Da Vinci Prior Authorization Support (PAS) FHIR IG
2.2.0-ballot - STU 2.2 - Ballot

Da Vinci Prior Authorization Support (PAS) FHIR IG, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.2.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pas/ and changes regularly. See the Directory of published versions

## Resource Profile: PAS Practitioner

Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner | Version: 2.2.0-ballot
Standards status: Trial-use | Maturity Level: 3 | Computable Name: PASPractitioner
Other Identifiers: OID:2.16.840.1.113883.4.642.40.24.42.68

PAS constraints on Practitioner resource mandating support for elements relevant to the care team involved in a prior authorization request

Usages:

- Refer to this Profile: ItemAuthorizedProvider, PAS Claim Response Base, PAS CommunicationRequest and PAS PractitionerRole
- Examples for this Profile: Practitioner/ReferralPractitionerExample and Practitioner/SurgicalPractitionerExample

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Practitioner |  | 0..* | USCorePractitionerProfile(7.0.0) | A person with a formal responsibility in the provisioning of healthcare or related services This profile also complies with the profile US Core Practitioner Profile (6.1.0)
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | S Σ | 1..* | PASIdentifier | An identifier for the person as this agent Slice: Unordered, Open by pattern:$this
identifier:NPI | S Σ C | 0..* | PASIdentifier | An identifier for the person as this agent Constraints: us-core-16, us-core-17 Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
use |  | 0..1 | code | usual | official | temp | secondary | old (If known)
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
value |  | 0..1 | string | The value that is unique
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
name | S Σ | 1..* | HumanName | The name(s) associated with the practitioner
use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
family | S Σ | 1..1 | string | Family name (often called 'Surname')
telecom | S Σ | 0..* | ContactPoint | A contact detail for the practitioner (that apply to all roles)
system | S Σ C | 0..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value | S Σ | 0..1 | string | The actual contact point details
use | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
address | S Σ | 0..* | Address | Address(es) of the practitioner
use | ?!Σ | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
line | S Σ | 0..4 | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street Example General: 49 MEADOW ST
city | S Σ | 0..1 | string | Name of city, town etc. Example General: Erewhon Example General: EVERYTOWN
state | S Σ | 0..1 | string | Sub-unit of country (abbreviations ok) Binding: UspsTwoLetterAlphabeticCodes (7.0.0) (extensible): Two letter USPS alphabetic codes. Example General: OK
postalCode | S Σ | 0..1 | string | US Zip Codes Example General: 9132 Example General: 74047
country | S Σ | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code)
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Practitioner.name.use | required | NameUse `http://hl7.org/fhir/ValueSet/name-use|4.0.1` From the FHIR Standard
Practitioner.telecom.system | required | ContactPointSystem `http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1` From the FHIR Standard
Practitioner.telecom.use | required | ContactPointUse `http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1` From the FHIR Standard
Practitioner.address.use | required | AddressUse `http://hl7.org/fhir/ValueSet/address-use|4.0.1` From the FHIR Standard
Practitioner.address.state | extensible | UspsTwoLetterAlphabeticCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state|7.0.0`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Practitioner | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Practitioner | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Practitioner | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Practitioner | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Practitioner | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
us-core-16 | error | Practitioner.identifier:NPI | NPI must be 10 digits : value.matches('^[0-9]{10}$') |
us-core-17 | error | Practitioner.identifier:NPI | NPI check digit must be valid (Luhn algorithm check) : (((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger()) + 24)mod 10=0) |

