臺灣電子處方箋與調劑單張實作指引(TW EMPD IG), published by 衛生福利部中央健康保險署. This guide is not an authorized publication; it is the continuous build for version 0.2.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/TWNHIFHIR/empd/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON
• TTL

Resource Profile: 電子處方箋/調劑單張-就醫身分別

用於表示電子處方箋與調劑單張之就醫身分別

Usages:

• Use this Profile: 調劑單張-Bundle and 電子處方箋-Bundle
• Refer to this Profile: 調劑單張-Composition, 電子處方箋-Composition, 調劑單張-處方內容(MedicationRequest) and 電子處方箋-處方內容(MedicationRequest)
• Examples for this Profile: Coverage/cov-01-ep, Coverage/cov-02-ep and Coverage/cov-ds
• CapabilityStatements using this Profile: 電子處方箋與調劑單張-用戶端 and 電子處方箋與調劑單張-伺服端

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
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement
Coverage.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Coverage.Slices for extension	S This element must be supported.	0..1	Extension	Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Coverage.Slices for extension.extension:PaymentCategory	S This element must be supported.	0..1	CodeableConcept	擴充的資料項目。[應填入電子處方箋給付類別 Payment Category] URL: https://nhicore.nhi.gov.tw/empd/StructureDefinition/Extension-PaymentCategory Binding: NHI-電子處方箋-給付類別值集 (required)
Coverage.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Coverage.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Fixed Value: active (no extensions allowed)
Coverage.type	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	表示本次就醫之就醫身分別，用以區分健保與非健保身分。[應填入就醫身分類別] Binding: NHI-電子處方箋-就醫身分別值集 (required)
Coverage.type.coding	Σ This element is included in summaries.	1..1	Coding	Code defined by a terminology system Binding: NHI-電子處方箋-就醫身分別值集 (required): 就醫身分別；應填入Identity Type值集中的其中一個代碼。
Coverage.type.coding.system	Σ This element is included in summaries.	1..1	uri	Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/empd/CodeSystem/nhi-identity-type (extensions allowed)
Coverage.type.coding.code	Σ This element is included in summaries.	1..1	code	Symbol in syntax defined by the system Binding: NHI-電子處方箋-就醫身分別值集 (required)
Coverage.beneficiary	Σ This element is included in summaries.	1..1	Reference(Patient)	Plan beneficiary
Coverage.payor	S This element must be supported. Σ This element is included in summaries.	1..*	Reference(Organization | Patient | RelatedPerson)	Issuer of the policy
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.status	Base	required	Financial Resource Status Codes	📍4.0.1	FHIR Std.
Coverage.type	Base	required	NHI-電子處方箋-就醫身分別值集	📦0.2.1	This IG
Coverage.type.coding	Base	required	NHI-電子處方箋-就醫身分別值集	📦0.2.1	This IG
Coverage.type.coding.​code	Base	required	NHI-電子處方箋-就醫身分別值集	📦0.2.1	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Coverage	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	Coverage	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	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Coverage	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()

This structure is derived from Coverage

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage			Coverage
Coverage.Slices for extension	S This element must be supported.	0..1	Extension	Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Coverage.Slices for extension.extension:PaymentCategory		0..1	CodeableConcept	擴充的資料項目。[應填入電子處方箋給付類別 Payment Category] URL: https://nhicore.nhi.gov.tw/empd/StructureDefinition/Extension-PaymentCategory Binding: NHI-電子處方箋-給付類別值集 (required)
Coverage.status	S This element must be supported.	1..1	code	active | cancelled | draft | entered-in-error Fixed Value: active (no extensions allowed)
Coverage.type	S This element must be supported.	1..1	CodeableConcept	表示本次就醫之就醫身分別，用以區分健保與非健保身分。[應填入就醫身分類別] Binding: NHI-電子處方箋-就醫身分別值集 (required)
Coverage.type.coding		1..1	Coding	Code defined by a terminology system Binding: NHI-電子處方箋-就醫身分別值集 (required): 就醫身分別；應填入Identity Type值集中的其中一個代碼。
Coverage.type.coding.system		1..1	uri	Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/empd/CodeSystem/nhi-identity-type (extensions allowed)
Coverage.type.coding.code		1..1	code	Symbol in syntax defined by the system Binding: NHI-電子處方箋-就醫身分別值集 (required)
Coverage.payor	S This element must be supported.	1..*	Reference(Organization | Patient | RelatedPerson)	Issuer of the policy
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Coverage.type	Base	required	NHI-電子處方箋-就醫身分別值集	📦0.2.1	This IG
Coverage.type.coding	Base	required	NHI-電子處方箋-就醫身分別值集	📦0.2.1	This IG
Coverage.type.coding.​code	Base	required	NHI-電子處方箋-就醫身分別值集	📦0.2.1	This IG

