Union of http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional and http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional

This is the set of resources that conform to either of the profiles PCT Good Faith Estimate Professional (http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional) and PCT Good Faith Estimate Professional (http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional). E.g. what you have to deal with if you get resources conforming to one of them

Structure

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Claim 0..*Claim, Pre-determination or Pre-authorization
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: ?? (preferred): A human language.
... text 0..1NarrativeText 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..*ResourceContained, inline Resources
... extension 0..*ExtensionExtension
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 1..*IdentifierBusiness Identifier for claim
... status ?!Σ1..1codeactive | cancelled | draft | entered-in-error
Binding: ?? (required): A code specifying the state of the resource instance.
... type Σ1..1CodeableConceptCategory or discipline
Binding: ?? (extensible): The type or discipline-style of the claim.
... subType 0..1CodeableConceptMore granular claim type
Binding: ?? (example): A more granular claim typecode.
... use Σ1..1codeclaim | preauthorization | predetermination
Binding: ?? (required): The purpose of the Claim: predetermination, preauthorization, claim.
... patient Σ1..1Reference(HRex Patient Demographics | #sd-hrex-patient-demographics-us-core-patient)The recipient of the products and services
... billablePeriod Σ0..1PeriodRelevant time frame for the claim
... created Σ1..1dateTimeResource creation date
... enterer 0..1Reference(Practitioner | PractitionerRole)Author of the claim
... insurer Σ0..1Reference(PCT Organization), Reference(PCT Organization)Target
... provider Σ1..1Reference(PCT Organization | PCT Practitioner), Reference(PCT Organization | PCT Practitioner)Billing provider - party responsible for the GFE
.... extension 1..*ExtensionExtension
.... reference Σ0..1stringLiteral reference, Relative, internal or absolute URL
.... type Σ0..1uriType the reference refers to (e.g. "Patient")
Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).
.... identifier Σ0..1IdentifierLogical reference, when literal reference is not known
.... display Σ0..1stringText alternative for the resource
... priority Σ1..1CodeableConceptDesired processing ugency
Binding: ?? (required)
... fundsReserve 0..1CodeableConceptFor whom to reserve funds
Binding: ?? (example): For whom funds are to be reserved: (Patient, Provider, None).
... related 0..*BackboneElementPrior or corollary claims
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... claim 0..1Reference(Claim)Reference to the related claim
.... relationship 0..1CodeableConceptHow the reference claim is related
Binding: ?? (example): Relationship of this claim to a related Claim.
.... reference 0..1IdentifierFile or case reference
... prescription 0..1Reference(DeviceRequest | MedicationRequest | VisionPrescription)Prescription authorizing services and products
... originalPrescription 0..1Reference(DeviceRequest | MedicationRequest | VisionPrescription)Original prescription if superseded by fulfiller
... payee S0..1BackboneElementRecipient of benefits payable
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type 1..1CodeableConceptCategory of recipient
Binding: ?? (example): A code for the party to be reimbursed.
.... party 0..1Reference(PCT Practitioner | PCT Organization), Reference(PCT Practitioner | PCT Organization)Recipient reference
... referral 0..1Reference(ServiceRequest)Treatment referral
.... extension 1..*ExtensionExtension
.... reference Σ0..1stringLiteral reference, Relative, internal or absolute URL
.... type Σ0..1uriType the reference refers to (e.g. "Patient")
Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).
.... identifier Σ0..1IdentifierLogical reference, when literal reference is not known
.... display Σ0..1stringText alternative for the resource
... facility 0..1Reference(Location)Servicing facility
... careTeam S0..*BackboneElementMembers of the care team
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntOrder of care team
