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Coverage.profile.json

Financial Management Work GroupMaturity Level: N/ABallot Status: InformativeCompartments: Patient, RelatedPerson

Raw JSON (каноническая форма + also see JSON Format Specification)

StructureDefinition for coverage

{
  "resourceType" : "StructureDefinition",
  "id" : "Coverage",
  "meta" : {
    "lastUpdated" : "2019-05-17T12:34:53.932+00:00"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div>!-- Snipped for Brevity --></div>"
  },
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode" : "trial-use"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger" : 2
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category",
    "valueCode" : "patient"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode" : "fm"
  }],
  "url" : "http://hl7.org/fhir/StructureDefinition/Coverage",
  "version" : "3.6.0",
  "name" : "Coverage",
  "status" : "draft",
  "date" : "2019-05-17T12:34:53+00:00",
  "publisher" : "Health Level Seven International (Financial Management)",
  "contact" : [{
    "telecom" : [{
      "system" : "url",
      "value" : "http://hl7.org/fhir"
    }]
  },
  {
    "telecom" : [{
      "system" : "url",
      "value" : "http://www.hl7.org/Special/committees/fm/index.cfm"
    }]
  }],
  "description" : "Финансовый инструмент, который может быть использован для оплаты или компенсации за продукты и услуги в области здравоохранения. Includes both insurance and self-payment.",
  "purpose" : "Coverage provides a link between covered parties (patients) and the payors of their healthcare costs (both insurance and self-pay).",
  "fhirVersion" : "3.6.0",
  "mapping" : [{
    "identity" : "workflow",
    "uri" : "http://hl7.org/fhir/workflow",
    "name" : "Workflow Pattern"
  },
  {
    "identity" : "rim",
    "uri" : "http://hl7.org/v3",
    "name" : "RIM Mapping"
  },
  {
    "identity" : "w5",
    "uri" : "http://hl7.org/fhir/fivews",
    "name" : "FiveWs Pattern"
  },
  {
    "identity" : "cdanetv4",
    "uri" : "http://www.cda-adc.ca/en/services/cdanet/",
    "name" : "Canadian Dental Association eclaims standard"
  },
  {
    "identity" : "v2",
    "uri" : "http://hl7.org/v2",
    "name" : "HL7 v2 Mapping"
  },
  {
    "identity" : "cpha3pharm",
    "uri" : "http://www.pharmacists.ca/",
    "name" : "Canadian Pharmacy Associaiton eclaims standard"
  }],
  "kind" : "resource",
  "abstract" : false,
  "type" : "Coverage",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/DomainResource",
  "derivation" : "specialization",
  "snapshot" : {
    "element" : [{
      "id" : "Coverage",
      "path" : "Coverage",
      "short" : "Insurance or medical plan or a payment agreement",
      "definition" : "Финансовый инструмент, который может быть использован для оплаты или компенсации за продукты и услуги в области здравоохранения. Includes both insurance and self-payment.",
      "comment" : "The Coverage resource contains the insurance card level information, which is customary to provide on claims and other communications between providers and insurers.",
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "Coverage",
        "min" : 0,
        "max" : "*"
      },
      "constraint" : [{
        "key" : "dom-2",
        "severity" : "error",
        "human" : "Если ресурс встроен в другой ресурс, он НЕ ДОЛЖЕН содержать описательной части",
        "expression" : "contained.contained.empty()",
        "xpath" : "not(parent::f:contained and f:contained)",
        "source" : "DomainResource"
      },
      {
        "key" : "dom-4",
        "severity" : "error",
        "human" : "Если ресурс встроен в другой ресурс, он НЕ ДОЛЖЕН иметь meta.versionId или meta.lastUpdated",
        "expression" : "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
        "xpath" : "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
        "source" : "DomainResource"
      },
      {
        "key" : "dom-3",
        "severity" : "error",
        "human" : "Если ресурс встроен в другой ресурс, где-то в родительском ресурсе на него ДОЛЖНА БЫТЬ дана ссылка or SHALL refer to the containing resource",
        "expression" : "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()",
        "xpath" : "not(exists(for $contained in f:contained return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
        "source" : "DomainResource"
      },
      {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
          "valueBoolean" : true
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
          "valueMarkdown" : "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
        }],
        "key" : "dom-6",
        "severity" : "warning",
        "human" : "A resource should have narrative for robust management",
        "expression" : "text.div.exists()",
        "xpath" : "exists(f:text/h:div)",
        "source" : "DomainResource"
      },
      {
        "key" : "dom-5",
        "severity" : "error",
        "human" : "If a resource is contained in another resource, it SHALL NOT have a security label",
        "expression" : "contained.meta.security.empty()",
        "xpath" : "not(exists(f:contained/*/f:meta/f:security))",
        "source" : "DomainResource"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "rim",
        "map" : "Entity. Role, or Act"
      },
      {
        "identity" : "workflow",
        "map" : "Event"
      },
      {
        "identity" : "rim",
        "map" : "Coverage"
      }]
    },
    {
      "id" : "Coverage.id",
      "path" : "Coverage.id",
      "short" : "Logical id of this artifact",
      "definition" : "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
      "comment" : "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "Resource.id",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "id"
      }],
      "isModifier" : false,
      "isSummary" : true
    },
    {
      "id" : "Coverage.meta",
      "path" : "Coverage.meta",
      "short" : "Метаданные ресурса",
      "definition" : "Метаданные ресурса. Это такая информация, которая поддерживается инфраструктурой. Изменения этой информации не всегда можно ассоциировать с версионными изменениями ресурса.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "Resource.meta",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "Meta"
      }],
      "isModifier" : false,
      "isSummary" : true
    },
    {
      "id" : "Coverage.implicitRules",
      "path" : "Coverage.implicitRules",
      "short" : "Свод правил, в соответствии с которыми создавалось это содержимое",
      "definition" : "Ссылка на свод правил, которым следовали при создании этого ресурса и которые необходимо понимать при обработке этого содержимого. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
      "comment" : "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "Resource.implicitRules",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "uri"
      }],
      "isModifier" : true,
      "isModifierReason" : "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
      "isSummary" : true
    },
    {
      "id" : "Coverage.language",
      "path" : "Coverage.language",
      "short" : "Язык содержимого ресурса",
      "definition" : "Основной язык, на котором написан ресурс.",