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement
Coverage.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
Coverage.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Coverage.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Coverage.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
Coverage.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
Coverage.contained		0..*	Resource	Contained, inline Resources
Coverage.Slices for extension	S This element must be supported.	0..1	Extension	Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Coverage.Slices for extension.extension:PaymentCategory	S This element must be supported.	0..1	CodeableConcept	擴充的資料項目。[應填入電子處方箋給付類別 Payment Category] URL: https://nhicore.nhi.gov.tw/empd/StructureDefinition/Extension-PaymentCategory Binding: NHI-電子處方箋-給付類別值集 (required)
Coverage.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Coverage.identifier	Σ This element is included in summaries.	0..*	Identifier	Business Identifier for the coverage
Coverage.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Fixed Value: active (no extensions allowed)
Coverage.type	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	表示本次就醫之就醫身分別，用以區分健保與非健保身分。[應填入就醫身分類別] Binding: NHI-電子處方箋-就醫身分別值集 (required)
Coverage.type.id		0..1	string	Unique id for inter-element referencing
Coverage.type.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Coverage.type.coding	Σ This element is included in summaries.	1..1	Coding	Code defined by a terminology system Binding: NHI-電子處方箋-就醫身分別值集 (required): 就醫身分別；應填入Identity Type值集中的其中一個代碼。
Coverage.type.coding.id		0..1	string	Unique id for inter-element referencing
Coverage.type.coding.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Coverage.type.coding.system	Σ This element is included in summaries.	1..1	uri	Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/empd/CodeSystem/nhi-identity-type (extensions allowed)
Coverage.type.coding.version	Σ This element is included in summaries.	0..1	string	Version of the system - if relevant
Coverage.type.coding.code	Σ This element is included in summaries.	1..1	code	Symbol in syntax defined by the system Binding: NHI-電子處方箋-就醫身分別值集 (required)
Coverage.type.coding.display	Σ This element is included in summaries.	0..1	string	Representation defined by the system
Coverage.type.coding.userSelected	Σ This element is included in summaries.	0..1	boolean	If this coding was chosen directly by the user
Coverage.type.text	Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
Coverage.policyHolder	Σ This element is included in summaries.	0..1	Reference(Patient | RelatedPerson | Organization)	Owner of the policy
Coverage.subscriber	Σ This element is included in summaries.	0..1	Reference(Patient | RelatedPerson)	Subscriber to the policy
Coverage.subscriberId	Σ This element is included in summaries.	0..1	string	ID assigned to the subscriber
Coverage.beneficiary	Σ This element is included in summaries.	1..1	Reference(Patient)	Plan beneficiary
Coverage.dependent	Σ This element is included in summaries.	0..1	string	Dependent number
Coverage.relationship		0..1	CodeableConcept	Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
Coverage.period	Σ This element is included in summaries.	0..1	Period	Coverage start and end dates
Coverage.payor	S This element must be supported. Σ This element is included in summaries.	1..*	Reference(Organization | Patient | RelatedPerson)	Issuer of the policy
Coverage.class		0..*	BackboneElement	Additional coverage classifications
Coverage.class.id		0..1	string	Unique id for inter-element referencing
Coverage.class.extension		0..*	Extension	Additional content defined by implementations
Coverage.class.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Coverage.class.type	Σ This element is included in summaries.	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
Coverage.class.value	Σ This element is included in summaries.	1..1	string	Value associated with the type
Coverage.class.name	Σ This element is included in summaries.	0..1	string	Human readable description of the type and value
Coverage.order	Σ This element is included in summaries.	0..1	positiveInt	Relative order of the coverage
Coverage.network	Σ This element is included in summaries.	0..1	string	Insurer network
Coverage.costToBeneficiary		0..*	BackboneElement	Patient payments for services/products
Coverage.costToBeneficiary.id		0..1	string	Unique id for inter-element referencing
Coverage.costToBeneficiary.extension		0..*	Extension	Additional content defined by implementations
Coverage.costToBeneficiary.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Coverage.costToBeneficiary.type	Σ This element is included in summaries.	0..1	CodeableConcept	Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified.
Coverage.costToBeneficiary.value[x]	Σ This element is included in summaries.	1..1		The amount or percentage due from the beneficiary
Coverage.costToBeneficiary.value[x].valueQuantity			Quantity(SimpleQuantity)
Coverage.costToBeneficiary.value[x].valueMoney			Money
Coverage.costToBeneficiary.exception		0..*	BackboneElement	Exceptions for patient payments
Coverage.costToBeneficiary.exception.id		0..1	string	Unique id for inter-element referencing
Coverage.costToBeneficiary.exception.extension		0..*	Extension	Additional content defined by implementations
Coverage.costToBeneficiary.exception.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Coverage.costToBeneficiary.exception.type	Σ This element is included in summaries.	1..1	CodeableConcept	Exception category Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays.
Coverage.costToBeneficiary.exception.period	Σ This element is included in summaries.	0..1	Period	The effective period of the exception
Coverage.subrogation		0..1	boolean	Reimbursement to insurer
Coverage.contract		0..*	Reference(Contract)	Contract details
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Coverage.status	Base	required	Financial Resource Status Codes	📍4.0.1	FHIR Std.
Coverage.type	Base	required	NHI-電子處方箋-就醫身分別值集	📦0.2.1	This IG
Coverage.type.coding	Base	required	NHI-電子處方箋-就醫身分別值集	📦0.2.1	This IG
Coverage.type.coding.​code	Base	required	NHI-電子處方箋-就醫身分別值集	📦0.2.1	This IG
Coverage.relationship	Base	extensible	SubscriberPolicyholder Relationship Codes	📍4.0.1	FHIR Std.
Coverage.class.type	Base	extensible	Coverage Class Codes	📍4.0.1	FHIR Std.
Coverage.costToBeneficiary.​type	Base	extensible	Coverage Copay Type Codes	📍4.0.1	FHIR Std.
Coverage.costToBeneficiary.​exception.type	Base	example	Example Coverage Financial Exception Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Coverage	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	Coverage	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	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Coverage	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()

