FHIR IG analytics| Package | hl7.fhir.uv.xver-r5.r3 |
| Resource Type | StructureDefinition |
| Id | StructureDefinition-ext-R5-Coverage.costToBeneficiary.json |
| FHIR Version | R3 |
| Source | http://hl7.org/fhir/uv/xver-r5.r3/0.1.0/StructureDefinition-ext-R5-Coverage.costToBeneficiary.html |
| URL | http://hl7.org/fhir/5.0/StructureDefinition/extension-Coverage.costToBeneficiary |
| Version | 0.1.0 |
| Status | active |
| Date | 2026-03-17T21:02:03.8104715+00:00 |
| Name | ExtensionCoverage_CostToBeneficiary |
| Title | R5: Patient payments for services/products (new) |
| Realm | uv |
| Authority | hl7 |
| Description | R5: `Coverage.costToBeneficiary` (new:BackboneElement) |
| Purpose | This extension is part of the cross-version definitions generated to enable use of the element `Coverage.costToBeneficiary` as defined in FHIR R5 in FHIR STU3. The source element is defined as: `Coverage.costToBeneficiary` 0..* `BackboneElement` Across FHIR versions, the element set has been mapped as: * R5: `Coverage.costToBeneficiary` 0..* `BackboneElement` * R4B: `Coverage.costToBeneficiary` 0..* `BackboneElement` * R4: `Coverage.costToBeneficiary` 0..* `BackboneElement` Following are the generation technical comments: Element `Coverage.costToBeneficiary` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`. Element `Coverage.costToBeneficiary` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). |
| Type | Extension |
| Kind | complex-type |
| ConceptMap | ||
| hl7.fhir.uv.xver-r5.r3#0.1.0 | R5-Coverage-element-map-to-R3 | Cross-version mapping for FHIR R5 Coverage to FHIR STU3 Coverage |
| ValueSet | ||
| hl7.fhir.uv.xver-r5.r3#0.1.0 | R5-coverage-copay-type-for-R3 | Cross-version ValueSet R5.CoverageCopayTypeCodes for use in FHIR STU3 |
| hl7.fhir.uv.xver-r5.r3#0.1.0 | R5-coverage-financial-exception-for-R3 | Cross-version ValueSet R5.ExampleCoverageFinancialExceptionCodes for use in FHIR STU3 |
| hl7.fhir.uv.xver-r5.r3#0.1.0 | R5-ex-benefitcategory-for-R3 | Cross-version ValueSet R5.BenefitCategoryCodes for use in FHIR STU3 |
No extension usage examples found
Note: links and images are rebased to the (stated) source
Generated Narrative: StructureDefinition ext-R5-Coverage.costToBeneficiary
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Extension | 0..* | Extension | R5: Patient payments for services/products (new) | |
  Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
   extension:type | 0..1 | Extension | R5: Cost category (new) | |
  url | 1..1 | uri | "type" | |
  value[x] | 0..1 | CodeableConcept | Cost category Binding: R5CoverageCopayTypeForR3 (0.1.0) (extensible): The types of services to which patient copayments are specified. | |
| extension:category | 0..1 | Extension | R5: Benefit classification (new) | |
| url | 1..1 | uri | "category" | |
| value[x] | 0..1 | CodeableConcept | Benefit classification Binding: R5ExBenefitcategoryForR3 (0.1.0) (example) | |
| extension:network | 0..1 | Extension | R5: In or out of network (new) | |
| url | 1..1 | uri | "network" | |
| value[x] | 0..1 | CodeableConcept | In or out of network Binding: Network Type Codes (example) | |
| extension:unit | 0..1 | Extension | R5: Individual or family (new) | |
| url | 1..1 | uri | "unit" | |
| value[x] | 0..1 | CodeableConcept | Individual or family Binding: Unit Type Codes (example) | |
| extension:term | 0..1 | Extension | R5: Annual or lifetime (new) | |
| url | 1..1 | uri | "term" | |
| value[x] | 0..1 | CodeableConcept | Annual or lifetime Binding: Benefit Term Codes (example) | |
| extension:value | 0..1 | Extension | R5: The amount or percentage due from the beneficiary (new) | |
| url | 1..1 | uri | "value" | |
 value[x] | 0..1 | The amount or percentage due from the beneficiary | ||
 valueQuantity | Quantity(SimpleQuantity) | |||
 valueMoney | Money | |||
 extension:exception | 0..* | Extension | R5: Exceptions for patient payments (new) | |
| Slices for extension | 1..* | Extension | Extension Slice: Unordered, Open by value:url | |
 extension:type | 1..1 | Extension | R5: Exception category (new) | |
| url | 1..1 | uri | "type" | |
| value[x] | 1..1 | CodeableConcept | Exception category Binding: R5CoverageFinancialExceptionForR3 (0.1.0) (example): The types of exceptions from the part or full value of financial obligations such as copays. | |
| extension:period | 0..1 | Extension | R5: The effective period of the exception (new) | |
| url | 1..1 | uri | "period" | |
| value[x] | 0..1 | Period | The effective period of the exception | |
| url | 1..1 | uri | "exception" | |
| value[x] | 0..0 | Value of extension | ||
| url | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-Coverage.costToBeneficiary" | |
| value[x] | 0..0 | Value of extension | ||
| Documentation for this format | ||||
FHIR
FHIRsmith{
"resourceType": "StructureDefinition",
"id": "ext-R5-Coverage.costToBeneficiary",
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode": "fhir"
},
{
"extension": [
{
"url": "packageId",
"valueId": "hl7.fhir.uv.xver-r5.r3"
},
{
"url": "version",
"valueString": "0.1.0"
},
{
"url": "uri",
"valueUri": "http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r3"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/package-source"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger": 0,
"_valueInteger": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
"valueUri": "http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r3"
}
]
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "trial-use",
