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FHIR IG Statistics: StructureDefinition/PayerPlanPeriod

Packagehl7.fhir.uv.omop
TypeStructureDefinition
IdPayerPlanPeriod
FHIR VersionR5
Sourcehttp://hl7.org/fhir/uv/omop/https://build.fhir.org/ig/HL7/fhir-omop-ig/StructureDefinition-PayerPlanPeriod.html
URLhttp://hl7.org/fhir/uv/omop/StructureDefinition/PayerPlanPeriod
Version1.0.0-ballot
Statusactive
Date2025-07-22T19:48:02+00:00
NamePayerPlanPeriod
TitlePayer Plan Period OMOP Table
Realmuv
Authorityhl7
DescriptionThe PAYER_PLAN_PERIOD table captures details of the period of time that a Person is continuously enrolled under a specific health Plan benefit structure from a given Payer. Each Person receiving healthcare is typically covered by a health benefit plan, which pays for (fully or partially), or directly provides, the care. These benefit plans are provided by payers, such as health insurances or state or government agencies. In each plan the details of the health benefits are defined for the Person or her family, and the health benefit Plan might change over time typically with increasing utilization (reaching certain cost thresholds such as deductibles), plan availability and purchasing choices of the Person. The unique combinations of Payer organizations, health benefit Plans and time periods in which they are valid for a Person are recorded in this table.
Typehttp://hl7.org/fhir/uv/omop/StructureDefinition/PayerPlanPeriod
Kindlogical

Resources that use this resource

StructureDefinition
CostCost OMOP Table

Resources that this resource uses

StructureDefinition
PersonPerson OMOP Table

Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: StructureDefinition PayerPlanPeriod

NameFlagsCard.TypeDescription & Constraintsdoco
.. PayerPlanPeriod 0..*BasePayer Plan Period OMOP Table
Instances of this logical model can be the target of a Reference
... payer_plan_period_id 1..1codePayer Plan Period Identifier
... person_id 1..1Reference(Person OMOP Table)Person
... payer_plan_period_start_date 1..1datePayer Plan Period Start Date
... payer_plan_period_end_date 1..1datePayer Plan Period End Date
... payer_concept_id 0..1codePayer
... payer_source_value 0..1stringPayer Source Value
... payer_source_concept_id 0..1codePayer Source
... plan_concept_id 0..1codePlan
... plan_source_value 0..1stringPlan Source Value
... plan_source_concept_id 0..1codePlan Source
... sponsor_concept_id 0..1codeSponsor
... sponsor_source_value 0..1stringSponsor Source Value
... sponsor_source_concept_id 0..1codeSponsor Source
... family_source_value 0..1stringFamily Source Value
... stop_reason_concept_id 0..1codeStop Reason
... stop_reason_source_value 0..1stringStop Reason Source Value
... stop_reason_source_concept_id 0..1codeStop Reason Source

