definition:
  v: Indicates whether the ordered/requested service is covered under patient's plan. This includes checking whether the proposed service is a benefit under the patient's plan. It **MAY** also involve checking whether the patient has reached their limits under the current plan period but is not required to.
comment:
  v: Details on why coverage does not exist would be conveyed in the 'reason' element.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
must support:
  v: true
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:covered.id
path:
  v: Extension.extension.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Extension.extension:covered.extension
path:
  v: Extension.extension.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: 0
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:covered.url
path:
  v: Extension.extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: covered
  l: covered
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:covered.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
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    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  strength:
    v: required
  value set:
    v: http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageInfo
    l: coverageInfo
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:pa-needed
path:
  v: Extension.extension
slice name:
  v: pa-needed
short:
  v: no-auth | auth-needed | satisfied | performpa | conditional | indeterminate
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  v: Indicates whether prior auth will be needed for coverage to be provided
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  v: 0
max:
  v: 1
base:
  path:
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    v: 0
  max:
    v: *
type:
  code:
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    l: Extension
condition:
  v: crd-ci-q2
condition:
  v: crd-ci-q5
constraint:
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    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
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    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
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  v: true
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:pa-needed.id
path:
  v: Extension.extension.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
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      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
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path:
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  discriminator:
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      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: 0
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
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    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
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  v: false
is summary:
  v: false

id:
  v: Extension.extension:pa-needed.url
path:
  v: Extension.extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
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      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
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      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: pa-needed
  l: pa-needed
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:pa-needed.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  strength:
    v: required
  value set:
    v: http://hl7.org/fhir/us/davinci-crd/ValueSet/coveragePaDetail
    l: coveragePaDetail
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:doc-needed
path:
  v: Extension.extension
slice name:
  v: doc-needed
short:
  v: clinical | admin | patient | conditional | indeterminate
definition:
  v: Indicates whether additional documentation needs to be captured (purpose in next element)
comment:
  v: See additional guidance in the [notes](StructureDefinition-ext-coverage-information.html#doc-needed-vs-info-needed)
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
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  severity:
    v: error
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    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
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    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
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  v: true
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:doc-needed.id
path:
  v: Extension.extension.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Extension.extension:doc-needed.extension
path:
  v: Extension.extension.extension
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  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: 0
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
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is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:doc-needed.url
path:
  v: Extension.extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: doc-needed
  l: doc-needed
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:doc-needed.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
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  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  strength:
    v: required
  value set:
    v: http://hl7.org/fhir/us/davinci-crd/ValueSet/AdditionalDocumentation
    l: AdditionalDocumentation
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
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path:
  v: Extension.extension
slice name:
  v: doc-purpose
short:
  v: withpa | withclaim | withorder | retain-doc | OTH
definition:
  v: Indicates the reason(s) for the additional documentation that needs to be captured
requirements:
  v: Knowing what the information will be used for may influence who will fill out the form(s) and how quickly the organization will get around to filling them out
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
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condition:
  v: crd-ci-q4
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
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must support:
  v: true
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:doc-purpose.id
path:
  v: Extension.extension.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
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    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
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path:
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  discriminator:
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      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
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  v: 0
max:
  v: 0
base:
  path:
    v: Element.extension
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    v: 0
  max:
    v: *
type:
  code:
    v: Extension
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constraint:
  key:
    v: ele-1
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    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
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  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
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    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
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is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:doc-purpose.url
path:
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representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
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  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
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    value: Url
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      l: uri
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fixed: Uri
  v: doc-purpose
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is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:doc-purpose.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  strength:
    v: required
  value set:
    v: http://hl7.org/fhir/us/davinci-crd/ValueSet/DocReason
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mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
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path:
  v: Extension.extension
slice name:
  v: info-needed
short:
  v: performer | location | timeframe | contract-window | detail-code | OTH
definition:
  v: Indicates whether information about the performer, location, and/or performance date is needed to determine coverage information
comment:
  v: See additional guidance in the [notes](StructureDefinition-ext-coverage-information.html#doc-needed-vs-info-needed) If this element is set to OTH, then there must be at least one detail element the explains the nature of the additional information needed to determine coverage, prior authorization, and/or documentation requirements. There **SHOULD** also be a doc-needed element indicating that DTR can be used to gather additional information.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
condition:
  v: crd-ci-q3
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
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  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
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    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
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    l: Extension
must support:
  v: true
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:info-needed.id
path:
  v: Extension.extension.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
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    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Extension.extension:info-needed.extension
path:
  v: Extension.extension.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: 0
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
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is modifier:
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is summary:
  v: false