This structure is derived from Coverage

Summary

Mandatory: 4 elements
Must-Support: 4 elements
Fixed: 1 element

Extensions

This structure refers to these extensions:

• https://nhicore.nhi.gov.tw/empd/StructureDefinition/Extension-PaymentCategory

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement
Coverage.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Coverage.Slices for extension	S This element must be supported.	0..1	Extension	Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Coverage.Slices for extension.extension:PaymentCategory	S This element must be supported.	0..1	CodeableConcept	擴充的資料項目。[應填入電子處方箋給付類別 Payment Category] URL: https://nhicore.nhi.gov.tw/empd/StructureDefinition/Extension-PaymentCategory Binding: NHI-電子處方箋-給付類別值集 (required)
Coverage.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Coverage.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Fixed Value: active (no extensions allowed)
Coverage.type	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	表示本次就醫之就醫身分別，用以區分健保與非健保身分。[應填入就醫身分類別] Binding: NHI-電子處方箋-就醫身分別值集 (required)
Coverage.type.coding	Σ This element is included in summaries.	1..1	Coding	Code defined by a terminology system Binding: NHI-電子處方箋-就醫身分別值集 (required): 就醫身分別；應填入Identity Type值集中的其中一個代碼。
Coverage.type.coding.system	Σ This element is included in summaries.	1..1	uri	Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/empd/CodeSystem/nhi-identity-type (extensions allowed)
Coverage.type.coding.code	Σ This element is included in summaries.	1..1	code	Symbol in syntax defined by the system Binding: NHI-電子處方箋-就醫身分別值集 (required)
Coverage.beneficiary	Σ This element is included in summaries.	1..1	Reference(Patient)	Plan beneficiary
Coverage.payor	S This element must be supported. Σ This element is included in summaries.	1..*	Reference(Organization | Patient | RelatedPerson)	Issuer of the policy
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.status	Base	required	Financial Resource Status Codes	📍4.0.1	FHIR Std.
Coverage.type	Base	required	NHI-電子處方箋-就醫身分別值集	📦0.2.1	This IG
Coverage.type.coding	Base	required	NHI-電子處方箋-就醫身分別值集	📦0.2.1	This IG
Coverage.type.coding.​code	Base	required	NHI-電子處方箋-就醫身分別值集	📦0.2.1	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Coverage	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	Coverage	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	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Coverage	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()