doco Documentation for this format

Source

{
  "resourceType": "StructureDefinition",
  "id": "PayerPlanPeriod",
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-type-characteristics",
      "valueCode": "can-be-target"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "brr"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 1,
      "_valueInteger": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical": "http://hl7.org/fhir/uv/omop/ImplementationGuide/hl7.fhir.uv.omop"
          }
        ]
      }
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode": "informative",
      "_valueCode": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical": "http://hl7.org/fhir/uv/omop/ImplementationGuide/hl7.fhir.uv.omop"
          }
        ]
      }
    }
  ],
  "url": "http://hl7.org/fhir/uv/omop/StructureDefinition/PayerPlanPeriod",
  "version": "1.0.0-ballot",
  "name": "PayerPlanPeriod",
  "title": "Payer Plan Period OMOP Table",
  "status": "active",
  "date": "2025-07-22T19:48:02+00:00",
  "publisher": "HL7 International / Biomedical Research and Regulation",
  "contact": [
    {
      "name": "HL7 International / Biomedical Research and Regulation",
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/rcrim"
        }
      ]
    }
  ],
  "description": "The PAYER_PLAN_PERIOD table captures details of the period of time that a Person is continuously enrolled under a specific health Plan benefit structure from a given Payer. Each Person receiving healthcare is typically covered by a health benefit plan, which pays for (fully or partially), or directly provides, the care. These benefit plans are provided by payers, such as health insurances or state or government agencies. In each plan the details of the health benefits are defined for the Person or her family, and the health benefit Plan might change over time typically with increasing utilization (reaching certain cost thresholds such as deductibles), plan availability and purchasing choices of the Person. The unique combinations of Payer organizations, health benefit Plans and time periods in which they are valid for a Person are recorded in this table.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001",
          "display": "World"
        }
      ]
    }
  ],
  "fhirVersion": "5.0.0",
  "mapping": [
    {
      "identity": "rim",
      "uri": "http://hl7.org/v3",
      "name": "RIM Mapping"
    }
  ],
  "kind": "logical",
  "abstract": false,
  "type": "http://hl7.org/fhir/uv/omop/StructureDefinition/PayerPlanPeriod",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Base",
  "derivation": "specialization",
  "snapshot": {
    "extension": [
      {
        "url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",
        "valueString": "5.0.0"
      }
    ],
    "element": [
      {
        "id": "PayerPlanPeriod",
        "path": "PayerPlanPeriod",
        "short": "Payer Plan Period OMOP Table",
        "definition": "The PAYER_PLAN_PERIOD table captures details of the period of time that a Person is continuously enrolled under a specific health Plan benefit structure from a given Payer. Each Person receiving healthcare is typically covered by a health benefit plan, which pays for (fully or partially), or directly provides, the care. These benefit plans are provided by payers, such as health insurances or state or government agencies. In each plan the details of the health benefits are defined for the Person or her family, and the health benefit Plan might change over time typically with increasing utilization (reaching certain cost thresholds such as deductibles), plan availability and purchasing choices of the Person. The unique combinations of Payer organizations, health benefit Plans and time periods in which they are valid for a Person are recorded in this table.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Base",
          "min": 0,
          "max": "*"
        },
        "isModifier": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.payer-plan-period-id",
        "path": "PayerPlanPeriod.payer_plan_period_id",
        "short": "Payer Plan Period Identifier",
        "definition": "Payer Plan Period Identifier",
        "min": 1,
        "max": "1",
        "base": {
          "path": "PayerPlanPeriod.payer_plan_period_id",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "code"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.person-id",
        "path": "PayerPlanPeriod.person_id",
        "short": "Person",
        "definition": "The Person covered by the Plan.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "PayerPlanPeriod.person_id",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/uv/omop/StructureDefinition/Person"
            ]
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.payer-plan-period-start-date",
        "path": "PayerPlanPeriod.payer_plan_period_start_date",
        "short": "Payer Plan Period Start Date",
        "definition": "Start date of Plan coverage.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "PayerPlanPeriod.payer_plan_period_start_date",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "date"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.payer-plan-period-end-date",
        "path": "PayerPlanPeriod.payer_plan_period_end_date",
        "short": "Payer Plan Period End Date",
        "definition": "End date of Plan coverage.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "PayerPlanPeriod.payer_plan_period_end_date",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "date"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.payer-concept-id",
        "path": "PayerPlanPeriod.payer_concept_id",
        "short": "Payer",
        "definition": "This field represents the organization who reimburses the provider which administers care to the Person.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "PayerPlanPeriod.payer_concept_id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "code"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.payer-source-value",
        "path": "PayerPlanPeriod.payer_source_value",
        "short": "Payer Source Value",
        "definition": "This is the Payer as it appears in the source data.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "PayerPlanPeriod.payer_source_value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.payer-source-concept-id",
        "path": "PayerPlanPeriod.payer_source_concept_id",
        "short": "Payer Source",
        "definition": "Payer Source",
        "min": 0,
        "max": "1",
        "base": {
          "path": "PayerPlanPeriod.payer_source_concept_id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "code"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.plan-concept-id",
        "path": "PayerPlanPeriod.plan_concept_id",
        "short": "Plan",
        "definition": "This field represents the specific health benefit Plan the Person is enrolled in.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "PayerPlanPeriod.plan_concept_id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "code"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.plan-source-value",
        "path": "PayerPlanPeriod.plan_source_value",
        "short": "Plan Source Value",
        "definition": "This is the health benefit Plan of the Person as it appears in the source data.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "PayerPlanPeriod.plan_source_value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.plan-source-concept-id",
        "path": "PayerPlanPeriod.plan_source_concept_id",
        "short": "Plan Source",
        "definition": "Plan Source",
        "min": 0,
        "max": "1",
        "base": {
          "path": "PayerPlanPeriod.plan_source_concept_id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "code"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.sponsor-concept-id",
        "path": "PayerPlanPeriod.sponsor_concept_id",
        "short": "Sponsor",
        "definition": "This field represents the sponsor of the Plan who finances the Plan. This includes self-insured, small group health plan and large group health plan.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "PayerPlanPeriod.sponsor_concept_id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "code"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.sponsor-source-value",