"_valueCode": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
"valueUri": "http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r3"
}
]
}
}
],
"url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Coverage.costToBeneficiary",
"version": "0.1.0",
"name": "ExtensionCoverage_CostToBeneficiary",
"title": "R5: Patient payments for services/products (new)",
"status": "active",
"experimental": false,
"date": "2026-03-17T21:02:03.8104715+00:00",
"publisher": "FHIR Infrastructure",
"contact": [
{
"name": "FHIR Infrastructure",
"telecom": [
{
"system": "url",
"value": "http://www.hl7.org/Special/committees/fiwg"
}
]
}
],
"description": "R5: `Coverage.costToBeneficiary` (new:BackboneElement)",
"jurisdiction": [
{
"coding": [
{
"system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
"code": "001",
"display": "World"
}
]
}
],
"purpose": "This extension is part of the cross-version definitions generated to enable use of the\r\nelement `Coverage.costToBeneficiary` as defined in FHIR R5\r\nin FHIR STU3.\r\n\r\nThe source element is defined as:\r\n`Coverage.costToBeneficiary` 0..* `BackboneElement`\r\n\r\nAcross FHIR versions, the element set has been mapped as:\r\n* R5: `Coverage.costToBeneficiary` 0..* `BackboneElement`\n* R4B: `Coverage.costToBeneficiary` 0..* `BackboneElement`\n* R4: `Coverage.costToBeneficiary` 0..* `BackboneElement`\r\n\r\nFollowing are the generation technical comments:\r\nElement `Coverage.costToBeneficiary` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"fhirVersion": "3.0.2",
"mapping": [
{
"identity": "rim",
"uri": "http://hl7.org/v3",
"name": "RIM Mapping"
}
],
"kind": "complex-type",
"abstract": false,
"contextType": "resource",
"context": [
"Coverage"
],
"type": "Extension",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
"derivation": "constraint",
"snapshot": {
"element": [
{
"id": "Extension",
"path": "Extension",
"short": "R5: Patient payments for services/products (new)",
"definition": "R5: `Coverage.costToBeneficiary` (new:BackboneElement)",
"comment": "Element `Coverage.costToBeneficiary` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).\nFor example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment.",
"min": 0,
"max": "*",
"base": {
"path": "Extension",
"min": 0,
"max": "*"
},
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false
},
{
"id": "Extension.id",
"path": "Extension.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Extension.extension",
"path": "Extension.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"ordered": false,
"rules": "open"
},
"short": "Extension",
"definition": "An Extension",
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
]
},
{
"id": "Extension.extension:type",
"path": "Extension.extension",
"sliceName": "type",
"short": "R5: Cost category (new)",
"definition": "R5: `Coverage.costToBeneficiary.type` (new:CodeableConcept)",
"comment": "Element `Coverage.costToBeneficiary.type` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.type` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.type` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).\nFor example visit, specialist visits, emergency, inpatient care, etc.",
"requirements": "Needed to identify the category associated with the amount for the patient. Element `Coverage.costToBeneficiary.type` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.type` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.type` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 0,
"max": "1",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
]
},
{
"id": "Extension.extension:type.id",
"path": "Extension.extension.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Extension.extension:type.extension",
"path": "Extension.extension.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional Content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Extension.extension:type.url",
"path": "Extension.extension.url",
"representation": [
"xmlAttr"
],
"short": "identifies the meaning of the extension",
"definition": "Source of the definition for the extension code - a logical name or a URL.",
"comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "type",
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Extension.extension:type.value[x]",
"path": "Extension.extension.value[x]",
"short": "Cost category",
"definition": "The category of patient centric costs associated with treatment.",
"comment": "For example visit, specialist visits, emergency, inpatient care, etc.",
"min": 0,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"strength": "extensible",
"description": "The types of services to which patient copayments are specified.",
"valueSetUri": "http://hl7.org/fhir/uv/xver/ValueSet/R5-coverage-copay-type-for-R3|0.1.0"
},
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Extension.extension:category",
"path": "Extension.extension",
"sliceName": "category",
"short": "R5: Benefit classification (new)",
"definition": "R5: `Coverage.costToBeneficiary.category` (new:CodeableConcept)",
"comment": "Element `Coverage.costToBeneficiary.category` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.category` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.category` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).\nExamples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.",