id:
  v: Extension.extension:info-needed.url
path:
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representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: info-needed
  l: info-needed
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:info-needed.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  strength:
    v: required
  value set:
    v: http://hl7.org/fhir/us/davinci-crd/ValueSet/informationNeeded
    l: informationNeeded
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:billingCode
path:
  v: Extension.extension
slice name:
  v: billingCode
short:
  v: Billing code
definition:
  v: Billing code(s) that must be used in the eventual claim for the coverage assertion to hold
comment:
  v: Codes may include modifier codes, leveraging [CPT's post-coordination syntax](https://terminology.hl7.org/CPT.html)
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
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    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
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  v: true
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:billingCode.id
path:
  v: Extension.extension.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Extension.extension:billingCode.extension
path:
  v: Extension.extension.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: 0
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
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is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:billingCode.url
path:
  v: Extension.extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: billingCode
  l: billingCode
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:billingCode.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Coding
    l: Coding
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  strength:
    v: example
  value set:
    v: http://hl7.org/fhir/ValueSet/service-uscls
    l: service-uscls
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:reason
path:
  v: Extension.extension
slice name:
  v: reason
short:
  v: Reason for assertion
definition:
  v: Indicates the 'reason' for the coverage assertion
comment:
  v: This can be used whenever the reason may not be obvious to the practitioner. E.g. prior authorization is waived because the provider is gold-carded; patient is no longer a minor and has not been registered as an adult dependent; patient has reached their limit for this type of service this year; etc. Additional standard reason codes may be introduced in the future. If no standard code applies, use text.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
condition:
  v: crd-ci-q7
condition:
  v: crd-ci-q8
condition:
  v: crd-ci-q6
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
must support:
  v: true
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:reason.id
path:
  v: Extension.extension.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Extension.extension:reason.extension
path:
  v: Extension.extension.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: 0
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
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    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:reason.url
path:
  v: Extension.extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: reason
  l: reason
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:reason.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  strength:
    v: extensible
  value set:
    v: http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons
    l: coverageAssertionReasons
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:detail
path:
  v: Extension.extension
slice name:
  v: detail
short:
  v: detail for assertion
definition:
  v: Indicates the 'detail' for the coverage assertion
comment:
  v: Additional information that qualifies, describes, or provides additional guidance about coverage or documentation requirements.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
must support:
  v: true
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:detail.id
path:
  v: Extension.extension.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Extension.extension:detail.extension
path:
  v: Extension.extension.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 3
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
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is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:detail.extension:category
path:
  v: Extension.extension.extension
slice name:
  v: category
short:
  v: Type of detail
definition:
  v: Indicates the nature of the detail, which in turn provides guidance for when it should be displayed.
comment:
  v: CRD clients **SHOULD** make both limitation and decisional details available to clinical users.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:detail.extension:category.id
path:
  v: Extension.extension.extension.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Extension.extension:detail.extension:category.extension
path:
  v: Extension.extension.extension.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: 0
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:detail.extension:category.url
path:
  v: Extension.extension.extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: category
  l: category
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:detail.extension:category.value[x]
path:
  v: Extension.extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  strength:
    v: required
  value set:
    v: http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageDetailCategories
    l: coverageDetailCategories
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:detail.extension:code
path:
  v: Extension.extension.extension
slice name:
  v: code
short:
  v: Name of name-value pair
definition:
  v: The type of detail or qualification expressed.
comment:
  v: The binding to the old temporary code system is retained for now for backward compatibility
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  v: 1
max:
  v: 1
base:
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    v: Element.extension
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    v: 0
  max:
    v: *
type:
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constraint:
  key:
    v: ele-1
  severity:
    v: error
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    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
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is summary:
  v: false

id:
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path:
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  v: xmlAttr
short:
  v: Unique id for inter-element referencing
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  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
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      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
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    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Extension.extension:detail.extension:code.extension
path:
  v: Extension.extension.extension.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
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  v: 0
max:
  v: 0
base:
  path:
    v: Element.extension
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    v: 0
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    v: *
type:
  code:
    v: Extension
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  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
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is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:detail.extension:code.url
path:
  v: Extension.extension.extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
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      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: code
  l: code
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:detail.extension:code.value[x]
path:
  v: Extension.extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    extension:
      url:
        v: key
        l: key
      value: Id
        v: ci-detailold
    extension:
      url:
        v: purpose
        l: purpose
      value: Code
        v: extensible
    extension:
      url:
        v: valueSet
        l: valueSet
      value: Canonical
        v: http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageDetail
        l: coverageDetail
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/additional-binding
      l: additional-binding
  strength:
    v: extensible
  value set:
    v: http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageDetailNew
    l: coverageDetailNew
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:detail.extension:value
path:
  v: Extension.extension.extension
slice name:
  v: value
short:
  v: Value of name-value pair
definition:
  v: The detail or qualification that applies to this coverage assertion.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
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    v: Extension
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  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
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    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
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is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:detail.extension:value.id
path:
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  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
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      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
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    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Extension.extension:detail.extension:value.extension
path:
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slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: 0
base:
  path:
    v: Element.extension
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    v: 0
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    v: *
type:
  code:
    v: Extension
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constraint:
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    v: ele-1
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    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
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is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:detail.extension:value.url
path:
  v: Extension.extension.extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
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      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: value
  l: value
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:detail.extension:value.value[x]
path:
  v: Extension.extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
    l: boolean
type:
  code:
    v: string
    l: string
type:
  code:
    v: url
    l: url
type:
  code:
    v: Period
    l: Period
type:
  code:
    v: Quantity
    l: Quantity
  profile:
    v: http://hl7.org/fhir/StructureDefinition/SimpleQuantity
    l: SimpleQuantity
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
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path:
  v: Extension.extension.extension
slice name:
  v: qualification
short:
  v: Additional info about detail
definition:
  v: Additional text that qualifies/expands on the computable detail. E.g. 'Provided coverage is renewed' or 'Does not account for deductible'
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
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is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:detail.extension:qualification.id
path:
  v: Extension.extension.extension.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
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path:
  v: Extension.extension.extension.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: 0
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
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constraint:
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  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
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  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
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    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
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  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
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is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:detail.extension:qualification.url
path:
  v: Extension.extension.extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
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      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: qualification
  l: qualification
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:detail.extension:qualification.value[x]
path:
  v: Extension.extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
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  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:detail.url
path:
  v: Extension.extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
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      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: detail
  l: detail
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:detail.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 0
max:
  v: 0
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: base64Binary
    l: base64Binary
type:
  code:
    v: boolean
    l: boolean
type:
  code:
    v: canonical
    l: canonical
type:
  code:
    v: code
    l: code
type:
  code:
    v: date
    l: date
type:
  code:
    v: dateTime
    l: dateTime
type:
  code:
    v: decimal
    l: decimal
type:
  code:
    v: id
    l: id
type:
  code:
    v: instant
    l: instant
type:
  code:
    v: integer
    l: integer
type:
  code:
    v: markdown
    l: markdown
type:
  code:
    v: oid
    l: oid
type:
  code:
    v: positiveInt
    l: positiveInt
type:
  code:
    v: string
    l: string
type:
  code:
    v: time
    l: time
type:
  code:
    v: unsignedInt
    l: unsignedInt
type:
  code:
    v: uri
    l: uri
type:
  code:
    v: url
    l: url
type:
  code:
    v: uuid
    l: uuid
type:
  code:
    v: Address
    l: Address
type:
  code:
    v: Age
    l: Age
type:
  code:
    v: Annotation
    l: Annotation
type:
  code:
    v: Attachment
    l: Attachment
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
type:
  code:
    v: Coding
    l: Coding
type:
  code:
    v: ContactPoint
    l: ContactPoint
type:
  code:
    v: Count
    l: Count
type:
  code:
    v: Distance
    l: Distance
type:
  code:
    v: Duration
    l: Duration
type:
  code:
    v: HumanName
    l: HumanName
type:
  code:
    v: Identifier
    l: Identifier
type:
  code:
    v: Money
    l: Money
type:
  code:
    v: Period
    l: Period
type:
  code:
    v: Quantity
    l: Quantity
type:
  code:
    v: Range
    l: Range
type:
  code:
    v: Ratio
    l: Ratio
type:
  code:
    v: Reference
    l: Reference
type:
  code:
    v: SampledData
    l: SampledData
type:
  code:
    v: Signature
    l: Signature
type:
  code:
    v: Timing
    l: Timing
type:
  code:
    v: ContactDetail
    l: ContactDetail
type:
  code:
    v: Contributor
    l: Contributor
type:
  code:
    v: DataRequirement
    l: DataRequirement
type:
  code:
    v: Expression
    l: Expression
type:
  code:
    v: ParameterDefinition
    l: ParameterDefinition
type:
  code:
    v: RelatedArtifact
    l: RelatedArtifact

