{
"description": "An InsurancePlan is a discrete package of health insurance coverage benefits that are offered under a particular network type. A given payer’s products typically differ by network type and/or covered benefits. A plan pairs a product’s covered benefits with the particular cost sharing structure offered to a consumer. A given product may comprise multiple plans (i.e. each plan offers different cost sharing requirements for the same set of covered benefits).\\n\\nInsurancePlan describes a health insurance offering comprised of a list of covered benefits (i.e. the product), costs associated with those benefits (i.e. the plan), and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.",
"_filename": "StructureDefinition-plannet-InsurancePlan.json",
"package_name": "hl7.fhir.us.davinci-pdex-plan-net",
"date": "2025-02-25T19:12:27+00:00",
"derivation": "constraint",
"publisher": "HL7 International / Financial Management",
"fhirVersion": "4.0.1",
"jurisdiction": [ {
"coding": [ {
"code": "US",
"system": "urn:iso:std:iso:3166"
} ]
} ],
"name": "PlannetInsurancePlan",
"mapping": [ {
"uri": "http://hl7.org/fhir/fivews",
"name": "FiveWs Pattern Mapping",
"identity": "w5"
}, {
"uri": "http://hl7.org/v3",
"name": "RIM Mapping",
"identity": "rim"
} ],
"abstract": false,
"type": "InsurancePlan",
"experimental": null,
"resourceType": "StructureDefinition",
"title": "Plan-Net InsurancePlan",
"package_version": "1.2.0",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode": "fm"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "trial-use",
"_valueCode": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
"valueCanonical": "http://hl7.org/fhir/us/davinci-pdex-plan-net/ImplementationGuide/hl7.fhir.us.davinci-pdex-plan-net"
} ]
}
} ],
"snapshot": {
"element": [ {
"constraint": [ {
"key": "dom-2",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"xpath": "not(parent::f:contained and f:contained)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.contained.empty()"
}, {
"key": "dom-3",
"human": "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",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "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()"
}, {
"key": "dom-4",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"
}, {
"key": "dom-5",
"human": "If a resource is contained in another resource, it SHALL NOT have a security label",
"xpath": "not(exists(f:contained/*/f:meta/f:security))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.meta.security.empty()"
}, {
"key": "dom-6",
"human": "A resource should have narrative for robust management",
"xpath": "exists(f:text/h:div)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "warning",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
"valueBoolean": true
}, {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
"valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
} ],
"expression": "text.`div`.exists()"
}, {
"key": "ipn-1",
"human": "The organization SHALL at least have a name or an idendtifier, and possibly more than one",
"xpath": "count(f:identifier | f:name) > 0",
"source": "http://hl7.org/fhir/StructureDefinition/InsurancePlan",
"severity": "error",
"expression": "(identifier.count() + name.count()) > 0"
}, {
"key": "network-or-plan-Network",
"human": "If an insuranceplan does not define a network, then each plan must define one",
"source": "http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-InsurancePlan",
"severity": "error",
"expression": "network.exists() or plan.network.exists()"
}, {
"key": "plan-type-is-distinct",
"human": "Each InsurancePlan.plan should have a distinct plan.type.",
"source": "http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-InsurancePlan",
"severity": "error",
"expression": "plan.type.coding.code.isDistinct()"
} ],
"path": "InsurancePlan",
"min": 0,
"definition": "Details of a Health Insurance product/plan provided by an organization.",
"isModifier": false,
"short": "Details of a Health Insurance product/plan provided by an organization",
"mapping": [ {
"map": "Entity. Role, or Act",
"identity": "rim"
} ],
"max": "*",
"id": "InsurancePlan",
"base": {
"max": "*",
"min": 0,
"path": "InsurancePlan"
},
"isSummary": false
}, {
"path": "InsurancePlan.id",
"min": 0,
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"isModifier": false,
"short": "Logical id of this artifact",
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "id"
} ]
} ],
"max": "1",
"id": "InsurancePlan.id",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"base": {
"max": "1",
"min": 0,
"path": "Resource.id"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.meta",
"min": 0,
"definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
"isModifier": false,
"short": "Metadata about the resource",
"type": [ {
"code": "Meta"
} ],
"max": "1",
"id": "InsurancePlan.meta",
"base": {
"max": "1",
"min": 0,
"path": "Resource.meta"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.implicitRules",
"min": 0,
"definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
"isModifier": true,
"short": "A set of rules under which this content was created",
"type": [ {
"code": "uri"
} ],
"max": "1",
"id": "InsurancePlan.implicitRules",
"comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
"base": {
"max": "1",
"min": 0,
"path": "Resource.implicitRules"
},
"isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.language",
"min": 0,
"definition": "The base language in which the resource is written.",
"isModifier": false,
"short": "Language of the resource content",
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/ValueSet/languages",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
} ],
"description": "A human language."