"requirements": "Needed to convey the category of service or product for which eligibility is sought. Element `Coverage.costToBeneficiary.category` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.category` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.category` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 0,
"max": "1",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
]
},
{
"id": "Extension.extension:category.id",
"path": "Extension.extension.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Extension.extension:category.extension",
"path": "Extension.extension.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional Content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Extension.extension:category.url",
"path": "Extension.extension.url",
"representation": [
"xmlAttr"
],
"short": "identifies the meaning of the extension",
"definition": "Source of the definition for the extension code - a logical name or a URL.",
"comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "category",
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Extension.extension:category.value[x]",
"path": "Extension.extension.value[x]",
"short": "Benefit classification",
"definition": "Code to identify the general type of benefits under which products and services are provided.",
"comment": "Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.",
"min": 0,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"strength": "example",
"valueSetUri": "http://hl7.org/fhir/uv/xver/ValueSet/R5-ex-benefitcategory-for-R3|0.1.0"
},
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Extension.extension:network",
"path": "Extension.extension",
"sliceName": "network",
"short": "R5: In or out of network (new)",
"definition": "R5: `Coverage.costToBeneficiary.network` (new:CodeableConcept)",
"comment": "Element `Coverage.costToBeneficiary.network` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.network` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.network` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"requirements": "Needed as in or out of network providers are treated differently under the coverage. Element `Coverage.costToBeneficiary.network` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.network` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.network` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 0,
"max": "1",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
]
},
{
"id": "Extension.extension:network.id",
"path": "Extension.extension.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Extension.extension:network.extension",
"path": "Extension.extension.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional Content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Extension.extension:network.url",
"path": "Extension.extension.url",
"representation": [
"xmlAttr"
],
"short": "identifies the meaning of the extension",
"definition": "Source of the definition for the extension code - a logical name or a URL.",
"comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "network",
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Extension.extension:network.value[x]",
"path": "Extension.extension.value[x]",
"short": "In or out of network",
"definition": "Is a flag to indicate whether the benefits refer to in-network providers or out-of-network providers.",
"min": 0,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"strength": "example",
"valueSetUri": "http://hl7.org/fhir/ValueSet/benefit-network|3.0.2"
},
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Extension.extension:unit",
"path": "Extension.extension",
"sliceName": "unit",
"short": "R5: Individual or family (new)",
"definition": "R5: `Coverage.costToBeneficiary.unit` (new:CodeableConcept)",
"comment": "Element `Coverage.costToBeneficiary.unit` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.unit` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.unit` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"requirements": "Needed for the understanding of the benefits. Element `Coverage.costToBeneficiary.unit` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.unit` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.unit` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 0,
"max": "1",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
]
},
{
"id": "Extension.extension:unit.id",
"path": "Extension.extension.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Extension.extension:unit.extension",
"path": "Extension.extension.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional Content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Extension.extension:unit.url",
"path": "Extension.extension.url",
"representation": [
"xmlAttr"
],
"short": "identifies the meaning of the extension",
"definition": "Source of the definition for the extension code - a logical name or a URL.",
"comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "unit",
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Extension.extension:unit.value[x]",
"path": "Extension.extension.value[x]",
"short": "Individual or family",
"definition": "Indicates if the benefits apply to an individual or to the family.",
"min": 0,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"strength": "example",
"valueSetUri": "http://hl7.org/fhir/ValueSet/benefit-unit|3.0.2"
},
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Extension.extension:term",
"path": "Extension.extension",
"sliceName": "term",
"short": "R5: Annual or lifetime (new)",
"definition": "R5: `Coverage.costToBeneficiary.term` (new:CodeableConcept)",