code:
  v: TriggerDefinition
  l: TriggerDefinition

code:
  v: UsageContext
  l: UsageContext

code:
  v: Dosage
  l: Dosage

code:
  v: Meta
  l: Meta

key:
  v: ele-1
severity:
  v: error
human:
  v: All FHIR elements must have a @value or children
expression:
  v: hasValue() or (children().count() > id.count())
xpath:
  v: @value|f:*|h:div
source:
  v: http://hl7.org/fhir/StructureDefinition/Element
  l: Element

v: false

v: false

identity:
  v: rim
map:
  v: N/A

id:
  v: Extension.extension:dependency
path:
  v: Extension.extension
slice name:
  v: dependency
short:
  v: Resources that impact this assertion
definition:
  v: If present, indicates that the determination represented here is dependent on the content, determination, and possibly execution of the referenced order(s)
requirements:
  v: For example, the authorization decision on a request for post-surgical physiotherapy might be dependent on the order for the surgery itself. If coverage for the surgery is not approved or the order for the surgery is cancelled, that might impact the decision on covering the physiotherapy.
min:
  v: 0
max:
  v: *
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    v: Element.extension
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    v: 0
  max:
    v: *
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  code:
    v: Extension
    l: Extension
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  key:
    v: ele-1
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    v: error
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    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
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    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
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  v: true
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  v: false
is summary:
  v: false

id:
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path:
  v: Extension.extension.id
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  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
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    v: 0
  max:
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    v: http://hl7.org/fhirpath/System.String
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is summary:
  v: false
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  identity:
    v: rim
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    v: n/a

id:
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    type:
      v: value
    path:
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    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
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  v: 0
max:
  v: 0
base:
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    v: Element.extension
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    v: 0
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    v: *
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  code:
    v: Extension
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    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
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  key:
    v: ext-1
  severity:
    v: error
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    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
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  v: false
is summary:
  v: false

id:
  v: Extension.extension:dependency.url
path:
  v: Extension.extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
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    v: 1
  max:
    v: 1
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    v: http://hl7.org/fhirpath/System.String
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fixed: Uri
  v: dependency
  l: dependency
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  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:dependency.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-appointment-with-order
    l: profile-appointment-with-order
  target profile:
    v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-appointment-no-order
    l: profile-appointment-no-order
  target profile:
    v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-communicationrequest
    l: profile-communicationrequest
  target profile:
    v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-devicerequest
    l: profile-devicerequest
  target profile:
    v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-medicationrequest
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  target profile:
    v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-nutritionorder
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  target profile:
    v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-servicerequest
    l: profile-servicerequest
  target profile:
    v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-visionprescription
    l: profile-visionprescription
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:questionnaire
path:
  v: Extension.extension
slice name:
  v: questionnaire
short:
  v: Questionnaire to complete
definition:
  v: A form to be filled out to gather more information.
comment:
  v: If using DTR, this will be used by DTR to determine the Questionnaire packages to be returned. If empty, DTR will determine the questionnaire packages itself. If not using DTR, providing a Questionnaire url is the only way to indicate what form to complete.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
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    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
condition:
  v: crd-ci-q1
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
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    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
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    v: http://hl7.org/fhir/StructureDefinition/Extension
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  v: true
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  v: false
is summary:
  v: false

id:
  v: Extension.extension:questionnaire.id
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  v: xmlAttr
short:
  v: Unique id for inter-element referencing
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  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
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    v: 0
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    v: 1
type:
  extension:
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      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
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      l: string
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    v: http://hl7.org/fhirpath/System.String
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  v: false
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  identity:
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    v: n/a

id:
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    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
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  v: 0
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  v: 0
base:
  path:
    v: Element.extension
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    v: 0
  max:
    v: *
type:
  code:
    v: Extension
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    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
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constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
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    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
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is summary:
  v: false

id:
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path:
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representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
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  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
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    v: 1
  max:
    v: 1
type:
  extension:
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    v: http://hl7.org/fhirpath/System.String
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fixed: Uri
  v: questionnaire
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is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
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path:
  v: Extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 0
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  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
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    v: http://hl7.org/fhir/StructureDefinition/Questionnaire
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constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
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    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
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path:
  v: Extension.extension
slice name:
  v: date
short:
  v: Assertion date
definition:
  v: Date on which assertion was made.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
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constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
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    v: extension.exists() != value.exists()
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    v: http://hl7.org/fhir/StructureDefinition/Extension
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  v: true
is modifier:
  v: false
is summary:
  v: false

id:
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path:
  v: Extension.extension.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
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    v: 0
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    v: 1
type:
  extension:
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      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
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path:
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  discriminator:
    type:
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    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
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  v: 0
base:
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    v: 0
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    v: *
type:
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    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
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    v: http://hl7.org/fhir/StructureDefinition/Element
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constraint:
  key:
    v: ext-1
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    v: error
  human:
    v: Must have either extensions or value[x], not both
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    v: extension.exists() != value.exists()
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id:
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  v: xmlAttr
short:
  v: identifies the meaning of the extension
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  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
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max:
  v: 1
base:
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    v: 1
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type:
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fixed: Uri
  v: date
  l: date
is modifier:
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is summary:
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mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:date.value[x]
path:
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  v: Value of extension
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  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
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  v: 1
max:
  v: 1
base:
  path:
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    v: 0
  max:
    v: 1
type:
  code:
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    l: date
constraint:
  key:
    v: ele-1
  severity:
    v: error
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    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
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  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
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mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
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path:
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slice name:
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short:
  v: Coverage assertion trace number
definition:
  v: Trace identifier to allow tracking the guidance in source system. This identifier can also be used to re-establish cached context information when subsequently launching DTR.
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  v: 1
max:
  v: 1
base:
  path:
    v: Element.extension
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    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
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    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
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    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
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must support:
  v: true
is modifier:
  v: false
is summary:
  v: false