This structure is derived from USCorePractitionerProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Practitioner |  |  | USCorePractitionerProfile(7.0.0) | This profile also complies with the profile US Core Practitioner Profile (6.1.0)
identifier |  | 1..* | PASIdentifier | An identifier for the person as this agent
Slices for identifier |  |  |  | Content/Rules for all slices
identifier:NPI |  | 0..* | PASIdentifier | An identifier for the person as this agent
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Practitioner |  | 0..* | USCorePractitionerProfile(7.0.0) | A person with a formal responsibility in the provisioning of healthcare or related services This profile also complies with the profile US Core Practitioner Profile (6.1.0)
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | S Σ | 1..* | PASIdentifier | An identifier for the person as this agent Slice: Unordered, Open by pattern:$this
identifier:NPI | S Σ C | 0..* | PASIdentifier | An identifier for the person as this agent Constraints: us-core-16, us-core-17 Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
use |  | 0..1 | code | usual | official | temp | secondary | old (If known)
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
value |  | 0..1 | string | The value that is unique
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
active | Σ | 0..1 | boolean | Whether this practitioner's record is in active use
name | S Σ | 1..* | HumanName | The name(s) associated with the practitioner
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text | Σ | 0..1 | string | Text representation of the full name
family | S Σ | 1..1 | string | Family name (often called 'Surname')
given | Σ | 0..* | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix | Σ | 0..* | string | Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix | Σ | 0..* | string | Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period | Σ | 0..1 | Period | Time period when name was/is in use
telecom | S Σ | 0..* | ContactPoint | A contact detail for the practitioner (that apply to all roles)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ C | 0..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value | S Σ | 0..1 | string | The actual contact point details
use | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
rank | Σ | 0..1 | positiveInt | Specify preferred order of use (1 = highest)
period | Σ | 0..1 | Period | Time period when the contact point was/is in use
address | S Σ | 0..* | Address | Address(es) of the practitioner
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
type | Σ | 0..1 | code | postal | physical | both Binding: AddressType (required): The type of an address (physical / postal). Example General: both
text | Σ | 0..1 | string | Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132
line | S Σ | 0..4 | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street Example General: 49 MEADOW ST
city | S Σ | 0..1 | string | Name of city, town etc. Example General: Erewhon Example General: EVERYTOWN
district | Σ | 0..1 | string | District name (aka county) Example General: Madison
state | S Σ | 0..1 | string | Sub-unit of country (abbreviations ok) Binding: UspsTwoLetterAlphabeticCodes (7.0.0) (extensible): Two letter USPS alphabetic codes. Example General: OK
postalCode | S Σ | 0..1 | string | US Zip Codes Example General: 9132 Example General: 74047
country | S Σ | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code)
period | Σ | 0..1 | Period | Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
gender | Σ | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate | Σ | 0..1 | date | The date on which the practitioner was born
photo |  | 0..* | Attachment | Image of the person
qualification |  | 0..* | BackboneElement | Certification, licenses, or training pertaining to the provision of care
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
identifier |  | 0..* | Identifier | An identifier for this qualification for the practitioner
code |  | 1..1 | CodeableConcept | Coded representation of the qualification Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.
period |  | 0..1 | Period | Period during which the qualification is valid
issuer |  | 0..1 | Reference(Organization) | Organization that regulates and issues the qualification
communication |  | 0..* | CodeableConcept | A language the practitioner can use in patient communication Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Practitioner.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Practitioner.name.use | required | NameUse `http://hl7.org/fhir/ValueSet/name-use|4.0.1` From the FHIR Standard
Practitioner.telecom.system | required | ContactPointSystem `http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1` From the FHIR Standard
Practitioner.telecom.use | required | ContactPointUse `http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1` From the FHIR Standard
Practitioner.address.use | required | AddressUse `http://hl7.org/fhir/ValueSet/address-use|4.0.1` From the FHIR Standard
Practitioner.address.type | required | AddressType `http://hl7.org/fhir/ValueSet/address-type|4.0.1` From the FHIR Standard
Practitioner.address.state | extensible | UspsTwoLetterAlphabeticCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state|7.0.0`
Practitioner.gender | required | AdministrativeGender `http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1` From the FHIR Standard
Practitioner.qualification.code | example | v2.0360.2.7(a valid code from `http://terminology.hl7.org/CodeSystem/v2-0360|2.7`) `http://terminology.hl7.org/ValueSet/v2-2.7-0360` From the FHIR Standard
Practitioner.communication | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Practitioner | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Practitioner | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Practitioner | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Practitioner | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Practitioner | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
us-core-16 | error | Practitioner.identifier:NPI | NPI must be 10 digits : value.matches('^[0-9]{10}$') |
us-core-17 | error | Practitioner.identifier:NPI | NPI check digit must be valid (Luhn algorithm check) : (((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger()) + 24)mod 10=0) |