},
"max": "1",
"id": "InsurancePlan.language",
"comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
"base": {
"max": "1",
"min": 0,
"path": "Resource.language"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.text",
"min": 0,
"definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
"isModifier": false,
"short": "Text summary of the resource, for human interpretation",
"mapping": [ {
"map": "Act.text?",
"identity": "rim"
} ],
"type": [ {
"code": "Narrative"
} ],
"alias": [ "narrative", "html", "xhtml", "display" ],
"max": "1",
"id": "InsurancePlan.text",
"comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
"base": {
"max": "1",
"min": 0,
"path": "DomainResource.text"
},
"isSummary": false
}, {
"path": "InsurancePlan.contained",
"min": 0,
"definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
"isModifier": false,
"short": "Contained, inline Resources",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Resource"
} ],
"alias": [ "inline resources", "anonymous resources", "contained resources" ],
"max": "*",
"id": "InsurancePlan.contained",
"comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.contained"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "InsurancePlan.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "InsurancePlan.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "InsurancePlan.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "InsurancePlan.modifierExtension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.identifier",
"min": 0,
"definition": "Business identifiers assigned to this health insurance product which remain constant as the resource is updated and propagates from server to server.",
"isModifier": false,
"short": "Business Identifier for Product",
"mapping": [ {
"map": "FiveWs.identifier",
"identity": "w5"
}, {
"map": ".scopes[Role](classCode=IDENT)",
"identity": "rim"
} ],
"type": [ {
"code": "Identifier"
} ],
"max": "*",
"id": "InsurancePlan.identifier",
"condition": [ "ipn-1" ],
"base": {
"max": "*",
"min": 0,
"path": "InsurancePlan.identifier"
},
"isSummary": true
}, {
"path": "InsurancePlan.identifier.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "InsurancePlan.identifier.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "InsurancePlan.identifier.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "InsurancePlan.identifier.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.identifier.use",
"requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
"min": 0,
"definition": "The purpose of this identifier.",
"isModifier": true,
"short": "usual | official | temp | secondary | old (If known)",
"mapping": [ {
"map": "N/A",
"identity": "v2"
}, {
"map": "Role.code or implied by context",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierUse"
} ],
"description": "Identifies the purpose for this identifier, if known ."
},
"max": "1",
"id": "InsurancePlan.identifier.use",
"comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
"base": {
"max": "1",
"min": 0,
"path": "Identifier.use"
},
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.identifier.type",
"requirements": "Allows users to make use of identifiers when the identifier system is not known.",
"min": 0,
"definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
"isModifier": false,
"short": "Description of identifier",
"mapping": [ {
"map": "CX.5",
"identity": "v2"
}, {
"map": "Role.code or implied by context",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-type",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierType"
} ],
"description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose."
},
"max": "1",
"id": "InsurancePlan.identifier.type",
"comment": "This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.",
"base": {
"max": "1",
"min": 0,
"path": "Identifier.type"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.identifier.system",
"requirements": "There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
"min": 0,
"definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
"isModifier": false,
"short": "The namespace for the identifier value",
"mapping": [ {
"map": "CX.4 / EI-2-4",
"identity": "v2"
}, {
"map": "II.root or Role.id.root",
"identity": "rim"
}, {
"map": "./IdentifierType",
"identity": "servd"
} ],
"type": [ {
"code": "uri"
} ],
"max": "1",
"id": "InsurancePlan.identifier.system",
"comment": "Identifier.system is always case sensitive.",
"example": [ {
"label": "General",
"valueUri": "http://www.acme.com/identifiers/patient"
} ],
"base": {
"max": "1",
"min": 0,
"path": "Identifier.system"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.identifier.value",
"min": 0,
"definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
"isModifier": false,
"short": "The value that is unique",
"mapping": [ {
"map": "CX.1 / EI.1",
"identity": "v2"
}, {
"map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)",
"identity": "rim"
}, {
"map": "./Value",
"identity": "servd"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"max": "1",
"id": "InsurancePlan.identifier.value",
"comment": "If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [Rendered Value extension](http://hl7.org/fhir/R4/extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.",
"example": [ {
"label": "General",
"valueString": "123456"
} ],
"base": {
"max": "1",
"min": 0,
"path": "Identifier.value"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.identifier.period",
"min": 0,
"definition": "Time period during which identifier is/was valid for use.",
"isModifier": false,
"short": "Time period when id is/was valid for use",
"mapping": [ {
"map": "CX.7 + CX.8",
"identity": "v2"
}, {
"map": "Role.effectiveTime or implied by context",
"identity": "rim"
}, {
"map": "./StartDate and ./EndDate",
"identity": "servd"
} ],
"type": [ {
"code": "Period"
} ],
"max": "1",
"id": "InsurancePlan.identifier.period",
"base": {
"max": "1",
"min": 0,
"path": "Identifier.period"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.identifier.assigner",
"min": 0,
"definition": "Organization that issued/manages the identifier.",
"isModifier": false,
"short": "Organization that issued id (may be just text)",
"mapping": [ {
"map": "CX.4 / (CX.4,CX.9,CX.10)",
"identity": "v2"
}, {
"map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper",
"identity": "rim"
}, {
"map": "./IdentifierIssuingAuthority",
"identity": "servd"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ],
"mustSupport": true,
"max": "1",
"id": "InsurancePlan.identifier.assigner",
"comment": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
"base": {
"max": "1",
"min": 0,
"path": "Identifier.assigner"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.status",
"fixedCode": "active",
"requirements": "Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI.",
"min": 1,
"definition": "The current state of the health insurance product.",
"isModifier": true,
"short": "draft | active | retired | unknown",
"mapping": [ {
"map": "FiveWs.status",
"identity": "w5"
}, {
"map": ".status",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"meaningWhenMissing": "Default interpretation is active.",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/publication-status|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "PublicationStatus"
} ],
"description": "The lifecycle status of an artifact."