id:
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path:
  v: Extension.extension.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
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      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Extension.extension:coverage-assertion-id.extension
path:
  v: Extension.extension.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: 0
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:coverage-assertion-id.url
path:
  v: Extension.extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
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      l: structuredefinition-fhir-type
    value: Url
      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: coverage-assertion-id
  l: coverage-assertion-id
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:coverage-assertion-id.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.value[x]
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    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:satisfied-pa-id
path:
  v: Extension.extension
slice name:
  v: satisfied-pa-id
short:
  v: Satisfied prior auth number
definition:
  v: An identifier indicating that prior authorization requirements have been met
comment:
  v: When operating under the CMS enforcement discretion, this element is a prior authorization number and can be submitted in the corresponding X12 element when submitting an eventual claim
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
condition:
  v: crd-ci-q5
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
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  v: true
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  v: false
is summary:
  v: false

id:
  v: Extension.extension:satisfied-pa-id.id
path:
  v: Extension.extension.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Extension.extension:satisfied-pa-id.extension
path:
  v: Extension.extension.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: 0
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
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  key:
    v: ele-1
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    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
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    v: http://hl7.org/fhir/StructureDefinition/Extension
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is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:satisfied-pa-id.url
path:
  v: Extension.extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
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      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
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      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: satisfied-pa-id
  l: satisfied-pa-id
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:satisfied-pa-id.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
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  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
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  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:contact
path:
  v: Extension.extension
slice name:
  v: contact
short:
  v: Contact information
definition:
  v: Name, phone number, fax number, email address, website, or other contact information that can be used to ask questions/escalate issues related to a coverage assertion.
comment:
  v: This **SHOULD** only be populated if the contact information is context-specific rather than a generic contact for the payer as a whole.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
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  key:
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  severity:
    v: error
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    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
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    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
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  v: true
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  v: false
is summary:
  v: false

id:
  v: Extension.extension:contact.id
path:
  v: Extension.extension.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
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  v: Extension.extension.extension
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  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: 0
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
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    v: ele-1
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    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
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    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
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is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:contact.url
path:
  v: Extension.extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
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    value: Url
      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: contact
  l: contact
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:contact.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: ContactDetail
    l: ContactDetail
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:expiry-date
path:
  v: Extension.extension
slice name:
  v: expiry-date
short:
  v: Expiration date
definition:
  v: Date after which the coverage assertion would no longer be valid.
comment:
  v: In this case, mustSupport means that if the payer knows of an expiry date, they must share it. However, if the payer never has expiry dates for their assertions, it is fine to omit.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
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  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
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    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
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    v: http://hl7.org/fhir/StructureDefinition/Extension
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must support:
  v: true
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  v: false
is summary:
  v: false

id:
  v: Extension.extension:expiry-date.id
path:
  v: Extension.extension.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
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      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
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    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Extension.extension:expiry-date.extension
path:
  v: Extension.extension.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: 0
base:
  path:
    v: Element.extension
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    v: 0
  max:
    v: *
type:
  code:
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    v: error
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    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
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  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
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    v: ext-1
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    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:expiry-date.url
path:
  v: Extension.extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
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      l: structuredefinition-fhir-type
    value: Url
      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: expiry-date
  l: expiry-date
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:expiry-date.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: date
    l: date
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.url
path:
  v: Extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
  l: ext-coverage-information
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.value[x]
path:
  v: Extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 0
max:
  v: 0
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: base64Binary
    l: base64Binary
type:
  code:
    v: boolean
    l: boolean
type:
  code:
    v: canonical
    l: canonical
type:
  code:
    v: code
    l: code
type:
  code:
    v: date
    l: date
type:
  code:
    v: dateTime
    l: dateTime
type:
  code:
    v: decimal
    l: decimal
type:
  code:
    v: id
    l: id
type:
  code:
    v: instant
    l: instant
type:
  code:
    v: integer
    l: integer
type:
  code:
    v: markdown
    l: markdown
type:
  code:
    v: oid
    l: oid
type:
  code:
    v: positiveInt
    l: positiveInt
type:
  code:
    v: string
    l: string
type:
  code:
    v: time
    l: time
type:
  code:
    v: unsignedInt
    l: unsignedInt
type:
  code:
    v: uri
    l: uri
type:
  code:
    v: url
    l: url
type:
  code:
    v: uuid
    l: uuid
type:
  code:
    v: Address
    l: Address
type:
  code:
    v: Age
    l: Age
type:
  code:
    v: Annotation
    l: Annotation
type:
  code:
    v: Attachment
    l: Attachment
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
type:
  code:
    v: Coding
    l: Coding
type:
  code:
    v: ContactPoint
    l: ContactPoint
type:
  code:
    v: Count
    l: Count
type:
  code:
    v: Distance
    l: Distance
type:
  code:
    v: Duration
    l: Duration
type:
  code:
    v: HumanName
    l: HumanName
type:
  code:
    v: Identifier
    l: Identifier
type:
  code:
    v: Money
    l: Money
type:
  code:
    v: Period
    l: Period
type:
  code:
    v: Quantity
    l: Quantity
type:
  code:
    v: Range
    l: Range
type:
  code:
    v: Ratio
    l: Ratio
type:
  code:
    v: Reference
    l: Reference
type:
  code:
    v: SampledData
    l: SampledData
type:
  code:
    v: Signature
    l: Signature
type:
  code:
    v: Timing
    l: Timing
type:
  code:
    v: ContactDetail
    l: ContactDetail
type:
  code:
    v: Contributor
    l: Contributor
type:
  code:
    v: DataRequirement
    l: DataRequirement
type:
  code:
    v: Expression
    l: Expression
type:
  code:
    v: ParameterDefinition
    l: ParameterDefinition
type:
  code:
    v: RelatedArtifact
    l: RelatedArtifact