.... provider 1..1Reference(PCT Practitioner | PCT Organization), Reference(PCT Practitioner | PCT Organization)Practitioner or organization
.... responsible 0..1booleanIndicator of the lead practitioner
.... role 1..1CodeableConceptFunction within the team
Binding: ?? (required)
.... qualification 0..1CodeableConceptPractitioner credential or specialization
Binding: ?? (required)
... supportingInfo S0..*BackboneElementSupporting information
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntInformation instance identifier
.... category 1..1CodeableConceptClassification of the supplied information
Binding: ?? (extensible)
.... code 0..1CodeableConceptType of information
Binding: ?? (example): The valuset used for additional information codes.
.... timing[x] 0..1When it occurred
..... timingDatedate
..... timingPeriodPeriod
.... value[x] 0..1Data to be provided
..... valueBooleanboolean
..... valueStringstring
..... valueQuantityQuantity
..... valueAttachmentAttachment
..... valueReferenceReference(Resource)
.... reason 0..1CodeableConceptExplanation for the information
Binding: ?? (example): Reason codes for the missing teeth.
... diagnosis S0..*BackboneElementPertinent diagnosis information
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntDiagnosis instance identifier
.... diagnosis[x] 1..1Nature of illness or problem
Binding: ?? (example): Example ICD10 Diagnostic codes.
..... diagnosisCodeableConceptCodeableConcept
..... diagnosisReferenceReference(Condition)
.... type S0..*CodeableConceptTiming or nature of the diagnosis
Binding: ?? (required)
.... onAdmission 0..1CodeableConceptPresent on admission
Binding: ?? (example): Present on admission.
.... packageCode 0..1CodeableConceptPackage billing code
Binding: ?? (example): The DRG codes associated with the diagnosis.
... procedure S0..*BackboneElementClinical procedures performed
.... extension 1..*ExtensionExtension
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntProcedure instance identifier
.... type S0..*CodeableConceptCategory of Procedure
Binding: ?? (required)
.... date 0..1dateTimeWhen the procedure was performed
.... procedure[x] 1..1Specific clinical procedure
Binding: ?? (example): Example ICD10 Procedure codes.
..... procedureCodeableConceptCodeableConcept
..... procedureReferenceReference(Procedure)
.... udi 0..*Reference(Device)Unique device identifier
... insurance Σ1..*BackboneElementPatient insurance information
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence Σ1..1positiveIntInsurance instance identifier
.... focal Σ1..1booleanCoverage to be used for adjudication
.... identifier 0..1IdentifierPre-assigned Claim number
.... coverage Σ1..1Reference(PCT Coverage | #sd-davinci-pct-coverage-davinci-pct-coverage)Insurance information
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... reference ΣC0..1stringLiteral reference, Relative, internal or absolute URL
..... type Σ0..1uriType the reference refers to (e.g. "Patient")
Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).
..... identifier Σ0..1IdentifierLogical reference, when literal reference is not known
..... display Σ0..1stringText alternative for the resource
.... businessArrangement 0..1stringAdditional provider contract number
.... preAuthRef 0..2stringPrior authorization reference number
.... claimResponse 0..1Reference(ClaimResponse)Adjudication results
... accident 0..1BackboneElementDetails of the event
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... date 1..1dateWhen the incident occurred
.... type 0..1CodeableConceptThe nature of the accident
Binding: ?? (extensible): Type of accident: work place, auto, etc.
.... location[x] 0..1AddressWhere the event occurred
..... extension 0..*ExtensionAdditional content defined by implementations
..... use ?!Σ0..1codehome | work | temp | old | billing - purpose of this address
Binding: ?? (required): The use of an address.
Example General: home
..... type Σ0..1codepostal | physical | both
Binding: ?? (required): The type of an address (physical / postal).
Example General: both
..... text Σ0..1stringText representation of the address
Example General: 137 Nowhere Street, Erewhon 9132
..... line Σ0..*stringStreet name, number, direction & P.O. Box etc.

