This is the set of resources that conform to both Payer Insurance Plan (http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PayerInsurancePlan) and Payer Insurance Plan (http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PayerInsurancePlan).
Name | Flags | Card. | Type | Description & Constraints | ||||
---|---|---|---|---|---|---|---|---|
InsurancePlan | C | 0..* | Details of a Health Insurance product/plan provided by an organization dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management ipn-1: The organization SHALL at least have a name or an idendtifier, and possibly more than one | |||||
meta | Σ | 0..1 | Meta | Metadata about the resource ele-1: All FHIR elements must have a @value or children | ||||
extension | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
versionId | Σ | 0..1 | id | Version specific identifier ele-1: All FHIR elements must have a @value or children | ||||
lastUpdated | SΣ | 1..1 | instant | When the resource version last changed ele-1: All FHIR elements must have a @value or children | ||||
source | Σ | 0..1 | uri | Identifies where the resource comes from ele-1: All FHIR elements must have a @value or children | ||||
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to ele-1: All FHIR elements must have a @value or children | ||||
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: ?? (extensible): Security Labels from the Healthcare Privacy and Security Classification System. ele-1: All FHIR elements must have a @value or children | ||||
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: ?? (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". ele-1: All FHIR elements must have a @value or children | ||||
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children | ||||
language | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
ele-1: All FHIR elements must have a @value or children | |||||
text | 0..1 | Narrative | Text summary of the resource, for human interpretation ele-1: All FHIR elements must have a @value or children | |||||
contained | 0..* | Resource | Contained, inline Resources | |||||
extension | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
identifier | SΣ | 1..* | Identifier | Business Identifier for Product ele-1: All FHIR elements must have a @value or children | ||||
status | ?!SΣ | 1..1 | code | draft | active | retired | unknown Binding: ?? (required): The lifecycle status of an artifact. ele-1: All FHIR elements must have a @value or children | ||||
type | SΣ | 1..1 | CodeableConcept | Product type Binding: ?? (extensible) ele-1: All FHIR elements must have a @value or children | ||||
name | SΣ | 0..1 | string | Official name ele-1: All FHIR elements must have a @value or children | ||||
alias | 0..* | string | Alternate names ele-1: All FHIR elements must have a @value or children | |||||
period | S | 0..1 | Period | When the product is available ele-1: All FHIR elements must have a @value or children | ||||
ownedBy | Σ | 0..1 | Reference(Organization) | Plan issuer ele-1: All FHIR elements must have a @value or children | ||||
administeredBy | Σ | 0..1 | Reference(Organization) | Product administrator ele-1: All FHIR elements must have a @value or children | ||||
coverageArea | SΣ | 0..* | Reference(Insurance Plan Location | #sd-usdf-InsurancePlanLocation-usdf-InsurancePlanLocation) | Where product applies ele-1: All FHIR elements must have a @value or children | ||||
contact | 0..* | BackboneElement | Contact information for the Insurance Plan including URLs for brochure and formulary information ele-1: All FHIR elements must have a @value or children | |||||
extension | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
purpose | 0..1 | CodeableConcept | The type of contact Binding: ?? (extensible) ele-1: All FHIR elements must have a @value or children | |||||
name | S | 0..1 | HumanName | A name associated with the contact ele-1: All FHIR elements must have a @value or children | ||||
extension | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: ?? (required): The use of a human name. ele-1: All FHIR elements must have a @value or children | ||||
text | SΣ | 0..1 | string | Text representation of the full name ele-1: All FHIR elements must have a @value or children | ||||
family | Σ | 0..1 | string | Family name (often called 'Surname') ele-1: All FHIR elements must have a @value or children | ||||
given | Σ | 0..* | string | Given names (not always 'first'). Includes middle names ele-1: All FHIR elements must have a @value or children | ||||
prefix | Σ | 0..* | string | Parts that come before the name ele-1: All FHIR elements must have a @value or children | ||||
suffix | Σ | 0..* | string | Parts that come after the name ele-1: All FHIR elements must have a @value or children | ||||
period | Σ | 0..1 | Period | Time period when name was/is in use ele-1: All FHIR elements must have a @value or children | ||||
telecom | S | 0..* | ContactPoint | Contact details (telephone, email, etc.) for a contact ele-1: All FHIR elements must have a @value or children | ||||
extension | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