code:
  v: TriggerDefinition
  l: TriggerDefinition

code:
  v: UsageContext
  l: UsageContext

code:
  v: Dosage
  l: Dosage

code:
  v: Meta
  l: Meta

key:
  v: ele-1
severity:
  v: error
human:
  v: All FHIR elements must have a @value or children
expression:
  v: hasValue() or (children().count() > id.count())
xpath:
  v: @value|f:*|h:div
source:
  v: http://hl7.org/fhir/StructureDefinition/Element
  l: Element

v: false

v: false

identity:
  v: rim
map:
  v: N/A

element:
  id:
    v: Extension
  path:
    v: Extension
  short:
    v: CoverageInfo
  definition:
    v: Indicates coverage information.
  constraint:
    key:
      v: crd-ci-q1
    severity:
      v: error
    human:
      v: Questionnaire is only allowed when doc-needed exists
    expression:
      v: extension.where(url='questionnaire').exists() implies extension.where(url = 'doc-needed').exists()
    source:
      v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
      l: ext-coverage-information
  constraint:
    key:
      v: crd-ci-q2
    severity:
      v: error
    human:
      v: If covered is set to 'not-covered', then 'pa-needed' must not exist.
    expression:
      v: extension.where(url = 'covered' and value = 'not-covered').exists() implies extension.where(url = 'pa-needed').exists().not()
    source:
      v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
      l: ext-coverage-information
  constraint:
    key:
      v: crd-ci-q3
    severity:
      v: error
    human:
      v: 'info-needed' SHALL exist if and only if at least one of 'covered', 'pa-needed', or 'doc-needed' is set to 'conditional'.
    expression:
      v: extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'conditional').count() >= 1 implies extension.where(url = 'info-needed').exists()
    source:
      v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
      l: ext-coverage-information
  constraint:
    key:
      v: crd-ci-q4
    severity:
      v: error
    human:
      v: If 'pa-needed' is 'satisfied', 'noauth', or 'not-covered', then 'Doc-purpose' cannot be 'withpa'.
    expression:
      v: extension.where(url = 'pa-needed' and (value = 'satisfied' or value = 'noauth' or value = 'not-covered')) and extension.where(url = 'doc-purpose').exists() implies extension.where(url = 'doc-purpose').all(value != 'withpa')
    source:
      v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
      l: ext-coverage-information
  constraint:
    key:
      v: crd-ci-q5
    severity:
      v: error
    human:
      v: 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'.
    expression:
      v: extension.where(url = 'pa-needed' and value = 'satisfied').exists() = extension.where(url = 'satisfied-pa-id').exists()
    source:
      v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
      l: ext-coverage-information
  constraint:
    key:
      v: crd-ci-q6
    severity:
      v: error
    human:
      v: If 'info-needed' is OTH, then reason must be specified
    expression:
      v: extension.where(url = 'info-needed' and value = 'OTH').exists() implies extension.where(url = 'reason').exists()
    source:
      v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
      l: ext-coverage-information
  constraint:
    key:
      v: crd-ci-q7
    severity:
      v: error
    human:
      v: If reason.coding is present and is not from the extensible value set, then reason.text must be present
    expression:
      v: extension.where(url = 'reason').empty() or extension.where(url = 'reason').value.text.exists() or extension.where(url = 'reason').value.memberOf('http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons')
    source:
      v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
      l: ext-coverage-information
  constraint:
    key:
      v: crd-ci-q8
    severity:
      v: error
    human:
      v: If doc-purpose is present with a value other than 'conditional', then reason must be present
    expression:
      v: extension.where(url = 'doc-purpose' and value != 'conditional').exists() implies extension.where(url = 'reason').exists()
    source:
      v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
      l: ext-coverage-information
  constraint:
    key:
      v: crd-ci-q9
    severity:
      v: error
    human:
      v: If any of 'covered', 'pa-needed', or 'doc-needed' is set to 'indeterminate', then reason must be present to explain the issue that is preventing the payer from making a coverage determination.
    expression:
      v: extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'indeterminate').count() >= 1 implies extension.where(url = 'reason').exists()
    source:
      v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
      l: ext-coverage-information
element:
  id:
    v: Extension.extension
  path:
    v: Extension.extension
  min:
    v: 4
element:
  id:
    v: Extension.extension:coverage
  path:
    v: Extension.extension
  slice name:
    v: coverage
  short:
    v: Reference to Coverage
  definition:
    v: Reference to Coverage that assertion applies to.
  comment:
    v: This will always be a link to a Coverage resource on the CRD client's system - typically accessed via prefetch or direct query using the CDS-Hooks token. If no coverage instance is available, the coverage-information extension cannot be returned.
  min:
    v: 1
  max:
    v: 1
  must support:
    v: true
element:
  id:
    v: Extension.extension:coverage.extension
  path:
    v: Extension.extension.extension
  max:
    v: 0
element:
  id:
    v: Extension.extension:coverage.url
  path:
    v: Extension.extension.url
  fixed: Uri
    v: coverage
    l: coverage
element:
  id:
    v: Extension.extension:coverage.value[x]
  path:
    v: Extension.extension.value[x]
  min:
    v: 1
  type:
    code:
      v: Reference
      l: Reference
    target profile:
      v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-coverage
      l: profile-coverage
element:
  id:
    v: Extension.extension:covered
  path:
    v: Extension.extension
  slice name:
    v: covered
  short:
    v: covered | not-covered | conditional | indeterminate
  definition:
    v: Indicates whether the ordered/requested service is covered under patient's plan. This includes checking whether the proposed service is a benefit under the patient's plan. It **MAY** also involve checking whether the patient has reached their limits under the current plan period but is not required to.
  comment:
    v: Details on why coverage does not exist would be conveyed in the 'reason' element.
  min:
    v: 1
  max:
    v: 1
  must support:
    v: true
element:
  id:
    v: Extension.extension:covered.extension
  path:
    v: Extension.extension.extension
  max:
    v: 0
element:
  id:
    v: Extension.extension:covered.url
  fixed: Uri