},
"max": "1",
"id": "InsurancePlan.status",
"base": {
"max": "1",
"min": 0,
"path": "InsurancePlan.status"
},
"isModifierReason": "This element is labeled as a modifier because it is a status element that contains codes which means that the resource should not be treated as valid",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.type",
"min": 1,
"definition": "The kind of health insurance product.",
"isModifier": false,
"short": "Product Type",
"mapping": [ {
"map": "FiveWs.class",
"identity": "w5"
}, {
"map": ".code",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/us/davinci-pdex-plan-net/ValueSet/InsuranceProductTypeVS"
},
"max": "1",
"id": "InsurancePlan.type",
"base": {
"max": "*",
"min": 0,
"path": "InsurancePlan.type"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.name",
"min": 0,
"definition": "Official name of the health insurance product as designated by the owner.",
"isModifier": false,
"short": "Official name",
"mapping": [ {
"map": ".name",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"max": "1",
"id": "InsurancePlan.name",
"condition": [ "ipn-1" ],
"comment": "If the name of the product/plan changes, consider putting the old name in the alias column so that it can still be located through searches.",
"base": {
"max": "1",
"min": 0,
"path": "InsurancePlan.name"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.alias",
"requirements": "Over time products/plans go through many changes and can be known by different names.\n\nFor searching knowing previous names that the product/plan was known by can be very useful.",
"min": 0,
"definition": "A list of alternate names that the product is known as, or was known as in the past.",
"isModifier": false,
"short": "Alternate names",
"mapping": [ {
"map": ".name",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"max": "*",
"id": "InsurancePlan.alias",
"comment": "There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the product/plan.",
"base": {
"max": "*",
"min": 0,
"path": "InsurancePlan.alias"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.period",
"min": 0,
"definition": "The period of time that the health insurance product is available.",
"isModifier": false,
"short": "When the product is available",
"type": [ {
"code": "Period"
} ],
"mustSupport": true,
"max": "1",
"id": "InsurancePlan.period",
"base": {
"max": "1",
"min": 0,
"path": "InsurancePlan.period"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.ownedBy",
"min": 1,
"definition": "The entity that is providing the health insurance product and underwriting the risk. This is typically an insurance carriers, other third-party payers, or health plan sponsors comonly referred to as 'payers'.",
"isModifier": false,
"short": "Plan issuer",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Organization" ]
} ],
"mustSupport": true,
"alias": [ "Payer" ],
"max": "1",
"id": "InsurancePlan.ownedBy",
"base": {
"max": "1",
"min": 0,
"path": "InsurancePlan.ownedBy"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.administeredBy",
"min": 1,
"definition": "An organization which administer other services such as underwriting, customer service and/or claims processing on behalf of the health insurance product owner.",
"isModifier": false,
"short": "Product administrator",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Organization" ]
} ],
"mustSupport": true,
"max": "1",
"id": "InsurancePlan.administeredBy",
"base": {
"max": "1",
"min": 0,
"path": "InsurancePlan.administeredBy"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.coverageArea",
"min": 0,
"definition": "The geographic region in which a health insurance product's benefits apply.",
"isModifier": false,
"short": "Where product applies",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Location" ]
} ],
"mustSupport": true,
"max": "*",
"id": "InsurancePlan.coverageArea",
"base": {
"max": "*",
"min": 0,
"path": "InsurancePlan.coverageArea"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.contact",
"requirements": "Need to keep track of assigned contact points within bigger organization.",
"min": 0,
"definition": "The contact for the health insurance product for a certain purpose.",
"isModifier": false,
"short": "Contact for the product",
"mapping": [ {
"map": ".contactParty",
"identity": "rim"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"mustSupport": true,
"max": "*",
"id": "InsurancePlan.contact",
"comment": "Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use.",
"base": {
"max": "*",
"min": 0,
"path": "InsurancePlan.contact"
},
"isSummary": false
}, {
"path": "InsurancePlan.contact.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "InsurancePlan.contact.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "InsurancePlan.contact.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "InsurancePlan.contact.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "InsurancePlan.contact.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "InsurancePlan.contact.modifierExtension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.contact.purpose",
"requirements": "Need to distinguish between multiple contact persons.",
"min": 0,
"definition": "Indicates a purpose for which the contact can be reached.",
"isModifier": false,
"short": "The type of contact",
"mapping": [ {
"map": "./type",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/contactentity-type",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ContactPartyType"
} ],
"description": "The purpose for which you would contact a contact party."
},
"max": "1",
"id": "InsurancePlan.contact.purpose",
"base": {
"max": "1",
"min": 0,
"path": "InsurancePlan.contact.purpose"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.contact.name",
"requirements": "Need to be able to track the person by name.",
"min": 0,
"definition": "A name associated with the contact.",
"isModifier": false,
"short": "A name associated with the contact",
"mapping": [ {
"map": "./name",
"identity": "rim"
} ],
"type": [ {
"code": "HumanName"
} ],
"mustSupport": true,
"max": "1",
"id": "InsurancePlan.contact.name",
"base": {
"max": "1",
"min": 0,
"path": "InsurancePlan.contact.name"
},
"isSummary": false
}, {
"path": "InsurancePlan.contact.name.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "InsurancePlan.contact.name.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "InsurancePlan.contact.name.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "InsurancePlan.contact.name.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.contact.name.use",
"requirements": "Allows the appropriate name for a particular context of use to be selected from among a set of names.",
"min": 0,
"definition": "Identifies the purpose for this name.",
"isModifier": true,
"short": "usual | official | temp | nickname | anonymous | old | maiden",
"mapping": [ {
"map": "XPN.7, but often indicated by which field contains the name",
"identity": "v2"
}, {
"map": "unique(./use)",
"identity": "rim"
}, {
"map": "./NamePurpose",
"identity": "servd"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/name-use|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "NameUse"
} ],
"description": "The use of a human name."