"comment": "Element `Coverage.costToBeneficiary.term` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.term` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.term` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"requirements": "Needed for the understanding of the benefits. Element `Coverage.costToBeneficiary.term` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.term` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.term` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 0,
"max": "1",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
]
},
{
"id": "Extension.extension:term.id",
"path": "Extension.extension.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Extension.extension:term.extension",
"path": "Extension.extension.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional Content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Extension.extension:term.url",
"path": "Extension.extension.url",
"representation": [
"xmlAttr"
],
"short": "identifies the meaning of the extension",
"definition": "Source of the definition for the extension code - a logical name or a URL.",
"comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "term",
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Extension.extension:term.value[x]",
"path": "Extension.extension.value[x]",
"short": "Annual or lifetime",
"definition": "The term or period of the values such as 'maximum lifetime benefit' or 'maximum annual visits'.",
"min": 0,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"strength": "example",
"valueSetUri": "http://hl7.org/fhir/ValueSet/benefit-term|3.0.2"
},
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Extension.extension:value",
"path": "Extension.extension",
"sliceName": "value",
"short": "R5: The amount or percentage due from the beneficiary (new)",
"definition": "R5: `Coverage.costToBeneficiary.value[x]` (new:Money, Quantity[SimpleQuantity])",
"comment": "Element `Coverage.costToBeneficiary.value[x]` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.value[x]` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.value[x]` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).\nAmount may be expressed as a percentage of the service/product cost or a fixed amount of currency.",
"requirements": "Needed to identify the amount for the patient associated with the category. Element `Coverage.costToBeneficiary.value[x]` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.value[x]` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.value[x]` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 0,
"max": "1",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
]
},
{
"id": "Extension.extension:value.id",
"path": "Extension.extension.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Extension.extension:value.extension",
"path": "Extension.extension.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional Content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Extension.extension:value.url",
"path": "Extension.extension.url",
"representation": [
"xmlAttr"
],
"short": "identifies the meaning of the extension",
"definition": "Source of the definition for the extension code - a logical name or a URL.",
"comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "value",
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Extension.extension:value.value[x]",
"path": "Extension.extension.value[x]",
"short": "The amount or percentage due from the beneficiary",
"definition": "The amount due from the patient for the cost category.",
"comment": "Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency.",
"min": 0,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Quantity",
"profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
},
{
"code": "Money"
}
],
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Extension.extension:exception",
"path": "Extension.extension",
"sliceName": "exception",
"short": "R5: Exceptions for patient payments (new)",
"definition": "R5: `Coverage.costToBeneficiary.exception` (new:BackboneElement)",
"comment": "Element `Coverage.costToBeneficiary.exception` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.exception` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.exception` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"requirements": "Required by providers to manage financial transaction with the patient. Element `Coverage.costToBeneficiary.exception` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.exception` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.exception` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
]
},
{
"id": "Extension.extension:exception.id",
"path": "Extension.extension.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Extension.extension:exception.extension",
"path": "Extension.extension.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"ordered": false,
"rules": "open"
},
"short": "Extension",
"definition": "An Extension",
"min": 1,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
]
},
{
"id": "Extension.extension:exception.extension:type",
"path": "Extension.extension.extension",
"sliceName": "type",
"short": "R5: Exception category (new)",
"definition": "R5: `Coverage.costToBeneficiary.exception.type` (new:CodeableConcept)",