v: Extension.extension.url

Uri
v: covered
l: covered

id:
  v: Extension.extension:covered.value[x]
path:
  v: Extension.extension.value[x]
min:
  v: 1
type:
  code:
    v: code
    l: code
binding:
  strength:
    v: required
  value set:
    v: http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageInfo
    l: coverageInfo

id:
  v: Extension.extension:pa-needed
path:
  v: Extension.extension
slice name:
  v: pa-needed
short:
  v: no-auth | auth-needed | satisfied | performpa | conditional | indeterminate
definition:
  v: Indicates whether prior auth will be needed for coverage to be provided
min:
  v: 0
max:
  v: 1
condition:
  v: crd-ci-q2
condition:
  v: crd-ci-q5
must support:
  v: true

id:
  v: Extension.extension:pa-needed.extension
path:
  v: Extension.extension.extension
max:
  v: 0

id:
  v: Extension.extension:pa-needed.url
path:
  v: Extension.extension.url
fixed: Uri
  v: pa-needed
  l: pa-needed

id:
  v: Extension.extension:pa-needed.value[x]
path:
  v: Extension.extension.value[x]
min:
  v: 1
type:
  code:
    v: code
    l: code
binding:
  strength:
    v: required
  value set:
    v: http://hl7.org/fhir/us/davinci-crd/ValueSet/coveragePaDetail
    l: coveragePaDetail

id:
  v: Extension.extension:doc-needed
path:
  v: Extension.extension
slice name:
  v: doc-needed
short:
  v: clinical | admin | patient | conditional | indeterminate
definition:
  v: Indicates whether additional documentation needs to be captured (purpose in next element)
comment:
  v: See additional guidance in the [notes](StructureDefinition-ext-coverage-information.html#doc-needed-vs-info-needed)
min:
  v: 0
max:
  v: *
must support:
  v: true

id:
  v: Extension.extension:doc-needed.extension
path:
  v: Extension.extension.extension
max:
  v: 0

id:
  v: Extension.extension:doc-needed.url
path:
  v: Extension.extension.url
fixed: Uri
  v: doc-needed
  l: doc-needed

id:
  v: Extension.extension:doc-needed.value[x]
path:
  v: Extension.extension.value[x]
min:
  v: 1
type:
  code:
    v: code
    l: code
binding:
  strength:
    v: required
  value set:
    v: http://hl7.org/fhir/us/davinci-crd/ValueSet/AdditionalDocumentation
    l: AdditionalDocumentation

id:
  v: Extension.extension:doc-purpose
path:
  v: Extension.extension
slice name:
  v: doc-purpose
short:
  v: withpa | withclaim | withorder | retain-doc | OTH
definition:
  v: Indicates the reason(s) for the additional documentation that needs to be captured
requirements:
  v: Knowing what the information will be used for may influence who will fill out the form(s) and how quickly the organization will get around to filling them out
min:
  v: 0
max:
  v: *
condition:
  v: crd-ci-q4
must support:
  v: true

id:
  v: Extension.extension:doc-purpose.extension
path:
  v: Extension.extension.extension
max:
  v: 0

id:
  v: Extension.extension:doc-purpose.url
path:
  v: Extension.extension.url
fixed: Uri
  v: doc-purpose
  l: doc-purpose

id:
  v: Extension.extension:doc-purpose.value[x]
path:
  v: Extension.extension.value[x]
min:
  v: 1
type:
  code:
    v: code
    l: code
binding:
  strength:
    v: required
  value set:
    v: http://hl7.org/fhir/us/davinci-crd/ValueSet/DocReason
    l: DocReason

id:
  v: Extension.extension:info-needed
path:
  v: Extension.extension
slice name:
  v: info-needed
short:
  v: performer | location | timeframe | contract-window | detail-code | OTH
definition:
  v: Indicates whether information about the performer, location, and/or performance date is needed to determine coverage information
comment:
  v: See additional guidance in the [notes](StructureDefinition-ext-coverage-information.html#doc-needed-vs-info-needed) If this element is set to OTH, then there must be at least one detail element the explains the nature of the additional information needed to determine coverage, prior authorization, and/or documentation requirements. There **SHOULD** also be a doc-needed element indicating that DTR can be used to gather additional information.
min:
  v: 0
max:
  v: *
condition:
  v: crd-ci-q3
must support:
  v: true

id:
  v: Extension.extension:info-needed.extension
path:
  v: Extension.extension.extension
max:
  v: 0

id:
  v: Extension.extension:info-needed.url
path:
  v: Extension.extension.url
fixed: Uri
  v: info-needed
  l: info-needed

id:
  v: Extension.extension:info-needed.value[x]
path:
  v: Extension.extension.value[x]
min:
  v: 1
type:
  code:
    v: code
    l: code
binding:
  strength:
    v: required
  value set:
    v: http://hl7.org/fhir/us/davinci-crd/ValueSet/informationNeeded
    l: informationNeeded

id:
  v: Extension.extension:billingCode
path:
  v: Extension.extension
slice name:
  v: billingCode
short:
  v: Billing code
definition:
  v: Billing code(s) that must be used in the eventual claim for the coverage assertion to hold
comment:
  v: Codes may include modifier codes, leveraging [CPT's post-coordination syntax](https://terminology.hl7.org/CPT.html)
min:
  v: 0
max:
  v: *
must support:
  v: true

id:
  v: Extension.extension:billingCode.extension
path:
  v: Extension.extension.extension
max:
  v: 0

id:
  v: Extension.extension:billingCode.url
path:
  v: Extension.extension.url
fixed: Uri
  v: billingCode
  l: billingCode

id:
  v: Extension.extension:billingCode.value[x]
path:
  v: Extension.extension.value[x]
min:
  v: 1
type:
  code:
    v: Coding
    l: Coding
binding:
  strength:
    v: example
  value set:
    v: http://hl7.org/fhir/ValueSet/service-uscls
    l: service-uscls