},
"max": "1",
"id": "InsurancePlan.contact.name.use",
"comment": "Applications can assume that a name is current unless it explicitly says that it is temporary or old.",
"base": {
"max": "1",
"min": 0,
"path": "HumanName.use"
},
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old name etc.for a current/permanent one",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.contact.name.text",
"requirements": "A renderable, unencoded form.",
"min": 0,
"definition": "Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.",
"isModifier": false,
"short": "Text representation of the full name",
"mapping": [ {
"map": "implied by XPN.11",
"identity": "v2"
}, {
"map": "./formatted",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"max": "1",
"id": "InsurancePlan.contact.name.text",
"comment": "Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.",
"base": {
"max": "1",
"min": 0,
"path": "HumanName.text"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.contact.name.family",
"min": 0,
"definition": "The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.",
"isModifier": false,
"short": "Family name (often called 'Surname')",
"mapping": [ {
"map": "XPN.1/FN.1",
"identity": "v2"
}, {
"map": "./part[partType = FAM]",
"identity": "rim"
}, {
"map": "./FamilyName",
"identity": "servd"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "surname" ],
"max": "1",
"id": "InsurancePlan.contact.name.family",
"comment": "Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).",
"base": {
"max": "1",
"min": 0,
"path": "HumanName.family"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.contact.name.given",
"min": 0,
"definition": "Given name.",
"isModifier": false,
"short": "Given names (not always 'first'). Includes middle names",
"mapping": [ {
"map": "XPN.2 + XPN.3",
"identity": "v2"
}, {
"map": "./part[partType = GIV]",
"identity": "rim"
}, {
"map": "./GivenNames",
"identity": "servd"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "first name", "middle name" ],
"max": "*",
"id": "InsurancePlan.contact.name.given",
"comment": "If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called \"first name\" since given names do not always come first.",
"orderMeaning": "Given Names appear in the correct order for presenting the name",
"base": {
"max": "*",
"min": 0,
"path": "HumanName.given"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.contact.name.prefix",
"min": 0,
"definition": "Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.",
"isModifier": false,
"short": "Parts that come before the name",
"mapping": [ {
"map": "XPN.5",
"identity": "v2"
}, {
"map": "./part[partType = PFX]",
"identity": "rim"
}, {
"map": "./TitleCode",
"identity": "servd"
} ],
"type": [ {
"code": "string"
} ],
"max": "*",
"id": "InsurancePlan.contact.name.prefix",
"orderMeaning": "Prefixes appear in the correct order for presenting the name",
"base": {
"max": "*",
"min": 0,
"path": "HumanName.prefix"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.contact.name.suffix",
"min": 0,
"definition": "Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.",
"isModifier": false,
"short": "Parts that come after the name",
"mapping": [ {
"map": "XPN/4",
"identity": "v2"
}, {
"map": "./part[partType = SFX]",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"max": "*",
"id": "InsurancePlan.contact.name.suffix",
"orderMeaning": "Suffixes appear in the correct order for presenting the name",
"base": {
"max": "*",
"min": 0,
"path": "HumanName.suffix"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.contact.name.period",
"requirements": "Allows names to be placed in historical context.",
"min": 0,
"definition": "Indicates the period of time when this name was valid for the named person.",
"isModifier": false,
"short": "Time period when name was/is in use",
"mapping": [ {
"map": "XPN.13 + XPN.14",
"identity": "v2"
}, {
"map": "./usablePeriod[type=\"IVL\"]",
"identity": "rim"
}, {
"map": "./StartDate and ./EndDate",
"identity": "servd"
} ],
"type": [ {
"code": "Period"
} ],
"max": "1",
"id": "InsurancePlan.contact.name.period",
"base": {
"max": "1",
"min": 0,
"path": "HumanName.period"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.contact.telecom",
"requirements": "People have (primary) ways to contact them in some way such as phone, email.",
"min": 0,
"definition": "A contact detail (e.g. a telephone number or an email address) by which the party may be contacted.",
"isModifier": false,
"short": "Contact details (telephone, email, etc.) for a contact",
"mapping": [ {
"map": "./telecom",
"identity": "rim"
} ],
"type": [ {
"code": "ContactPoint"
} ],
"mustSupport": true,
"max": "*",
"id": "InsurancePlan.contact.telecom",
"base": {
"max": "*",
"min": 0,
"path": "InsurancePlan.contact.telecom"
},
"isSummary": false
}, {
"path": "InsurancePlan.contact.telecom.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "InsurancePlan.contact.telecom.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "InsurancePlan.contact.telecom.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "InsurancePlan.contact.telecom.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.contact.telecom.system",
"min": 0,
"definition": "Telecommunications form for contact point - what communications system is required to make use of the contact.",
"isModifier": false,
"short": "phone | fax | email | pager | url | sms | other",
"mapping": [ {
"map": "XTN.3",
"identity": "v2"
}, {
"map": "./scheme",
"identity": "rim"
}, {
"map": "./ContactPointType",
"identity": "servd"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ContactPointSystem"
} ],
"description": "Telecommunications form for contact point."
},
"max": "1",
"id": "InsurancePlan.contact.telecom.system",
"condition": [ "cpt-2" ],
"base": {
"max": "1",
"min": 0,
"path": "ContactPoint.system"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.contact.telecom.value",
"requirements": "Need to support legacy numbers that are not in a tightly controlled format.",
"min": 0,
"definition": "The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).",
"isModifier": false,
"short": "The actual contact point details",
"mapping": [ {
"map": "XTN.1 (or XTN.12)",
"identity": "v2"
}, {
"map": "./url",
"identity": "rim"
}, {
"map": "./Value",
"identity": "servd"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"max": "1",
"id": "InsurancePlan.contact.telecom.value",
"comment": "Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.",
"base": {
"max": "1",
"min": 0,
"path": "ContactPoint.value"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.contact.telecom.use",
"requirements": "Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.",
"min": 0,
"definition": "Identifies the purpose for the contact point.",
"isModifier": true,
"short": "home | work | temp | old | mobile - purpose of this contact point",
"mapping": [ {
"map": "XTN.2 - but often indicated by field",
"identity": "v2"
}, {
"map": "unique(./use)",
"identity": "rim"
}, {
"map": "./ContactPointPurpose",
"identity": "servd"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ContactPointUse"
} ],
"description": "Use of contact point."