      "comment" : "Язык указывается для поддержки предварительной обработки текстов и доступности для понимания (например при преобразовании текста в речь используется языковой тег). HTML-тег language в описательной части применяется к этой описательной части. Языковой тег ресурса может использоваться для указания языков других представлений, генерируемых из данных ресурса\n\nНе все содержание ресурса должно быть на указанном основном языке. Resource.language нельзя автоматически принимать за язык описательной части. Если язык указан, его также следует указать в элементе div в HTML (информацию о связи между xml:lang и HTML-атрибутом lang см. в правилах HTML5).",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "Resource.language",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "code"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
          "valueCanonical" : "http://hl7.org/fhir/ValueSet/all-languages"
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "Language"
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean" : true
        }],
        "strength" : "preferred",
        "description" : "Естественный язык.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/languages"
      }
    },
    {
      "id" : "Coverage.text",
      "path" : "Coverage.text",
      "short" : "Краткое текстовое изложение ресурса для интерпретации человеком",
      "definition" : "Человекочитаемая описательная часть, содержащая краткое изложение ресурса, которая может использоваться для представления содержимого ресурса человеку. От описательной части не требуется кодировать все структурированные данные, но она должна содержать достаточно сведений, чтобы простое её прочтение человеком было \"клинически безопасным\". Определения ресурсов могут описывать, какое содержимое должно быть представлено в описательной части для обеспечения клинической безопасной.",
      "comment" : "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
      "alias" : ["narrative",
      "html",
      "xhtml",
      "display"],
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "DomainResource.text",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "Narrative"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "rim",
        "map" : "Act.text?"
      }]
    },
    {
      "id" : "Coverage.contained",
      "path" : "Coverage.contained",
      "short" : "Вложенные, встроенные инлайн ресурсы",
      "definition" : "Эти ресурсы не обладают независимым существованием вне ресурса, который их содержит - их нельзя идентифицировать независимо, и они не могут иметь своей собственной независимой транзакционной области действия.",
      "comment" : "Этого не следует делать, когда содержимое может быть идентифицировано должным образом, поскольку, потеряв идентификацию, будет чрезвычайно сложно (и контекстно-зависимо) снова восстановить её. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
      "alias" : ["inline resources",
      "anonymous resources",
      "contained resources"],
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "DomainResource.contained",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "Resource"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "rim",
        "map" : "N/A"
      }]
    },
    {
      "id" : "Coverage.extension",
      "path" : "Coverage.extension",
      "short" : "Дополнительное содержимое, определенное реализаторами",
      "definition" : "Может использоваться для представления дополнительной информации, не являющейся частью базового определения ресурса. Чтобы сделать использование расширений надежным и управляемым, существует строгий набор управления применительно к определению и использованию расширений. Хотя каждому реализатору разрешается определять расширения, имеется набор требований, которые должны выполняться в рамках определения расширения.",
      "comment" : "Не должно быть никаких предрассудков по использованию расширений любыми приложениями, проектами или стандартами - вне зависимости от учреждения или юрисдикции, которые используют или задают расширение. Именно использование расширений позволяет спецификации FHIR сохранять простоту для всех.",
      "alias" : ["extensions",
      "user content"],
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "DomainResource.extension",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "Extension"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "rim",
        "map" : "N/A"
      }]
    },
    {
      "id" : "Coverage.modifierExtension",
      "path" : "Coverage.modifierExtension",
      "short" : "Расширения, которые нельзя игнорировать",
      "definition" : "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "comment" : "Не должно быть никаких предрассудков по использованию расширений любыми приложениями, проектами или стандартами - вне зависимости от учреждения или юрисдикции, которые используют или задают расширение. Именно использование расширений позволяет спецификации FHIR сохранять простоту для всех.",
      "alias" : ["extensions",
      "user content"],
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "DomainResource.modifierExtension",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "Extension"
      }],
      "isModifier" : true,
      "isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
      "isSummary" : false,
      "mapping" : [{
        "identity" : "rim",
        "map" : "N/A"
      }]
    },
    {
      "id" : "Coverage.identifier",
      "path" : "Coverage.identifier",
      "short" : "Business Identifier for the coverage",
      "definition" : "A unique identifier assigned to this coverage.",
      "comment" : "The main (and possibly only) identifier for the coverage - often referred to as a Member Id, Certificate number, Personal Health Number or Case ID. May be constructed as the concatenation of the Coverage.SubscriberID and the Coverage.dependant.",
      "requirements" : "Allows coverages to be distinguished and referenced.",
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "Coverage.identifier",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "Identifier"
      }],
      "isModifier" : false,
      "isSummary" : true,
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Event.identifier"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.identifier"
      },
      {
        "identity" : "cdanetv4",
        "map" : "C02"
      },
      {
        "identity" : "v2",
        "map" : "IN1-2"
      },
      {
        "identity" : "rim",
        "map" : ".id"
      },
      {
        "identity" : "cpha3pharm",
        "map" : "C.32, C.33, C.39"
      }]
    },
    {
      "id" : "Coverage.status",
      "path" : "Coverage.status",
      "short" : "active | cancelled | draft | entered-in-error",
      "definition" : "The status of the resource instance.",
      "comment" : "This element is labeled as a modifier because the status contains the code entered-in-error that marks the coverage as not currently valid.",
      "requirements" : "Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.",
      "min" : 1,
      "max" : "1",
      "base" : {
        "path" : "Coverage.status",
        "min" : 1,
        "max" : "1"
      },
      "type" : [{
        "code" : "code"
      }],
      "isModifier" : true,
      "isModifierReason" : "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
      "isSummary" : true,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "CoverageStatus"
        }],
        "strength" : "required",
        "description" : "A code specifying the state of the resource instance.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/fm-status"
      },
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Event.status"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.status"
      },
      {
        "identity" : "rim",
        "map" : "Act.status"
      }]
    },
    {
      "id" : "Coverage.type",
      "path" : "Coverage.type",