Differential View

This structure is derived from Coverage

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage			Coverage
Coverage.Slices for extension	S This element must be supported.	0..1	Extension	Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Coverage.Slices for extension.extension:PaymentCategory		0..1	CodeableConcept	擴充的資料項目。[應填入電子處方箋給付類別 Payment Category] URL: https://nhicore.nhi.gov.tw/empd/StructureDefinition/Extension-PaymentCategory Binding: NHI-電子處方箋-給付類別值集 (required)
Coverage.status	S This element must be supported.	1..1	code	active | cancelled | draft | entered-in-error Fixed Value: active (no extensions allowed)
Coverage.type	S This element must be supported.	1..1	CodeableConcept	表示本次就醫之就醫身分別，用以區分健保與非健保身分。[應填入就醫身分類別] Binding: NHI-電子處方箋-就醫身分別值集 (required)
Coverage.type.coding		1..1	Coding	Code defined by a terminology system Binding: NHI-電子處方箋-就醫身分別值集 (required): 就醫身分別；應填入Identity Type值集中的其中一個代碼。
Coverage.type.coding.system		1..1	uri	Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/empd/CodeSystem/nhi-identity-type (extensions allowed)
Coverage.type.coding.code		1..1	code	Symbol in syntax defined by the system Binding: NHI-電子處方箋-就醫身分別值集 (required)
Coverage.payor	S This element must be supported.	1..*	Reference(Organization | Patient | RelatedPerson)	Issuer of the policy
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Coverage.type	Base	required	NHI-電子處方箋-就醫身分別值集	📦0.2.1	This IG
Coverage.type.coding	Base	required	NHI-電子處方箋-就醫身分別值集	📦0.2.1	This IG
Coverage.type.coding.​code	Base	required	NHI-電子處方箋-就醫身分別值集	📦0.2.1	This IG

