description: Coverage resource in which no personally-identifiable information is included. Used for representing non-patient-specific payment sources such as medication discount cards.
package_name: hl7.fhir.us.carin-rtpbc
derivation: constraint
name: RtpbcCoverageNonPHI
type: Coverage
elements:
  subscriberId:
    label: Subscriber ID (masked)
    short: Subscriber ID (masked)
    index: 0
    extensions:
      data-masked:
        url: http://hl7.org/fhir/StructureDefinition/data-absent-reason|5.2.0
        type: Extension
        mustSupport: true
        index: 2
        elements:
          value:
            pattern: {type: Code, value: masked}
            choices: []
            index: 4
    elements:
      extension:
        mustSupport: true
        index: 1
        slicing:
          rules: open
          ordered: false
          discriminator:
          - {path: url, type: value}
          min: 1
          slices:
            data-masked:
              match: {url: null}
              schema:
                type: Extension
                mustSupport: true
                url: http://hl7.org/fhir/StructureDefinition/data-absent-reason|5.2.0
                index: 2
                elements:
                  value:
                    pattern: {type: Code, value: masked}
                    choices: []
                    index: 4
    required: [extension]
  beneficiary:
    label: Patient information (masked)
    short: Patient information (masked)
    index: 5
    extensions:
      data-masked:
        url: http://hl7.org/fhir/StructureDefinition/data-absent-reason|5.2.0
        type: Extension
        mustSupport: true
        index: 7
        elements:
          value:
            pattern: {type: Code, value: masked}
            choices: []
            index: 9
    elements:
      extension:
        mustSupport: true
        index: 6
        slicing:
          slices:
            data-masked:
              match: {}
              schema:
                type: Extension
                mustSupport: true
                url: http://hl7.org/fhir/StructureDefinition/data-absent-reason|5.2.0
                index: 7
                elements:
                  value:
                    pattern: {type: Code, value: masked}
                    choices: []
                    index: 9
      reference: {index: 10}
      type: {index: 11}
      identifier: {label: 'Unique, non-personally identifiable code', short: 'Unique, non-personally identifiable code', index: 12}
      display: {index: 13}
    required: [extension]
  relationship:
    index: 14
    elements:
      coding:
        elements:
          system:
            pattern: {type: Uri, value: 'http://terminology.hl7.org/CodeSystem/subscriber-relationship'}
            index: 15
          code:
            pattern: {type: Code, value: self}
            index: 16
  payor:
    elements:
      identifier:
        label: Payer ID
        short: Payer ID
        mustSupport: true
        index: 17
        elements:
          value: {label: Payer ID Value, short: Payer ID Value, mustSupport: true, index: 18}
        required: [value]
  class:
    label: Pharmacy coverage identifiers
    short: Pharmacy coverage identifiers
    index: 19
    elements:
      type:
        binding: {strength: extensible, valueSet: 'http://hl7.org/fhir/ValueSet/coverage-class'}
        index: 20
    slicing:
      rules: open
      ordered: false
      description: Identifiers used by the payer/PBM to located the patient's coverage. IIN (BIN) number, Processor Control Number (PCN), pharmacy benefit Group ID and patient's PBM Member ID.
      discriminator:
      - {path: type, type: value}
      min: null
      slices:
        bin:
          match:
            type:
              coding:
              - {code: rxbin, system: 'http://terminology.hl7.org/CodeSystem/coverage-class'}
          schema:
            label: IIN (BIN) number
            short: IIN (BIN) number
            mustSupport: true
            index: 21
            elements:
              type:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: rxbin, system: 'http://terminology.hl7.org/CodeSystem/coverage-class'}
                index: 22
        pcn:
          match:
            type:
              coding:
              - {code: rxpcn, system: 'http://terminology.hl7.org/CodeSystem/coverage-class'}
          schema:
            label: Processor Control Number (PCN)
            short: Processor Control Number (PCN)
            mustSupport: true
            index: 23
            elements:
              type:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: rxpcn, system: 'http://terminology.hl7.org/CodeSystem/coverage-class'}
                index: 24
        rxgroup-id:
          match:
            type:
              coding:
              - {code: rxgroup, system: 'http://terminology.hl7.org/CodeSystem/coverage-class'}
          schema:
            label: Pharmacy Benefit Group ID
            short: Pharmacy Benefit Group ID
            mustSupport: true
            index: 25
            elements:
              type:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: rxgroup, system: 'http://terminology.hl7.org/CodeSystem/coverage-class'}
                index: 26
        member-id:
          match:
            type:
              coding:
              - {code: rxid, system: 'http://terminology.hl7.org/CodeSystem/coverage-class'}
          schema:
            label: PBM Member ID
            short: PBM Member ID
            mustSupport: true
            index: 27
            elements:
              type:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: rxid, system: 'http://terminology.hl7.org/CodeSystem/coverage-class'}
                index: 28
package_version: 2.0.0-ballot
class: profile
kind: resource
url: http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-coverage-non-phi
base: http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage
version: 2.0.0-ballot