Example General: 137 Nowhere Street
..... city Σ0..1stringName of city, town etc.
Example General: Erewhon
..... district Σ0..1stringDistrict name (aka county)
Example General: Madison
..... state Σ0..1stringSub-unit of country (abbreviations ok)
..... postalCode Σ0..1stringPostal code for area
Example General: 9132
..... country Σ0..1stringCountry (e.g. can be ISO 3166 2 or 3 letter code)
Binding: ?? (required)
..... period Σ0..1PeriodTime period when address was/is in use
Example General: {"start":"2010-03-23","end":"2010-07-01"}
... item 1..50BackboneElementProduct or service provided
.... extension 1..*ExtensionExtension
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntItem instance identifier
.... careTeamSequence S0..*positiveIntApplicable careTeam members
.... diagnosisSequence 0..*positiveIntApplicable diagnoses
.... procedureSequence 0..*positiveIntApplicable procedures
.... informationSequence 0..*positiveIntApplicable exception and supporting information
.... revenue 0..1CodeableConceptRevenue or cost center code
Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products.
.... category 0..1CodeableConceptBenefit classification
Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses.
.... productOrService 1..1CodeableConceptBilling, service, product, or drug code
Binding: ?? (required)
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding ΣC0..*CodingCode defined by a terminology system
Constraints: pct-cpt-display
..... text Σ0..1stringPlain text representation of the concept
.... modifier S0..4CodeableConceptProduct or service billing modifiers
Binding: ?? (required)
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding ΣC0..*CodingCode defined by a terminology system
Constraints: pct-cpt-display
..... text Σ0..1stringPlain text representation of the concept
.... programCode 0..*CodeableConceptProgram the product or service is provided under
Binding: ?? (example): Program specific reason codes.
.... serviced[x] S1..1This is the planned or estimated date(s)s of service
..... servicedDatedate
..... servicedPeriodPeriod
.... location[x] 1..1CodeableConceptPlace of service or where product was supplied
Binding: ?? (required)
.... quantity 1..1??Count of products or services
.... unitPrice 1..1MoneyFee, charge or cost per item
.... factor 0..1decimalPrice scaling factor
.... net 1..1MoneyTotal charge amount for the service line
.... udi 0..*Reference(Device)Unique device identifier
.... bodySite 0..1CodeableConceptAnatomical location
Binding: ?? (example): The code for the teeth, quadrant, sextant and arch.
.... subSite 0..*CodeableConceptAnatomical sub-location
Binding: ?? (example): The code for the tooth surface and surface combinations.
.... encounter 0..*Reference(Encounter)Encounters related to this billed item
.... detail S0..*BackboneElementDrug Identification Information
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... sequence 1..1positiveIntItem instance identifier
..... revenue 0..1CodeableConceptRevenue or cost center code
Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products.
..... category 0..1CodeableConceptBenefit classification
Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses.
..... productOrService 1..1CodeableConceptBilling, service, product, or drug code
Binding: ?? (required)
..... modifier 0..*CodeableConceptService/Product billing modifiers
Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
..... programCode 0..*CodeableConceptProgram the product or service is provided under
Binding: ?? (example): Program specific reason codes.
..... quantity S0..1??Count of products or services
..... unitPrice 0..1MoneyFee, charge or cost per item
..... factor 0..1decimalPrice scaling factor
..... net 0..1MoneyTotal item cost
..... udi 0..*Reference(Device)Unique device identifier
..... subDetail 0..*BackboneElementProduct or service provided
...... extension 0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... sequence 1..1positiveIntItem instance identifier
...... revenue 0..1CodeableConceptRevenue or cost center code
Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products.
...... category 0..1CodeableConceptBenefit classification
Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses.
...... productOrService 1..1CodeableConceptBilling, service, product, or drug code
Binding: ?? (example): Allowable service and product codes.
...... modifier 0..*CodeableConceptService/Product billing modifiers
Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
...... programCode 0..*CodeableConceptProgram the product or service is provided under
Binding: ?? (example): Program specific reason codes.
...... quantity 0..1??Count of products or services
...... unitPrice 0..1MoneyFee, charge or cost per item
...... factor 0..1decimalPrice scaling factor
...... net 0..1MoneyTotal item cost
...... udi 0..*Reference(Device)Unique device identifier
... total 1..1MoneyTotal GFE Charges Submitted

doco Documentation for this format