"comment": "Element `Coverage.costToBeneficiary.exception.type` is part of an existing definition because parent element `Coverage.costToBeneficiary.exception` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.exception.type` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.exception.type` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"requirements": "Needed to identify the exception associated with the amount for the patient. Element `Coverage.costToBeneficiary.exception.type` is part of an existing definition because parent element `Coverage.costToBeneficiary.exception` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.exception.type` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.exception.type` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 1,
"max": "1",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
]
},
{
"id": "Extension.extension:exception.extension:type.id",
"path": "Extension.extension.extension.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Extension.extension:exception.extension:type.extension",
"path": "Extension.extension.extension.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional Content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Extension.extension:exception.extension:type.url",
"path": "Extension.extension.extension.url",
"representation": [
"xmlAttr"
],
"short": "identifies the meaning of the extension",
"definition": "Source of the definition for the extension code - a logical name or a URL.",
"comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "type",
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Extension.extension:exception.extension:type.value[x]",
"path": "Extension.extension.extension.value[x]",
"short": "Exception category",
"definition": "The code for the specific exception.",
"min": 1,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"strength": "example",
"description": "The types of exceptions from the part or full value of financial obligations such as copays.",
"valueSetUri": "http://hl7.org/fhir/uv/xver/ValueSet/R5-coverage-financial-exception-for-R3|0.1.0"
},
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Extension.extension:exception.extension:period",
"path": "Extension.extension.extension",
"sliceName": "period",
"short": "R5: The effective period of the exception (new)",
"definition": "R5: `Coverage.costToBeneficiary.exception.period` (new:Period)",
"comment": "Element `Coverage.costToBeneficiary.exception.period` is part of an existing definition because parent element `Coverage.costToBeneficiary.exception` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.exception.period` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.exception.period` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"requirements": "Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs. Element `Coverage.costToBeneficiary.exception.period` is part of an existing definition because parent element `Coverage.costToBeneficiary.exception` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.exception.period` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.exception.period` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 0,
"max": "1",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
]
},
{
"id": "Extension.extension:exception.extension:period.id",
"path": "Extension.extension.extension.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Extension.extension:exception.extension:period.extension",
"path": "Extension.extension.extension.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional Content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Extension.extension:exception.extension:period.url",
"path": "Extension.extension.extension.url",
"representation": [
"xmlAttr"
],
"short": "identifies the meaning of the extension",
"definition": "Source of the definition for the extension code - a logical name or a URL.",
"comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "period",
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Extension.extension:exception.extension:period.value[x]",
"path": "Extension.extension.extension.value[x]",
"short": "The effective period of the exception",
"definition": "The timeframe the exception is in force.",
"min": 0,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Extension.extension:exception.url",
"path": "Extension.extension.url",
"representation": [
"xmlAttr"
],
"short": "identifies the meaning of the extension",
"definition": "Source of the definition for the extension code - a logical name or a URL.",
"comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "exception",
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Extension.extension:exception.value[x]",
"path": "Extension.extension.value[x]",
"short": "Value of extension",
"definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
"min": 0,
"max": "0",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "base64Binary"
},
{
"code": "boolean"
},
{
"code": "code"
},
{
"code": "date"
},
{
"code": "dateTime"
},
{
"code": "decimal"
},
{
"code": "id"
},
{
"code": "instant"
},
{
"code": "integer"
},
{
"code": "markdown"
},
{
"code": "oid"
},
{
"code": "positiveInt"
},
{
"code": "string"
},
{
"code": "time"
},
{
"code": "unsignedInt"
},
{
"code": "uri"
},
{
"code": "Address"
},
{
"code": "Age"
},
{
"code": "Annotation"
},
{
"code": "Attachment"
},
{
"code": "CodeableConcept"
},
{
"code": "Coding"
},
{
"code": "ContactPoint"
},
{
"code": "Count"
},
{
"code": "Distance"
},
{
"code": "Duration"
},
{
"code": "HumanName"
},
{
"code": "Identifier"
},
{
"code": "Money"
},
{
"code": "Period"
},
{
"code": "Quantity"
},
{
"code": "Range"
},
{
"code": "Ratio"
},
{
"code": "Reference"
},
{
"code": "SampledData"