},
"max": "1",
"id": "InsurancePlan.contact.telecom.use",
"comment": "Applications can assume that a contact is current unless it explicitly says that it is temporary or old.",
"base": {
"max": "1",
"min": 0,
"path": "ContactPoint.use"
},
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old contact etc.for a current/permanent one",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.contact.telecom.rank",
"min": 0,
"definition": "Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.",
"isModifier": false,
"short": "Specify preferred order of use (1 = highest)",
"mapping": [ {
"map": "n/a",
"identity": "v2"
}, {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "positiveInt"
} ],
"max": "1",
"id": "InsurancePlan.contact.telecom.rank",
"comment": "Note that rank does not necessarily follow the order in which the contacts are represented in the instance.",
"base": {
"max": "1",
"min": 0,
"path": "ContactPoint.rank"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.contact.telecom.period",
"min": 0,
"definition": "Time period when the contact point was/is in use.",
"isModifier": false,
"short": "Time period when the contact point was/is in use",
"mapping": [ {
"map": "N/A",
"identity": "v2"
}, {
"map": "./usablePeriod[type=\"IVL\"]",
"identity": "rim"
}, {
"map": "./StartDate and ./EndDate",
"identity": "servd"
} ],
"type": [ {
"code": "Period"
} ],
"max": "1",
"id": "InsurancePlan.contact.telecom.period",
"base": {
"max": "1",
"min": 0,
"path": "ContactPoint.period"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.contact.address",
"requirements": "May need to keep track of a contact party's address for contacting, billing or reporting requirements.",
"min": 0,
"definition": "Visiting or postal addresses for the contact.",
"isModifier": false,
"short": "Visiting or postal addresses for the contact",
"mapping": [ {
"map": "./addr",
"identity": "rim"
} ],
"type": [ {
"code": "Address"
} ],
"max": "1",
"id": "InsurancePlan.contact.address",
"base": {
"max": "1",
"min": 0,
"path": "InsurancePlan.contact.address"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.endpoint",
"requirements": "Organizations have multiple systems that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose.",
"min": 0,
"definition": "The technical endpoints providing access to services operated for the health insurance product.",
"isModifier": false,
"short": "Technical endpoint",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Endpoint" ]
} ],
"mustSupport": true,
"max": "*",
"id": "InsurancePlan.endpoint",
"base": {
"max": "*",
"min": 0,
"path": "InsurancePlan.endpoint"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.network",
"min": 0,
"definition": "Reference to the network included in the health insurance product.",
"isModifier": false,
"short": "What networks are Included",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Network" ]
} ],
"mustSupport": true,
"max": "*",
"id": "InsurancePlan.network",
"comment": "Networks are represented as a hierarchy of organization resources.",
"base": {
"max": "*",
"min": 0,
"path": "InsurancePlan.network"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.coverage",
"min": 0,
"definition": "Details about the coverage offered by the insurance product.",
"isModifier": false,
"short": "Coverage details",
"type": [ {
"code": "BackboneElement"
} ],
"max": "*",
"id": "InsurancePlan.coverage",
"base": {
"max": "*",
"min": 0,
"path": "InsurancePlan.coverage"
},
"isSummary": false
}, {
"path": "InsurancePlan.coverage.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "InsurancePlan.coverage.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "InsurancePlan.coverage.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "InsurancePlan.coverage.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "InsurancePlan.coverage.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "InsurancePlan.coverage.modifierExtension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.coverage.type",
"min": 1,
"definition": "Type of coverage (Medical; Dental; Mental Health; Substance Abuse; Vision; Drug; Short Term; Long Term Care; Hospice; Home Health).",
"isModifier": false,
"short": "Type of coverage",
"type": [ {
"code": "CodeableConcept"
} ],
"max": "1",
"id": "InsurancePlan.coverage.type",
"base": {
"max": "1",
"min": 1,
"path": "InsurancePlan.coverage.type"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.coverage.network",
"min": 0,
"definition": "Reference to the network that providing the type of coverage.",
"isModifier": false,
"short": "What networks provide coverage",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ],
"max": "*",
"id": "InsurancePlan.coverage.network",
"comment": "Networks are represented as a hierarchy of organization resources.",
"base": {
"max": "*",
"min": 0,
"path": "InsurancePlan.coverage.network"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.coverage.benefit",
"min": 1,
"definition": "Specific benefits under this type of coverage.",
"isModifier": false,
"short": "List of benefits",
"type": [ {
"code": "BackboneElement"
} ],
"max": "*",
"id": "InsurancePlan.coverage.benefit",
"base": {
"max": "*",
"min": 1,
"path": "InsurancePlan.coverage.benefit"
},
"isSummary": false
}, {
"path": "InsurancePlan.coverage.benefit.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "InsurancePlan.coverage.benefit.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "InsurancePlan.coverage.benefit.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "InsurancePlan.coverage.benefit.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "InsurancePlan.coverage.benefit.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "InsurancePlan.coverage.benefit.modifierExtension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.coverage.benefit.type",
"min": 1,
"definition": "Type of benefit (primary care; speciality care; inpatient; outpatient).",
"isModifier": false,
"short": "Type of benefit",
"type": [ {
"code": "CodeableConcept"
} ],
"max": "1",
"id": "InsurancePlan.coverage.benefit.type",
"base": {
"max": "1",
"min": 1,
"path": "InsurancePlan.coverage.benefit.type"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.coverage.benefit.requirement",
"min": 0,
"definition": "The referral requirements to have access/coverage for this benefit.",
"isModifier": false,
"short": "Referral requirements",
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "InsurancePlan.coverage.benefit.requirement",
"base": {
"max": "1",
"min": 0,
"path": "InsurancePlan.coverage.benefit.requirement"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.coverage.benefit.limit",
"min": 0,
"definition": "The specific limits on the benefit.",
"isModifier": false,
"short": "Benefit limits",
"type": [ {
"code": "BackboneElement"
} ],
"max": "*",
"id": "InsurancePlan.coverage.benefit.limit",
"base": {
"max": "*",
"min": 0,
"path": "InsurancePlan.coverage.benefit.limit"
},
"isSummary": false
}, {
"path": "InsurancePlan.coverage.benefit.limit.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "InsurancePlan.coverage.benefit.limit.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "InsurancePlan.coverage.benefit.limit.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "InsurancePlan.coverage.benefit.limit.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "InsurancePlan.coverage.benefit.limit.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "InsurancePlan.coverage.benefit.limit.modifierExtension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.coverage.benefit.limit.value",