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement
Coverage.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
Coverage.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Coverage.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Coverage.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
Coverage.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
Coverage.contained		0..*	Resource	Contained, inline Resources
Coverage.Slices for extension	S This element must be supported.	0..1	Extension	Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Coverage.Slices for extension.extension:PaymentCategory	S This element must be supported.	0..1	CodeableConcept	擴充的資料項目。[應填入電子處方箋給付類別 Payment Category] URL: https://nhicore.nhi.gov.tw/empd/StructureDefinition/Extension-PaymentCategory Binding: NHI-電子處方箋-給付類別值集 (required)
Coverage.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Coverage.identifier	Σ This element is included in summaries.	0..*	Identifier	Business Identifier for the coverage
Coverage.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Fixed Value: active (no extensions allowed)
Coverage.type	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	表示本次就醫之就醫身分別，用以區分健保與非健保身分。[應填入就醫身分類別] Binding: NHI-電子處方箋-就醫身分別值集 (required)
Coverage.type.id		0..1	string	Unique id for inter-element referencing
Coverage.type.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Coverage.type.coding	Σ This element is included in summaries.	1..1	Coding	Code defined by a terminology system Binding: NHI-電子處方箋-就醫身分別值集 (required): 就醫身分別；應填入Identity Type值集中的其中一個代碼。
Coverage.type.coding.id		0..1	string	Unique id for inter-element referencing
Coverage.type.coding.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Coverage.type.coding.system	Σ This element is included in summaries.	1..1	uri	Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/empd/CodeSystem/nhi-identity-type (extensions allowed)
Coverage.type.coding.version	Σ This element is included in summaries.	0..1	string	Version of the system - if relevant
Coverage.type.coding.code	Σ This element is included in summaries.	1..1	code	Symbol in syntax defined by the system Binding: NHI-電子處方箋-就醫身分別值集 (required)
Coverage.type.coding.display	Σ This element is included in summaries.	0..1	string	Representation defined by the system
Coverage.type.coding.userSelected	Σ This element is included in summaries.	0..1	boolean	If this coding was chosen directly by the user
Coverage.type.text	Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
Coverage.policyHolder	Σ This element is included in summaries.	0..1	Reference(Patient | RelatedPerson | Organization)	Owner of the policy
Coverage.subscriber	Σ This element is included in summaries.	0..1	Reference(Patient | RelatedPerson)	Subscriber to the policy
Coverage.subscriberId	Σ This element is included in summaries.	0..1	string	ID assigned to the subscriber
Coverage.beneficiary	Σ This element is included in summaries.	1..1	Reference(Patient)	Plan beneficiary
Coverage.dependent	Σ This element is included in summaries.	0..1	string	Dependent number
Coverage.relationship		0..1	CodeableConcept	Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
Coverage.period	Σ This element is included in summaries.	0..1	Period	Coverage start and end dates
Coverage.payor	S This element must be supported. Σ This element is included in summaries.	1..*	Reference(Organization | Patient | RelatedPerson)	Issuer of the policy
Coverage.class		0..*	BackboneElement	Additional coverage classifications
Coverage.class.id		0..1	string	Unique id for inter-element referencing
Coverage.class.extension		0..*	Extension	Additional content defined by implementations
Coverage.class.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Coverage.class.type	Σ This element is included in summaries.	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
Coverage.class.value	Σ This element is included in summaries.	1..1	string	Value associated with the type
Coverage.class.name	Σ This element is included in summaries.	0..1	string	Human readable description of the type and value
Coverage.order	Σ This element is included in summaries.	0..1	positiveInt	Relative order of the coverage
Coverage.network	Σ This element is included in summaries.	0..1	string	Insurer network
Coverage.costToBeneficiary		0..*	BackboneElement	Patient payments for services/products
Coverage.costToBeneficiary.id		0..1	string	Unique id for inter-element referencing
Coverage.costToBeneficiary.extension		0..*	Extension	Additional content defined by implementations
Coverage.costToBeneficiary.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Coverage.costToBeneficiary.type	Σ This element is included in summaries.	0..1	CodeableConcept	Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified.
Coverage.costToBeneficiary.value[x]	Σ This element is included in summaries.	1..1		The amount or percentage due from the beneficiary
Coverage.costToBeneficiary.value[x].valueQuantity			Quantity(SimpleQuantity)
Coverage.costToBeneficiary.value[x].valueMoney			Money
Coverage.costToBeneficiary.exception		0..*	BackboneElement	Exceptions for patient payments
Coverage.costToBeneficiary.exception.id		0..1	string	Unique id for inter-element referencing
Coverage.costToBeneficiary.exception.extension		0..*	Extension	Additional content defined by implementations
Coverage.costToBeneficiary.exception.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Coverage.costToBeneficiary.exception.type	Σ This element is included in summaries.	1..1	CodeableConcept	Exception category Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays.
Coverage.costToBeneficiary.exception.period	Σ This element is included in summaries.	0..1	Period	The effective period of the exception
Coverage.subrogation		0..1	boolean	Reimbursement to insurer
Coverage.contract		0..*	Reference(Contract)	Contract details
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Coverage.status	Base	required	Financial Resource Status Codes	📍4.0.1	FHIR Std.
Coverage.type	Base	required	NHI-電子處方箋-就醫身分別值集	📦0.2.1	This IG
Coverage.type.coding	Base	required	NHI-電子處方箋-就醫身分別值集	📦0.2.1	This IG
Coverage.type.coding.​code	Base	required	NHI-電子處方箋-就醫身分別值集	📦0.2.1	This IG
Coverage.relationship	Base	extensible	SubscriberPolicyholder Relationship Codes	📍4.0.1	FHIR Std.
Coverage.class.type	Base	extensible	Coverage Class Codes	📍4.0.1	FHIR Std.
Coverage.costToBeneficiary.​type	Base	extensible	Coverage Copay Type Codes	📍4.0.1	FHIR Std.
Coverage.costToBeneficiary.​exception.type	Base	example	Example Coverage Financial Exception Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Coverage	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	Coverage	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	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Coverage	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()

This structure is derived from Coverage

Summary

Mandatory: 4 elements
Must-Support: 4 elements
Fixed: 1 element

Extensions

This structure refers to these extensions:

• https://nhicore.nhi.gov.tw/empd/StructureDefinition/Extension-PaymentCategory

Other representations of profile: CSV, Excel, Schematron