system | SΣ | 0..1 | code | phone | fax | email | pager | url | sms | other Binding: ?? (required): Telecommunications form for contact point. ele-1: All FHIR elements must have a @value or children | ||||
value | SΣ | 0..1 | string | The actual contact point details ele-1: All FHIR elements must have a @value or children | ||||
use | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ?? (required): Use of contact point. ele-1: All FHIR elements must have a @value or children | ||||
rank | Σ | 0..1 | positiveInt | Specify preferred order of use (1 = highest) ele-1: All FHIR elements must have a @value or children | ||||
period | Σ | 0..1 | Period | Time period when the contact point was/is in use ele-1: All FHIR elements must have a @value or children | ||||
address | 0..1 | Address | Visiting or postal addresses for the contact ele-1: All FHIR elements must have a @value or children | |||||
endpoint | 0..* | Reference(Endpoint) | Technical endpoint ele-1: All FHIR elements must have a @value or children | |||||
network | 0..* | Reference(Organization) | What networks are Included ele-1: All FHIR elements must have a @value or children | |||||
coverage | S | 1..* | BackboneElement | Coverage details ele-1: All FHIR elements must have a @value or children | ||||
extension | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
type | S | 1..1 | CodeableConcept | Type of coverage ele-1: All FHIR elements must have a @value or children | ||||
network | 0..* | Reference(Organization) | What networks provide coverage ele-1: All FHIR elements must have a @value or children | |||||
benefit | 1..* | BackboneElement | List of benefits ele-1: All FHIR elements must have a @value or children | |||||
extension | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
type | 1..1 | CodeableConcept | Type of benefit ele-1: All FHIR elements must have a @value or children | |||||
requirement | 0..1 | string | Referral requirements ele-1: All FHIR elements must have a @value or children | |||||
limit | 0..* | BackboneElement | Benefit limits ele-1: All FHIR elements must have a @value or children | |||||
extension | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
value | 0..1 | Quantity | Maximum value allowed ele-1: All FHIR elements must have a @value or children | |||||
code | 0..1 | CodeableConcept | Benefit limit details ele-1: All FHIR elements must have a @value or children | |||||
plan | S | 1..* | BackboneElement | Plan details ele-1: All FHIR elements must have a @value or children | ||||
extension | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
identifier | Σ | 0..* | Identifier | Business Identifier for Product ele-1: All FHIR elements must have a @value or children | ||||
type | 0..1 | CodeableConcept | Type of plan Binding: ?? (extensible) ele-1: All FHIR elements must have a @value or children | |||||
coverageArea | Σ | 0..* | Reference(Location) | Where product applies ele-1: All FHIR elements must have a @value or children | ||||
network | 0..* | Reference(Organization) | What networks provide coverage ele-1: All FHIR elements must have a @value or children | |||||
generalCost | 0..* | BackboneElement | Overall costs ele-1: All FHIR elements must have a @value or children | |||||
extension | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
type | 0..1 | CodeableConcept | Type of cost ele-1: All FHIR elements must have a @value or children | |||||
groupSize | 0..1 | positiveInt | Number of enrollees ele-1: All FHIR elements must have a @value or children | |||||
cost | 0..1 | Money | Cost value ele-1: All FHIR elements must have a @value or children | |||||
comment | 0..1 | string | Additional cost information ele-1: All FHIR elements must have a @value or children | |||||
specificCost | 0..* | BackboneElement | Specific costs ele-1: All FHIR elements must have a @value or children | |||||
extension | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
category | 1..1 | CodeableConcept | General category of benefit ele-1: All FHIR elements must have a @value or children | |||||
benefit | 0..* | BackboneElement | Benefits list ele-1: All FHIR elements must have a @value or children | |||||
extension | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
type | 1..1 | CodeableConcept | Type of specific benefit ele-1: All FHIR elements must have a @value or children | |||||
cost | 0..* | BackboneElement | List of the costs ele-1: All FHIR elements must have a @value or children | |||||
extension | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
type | 1..1 | CodeableConcept | Type of cost ele-1: All FHIR elements must have a @value or children | |||||
applicability | 0..1 | CodeableConcept | in-network | out-of-network | other Binding: ?? (required): Whether the cost applies to in-network or out-of-network providers. ele-1: All FHIR elements must have a @value or children | |||||
qualifiers | 0..* | CodeableConcept | Additional information about the cost ele-1: All FHIR elements must have a @value or children | |||||
value | 0..1 | Quantity | The actual cost value ele-1: All FHIR elements must have a @value or children | |||||
Documentation for this format |