      "short" : "Coverage category such as medical or accident",
      "definition" : "The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization.",
      "requirements" : "От типа страхового покрытия зависит порядок применения страховых покрытий.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "Coverage.type",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "isModifier" : false,
      "isSummary" : true,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "CoverageType"
        }],
        "strength" : "preferred",
        "description" : "The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/coverage-type"
      },
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.class"
      },
      {
        "identity" : "v2",
        "map" : "IN1-15"
      }]
    },
    {
      "id" : "Coverage.policyHolder",
      "path" : "Coverage.policyHolder",
      "short" : "Owner of the policy",
      "definition" : "The party who 'owns' the insurance policy.",
      "comment" : "For example: may be an individual, corporation or the subscriber's employer.",
      "requirements" : "This provides employer information in the case of Worker's Compensation and other policies.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "Coverage.policyHolder",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Patient",
        "http://hl7.org/fhir/StructureDefinition/RelatedPerson",
        "http://hl7.org/fhir/StructureDefinition/Organization"]
      }],
      "isModifier" : false,
      "isSummary" : true,
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.subject[x]"
      },
      {
        "identity" : "cdanetv4",
        "map" : "D01 through D09"
      },
      {
        "identity" : "v2",
        "map" : "IN1-16, 18,  19-name of insured, address, date of birth"
      },
      {
        "identity" : "cpha3pharm",
        "map" : "C.35"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.subject"
      }]
    },
    {
      "id" : "Coverage.subscriber",
      "path" : "Coverage.subscriber",
      "short" : "Subscriber to the policy",
      "definition" : "The party who has signed-up for or 'owns' the contractual relationship to the policy or to whom the benefit of the policy for services rendered to them or their family is due.",
      "comment" : "May be self or a parent in the case of dependants.",
      "requirements" : "This is the party who is entitled to the benfits under the policy.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "Coverage.subscriber",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Patient",
        "http://hl7.org/fhir/StructureDefinition/RelatedPerson"]
      }],
      "isModifier" : false,
      "isSummary" : true,
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.subject[x]"
      },
      {
        "identity" : "cdanetv4",
        "map" : "D01 through D09"
      },
      {
        "identity" : "v2",
        "map" : "IN1-16, 18,  19-name of insured, address, date of birth"
      },
      {
        "identity" : "cpha3pharm",
        "map" : "C.35"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.subject"
      }]
    },
    {
      "id" : "Coverage.subscriberId",
      "path" : "Coverage.subscriberId",
      "short" : "ID assigned to the subscriber",
      "definition" : "The insurer assigned ID for the Subscriber.",
      "requirements" : "The insurer requires this identifier on correspondance and claims (digital and otherwise).",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "Coverage.subscriberId",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "string"
      }],
      "isModifier" : false,
      "isSummary" : true,
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.subject[x]"
      },
      {
        "identity" : "cdanetv4",
        "map" : "D01 through D09"
      },
      {
        "identity" : "v2",
        "map" : "IN1-16, 18,  19-name of insured, address, date of birth"
      },
      {
        "identity" : "cpha3pharm",
        "map" : "C.35"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.subject"
      }]
    },
    {
      "id" : "Coverage.beneficiary",
      "path" : "Coverage.beneficiary",
      "short" : "Выгодоприобретатель плана",
      "definition" : "The party who benefits from the insurance coverage; the patient when products and/or services are provided.",
      "requirements" : "This is the party who receives treatment for which the costs are reimbursed under the coverage.",
      "min" : 1,
      "max" : "1",
      "base" : {
        "path" : "Coverage.beneficiary",
        "min" : 1,
        "max" : "1"
      },
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Patient"]
      }],
      "isModifier" : false,
      "isSummary" : true,
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Event.subject"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.subject[x]"
      },
      {
        "identity" : "cdanetv4",
        "map" : "D01 through D09"
      },
      {
        "identity" : "v2",
        "map" : "IN1-16, 18,  19-name of insured, address, date of birth"
      },
      {
        "identity" : "cpha3pharm",
        "map" : "C.35"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.subject"
      }]
    },
    {
      "id" : "Coverage.dependent",
      "path" : "Coverage.dependent",
      "short" : "Номер материально зависимого лица",
      "definition" : "Уникальный идентификатор материально зависимого лица страхового покрытия.",
      "comment" : "Periodically the member number is constructed from the subscriberId and the dependant number.",
      "requirements" : "For some coverages a single identifier is issued to the Subscriber and then a unique dependent number is issued to each beneficiary.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "Coverage.dependent",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "string"
      }],
      "isModifier" : false,
      "isSummary" : true,
      "mapping" : [{
        "identity" : "cdanetv4",
        "map" : "C17"
      },
      {
        "identity" : "v2",
        "map" : "- No exact HL7 v2 equivalent concept seems to exist;"
      }]
    },
    {
      "id" : "Coverage.relationship",
      "path" : "Coverage.relationship",
      "short" : "Beneficiary relationship to the subscriber",
      "definition" : "The relationship of beneficiary (patient) to the subscriber.",
      "comment" : "Typically, an individual uses policies which are theirs (relationship='self') before policies owned by others.",
      "requirements" : "To determine relationship between the patient and the subscriber to determine coordination of benefits.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "Coverage.relationship",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "Relationship"
        }],
        "strength" : "extensible",
        "description" : "The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).",
        "valueSet" : "http://hl7.org/fhir/ValueSet/subscriber-relationship"
      },
      "mapping" : [{
        "identity" : "cdanetv4",
        "map" : "C03"
      }]
    },
    {
      "id" : "Coverage.period",
      "path" : "Coverage.period",
      "short" : "Дата начала и окончания действия страхового покрытия",
      "definition" : "Период действия страхового покрытия. Отсутствие даты начала означает, что дата начала действия не известна, отсутствие даты окончания значит, что страховое покрытие продолжает оставаться в силе.",
      "requirements" : "Some insurers require the submission of the coverage term.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "Coverage.period",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "Period"