},
{
"code": "Signature"
},
{
"code": "Timing"
},
{
"code": "Meta"
}
],
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Extension.url",
"path": "Extension.url",
"representation": [
"xmlAttr"
],
"short": "identifies the meaning of the extension",
"definition": "Source of the definition for the extension code - a logical name or a URL.",
"comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Coverage.costToBeneficiary",
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Extension.value[x]",
"path": "Extension.value[x]",
"short": "Value of extension",
"definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
"min": 0,
"max": "0",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "base64Binary"
},
{
"code": "boolean"
},
{
"code": "code"
},
{
"code": "date"
},
{
"code": "dateTime"
},
{
"code": "decimal"
},
{
"code": "id"
},
{
"code": "instant"
},
{
"code": "integer"
},
{
"code": "markdown"
},
{
"code": "oid"
},
{
"code": "positiveInt"
},
{
"code": "string"
},
{
"code": "time"
},
{
"code": "unsignedInt"
},
{
"code": "uri"
},
{
"code": "Address"
},
{
"code": "Age"
},
{
"code": "Annotation"
},
{
"code": "Attachment"
},
{
"code": "CodeableConcept"
},
{
"code": "Coding"
},
{
"code": "ContactPoint"
},
{
"code": "Count"
},
{
"code": "Distance"
},
{
"code": "Duration"
},
{
"code": "HumanName"
},
{
"code": "Identifier"
},
{
"code": "Money"
},
{
"code": "Period"
},
{
"code": "Quantity"
},
{
"code": "Range"
},
{
"code": "Ratio"
},
{
"code": "Reference"
},
{
"code": "SampledData"
},
{
"code": "Signature"
},
{
"code": "Timing"
},
{
"code": "Meta"
}
],
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
}
]
},
"differential": {
"element": [
{
"id": "Extension",
"path": "Extension",
"short": "R5: Patient payments for services/products (new)",
"definition": "R5: `Coverage.costToBeneficiary` (new:BackboneElement)",
"comment": "Element `Coverage.costToBeneficiary` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).\nFor example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment.",
"min": 0,
"max": "*",
"base": {
"path": "Extension",
"min": 0,
"max": "*"
},
"isModifier": false
},
{
"id": "Extension.extension",
"path": "Extension.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"min": 0,
"max": "*",
"base": {
"path": "Extension.extension",
"min": 0,
"max": "*"
}
},
{
"id": "Extension.extension:type",
"path": "Extension.extension",
"sliceName": "type",
"short": "R5: Cost category (new)",
"definition": "R5: `Coverage.costToBeneficiary.type` (new:CodeableConcept)",
"comment": "Element `Coverage.costToBeneficiary.type` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.type` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.type` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).\nFor example visit, specialist visits, emergency, inpatient care, etc.",
"requirements": "Needed to identify the category associated with the amount for the patient. Element `Coverage.costToBeneficiary.type` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.type` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.type` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 0,
"max": "1",
"base": {
"path": "Extension.extension",
"min": 0,
"max": "*"
}
},
{
"id": "Extension.extension:type.url",
"path": "Extension.extension.url",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"fixedUri": "type"
},
{
"id": "Extension.extension:type.value[x]",
"path": "Extension.extension.value[x]",
"short": "Cost category",
"definition": "The category of patient centric costs associated with treatment.",
"comment": "For example visit, specialist visits, emergency, inpatient care, etc.",
"min": 0,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"strength": "extensible",
"description": "The types of services to which patient copayments are specified.",
"valueSetUri": "http://hl7.org/fhir/uv/xver/ValueSet/R5-coverage-copay-type-for-R3|0.1.0"
}
},
{
"id": "Extension.extension:category",
"path": "Extension.extension",
"sliceName": "category",
"short": "R5: Benefit classification (new)",
"definition": "R5: `Coverage.costToBeneficiary.category` (new:CodeableConcept)",
"comment": "Element `Coverage.costToBeneficiary.category` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.category` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.category` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).\nExamples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.",
"requirements": "Needed to convey the category of service or product for which eligibility is sought. Element `Coverage.costToBeneficiary.category` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.category` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.category` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 0,
"max": "1",
"base": {
"path": "Extension.extension",
"min": 0,
"max": "*"
}
},
{
"id": "Extension.extension:category.url",
"path": "Extension.extension.url",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"fixedUri": "category"
},
{
"id": "Extension.extension:category.value[x]",
"path": "Extension.extension.value[x]",
"short": "Benefit classification",
"definition": "Code to identify the general type of benefits under which products and services are provided.",
"comment": "Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.",
"min": 0,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"strength": "example",
"valueSetUri": "http://hl7.org/fhir/uv/xver/ValueSet/R5-ex-benefitcategory-for-R3|0.1.0"
}
},
{