id:
  v: Extension.extension:reason
path:
  v: Extension.extension
slice name:
  v: reason
short:
  v: Reason for assertion
definition:
  v: Indicates the 'reason' for the coverage assertion
comment:
  v: This can be used whenever the reason may not be obvious to the practitioner. E.g. prior authorization is waived because the provider is gold-carded; patient is no longer a minor and has not been registered as an adult dependent; patient has reached their limit for this type of service this year; etc. Additional standard reason codes may be introduced in the future. If no standard code applies, use text.
min:
  v: 0
max:
  v: *
condition:
  v: crd-ci-q7
condition:
  v: crd-ci-q8
condition:
  v: crd-ci-q6
must support:
  v: true

id:
  v: Extension.extension:reason.extension
path:
  v: Extension.extension.extension
max:
  v: 0

id:
  v: Extension.extension:reason.url
path:
  v: Extension.extension.url
fixed: Uri
  v: reason
  l: reason

id:
  v: Extension.extension:reason.value[x]
path:
  v: Extension.extension.value[x]
min:
  v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
binding:
  strength:
    v: extensible
  value set:
    v: http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons
    l: coverageAssertionReasons

id:
  v: Extension.extension:detail
path:
  v: Extension.extension
slice name:
  v: detail
short:
  v: detail for assertion
definition:
  v: Indicates the 'detail' for the coverage assertion
comment:
  v: Additional information that qualifies, describes, or provides additional guidance about coverage or documentation requirements.
min:
  v: 0
max:
  v: *
must support:
  v: true

id:
  v: Extension.extension:detail.extension
path:
  v: Extension.extension.extension
min:
  v: 3

id:
  v: Extension.extension:detail.extension:category
path:
  v: Extension.extension.extension
slice name:
  v: category
short:
  v: Type of detail
definition:
  v: Indicates the nature of the detail, which in turn provides guidance for when it should be displayed.
comment:
  v: CRD clients **SHOULD** make both limitation and decisional details available to clinical users.
min:
  v: 1
max:
  v: 1

id:
  v: Extension.extension:detail.extension:category.extension
path:
  v: Extension.extension.extension.extension
max:
  v: 0

id:
  v: Extension.extension:detail.extension:category.url
path:
  v: Extension.extension.extension.url
fixed: Uri
  v: category
  l: category

id:
  v: Extension.extension:detail.extension:category.value[x]
path:
  v: Extension.extension.extension.value[x]
type:
  code:
    v: code
    l: code
binding:
  strength:
    v: required
  value set:
    v: http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageDetailCategories
    l: coverageDetailCategories

id:
  v: Extension.extension:detail.extension:code
path:
  v: Extension.extension.extension
slice name:
  v: code
short:
  v: Name of name-value pair
definition:
  v: The type of detail or qualification expressed.
comment:
  v: The binding to the old temporary code system is retained for now for backward compatibility
min:
  v: 1
max:
  v: 1

id:
  v: Extension.extension:detail.extension:code.extension
path:
  v: Extension.extension.extension.extension
max:
  v: 0

id:
  v: Extension.extension:detail.extension:code.url
path:
  v: Extension.extension.extension.url
fixed: Uri
  v: code
  l: code

id:
  v: Extension.extension:detail.extension:code.value[x]
path:
  v: Extension.extension.extension.value[x]
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
binding:
  extension:
    extension:
      url:
        v: key
        l: key
      value: Id
        v: ci-detailold
    extension:
      url:
        v: purpose
        l: purpose
      value: Code
        v: extensible
    extension:
      url:
        v: valueSet
        l: valueSet
      value: Canonical
        v: http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageDetail
        l: coverageDetail
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/additional-binding
      l: additional-binding
  strength:
    v: extensible
  value set:
    v: http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageDetailNew
    l: coverageDetailNew

id:
  v: Extension.extension:detail.extension:value
path:
  v: Extension.extension.extension
slice name:
  v: value
short:
  v: Value of name-value pair
definition:
  v: The detail or qualification that applies to this coverage assertion.
min:
  v: 1
max:
  v: 1

id:
  v: Extension.extension:detail.extension:value.extension
path:
  v: Extension.extension.extension.extension
max:
  v: 0

id:
  v: Extension.extension:detail.extension:value.url
path:
  v: Extension.extension.extension.url
fixed: Uri
  v: value
  l: value

id:
  v: Extension.extension:detail.extension:value.value[x]
path:
  v: Extension.extension.extension.value[x]
type:
  code:
    v: boolean
    l: boolean
type:
  code:
    v: string
    l: string
type:
  code:
    v: url
    l: url
type:
  code:
    v: Period
    l: Period
type:
  code:
    v: Quantity
    l: Quantity
  profile:
    v: http://hl7.org/fhir/StructureDefinition/SimpleQuantity
    l: SimpleQuantity

id:
  v: Extension.extension:detail.extension:qualification
path:
  v: Extension.extension.extension
slice name:
  v: qualification
short:
  v: Additional info about detail
definition:
  v: Additional text that qualifies/expands on the computable detail. E.g. 'Provided coverage is renewed' or 'Does not account for deductible'
min:
  v: 0
max:
  v: 1

id:
  v: Extension.extension:detail.extension:qualification.extension
path:
  v: Extension.extension.extension.extension
max:
  v: 0

id:
  v: Extension.extension:detail.extension:qualification.url
path:
  v: Extension.extension.extension.url
fixed: Uri
  v: qualification
  l: qualification

id:
  v: Extension.extension:detail.extension:qualification.value[x]
path:
  v: Extension.extension.extension.value[x]
type:
  code:
    v: string
    l: string

id:
  v: Extension.extension:detail.url
path:
  v: Extension.extension.url
fixed: Uri
  v: detail
  l: detail

id:
  v: Extension.extension:detail.value[x]
path:
  v: Extension.extension.value[x]
max:
  v: 0

id:
  v: Extension.extension:dependency
path:
  v: Extension.extension
slice name:
  v: dependency
short:
  v: Resources that impact this assertion
definition:
  v: If present, indicates that the determination represented here is dependent on the content, determination, and possibly execution of the referenced order(s)
requirements:
  v: For example, the authorization decision on a request for post-surgical physiotherapy might be dependent on the order for the surgery itself. If coverage for the surgery is not approved or the order for the surgery is cancelled, that might impact the decision on covering the physiotherapy.
min:
  v: 0
max:
  v: *
must support:
  v: true

id:
  v: Extension.extension:dependency.extension
path:
  v: Extension.extension.extension
max:
  v: 0