This structure is derived from USCorePractitionerProfile

Summary

Structures

This structure refers to these other structures:

- PAS Identifier (http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-identifier)

Maturity: 3

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Practitioner |  | 0..* | USCorePractitionerProfile(7.0.0) | A person with a formal responsibility in the provisioning of healthcare or related services This profile also complies with the profile US Core Practitioner Profile (6.1.0)
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | S Σ | 1..* | PASIdentifier | An identifier for the person as this agent Slice: Unordered, Open by pattern:$this
identifier:NPI | S Σ C | 0..* | PASIdentifier | An identifier for the person as this agent Constraints: us-core-16, us-core-17 Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
use |  | 0..1 | code | usual | official | temp | secondary | old (If known)
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
value |  | 0..1 | string | The value that is unique
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
name | S Σ | 1..* | HumanName | The name(s) associated with the practitioner
use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
family | S Σ | 1..1 | string | Family name (often called 'Surname')
telecom | S Σ | 0..* | ContactPoint | A contact detail for the practitioner (that apply to all roles)
system | S Σ C | 0..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value | S Σ | 0..1 | string | The actual contact point details
use | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
address | S Σ | 0..* | Address | Address(es) of the practitioner
use | ?!Σ | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
line | S Σ | 0..4 | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street Example General: 49 MEADOW ST
city | S Σ | 0..1 | string | Name of city, town etc. Example General: Erewhon Example General: EVERYTOWN
state | S Σ | 0..1 | string | Sub-unit of country (abbreviations ok) Binding: UspsTwoLetterAlphabeticCodes (7.0.0) (extensible): Two letter USPS alphabetic codes. Example General: OK
postalCode | S Σ | 0..1 | string | US Zip Codes Example General: 9132 Example General: 74047
country | S Σ | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code)
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Practitioner.name.use | required | NameUse `http://hl7.org/fhir/ValueSet/name-use|4.0.1` From the FHIR Standard
Practitioner.telecom.system | required | ContactPointSystem `http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1` From the FHIR Standard
Practitioner.telecom.use | required | ContactPointUse `http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1` From the FHIR Standard
Practitioner.address.use | required | AddressUse `http://hl7.org/fhir/ValueSet/address-use|4.0.1` From the FHIR Standard
Practitioner.address.state | extensible | UspsTwoLetterAlphabeticCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state|7.0.0`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Practitioner | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Practitioner | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Practitioner | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Practitioner | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Practitioner | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
us-core-16 | error | Practitioner.identifier:NPI | NPI must be 10 digits : value.matches('^[0-9]{10}$') |
us-core-17 | error | Practitioner.identifier:NPI | NPI check digit must be valid (Luhn algorithm check) : (((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger()) + 24)mod 10=0) |