"id": "Extension.extension:network",
"path": "Extension.extension",
"sliceName": "network",
"short": "R5: In or out of network (new)",
"definition": "R5: `Coverage.costToBeneficiary.network` (new:CodeableConcept)",
"comment": "Element `Coverage.costToBeneficiary.network` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.network` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.network` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"requirements": "Needed as in or out of network providers are treated differently under the coverage. Element `Coverage.costToBeneficiary.network` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.network` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.network` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 0,
"max": "1",
"base": {
"path": "Extension.extension",
"min": 0,
"max": "*"
}
},
{
"id": "Extension.extension:network.url",
"path": "Extension.extension.url",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"fixedUri": "network"
},
{
"id": "Extension.extension:network.value[x]",
"path": "Extension.extension.value[x]",
"short": "In or out of network",
"definition": "Is a flag to indicate whether the benefits refer to in-network providers or out-of-network providers.",
"min": 0,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"strength": "example",
"valueSetUri": "http://hl7.org/fhir/ValueSet/benefit-network|3.0.2"
}
},
{
"id": "Extension.extension:unit",
"path": "Extension.extension",
"sliceName": "unit",
"short": "R5: Individual or family (new)",
"definition": "R5: `Coverage.costToBeneficiary.unit` (new:CodeableConcept)",
"comment": "Element `Coverage.costToBeneficiary.unit` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.unit` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.unit` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"requirements": "Needed for the understanding of the benefits. Element `Coverage.costToBeneficiary.unit` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.unit` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.unit` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 0,
"max": "1",
"base": {
"path": "Extension.extension",
"min": 0,
"max": "*"
}
},
{
"id": "Extension.extension:unit.url",
"path": "Extension.extension.url",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"fixedUri": "unit"
},
{
"id": "Extension.extension:unit.value[x]",
"path": "Extension.extension.value[x]",
"short": "Individual or family",
"definition": "Indicates if the benefits apply to an individual or to the family.",
"min": 0,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"strength": "example",
"valueSetUri": "http://hl7.org/fhir/ValueSet/benefit-unit|3.0.2"
}
},
{
"id": "Extension.extension:term",
"path": "Extension.extension",
"sliceName": "term",
"short": "R5: Annual or lifetime (new)",
"definition": "R5: `Coverage.costToBeneficiary.term` (new:CodeableConcept)",
"comment": "Element `Coverage.costToBeneficiary.term` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.term` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.term` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"requirements": "Needed for the understanding of the benefits. Element `Coverage.costToBeneficiary.term` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.term` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.term` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 0,
"max": "1",
"base": {
"path": "Extension.extension",
"min": 0,
"max": "*"
}
},
{
"id": "Extension.extension:term.url",
"path": "Extension.extension.url",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"fixedUri": "term"
},
{
"id": "Extension.extension:term.value[x]",
"path": "Extension.extension.value[x]",
"short": "Annual or lifetime",
"definition": "The term or period of the values such as 'maximum lifetime benefit' or 'maximum annual visits'.",
"min": 0,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"strength": "example",
"valueSetUri": "http://hl7.org/fhir/ValueSet/benefit-term|3.0.2"
}
},
{
"id": "Extension.extension:value",
"path": "Extension.extension",
"sliceName": "value",
"short": "R5: The amount or percentage due from the beneficiary (new)",
"definition": "R5: `Coverage.costToBeneficiary.value[x]` (new:Money, Quantity[SimpleQuantity])",
"comment": "Element `Coverage.costToBeneficiary.value[x]` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.value[x]` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.value[x]` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).\nAmount may be expressed as a percentage of the service/product cost or a fixed amount of currency.",
"requirements": "Needed to identify the amount for the patient associated with the category. Element `Coverage.costToBeneficiary.value[x]` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.value[x]` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.value[x]` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 0,
"max": "1",
"base": {
"path": "Extension.extension",
"min": 0,
"max": "*"
}
},
{
"id": "Extension.extension:value.url",
"path": "Extension.extension.url",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"fixedUri": "value"
},
{
"id": "Extension.extension:value.value[x]",
"path": "Extension.extension.value[x]",
"short": "The amount or percentage due from the beneficiary",
"definition": "The amount due from the patient for the cost category.",
"comment": "Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency.",