      }],
      "isModifier" : false,
      "isSummary" : true,
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Event.occurrence[x]"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.done[x]"
      },
      {
        "identity" : "v2",
        "map" : "IN1-12 / IN1-13"
      },
      {
        "identity" : "rim",
        "map" : "Act.effectiveTime"
      }]
    },
    {
      "id" : "Coverage.payor",
      "path" : "Coverage.payor",
      "short" : "Issuer of the policy",
      "definition" : "The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements.",
      "comment" : "May provide multiple identifiers such as insurance company identifier or business identifier (Бизнес-идентификационный номер).\nFor selfpay it may provide multiple paying persons and/or organizations.",
      "requirements" : "Need to identify the issuer to target for claim processing and for coordination of benefit processing.",
      "min" : 1,
      "max" : "*",
      "base" : {
        "path" : "Coverage.payor",
        "min" : 1,
        "max" : "*"
      },
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Organization",
        "http://hl7.org/fhir/StructureDefinition/Patient",
        "http://hl7.org/fhir/StructureDefinition/RelatedPerson"]
      }],
      "isModifier" : false,
      "isSummary" : true,
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.author"
      },
      {
        "identity" : "cdanetv4",
        "map" : "A05"
      },
      {
        "identity" : "v2",
        "map" : "IN1-3"
      },
      {
        "identity" : "cpha3pharm",
        "map" : "C.30"
      }]
    },
    {
      "id" : "Coverage.class",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "Class"
      }],
      "path" : "Coverage.class",
      "short" : "Additional coverage classifications",
      "definition" : "A suite of underwriter specific classifiers.",
      "comment" : "For example may be used to identify a class of coverage or employer group, Policy, Plan.",
      "requirements" : "The codes provided on the health card which identify or confirm the specific policy for the insurer.",
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "Coverage.class",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "BackboneElement"
      }],
      "constraint" : [{
        "key" : "ele-1",
        "severity" : "error",
        "human" : "All FHIR elements must have a @value or children",
        "expression" : "hasValue() or (children().count() > id.count())",
        "xpath" : "@value|f:*|h:div",
        "source" : "Element"
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "Coverage.class.id",
      "path" : "Coverage.class.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"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "rim",
        "map" : "n/a"
      }]
    },
    {
      "id" : "Coverage.class.extension",
      "path" : "Coverage.class.extension",
      "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. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "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"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "rim",
        "map" : "n/a"
      }]
    },
    {
      "id" : "Coverage.class.modifierExtension",
      "path" : "Coverage.class.modifierExtension",
      "short" : "Extensions that cannot be ignored even if unrecognized",
      "definition" : "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "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",
      "modifiers"],
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "BackboneElement.modifierExtension",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "Extension"
      }],
      "isModifier" : true,
      "isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary" : true,
      "mapping" : [{
        "identity" : "rim",
        "map" : "N/A"
      }]
    },
    {
      "id" : "Coverage.class.type",
      "path" : "Coverage.class.type",
      "short" : "Type of class such as 'group' or 'plan'",
      "definition" : "The type of classification for which an insurer-specific class label or number and optional name is provided, for example may be used to identify a class of coverage or employer group, Policy, Plan.",
      "requirements" : "The insurer issued label for a specific health card value.",
      "min" : 1,
      "max" : "1",
      "base" : {
        "path" : "Coverage.class.type",
        "min" : 1,
        "max" : "1"
      },
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "isModifier" : false,
      "isSummary" : true,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "CoverageClass"
        }],
        "strength" : "extensible",
        "description" : "The policy classifications, eg. Group, Plan, Class, etc.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/coverage-class"
      }
    },
    {
      "id" : "Coverage.class.value",
      "path" : "Coverage.class.value",
      "short" : "Value associated with the type",
      "definition" : "The alphanumeric string value associated with the insurer issued label.",
      "comment" : "For example, the Group or Plan number.",
      "requirements" : "The insurer issued label and value are necessary to identify the specific policy.",
      "min" : 1,
      "max" : "1",
      "base" : {
        "path" : "Coverage.class.value",
        "min" : 1,
        "max" : "1"
      },
      "type" : [{
        "code" : "string"
      }],
      "isModifier" : false,
      "isSummary" : true,
      "mapping" : [{
        "identity" : "cdanetv4",
        "map" : "C11 (Division,Section)"
      },
      {
        "identity" : "v2",
        "map" : "IN1-8"
      },
      {
        "identity" : "cpha3pharm",
        "map" : "C.31"
      }]
    },
    {
      "id" : "Coverage.class.name",
      "path" : "Coverage.class.name",
      "short" : "Human readable description of the type and value",
      "definition" : "A short description for the class.",
      "requirements" : "Used to provide a meaningful description in correspondence to the patient.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "Coverage.class.name",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "string"
      }],
      "isModifier" : false,
      "isSummary" : true,
      "mapping" : [{
        "identity" : "cdanetv4",
        "map" : "C11 (Division,Section)"
      },
      {
        "identity" : "v2",
        "map" : "IN1-8"
      },
      {
        "identity" : "cpha3pharm",
        "map" : "C.31"
      }]
    },
    {
      "id" : "Coverage.order",
      "path" : "Coverage.order",
      "short" : "Relative order of the coverage",
      "definition" : "The order of applicability of this coverage relative to other coverages which are currently in force. Note, there may be gaps in the numbering and this does not imply primary, secondary etc. as the specific positioning of coverages depends upon the episode of care.",
      "requirements" : "Used in managing the coordination of benefits.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "Coverage.order",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "positiveInt"
      }],
      "isModifier" : false,
      "isSummary" : true,
      "mapping" : [{
        "identity" : "v2",
        "map" : "- No exact HL7 v2 equivalent concept seems to exist;"
      }]
    },
    {
      "id" : "Coverage.network",
      "path" : "Coverage.network",
      "short" : "Сеть страховых компаний",