Differential View

This structure is derived from USCorePractitionerProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Practitioner |  |  | USCorePractitionerProfile(7.0.0) | This profile also complies with the profile US Core Practitioner Profile (6.1.0)
identifier |  | 1..* | PASIdentifier | An identifier for the person as this agent
Slices for identifier |  |  |  | Content/Rules for all slices
identifier:NPI |  | 0..* | PASIdentifier | An identifier for the person as this agent
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Practitioner |  | 0..* | USCorePractitionerProfile(7.0.0) | A person with a formal responsibility in the provisioning of healthcare or related services This profile also complies with the profile US Core Practitioner Profile (6.1.0)
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | S Σ | 1..* | PASIdentifier | An identifier for the person as this agent Slice: Unordered, Open by pattern:$this
identifier:NPI | S Σ C | 0..* | PASIdentifier | An identifier for the person as this agent Constraints: us-core-16, us-core-17 Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
use |  | 0..1 | code | usual | official | temp | secondary | old (If known)
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
value |  | 0..1 | string | The value that is unique
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
active | Σ | 0..1 | boolean | Whether this practitioner's record is in active use
name | S Σ | 1..* | HumanName | The name(s) associated with the practitioner
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text | Σ | 0..1 | string | Text representation of the full name
family | S Σ | 1..1 | string | Family name (often called 'Surname')
given | Σ | 0..* | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix | Σ | 0..* | string | Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix | Σ | 0..* | string | Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period | Σ | 0..1 | Period | Time period when name was/is in use
telecom | S Σ | 0..* | ContactPoint | A contact detail for the practitioner (that apply to all roles)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ C | 0..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value | S Σ | 0..1 | string | The actual contact point details
use | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
rank | Σ | 0..1 | positiveInt | Specify preferred order of use (1 = highest)
period | Σ | 0..1 | Period | Time period when the contact point was/is in use
address | S Σ | 0..* | Address | Address(es) of the practitioner
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
type | Σ | 0..1 | code | postal | physical | both Binding: AddressType (required): The type of an address (physical / postal). Example General: both
text | Σ | 0..1 | string | Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132
line | S Σ | 0..4 | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street Example General: 49 MEADOW ST
city | S Σ | 0..1 | string | Name of city, town etc. Example General: Erewhon Example General: EVERYTOWN
district | Σ | 0..1 | string | District name (aka county) Example General: Madison
state | S Σ | 0..1 | string | Sub-unit of country (abbreviations ok) Binding: UspsTwoLetterAlphabeticCodes (7.0.0) (extensible): Two letter USPS alphabetic codes. Example General: OK
postalCode | S Σ | 0..1 | string | US Zip Codes Example General: 9132 Example General: 74047
country | S Σ | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code)
period | Σ | 0..1 | Period | Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
gender | Σ | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate | Σ | 0..1 | date | The date on which the practitioner was born
photo |  | 0..* | Attachment | Image of the person
qualification |  | 0..* | BackboneElement | Certification, licenses, or training pertaining to the provision of care
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
identifier |  | 0..* | Identifier | An identifier for this qualification for the practitioner
code |  | 1..1 | CodeableConcept | Coded representation of the qualification Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.
period |  | 0..1 | Period | Period during which the qualification is valid
issuer |  | 0..1 | Reference(Organization) | Organization that regulates and issues the qualification
communication |  | 0..* | CodeableConcept | A language the practitioner can use in patient communication Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Practitioner.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Practitioner.name.use | required | NameUse `http://hl7.org/fhir/ValueSet/name-use|4.0.1` From the FHIR Standard
Practitioner.telecom.system | required | ContactPointSystem `http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1` From the FHIR Standard
Practitioner.telecom.use | required | ContactPointUse `http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1` From the FHIR Standard
Practitioner.address.use | required | AddressUse `http://hl7.org/fhir/ValueSet/address-use|4.0.1` From the FHIR Standard
Practitioner.address.type | required | AddressType `http://hl7.org/fhir/ValueSet/address-type|4.0.1` From the FHIR Standard
Practitioner.address.state | extensible | UspsTwoLetterAlphabeticCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state|7.0.0`
Practitioner.gender | required | AdministrativeGender `http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1` From the FHIR Standard
Practitioner.qualification.code | example | v2.0360.2.7(a valid code from `http://terminology.hl7.org/CodeSystem/v2-0360|2.7`) `http://terminology.hl7.org/ValueSet/v2-2.7-0360` From the FHIR Standard
Practitioner.communication | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Practitioner | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Practitioner | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Practitioner | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Practitioner | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Practitioner | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
us-core-16 | error | Practitioner.identifier:NPI | NPI must be 10 digits : value.matches('^[0-9]{10}$') |
us-core-17 | error | Practitioner.identifier:NPI | NPI check digit must be valid (Luhn algorithm check) : (((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger()) + 24)mod 10=0) |

This structure is derived from USCorePractitionerProfile

Summary

Structures

This structure refers to these other structures:

- PAS Identifier (http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-identifier)

Maturity: 3

Other representations of profile: CSV, Excel, Schematron