"min": 0,
"definition": "The maximum amount of a service item a plan will pay for a covered benefit. For examples. wellness visits, or eyeglasses.",
"isModifier": false,
"short": "Maximum value allowed",
"type": [ {
"code": "Quantity"
} ],
"max": "1",
"id": "InsurancePlan.coverage.benefit.limit.value",
"comment": "May also be called “eligible expense,” “payment allowance,” or “negotiated rate.”.",
"base": {
"max": "1",
"min": 0,
"path": "InsurancePlan.coverage.benefit.limit.value"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.coverage.benefit.limit.code",
"min": 0,
"definition": "The specific limit on the benefit.",
"isModifier": false,
"short": "Benefit limit details",
"type": [ {
"code": "CodeableConcept"
} ],
"max": "1",
"id": "InsurancePlan.coverage.benefit.limit.code",
"comment": "Use `CodeableConcept.text` element if the data is free (uncoded) text.",
"base": {
"max": "1",
"min": 0,
"path": "InsurancePlan.coverage.benefit.limit.code"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.plan",
"min": 0,
"definition": "Details about an insurance plan.",
"isModifier": false,
"short": "Cost sharing details for the plan",
"type": [ {
"code": "BackboneElement"
} ],
"max": "*",
"id": "InsurancePlan.plan",
"base": {
"max": "*",
"min": 0,
"path": "InsurancePlan.plan"
},
"isSummary": false
}, {
"path": "InsurancePlan.plan.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "InsurancePlan.plan.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "InsurancePlan.plan.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "InsurancePlan.plan.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "InsurancePlan.plan.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "InsurancePlan.plan.modifierExtension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.plan.identifier",
"min": 0,
"definition": "Business identifiers assigned to this health insurance plan which remain constant as the resource is updated and propagates from server to server.",
"isModifier": false,
"short": "Business Identifier for Product",
"mapping": [ {
"map": "FiveWs.identifier",
"identity": "w5"
}, {
"map": ".scopes[Role](classCode=IDENT)",
"identity": "rim"
} ],
"type": [ {
"code": "Identifier"
} ],
"max": "*",
"id": "InsurancePlan.plan.identifier",
"base": {
"max": "*",
"min": 0,
"path": "InsurancePlan.plan.identifier"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.plan.type",
"min": 0,
"definition": "Type of plan. For example, \"Platinum\" or \"High Deductable\".",
"isModifier": false,
"short": "Categorization of the cost sharing for the plan",
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/us/davinci-pdex-plan-net/ValueSet/InsurancePlanTypeVS"
},
"max": "1",
"id": "InsurancePlan.plan.type",
"base": {
"max": "1",
"min": 0,
"path": "InsurancePlan.plan.type"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.plan.coverageArea",
"min": 0,
"definition": "The geographic region in which a health insurance plan's benefits apply.",
"isModifier": false,
"short": "Where product applies",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Location" ]
} ],
"mustSupport": true,
"max": "*",
"id": "InsurancePlan.plan.coverageArea",
"base": {
"max": "*",
"min": 0,
"path": "InsurancePlan.plan.coverageArea"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
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"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.plan.network",
"min": 0,
"definition": "Reference to the network that providing the type of coverage.",
"isModifier": false,
"short": "What networks provide coverage",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Network" ]
} ],
"max": "*",
"id": "InsurancePlan.plan.network",
"comment": "Networks are represented as a hierarchy of organization resources.",
"base": {
"max": "*",
"min": 0,
"path": "InsurancePlan.plan.network"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.plan.generalCost",
"min": 0,
"definition": "Overall costs associated with the plan.",
"isModifier": false,
"short": "Overall costs",
"type": [ {
"code": "BackboneElement"
} ],
"max": "*",
"id": "InsurancePlan.plan.generalCost",
"base": {
"max": "*",
"min": 0,
"path": "InsurancePlan.plan.generalCost"
},
"isSummary": false
}, {
"path": "InsurancePlan.plan.generalCost.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "InsurancePlan.plan.generalCost.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
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"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "InsurancePlan.plan.generalCost.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
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} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "InsurancePlan.plan.generalCost.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
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"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
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"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "InsurancePlan.plan.generalCost.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "InsurancePlan.plan.generalCost.modifierExtension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
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"xpath": "@value|f:*|h:div",
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"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.plan.generalCost.type",
"min": 0,
"definition": "Type of cost.",
"isModifier": false,
"short": "Type of cost",
"type": [ {
"code": "CodeableConcept"
} ],
"max": "1",
"id": "InsurancePlan.plan.generalCost.type",
"base": {
"max": "1",
"min": 0,
"path": "InsurancePlan.plan.generalCost.type"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
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"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.plan.generalCost.groupSize",
"min": 0,
"definition": "Number of participants enrolled in the plan.",
"isModifier": false,
"short": "Number of enrollees",
"type": [ {
"code": "positiveInt"
} ],
"max": "1",
"id": "InsurancePlan.plan.generalCost.groupSize",
"base": {
"max": "1",
"min": 0,
"path": "InsurancePlan.plan.generalCost.groupSize"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
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"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.plan.generalCost.cost",
"min": 0,
"definition": "Value of the cost.",
"isModifier": false,
"short": "Cost value",
"type": [ {
"code": "Money"
} ],
"max": "1",
"id": "InsurancePlan.plan.generalCost.cost",
"base": {
"max": "1",
"min": 0,
"path": "InsurancePlan.plan.generalCost.cost"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
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"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.plan.generalCost.comment",
"min": 0,
"definition": "Additional information about the general costs associated with this plan.",
"isModifier": false,
"short": "Additional cost information",
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "InsurancePlan.plan.generalCost.comment",
"base": {
"max": "1",
"min": 0,
"path": "InsurancePlan.plan.generalCost.comment"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
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"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.plan.specificCost",