      "definition" : "The insurer-specific identifier for the insurer-defined network of providers to which the beneficiary may seek treatment which will be covered at the 'in-network' rate, otherwise 'out of network' terms and conditions apply.",
      "requirements" : "Used in referral for treatment and in claims processing.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "Coverage.network",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "string"
      }],
      "isModifier" : false,
      "isSummary" : true,
      "mapping" : [{
        "identity" : "cdanetv4",
        "map" : "D10"
      }]
    },
    {
      "id" : "Coverage.costToBeneficiary",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "CostToBeneficiary"
      }],
      "path" : "Coverage.costToBeneficiary",
      "short" : "Patient payments for services/products",
      "definition" : "A suite of codes indicating the cost category and associated amount which have been detailed in the policy and may have been  included on the health card.",
      "comment" : "For example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment.",
      "requirements" : "Required by providers to manage financial transaction with the patient.",
      "alias" : ["CoPay",
      "Deductible",
      "Exceptions"],
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "Coverage.costToBeneficiary",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "BackboneElement"
      }],
      "constraint" : [{
        "key" : "ele-1",
        "severity" : "error",
        "human" : "All FHIR elements must have a @value or children",
        "expression" : "hasValue() or (children().count() > id.count())",
        "xpath" : "@value|f:*|h:div",
        "source" : "Element"
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "Coverage.costToBeneficiary.id",
      "path" : "Coverage.costToBeneficiary.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"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "rim",
        "map" : "n/a"
      }]
    },
    {
      "id" : "Coverage.costToBeneficiary.extension",
      "path" : "Coverage.costToBeneficiary.extension",
      "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. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "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"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "rim",
        "map" : "n/a"
      }]
    },
    {
      "id" : "Coverage.costToBeneficiary.modifierExtension",
      "path" : "Coverage.costToBeneficiary.modifierExtension",
      "short" : "Extensions that cannot be ignored even if unrecognized",
      "definition" : "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "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",
      "modifiers"],
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "BackboneElement.modifierExtension",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "Extension"
      }],
      "isModifier" : true,
      "isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary" : true,
      "mapping" : [{
        "identity" : "rim",
        "map" : "N/A"
      }]
    },
    {
      "id" : "Coverage.costToBeneficiary.type",
      "path" : "Coverage.costToBeneficiary.type",
      "short" : "Cost category",
      "definition" : "The category of patient centric costs associated with treatment.",
      "comment" : "For example visit, specialist visits, emergency, inpatient care, etc.",
      "requirements" : "Needed to identify the category associated with the amount for the patient.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "Coverage.costToBeneficiary.type",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "isModifier" : false,
      "isSummary" : true,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "CopayTypes"
        }],
        "strength" : "extensible",
        "description" : "The types of services to which patient copayments are specified.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/coverage-copay-type"
      }
    },
    {
      "id" : "Coverage.costToBeneficiary.value[x]",
      "path" : "Coverage.costToBeneficiary.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.",
      "requirements" : "Needed to identify the amount for the patient associated with the category.",
      "min" : 1,
      "max" : "1",
      "base" : {
        "path" : "Coverage.costToBeneficiary.value[x]",
        "min" : 1,
        "max" : "1"
      },
      "type" : [{
        "code" : "Quantity",
        "profile" : ["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]
      },
      {
        "code" : "Money"
      }],
      "isModifier" : false,
      "isSummary" : true,
      "mapping" : [{
        "identity" : "cdanetv4",
        "map" : "C11 (Division,Section)"
      },
      {
        "identity" : "v2",
        "map" : "IN1-8"
      },
      {
        "identity" : "cpha3pharm",
        "map" : "C.31"
      }]
    },
    {
      "id" : "Coverage.costToBeneficiary.exception",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "Exemption"
      }],
      "path" : "Coverage.costToBeneficiary.exception",
      "short" : "Exceptions for patient payments",
      "definition" : "A suite of codes indicating exceptions or reductions to patient costs and their effective periods.",
      "requirements" : "Required by providers to manage financial transaction with the patient.",
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "Coverage.costToBeneficiary.exception",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "BackboneElement"
      }],
      "constraint" : [{
        "key" : "ele-1",
        "severity" : "error",
        "human" : "All FHIR elements must have a @value or children",
        "expression" : "hasValue() or (children().count() > id.count())",
        "xpath" : "@value|f:*|h:div",
        "source" : "Element"
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "Coverage.costToBeneficiary.exception.id",
      "path" : "Coverage.costToBeneficiary.exception.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"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "rim",
        "map" : "n/a"
      }]
    },
    {
      "id" : "Coverage.costToBeneficiary.exception.extension",
      "path" : "Coverage.costToBeneficiary.exception.extension",
      "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. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "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"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "rim",
        "map" : "n/a"
      }]
    },
    {
      "id" : "Coverage.costToBeneficiary.exception.modifierExtension",
      "path" : "Coverage.costToBeneficiary.exception.modifierExtension",
      "short" : "Extensions that cannot be ignored even if unrecognized",
      "definition" : "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "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",
      "modifiers"],
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "BackboneElement.modifierExtension",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "Extension"
      }],
      "isModifier" : true,
      "isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary" : true,
      "mapping" : [{
        "identity" : "rim",
        "map" : "N/A"
      }]
    },
    {
      "id" : "Coverage.costToBeneficiary.exception.type",
      "path" : "Coverage.costToBeneficiary.exception.type",
      "short" : "Exception category",
      "definition" : "The code for the specific exception.",
      "requirements" : "Needed to identify the exception associated with the amount for the patient.",
      "min" : 1,
      "max" : "1",
      "base" : {
        "path" : "Coverage.costToBeneficiary.exception.type",