id:
  v: Extension.extension:dependency.url
path:
  v: Extension.extension.url
fixed: Uri
  v: dependency
  l: dependency

id:
  v: Extension.extension:dependency.value[x]
path:
  v: Extension.extension.value[x]
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-appointment-with-order
    l: profile-appointment-with-order
  target profile:
    v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-appointment-no-order
    l: profile-appointment-no-order
  target profile:
    v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-communicationrequest
    l: profile-communicationrequest
  target profile:
    v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-devicerequest
    l: profile-devicerequest
  target profile:
    v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-medicationrequest
    l: profile-medicationrequest
  target profile:
    v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-nutritionorder
    l: profile-nutritionorder
  target profile:
    v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-servicerequest
    l: profile-servicerequest
  target profile:
    v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-visionprescription
    l: profile-visionprescription

id:
  v: Extension.extension:questionnaire
path:
  v: Extension.extension
slice name:
  v: questionnaire
short:
  v: Questionnaire to complete
definition:
  v: A form to be filled out to gather more information.
comment:
  v: If using DTR, this will be used by DTR to determine the Questionnaire packages to be returned. If empty, DTR will determine the questionnaire packages itself. If not using DTR, providing a Questionnaire url is the only way to indicate what form to complete.
min:
  v: 0
max:
  v: *
condition:
  v: crd-ci-q1
must support:
  v: true

id:
  v: Extension.extension:questionnaire.extension
path:
  v: Extension.extension.extension
max:
  v: 0

id:
  v: Extension.extension:questionnaire.url
path:
  v: Extension.extension.url
fixed: Uri
  v: questionnaire
  l: questionnaire

id:
  v: Extension.extension:questionnaire.value[x]
path:
  v: Extension.extension.value[x]
type:
  code:
    v: canonical
    l: canonical
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Questionnaire
    l: Questionnaire

id:
  v: Extension.extension:date
path:
  v: Extension.extension
slice name:
  v: date
short:
  v: Assertion date
definition:
  v: Date on which assertion was made.
min:
  v: 1
max:
  v: 1
must support:
  v: true

id:
  v: Extension.extension:date.extension
path:
  v: Extension.extension.extension
max:
  v: 0

id:
  v: Extension.extension:date.url
path:
  v: Extension.extension.url
fixed: Uri
  v: date
  l: date

id:
  v: Extension.extension:date.value[x]
path:
  v: Extension.extension.value[x]
min:
  v: 1
type:
  code:
    v: date
    l: date

id:
  v: Extension.extension:coverage-assertion-id
path:
  v: Extension.extension
slice name:
  v: coverage-assertion-id
short:
  v: Coverage assertion trace number
definition:
  v: Trace identifier to allow tracking the guidance in source system. This identifier can also be used to re-establish cached context information when subsequently launching DTR.
min:
  v: 1
max:
  v: 1
must support:
  v: true

id:
  v: Extension.extension:coverage-assertion-id.extension
path:
  v: Extension.extension.extension
max:
  v: 0

id:
  v: Extension.extension:coverage-assertion-id.url
path:
  v: Extension.extension.url
fixed: Uri
  v: coverage-assertion-id
  l: coverage-assertion-id

id:
  v: Extension.extension:coverage-assertion-id.value[x]
path:
  v: Extension.extension.value[x]
min:
  v: 1
type:
  code:
    v: string
    l: string

id:
  v: Extension.extension:satisfied-pa-id
path:
  v: Extension.extension
slice name:
  v: satisfied-pa-id
short:
  v: Satisfied prior auth number
definition:
  v: An identifier indicating that prior authorization requirements have been met
comment:
  v: When operating under the CMS enforcement discretion, this element is a prior authorization number and can be submitted in the corresponding X12 element when submitting an eventual claim
min:
  v: 0
max:
  v: 1
condition:
  v: crd-ci-q5
must support:
  v: true

id:
  v: Extension.extension:satisfied-pa-id.extension
path:
  v: Extension.extension.extension
max:
  v: 0

id:
  v: Extension.extension:satisfied-pa-id.url
path:
  v: Extension.extension.url
fixed: Uri
  v: satisfied-pa-id
  l: satisfied-pa-id

id:
  v: Extension.extension:satisfied-pa-id.value[x]
path:
  v: Extension.extension.value[x]
type:
  code:
    v: string
    l: string

id:
  v: Extension.extension:contact
path:
  v: Extension.extension
slice name:
  v: contact
short:
  v: Contact information
definition:
  v: Name, phone number, fax number, email address, website, or other contact information that can be used to ask questions/escalate issues related to a coverage assertion.
comment:
  v: This **SHOULD** only be populated if the contact information is context-specific rather than a generic contact for the payer as a whole.
min:
  v: 0
max:
  v: *
must support:
  v: true

id:
  v: Extension.extension:contact.extension
path:
  v: Extension.extension.extension
max:
  v: 0

id:
  v: Extension.extension:contact.url
path:
  v: Extension.extension.url
fixed: Uri
  v: contact
  l: contact

id:
  v: Extension.extension:contact.value[x]
path:
  v: Extension.extension.value[x]
type:
  code:
    v: ContactDetail
    l: ContactDetail

id:
  v: Extension.extension:expiry-date
path:
  v: Extension.extension
slice name:
  v: expiry-date
short:
  v: Expiration date
definition:
  v: Date after which the coverage assertion would no longer be valid.
comment:
  v: In this case, mustSupport means that if the payer knows of an expiry date, they must share it. However, if the payer never has expiry dates for their assertions, it is fine to omit.
min:
  v: 0
max:
  v: 1
must support:
  v: true

id:
  v: Extension.extension:expiry-date.extension
path:
  v: Extension.extension.extension
max:
  v: 0

id:
  v: Extension.extension:expiry-date.url
path:
  v: Extension.extension.url
fixed: Uri
  v: expiry-date
  l: expiry-date

id:
  v: Extension.extension:expiry-date.value[x]
path:
  v: Extension.extension.value[x]
type:
  code:
    v: date
    l: date

id:
  v: Extension.url
path:
  v: Extension.url
fixed: Uri
  v: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
  l: ext-coverage-information

id:
  v: Extension.value[x]
path:
  v: Extension.value[x]
max:
  v: 0