"min": 0,
"definition": "Costs associated with the coverage provided by the product.",
"isModifier": false,
"short": "Specific costs",
"type": [ {
"code": "BackboneElement"
} ],
"max": "*",
"id": "InsurancePlan.plan.specificCost",
"base": {
"max": "*",
"min": 0,
"path": "InsurancePlan.plan.specificCost"
},
"isSummary": false
}, {
"path": "InsurancePlan.plan.specificCost.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "InsurancePlan.plan.specificCost.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
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"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
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"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "InsurancePlan.plan.specificCost.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
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"mapping": [ {
"map": "n/a",
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} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "InsurancePlan.plan.specificCost.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
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}, {
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"severity": "error",
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} ],
"path": "InsurancePlan.plan.specificCost.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
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} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "InsurancePlan.plan.specificCost.modifierExtension",
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"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
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}, {
"constraint": [ {
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"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.plan.specificCost.category",
"min": 1,
"definition": "General category of benefit (Medical; Dental; Vision; Drug; Mental Health; Substance Abuse; Hospice, Home Health).",
"isModifier": false,
"short": "General category of benefit",
"type": [ {
"code": "CodeableConcept"
} ],
"max": "1",
"id": "InsurancePlan.plan.specificCost.category",
"base": {
"max": "1",
"min": 1,
"path": "InsurancePlan.plan.specificCost.category"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
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"severity": "error",
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} ],
"path": "InsurancePlan.plan.specificCost.benefit",
"min": 0,
"definition": "List of the specific benefits under this category of benefit.",
"isModifier": false,
"short": "Benefits list",
"type": [ {
"code": "BackboneElement"
} ],
"max": "*",
"id": "InsurancePlan.plan.specificCost.benefit",
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"max": "*",
"min": 0,
"path": "InsurancePlan.plan.specificCost.benefit"
},
"isSummary": false
}, {
"path": "InsurancePlan.plan.specificCost.benefit.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
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"mapping": [ {
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} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
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"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "InsurancePlan.plan.specificCost.benefit.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
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}, {
"constraint": [ {
"key": "ele-1",
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}, {
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} ],
"path": "InsurancePlan.plan.specificCost.benefit.extension",
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"type": [ {
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"max": "*",
"id": "InsurancePlan.plan.specificCost.benefit.extension",
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"base": {
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"path": "Element.extension"
},
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}, {
"constraint": [ {
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}, {
"key": "ext-1",
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} ],
"path": "InsurancePlan.plan.specificCost.benefit.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
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"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
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} ],
"type": [ {
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} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "InsurancePlan.plan.specificCost.benefit.modifierExtension",
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"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
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"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.plan.specificCost.benefit.type",
"min": 1,
"definition": "Type of specific benefit (preventative; primary care office visit; speciality office visit; hospitalization; emergency room; urgent care).",
"isModifier": false,
"short": "Type of specific benefit",
"type": [ {
"code": "CodeableConcept"
} ],
"max": "1",
"id": "InsurancePlan.plan.specificCost.benefit.type",
"base": {
"max": "1",
"min": 1,
"path": "InsurancePlan.plan.specificCost.benefit.type"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
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"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.plan.specificCost.benefit.cost",
"min": 0,
"definition": "List of the costs associated with a specific benefit.",
"isModifier": false,
"short": "List of the costs",
"type": [ {
"code": "BackboneElement"
} ],
"max": "*",
"id": "InsurancePlan.plan.specificCost.benefit.cost",
"base": {
"max": "*",
"min": 0,
"path": "InsurancePlan.plan.specificCost.benefit.cost"
},
"isSummary": false
}, {
"path": "InsurancePlan.plan.specificCost.benefit.cost.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "InsurancePlan.plan.specificCost.benefit.cost.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "InsurancePlan.plan.specificCost.benefit.cost.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "InsurancePlan.plan.specificCost.benefit.cost.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "InsurancePlan.plan.specificCost.benefit.cost.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "InsurancePlan.plan.specificCost.benefit.cost.modifierExtension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.plan.specificCost.benefit.cost.type",
"min": 1,
"definition": "Type of cost (copay; individual cap; family cap; coinsurance; deductible).",
"isModifier": false,
"short": "Type of cost",
"type": [ {
"code": "CodeableConcept"
} ],
"max": "1",
"id": "InsurancePlan.plan.specificCost.benefit.cost.type",
"base": {
"max": "1",
"min": 1,
"path": "InsurancePlan.plan.specificCost.benefit.cost.type"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.plan.specificCost.benefit.cost.applicability",
"min": 0,
"definition": "Whether the cost applies to in-network or out-of-network providers (in-network; out-of-network; other).",
"isModifier": false,
"short": "in-network | out-of-network | other",
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/insuranceplan-applicability|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "BenefitCostApplicability"
} ],
"description": "Whether the cost applies to in-network or out-of-network providers."