        "min" : 1,
        "max" : "1"
      },
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "isModifier" : false,
      "isSummary" : true,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "CoverageFinancialException"
        }],
        "strength" : "example",
        "description" : "The types of exceptions from the part or full value of financial obligations such as copays.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/coverage-financial-exception"
      }
    },
    {
      "id" : "Coverage.costToBeneficiary.exception.period",
      "path" : "Coverage.costToBeneficiary.exception.period",
      "short" : "The effective period of the exception",
      "definition" : "The timeframe during when the exception is in force.",
      "requirements" : "Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "Coverage.costToBeneficiary.exception.period",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "Period"
      }],
      "isModifier" : false,
      "isSummary" : true
    },
    {
      "id" : "Coverage.subrogation",
      "path" : "Coverage.subrogation",
      "short" : "Reimbursement to insurer",
      "definition" : "When 'subrogation=true' this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs.",
      "comment" : "Typically, automotive and worker's compensation policies would be flagged with 'subrogation=true' to enable healthcare payors to collect against accident claims.",
      "requirements" : "See definition for when to be used.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "Coverage.subrogation",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "boolean"
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "Coverage.contract",
      "path" : "Coverage.contract",
      "short" : "Детали контракта",
      "definition" : "Страховой полис(-ы), который подтверждает это страховое покрытие.",
      "requirements" : "To reference the legally binding contract between the policy holder and the insurer.",
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "Coverage.contract",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Contract"]
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "cdanetv4",
        "map" : "D01 through D09"
      },
      {
        "identity" : "v2",
        "map" : "IN1-16, 18,  19"
      },
      {
        "identity" : "rim",
        "map" : "n/a"
      },
      {
        "identity" : "cpha3pharm",
        "map" : "C.35"
      }]
    }]
  },
  "differential" : {
    "element" : [{
      "id" : "Coverage",
      "path" : "Coverage",
      "short" : "Insurance or medical plan or a payment agreement",
      "definition" : "Финансовый инструмент, который может быть использован для оплаты или компенсации за продукты и услуги в области здравоохранения. Includes both insurance and self-payment.",
      "comment" : "The Coverage resource contains the insurance card level information, which is customary to provide on claims and other communications between providers and insurers.",
      "min" : 0,
      "max" : "*",
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Event"
      },
      {
        "identity" : "rim",
        "map" : "Coverage"
      }]
    },
    {
      "id" : "Coverage.identifier",
      "path" : "Coverage.identifier",
      "short" : "Business Identifier for the coverage",
      "definition" : "A unique identifier assigned to this coverage.",
      "comment" : "The main (and possibly only) identifier for the coverage - often referred to as a Member Id, Certificate number, Personal Health Number or Case ID. May be constructed as the concatenation of the Coverage.SubscriberID and the Coverage.dependant.",
      "requirements" : "Allows coverages to be distinguished and referenced.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "Identifier"
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Event.identifier"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.identifier"
      },
      {
        "identity" : "cdanetv4",
        "map" : "C02"
      },
      {
        "identity" : "v2",
        "map" : "IN1-2"
      },
      {
        "identity" : "rim",
        "map" : ".id"
      },
      {
        "identity" : "cpha3pharm",
        "map" : "C.32, C.33, C.39"
      }]
    },
    {
      "id" : "Coverage.status",
      "path" : "Coverage.status",
      "short" : "active | cancelled | draft | entered-in-error",
      "definition" : "The status of the resource instance.",
      "comment" : "This element is labeled as a modifier because the status contains the code entered-in-error that marks the coverage as not currently valid.",
      "requirements" : "Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "code"
      }],
      "isModifier" : true,
      "isModifierReason" : "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
      "isSummary" : true,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "CoverageStatus"
        }],
        "strength" : "required",
        "description" : "A code specifying the state of the resource instance.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/fm-status"
      },
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Event.status"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.status"
      },
      {
        "identity" : "rim",
        "map" : "Act.status"
      }]
    },
    {
      "id" : "Coverage.type",
      "path" : "Coverage.type",
      "short" : "Coverage category such as medical or accident",
      "definition" : "The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization.",
      "requirements" : "От типа страхового покрытия зависит порядок применения страховых покрытий.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "isSummary" : true,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "CoverageType"
        }],
        "strength" : "preferred",
        "description" : "The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/coverage-type"
      },
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.class"
      },
      {
        "identity" : "v2",
        "map" : "IN1-15"
      }]
    },
    {
      "id" : "Coverage.policyHolder",
      "path" : "Coverage.policyHolder",
      "short" : "Owner of the policy",
      "definition" : "The party who 'owns' the insurance policy.",
      "comment" : "For example: may be an individual, corporation or the subscriber's employer.",
      "requirements" : "This provides employer information in the case of Worker's Compensation and other policies.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Patient",
        "http://hl7.org/fhir/StructureDefinition/RelatedPerson",
        "http://hl7.org/fhir/StructureDefinition/Organization"]
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.subject[x]"
      },
      {
        "identity" : "cdanetv4",
        "map" : "D01 through D09"
      },
      {
        "identity" : "v2",
        "map" : "IN1-16, 18,  19-name of insured, address, date of birth"
      },
      {
        "identity" : "cpha3pharm",
        "map" : "C.35"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.subject"
      }]
    },
    {
      "id" : "Coverage.subscriber",
      "path" : "Coverage.subscriber",
      "short" : "Subscriber to the policy",
      "definition" : "The party who has signed-up for or 'owns' the contractual relationship to the policy or to whom the benefit of the policy for services rendered to them or their family is due.",
      "comment" : "May be self or a parent in the case of dependants.",
      "requirements" : "This is the party who is entitled to the benfits under the policy.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Patient",