        "path": "PayerPlanPeriod.sponsor_source_value",
        "short": "Sponsor Source Value",
        "definition": "The Plan sponsor as it appears in the source data.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "PayerPlanPeriod.sponsor_source_value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.sponsor-source-concept-id",
        "path": "PayerPlanPeriod.sponsor_source_concept_id",
        "short": "Sponsor Source",
        "definition": "Sponsor Source",
        "min": 0,
        "max": "1",
        "base": {
          "path": "PayerPlanPeriod.sponsor_source_concept_id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "code"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.family-source-value",
        "path": "PayerPlanPeriod.family_source_value",
        "short": "Family Source Value",
        "definition": "The common identifier for all people (often a family) that covered by the same policy.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "PayerPlanPeriod.family_source_value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.stop-reason-concept-id",
        "path": "PayerPlanPeriod.stop_reason_concept_id",
        "short": "Stop Reason",
        "definition": "This field represents the reason the Person left the Plan, if known.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "PayerPlanPeriod.stop_reason_concept_id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "code"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.stop-reason-source-value",
        "path": "PayerPlanPeriod.stop_reason_source_value",
        "short": "Stop Reason Source Value",
        "definition": "The Plan stop reason as it appears in the source data.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "PayerPlanPeriod.stop_reason_source_value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.stop-reason-source-concept-id",
        "path": "PayerPlanPeriod.stop_reason_source_concept_id",
        "short": "Stop Reason Source",
        "definition": "Stop Reason Source",
        "min": 0,
        "max": "1",
        "base": {
          "path": "PayerPlanPeriod.stop_reason_source_concept_id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "code"
          }
        ]
      }
    ]
  },
  "differential": {
    "element": [
      {
        "id": "PayerPlanPeriod",
        "path": "PayerPlanPeriod",
        "short": "Payer Plan Period OMOP Table",
        "definition": "The PAYER_PLAN_PERIOD table captures details of the period of time that a Person is continuously enrolled under a specific health Plan benefit structure from a given Payer. Each Person receiving healthcare is typically covered by a health benefit plan, which pays for (fully or partially), or directly provides, the care. These benefit plans are provided by payers, such as health insurances or state or government agencies. In each plan the details of the health benefits are defined for the Person or her family, and the health benefit Plan might change over time typically with increasing utilization (reaching certain cost thresholds such as deductibles), plan availability and purchasing choices of the Person. The unique combinations of Payer organizations, health benefit Plans and time periods in which they are valid for a Person are recorded in this table."
      },
      {
        "id": "PayerPlanPeriod.payer-plan-period-id",
        "path": "PayerPlanPeriod.payer_plan_period_id",
        "short": "Payer Plan Period Identifier",
        "definition": "Payer Plan Period Identifier",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "code"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.person-id",
        "path": "PayerPlanPeriod.person_id",
        "short": "Person",
        "definition": "The Person covered by the Plan.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/uv/omop/StructureDefinition/Person"
            ]
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.payer-plan-period-start-date",
        "path": "PayerPlanPeriod.payer_plan_period_start_date",
        "short": "Payer Plan Period Start Date",
        "definition": "Start date of Plan coverage.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "date"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.payer-plan-period-end-date",
        "path": "PayerPlanPeriod.payer_plan_period_end_date",
        "short": "Payer Plan Period End Date",
        "definition": "End date of Plan coverage.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "date"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.payer-concept-id",
        "path": "PayerPlanPeriod.payer_concept_id",
        "short": "Payer",
        "definition": "This field represents the organization who reimburses the provider which administers care to the Person.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "code"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.payer-source-value",
        "path": "PayerPlanPeriod.payer_source_value",
        "short": "Payer Source Value",
        "definition": "This is the Payer as it appears in the source data.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.payer-source-concept-id",
        "path": "PayerPlanPeriod.payer_source_concept_id",
        "short": "Payer Source",
        "definition": "Payer Source",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "code"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.plan-concept-id",
        "path": "PayerPlanPeriod.plan_concept_id",
        "short": "Plan",
        "definition": "This field represents the specific health benefit Plan the Person is enrolled in.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "code"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.plan-source-value",
        "path": "PayerPlanPeriod.plan_source_value",
        "short": "Plan Source Value",
        "definition": "This is the health benefit Plan of the Person as it appears in the source data.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.plan-source-concept-id",
        "path": "PayerPlanPeriod.plan_source_concept_id",
        "short": "Plan Source",
        "definition": "Plan Source",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "code"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.sponsor-concept-id",
        "path": "PayerPlanPeriod.sponsor_concept_id",
        "short": "Sponsor",
        "definition": "This field represents the sponsor of the Plan who finances the Plan. This includes self-insured, small group health plan and large group health plan.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "code"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.sponsor-source-value",
        "path": "PayerPlanPeriod.sponsor_source_value",
        "short": "Sponsor Source Value",
        "definition": "The Plan sponsor as it appears in the source data.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.sponsor-source-concept-id",
        "path": "PayerPlanPeriod.sponsor_source_concept_id",
        "short": "Sponsor Source",
        "definition": "Sponsor Source",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "code"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.family-source-value",
        "path": "PayerPlanPeriod.family_source_value",
        "short": "Family Source Value",
        "definition": "The common identifier for all people (often a family) that covered by the same policy.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.stop-reason-concept-id",
        "path": "PayerPlanPeriod.stop_reason_concept_id",
        "short": "Stop Reason",
        "definition": "This field represents the reason the Person left the Plan, if known.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "code"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.stop-reason-source-value",
        "path": "PayerPlanPeriod.stop_reason_source_value",
        "short": "Stop Reason Source Value",
        "definition": "The Plan stop reason as it appears in the source data.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "id": "PayerPlanPeriod.stop-reason-source-concept-id",
        "path": "PayerPlanPeriod.stop_reason_source_concept_id",
        "short": "Stop Reason Source",
        "definition": "Stop Reason Source",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "code"
          }
        ]
      }
    ]
  }
}