},
"max": "1",
"id": "InsurancePlan.plan.specificCost.benefit.cost.applicability",
"base": {
"max": "1",
"min": 0,
"path": "InsurancePlan.plan.specificCost.benefit.cost.applicability"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.plan.specificCost.benefit.cost.qualifiers",
"min": 0,
"definition": "Additional information about the cost, such as information about funding sources (e.g. HSA, HRA, FSA, RRA).",
"isModifier": false,
"short": "Additional information about the cost",
"type": [ {
"code": "CodeableConcept"
} ],
"max": "*",
"id": "InsurancePlan.plan.specificCost.benefit.cost.qualifiers",
"base": {
"max": "*",
"min": 0,
"path": "InsurancePlan.plan.specificCost.benefit.cost.qualifiers"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "InsurancePlan.plan.specificCost.benefit.cost.value",
"min": 0,
"definition": "The actual cost value. (some of the costs may be represented as percentages rather than currency, e.g. 10% coinsurance).",
"isModifier": false,
"short": "The actual cost value",
"type": [ {
"code": "Quantity"
} ],
"max": "1",
"id": "InsurancePlan.plan.specificCost.benefit.cost.value",
"base": {
"max": "1",
"min": 0,
"path": "InsurancePlan.plan.specificCost.benefit.cost.value"
},
"isSummary": false
} ],
"extension": [ {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",
"valueString": "4.0.1"
} ]
},
"status": "active",
"id": "f0b5c476-15d5-46ea-8096-bf82a1a750a8",
"kind": "resource",
"url": "http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-InsurancePlan",
"version": "1.2.0",
"differential": {
"element": [ {
"id": "InsurancePlan",
"path": "InsurancePlan",
"constraint": [ {
"key": "network-or-plan-Network",
"human": "If an insuranceplan does not define a network, then each plan must define one",
"source": "http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-InsurancePlan",
"severity": "error",
"expression": "network.exists() or plan.network.exists()"
}, {
"key": "plan-type-is-distinct",
"human": "Each InsurancePlan.plan should have a distinct plan.type.",
"source": "http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-InsurancePlan",
"severity": "error",
"expression": "plan.type.coding.code.isDistinct()"
} ]
}, {
"id": "InsurancePlan.identifier.type",
"path": "InsurancePlan.identifier.type",
"mustSupport": true
}, {
"id": "InsurancePlan.identifier.value",
"path": "InsurancePlan.identifier.value",
"mustSupport": true
}, {
"id": "InsurancePlan.identifier.assigner",
"path": "InsurancePlan.identifier.assigner",
"mustSupport": true
}, {
"id": "InsurancePlan.status",
"min": 1,
"path": "InsurancePlan.status",
"fixedCode": "active",
"mustSupport": true
}, {
"id": "InsurancePlan.type",
"max": "1",
"min": 1,
"path": "InsurancePlan.type",
"short": "Product Type",
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/us/davinci-pdex-plan-net/ValueSet/InsuranceProductTypeVS"
},
"mustSupport": true
}, {
"id": "InsurancePlan.name",
"path": "InsurancePlan.name",
"mustSupport": true
}, {
"id": "InsurancePlan.alias",
"path": "InsurancePlan.alias",
"mustSupport": true
}, {
"id": "InsurancePlan.period",
"path": "InsurancePlan.period",
"mustSupport": true
}, {
"id": "InsurancePlan.ownedBy",
"min": 1,
"path": "InsurancePlan.ownedBy",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Organization" ]
} ],
"mustSupport": true
}, {
"id": "InsurancePlan.administeredBy",
"min": 1,
"path": "InsurancePlan.administeredBy",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Organization" ]
} ],
"mustSupport": true
}, {
"id": "InsurancePlan.coverageArea",
"path": "InsurancePlan.coverageArea",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Location" ]
} ],
"mustSupport": true
}, {
"id": "InsurancePlan.contact",
"path": "InsurancePlan.contact",
"mustSupport": true
}, {
"id": "InsurancePlan.contact.name",
"path": "InsurancePlan.contact.name",
"mustSupport": true
}, {
"id": "InsurancePlan.contact.name.text",
"path": "InsurancePlan.contact.name.text",
"mustSupport": true
}, {
"id": "InsurancePlan.contact.telecom",
"path": "InsurancePlan.contact.telecom",
"mustSupport": true
}, {
"id": "InsurancePlan.contact.telecom.system",
"path": "InsurancePlan.contact.telecom.system",
"mustSupport": true
}, {
"id": "InsurancePlan.contact.telecom.value",
"path": "InsurancePlan.contact.telecom.value",
"mustSupport": true
}, {
"id": "InsurancePlan.endpoint",
"path": "InsurancePlan.endpoint",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Endpoint" ]
} ],
"mustSupport": true
}, {
"id": "InsurancePlan.network",
"path": "InsurancePlan.network",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Network" ]
} ],
"mustSupport": true
}, {
"id": "InsurancePlan.plan",
"path": "InsurancePlan.plan",
"short": "Cost sharing details for the plan"
}, {
"id": "InsurancePlan.plan.type",
"path": "InsurancePlan.plan.type",
"short": "Categorization of the cost sharing for the plan",
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/us/davinci-pdex-plan-net/ValueSet/InsurancePlanTypeVS"
},
"mustSupport": true
}, {
"id": "InsurancePlan.plan.coverageArea",
"path": "InsurancePlan.plan.coverageArea",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Location" ]
} ],
"mustSupport": true
}, {
"id": "InsurancePlan.plan.network",
"path": "InsurancePlan.plan.network",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Network" ]
} ]
} ]
},
"contact": [ {
"name": "HL7 International / Financial Management",
"telecom": [ {
"value": "http://www.hl7.org/Special/committees/fm",
"system": "url"
}, {
"value": "fm@lists.HL7.org",
"system": "email"
} ]
} ],
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/InsurancePlan"
}