        "http://hl7.org/fhir/StructureDefinition/RelatedPerson"]
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.subject[x]"
      },
      {
        "identity" : "cdanetv4",
        "map" : "D01 through D09"
      },
      {
        "identity" : "v2",
        "map" : "IN1-16, 18,  19-name of insured, address, date of birth"
      },
      {
        "identity" : "cpha3pharm",
        "map" : "C.35"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.subject"
      }]
    },
    {
      "id" : "Coverage.subscriberId",
      "path" : "Coverage.subscriberId",
      "short" : "ID assigned to the subscriber",
      "definition" : "The insurer assigned ID for the Subscriber.",
      "requirements" : "The insurer requires this identifier on correspondance and claims (digital and otherwise).",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "string"
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.subject[x]"
      },
      {
        "identity" : "cdanetv4",
        "map" : "D01 through D09"
      },
      {
        "identity" : "v2",
        "map" : "IN1-16, 18,  19-name of insured, address, date of birth"
      },
      {
        "identity" : "cpha3pharm",
        "map" : "C.35"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.subject"
      }]
    },
    {
      "id" : "Coverage.beneficiary",
      "path" : "Coverage.beneficiary",
      "short" : "Выгодоприобретатель плана",
      "definition" : "The party who benefits from the insurance coverage; the patient when products and/or services are provided.",
      "requirements" : "This is the party who receives treatment for which the costs are reimbursed under the coverage.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Patient"]
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Event.subject"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.subject[x]"
      },
      {
        "identity" : "cdanetv4",
        "map" : "D01 through D09"
      },
      {
        "identity" : "v2",
        "map" : "IN1-16, 18,  19-name of insured, address, date of birth"
      },
      {
        "identity" : "cpha3pharm",
        "map" : "C.35"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.subject"
      }]
    },
    {
      "id" : "Coverage.dependent",
      "path" : "Coverage.dependent",
      "short" : "Номер материально зависимого лица",
      "definition" : "Уникальный идентификатор материально зависимого лица страхового покрытия.",
      "comment" : "Periodically the member number is constructed from the subscriberId and the dependant number.",
      "requirements" : "For some coverages a single identifier is issued to the Subscriber and then a unique dependent number is issued to each beneficiary.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "string"
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "cdanetv4",
        "map" : "C17"
      },
      {
        "identity" : "v2",
        "map" : "- No exact HL7 v2 equivalent concept seems to exist;"
      }]
    },
    {
      "id" : "Coverage.relationship",
      "path" : "Coverage.relationship",
      "short" : "Beneficiary relationship to the subscriber",
      "definition" : "The relationship of beneficiary (patient) to the subscriber.",
      "comment" : "Typically, an individual uses policies which are theirs (relationship='self') before policies owned by others.",
      "requirements" : "To determine relationship between the patient and the subscriber to determine coordination of benefits.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "Relationship"
        }],
        "strength" : "extensible",
        "description" : "The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).",
        "valueSet" : "http://hl7.org/fhir/ValueSet/subscriber-relationship"
      },
      "mapping" : [{
        "identity" : "cdanetv4",
        "map" : "C03"
      }]
    },
    {
      "id" : "Coverage.period",
      "path" : "Coverage.period",
      "short" : "Дата начала и окончания действия страхового покрытия",
      "definition" : "Период действия страхового покрытия. Отсутствие даты начала означает, что дата начала действия не известна, отсутствие даты окончания значит, что страховое покрытие продолжает оставаться в силе.",
      "requirements" : "Some insurers require the submission of the coverage term.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Period"
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Event.occurrence[x]"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.done[x]"
      },
      {
        "identity" : "v2",
        "map" : "IN1-12 / IN1-13"
      },
      {
        "identity" : "rim",
        "map" : "Act.effectiveTime"
      }]
    },
    {
      "id" : "Coverage.payor",
      "path" : "Coverage.payor",
      "short" : "Issuer of the policy",
      "definition" : "The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements.",
      "comment" : "May provide multiple identifiers such as insurance company identifier or business identifier (Бизнес-идентификационный номер).\nFor selfpay it may provide multiple paying persons and/or organizations.",
      "requirements" : "Need to identify the issuer to target for claim processing and for coordination of benefit processing.",
      "min" : 1,
      "max" : "*",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Organization",
        "http://hl7.org/fhir/StructureDefinition/Patient",
        "http://hl7.org/fhir/StructureDefinition/RelatedPerson"]
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.author"
      },
      {
        "identity" : "cdanetv4",
        "map" : "A05"
      },
      {
        "identity" : "v2",
        "map" : "IN1-3"
      },
      {
        "identity" : "cpha3pharm",
        "map" : "C.30"
      }]
    },
    {
      "id" : "Coverage.class",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "Class"
      }],
      "path" : "Coverage.class",
      "short" : "Additional coverage classifications",
      "definition" : "A suite of underwriter specific classifiers.",
      "comment" : "For example may be used to identify a class of coverage or employer group, Policy, Plan.",
      "requirements" : "The codes provided on the health card which identify or confirm the specific policy for the insurer.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "BackboneElement"
      }]
    },
    {
      "id" : "Coverage.class.type",
      "path" : "Coverage.class.type",
      "short" : "Type of class such as 'group' or 'plan'",
      "definition" : "The type of classification for which an insurer-specific class label or number and optional name is provided, for example may be used to identify a class of coverage or employer group, Policy, Plan.",
      "requirements" : "The insurer issued label for a specific health card value.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "isSummary" : true,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "CoverageClass"
        }],
        "strength" : "extensible",
        "description" : "The policy classifications, eg. Group, Plan, Class, etc.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/coverage-class"
      }
    },
    {
      "id" : "Coverage.class.value",
      "path" : "Coverage.class.value",
      "short" : "Value associated with the type",
      "definition" : "The alphanumeric string value associated with the insurer issued label.",
      "comment" : "For example, the Group or Plan number.",
      "requirements" : "The insurer issued label and value are necessary to identify the specific policy.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "string"