"min": 0,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Quantity",
"profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
},
{
"code": "Money"
}
]
},
{
"id": "Extension.extension:exception",
"path": "Extension.extension",
"sliceName": "exception",
"short": "R5: Exceptions for patient payments (new)",
"definition": "R5: `Coverage.costToBeneficiary.exception` (new:BackboneElement)",
"comment": "Element `Coverage.costToBeneficiary.exception` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.exception` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.exception` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"requirements": "Required by providers to manage financial transaction with the patient. Element `Coverage.costToBeneficiary.exception` is part of an existing definition because parent element `Coverage.costToBeneficiary` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.exception` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.exception` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 0,
"max": "*",
"base": {
"path": "Extension.extension",
"min": 0,
"max": "*"
}
},
{
"id": "Extension.extension:exception.extension",
"path": "Extension.extension.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"min": 1,
"max": "*",
"base": {
"path": "Extension.extension",
"min": 0,
"max": "*"
}
},
{
"id": "Extension.extension:exception.extension:type",
"path": "Extension.extension.extension",
"sliceName": "type",
"short": "R5: Exception category (new)",
"definition": "R5: `Coverage.costToBeneficiary.exception.type` (new:CodeableConcept)",
"comment": "Element `Coverage.costToBeneficiary.exception.type` is part of an existing definition because parent element `Coverage.costToBeneficiary.exception` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.exception.type` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.exception.type` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"requirements": "Needed to identify the exception associated with the amount for the patient. Element `Coverage.costToBeneficiary.exception.type` is part of an existing definition because parent element `Coverage.costToBeneficiary.exception` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.exception.type` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.exception.type` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 1,
"max": "1",
"base": {
"path": "Extension.extension",
"min": 0,
"max": "*"
}
},
{
"id": "Extension.extension:exception.extension:type.url",
"path": "Extension.extension.extension.url",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"fixedUri": "type"
},
{
"id": "Extension.extension:exception.extension:type.value[x]",
"path": "Extension.extension.extension.value[x]",
"short": "Exception category",
"definition": "The code for the specific exception.",
"min": 1,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"strength": "example",
"description": "The types of exceptions from the part or full value of financial obligations such as copays.",
"valueSetUri": "http://hl7.org/fhir/uv/xver/ValueSet/R5-coverage-financial-exception-for-R3|0.1.0"
}
},
{
"id": "Extension.extension:exception.extension:period",
"path": "Extension.extension.extension",
"sliceName": "period",
"short": "R5: The effective period of the exception (new)",
"definition": "R5: `Coverage.costToBeneficiary.exception.period` (new:Period)",
"comment": "Element `Coverage.costToBeneficiary.exception.period` is part of an existing definition because parent element `Coverage.costToBeneficiary.exception` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.exception.period` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.exception.period` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"requirements": "Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs. Element `Coverage.costToBeneficiary.exception.period` is part of an existing definition because parent element `Coverage.costToBeneficiary.exception` requires a cross-version extension.\nElement `Coverage.costToBeneficiary.exception.period` has a context of Coverage based on following the parent source element upwards and mapping to `Coverage`.\nElement `Coverage.costToBeneficiary.exception.period` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 0,
"max": "1",
"base": {
"path": "Extension.extension",
"min": 0,
"max": "*"
}
},
{
"id": "Extension.extension:exception.extension:period.url",
"path": "Extension.extension.extension.url",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"fixedUri": "period"
},
{
"id": "Extension.extension:exception.extension:period.value[x]",
"path": "Extension.extension.extension.value[x]",
"short": "The effective period of the exception",
"definition": "The timeframe the exception is in force.",
"min": 0,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
]
},
{
"id": "Extension.extension:exception.url",
"path": "Extension.extension.url",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"fixedUri": "exception"
},
{
"id": "Extension.extension:exception.value[x]",
"path": "Extension.extension.value[x]",
"min": 0,
"max": "0",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
}
},
{
"id": "Extension.url",
"path": "Extension.url",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"fixedUri": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Coverage.costToBeneficiary"
},
{
"id": "Extension.value[x]",
"path": "Extension.value[x]",
"min": 0,
"max": "0",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
}
}
]
}
}