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "cdanetv4",
        "map" : "C11 (Division,Section)"
      },
      {
        "identity" : "v2",
        "map" : "IN1-8"
      },
      {
        "identity" : "cpha3pharm",
        "map" : "C.31"
      }]
    },
    {
      "id" : "Coverage.class.name",
      "path" : "Coverage.class.name",
      "short" : "Human readable description of the type and value",
      "definition" : "A short description for the class.",
      "requirements" : "Used to provide a meaningful description in correspondence to the patient.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "string"
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "cdanetv4",
        "map" : "C11 (Division,Section)"
      },
      {
        "identity" : "v2",
        "map" : "IN1-8"
      },
      {
        "identity" : "cpha3pharm",
        "map" : "C.31"
      }]
    },
    {
      "id" : "Coverage.order",
      "path" : "Coverage.order",
      "short" : "Relative order of the coverage",
      "definition" : "The order of applicability of this coverage relative to other coverages which are currently in force. Note, there may be gaps in the numbering and this does not imply primary, secondary etc. as the specific positioning of coverages depends upon the episode of care.",
      "requirements" : "Used in managing the coordination of benefits.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "positiveInt"
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "v2",
        "map" : "- No exact HL7 v2 equivalent concept seems to exist;"
      }]
    },
    {
      "id" : "Coverage.network",
      "path" : "Coverage.network",
      "short" : "Сеть страховых компаний",
      "definition" : "The insurer-specific identifier for the insurer-defined network of providers to which the beneficiary may seek treatment which will be covered at the 'in-network' rate, otherwise 'out of network' terms and conditions apply.",
      "requirements" : "Used in referral for treatment and in claims processing.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "string"
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "cdanetv4",
        "map" : "D10"
      }]
    },
    {
      "id" : "Coverage.costToBeneficiary",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "CostToBeneficiary"
      }],
      "path" : "Coverage.costToBeneficiary",
      "short" : "Patient payments for services/products",
      "definition" : "A suite of codes indicating the cost category and associated amount which have been detailed in the policy and may have been  included on the health card.",
      "comment" : "For example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment.",
      "requirements" : "Required by providers to manage financial transaction with the patient.",
      "alias" : ["CoPay",
      "Deductible",
      "Exceptions"],
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "BackboneElement"
      }]
    },
    {
      "id" : "Coverage.costToBeneficiary.type",
      "path" : "Coverage.costToBeneficiary.type",
      "short" : "Cost category",
      "definition" : "The category of patient centric costs associated with treatment.",
      "comment" : "For example visit, specialist visits, emergency, inpatient care, etc.",
      "requirements" : "Needed to identify the category associated with the amount for the patient.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "isSummary" : true,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "CopayTypes"
        }],
        "strength" : "extensible",
        "description" : "The types of services to which patient copayments are specified.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/coverage-copay-type"
      }
    },
    {
      "id" : "Coverage.costToBeneficiary.value[x]",
      "path" : "Coverage.costToBeneficiary.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.",
      "requirements" : "Needed to identify the amount for the patient associated with the category.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "Quantity",
        "profile" : ["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]
      },
      {
        "code" : "Money"
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "cdanetv4",
        "map" : "C11 (Division,Section)"
      },
      {
        "identity" : "v2",
        "map" : "IN1-8"
      },
      {
        "identity" : "cpha3pharm",
        "map" : "C.31"
      }]
    },
    {
      "id" : "Coverage.costToBeneficiary.exception",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "Exemption"
      }],
      "path" : "Coverage.costToBeneficiary.exception",
      "short" : "Exceptions for patient payments",
      "definition" : "A suite of codes indicating exceptions or reductions to patient costs and their effective periods.",
      "requirements" : "Required by providers to manage financial transaction with the patient.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "BackboneElement"
      }]
    },
    {
      "id" : "Coverage.costToBeneficiary.exception.type",
      "path" : "Coverage.costToBeneficiary.exception.type",
      "short" : "Exception category",
      "definition" : "The code for the specific exception.",
      "requirements" : "Needed to identify the exception associated with the amount for the patient.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "isSummary" : true,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "CoverageFinancialException"
        }],
        "strength" : "example",
        "description" : "The types of exceptions from the part or full value of financial obligations such as copays.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/coverage-financial-exception"
      }
    },
    {
      "id" : "Coverage.costToBeneficiary.exception.period",
      "path" : "Coverage.costToBeneficiary.exception.period",
      "short" : "The effective period of the exception",
      "definition" : "The timeframe during when the exception is in force.",
      "requirements" : "Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Period"
      }],
      "isSummary" : true
    },
    {
      "id" : "Coverage.subrogation",
      "path" : "Coverage.subrogation",
      "short" : "Reimbursement to insurer",
      "definition" : "When 'subrogation=true' this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs.",
      "comment" : "Typically, automotive and worker's compensation policies would be flagged with 'subrogation=true' to enable healthcare payors to collect against accident claims.",
      "requirements" : "See definition for when to be used.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "boolean"
      }]
    },
    {
      "id" : "Coverage.contract",
      "path" : "Coverage.contract",
      "short" : "Детали контракта",
      "definition" : "Страховой полис(-ы), который подтверждает это страховое покрытие.",
      "requirements" : "To reference the legally binding contract between the policy holder and the insurer.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Contract"]
      }],
      "mapping" : [{
        "identity" : "cdanetv4",
        "map" : "D01 through D09"
      },
      {
        "identity" : "v2",
        "map" : "IN1-16, 18,  19"
      },
      {
        "identity" : "rim",
        "map" : "n/a"
      },
      {
        "identity" : "cpha3pharm",
        "map" : "C.35"
      }]
    }]
  }
}

Примечание к использованию: мы очень стараемся приводить корректные и полезные примеры, но нормативно они не являются частью спецификации.