Current Build

Переводит команда Health Samurai. Приглашаем поучаствовать в русификации стандарта FHIR: GitHub, Email.

Coverageeligibilityrequest.profile.json

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

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

StructureDefinition for coverageeligibilityrequest

{
  "resourceType" : "StructureDefinition",
  "id" : "CoverageEligibilityRequest",
  "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/CoverageEligibilityRequest",
  "version" : "3.6.0",
  "name" : "CoverageEligibilityRequest",
  "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" : "The CoverageEligibilityRequest provides patient and insurance coverage information to an insurer for them to respond, in the form of an CoverageEligibilityResponse, with information regarding whether the stated coverage is valid and in-force and optionally to provide the insurance details of the policy.",
  "fhirVersion" : "3.6.0",
  "mapping" : [{
    "identity" : "workflow",
    "uri" : "http://hl7.org/fhir/workflow",
    "name" : "Workflow Pattern"
  },
  {
    "identity" : "w5",
    "uri" : "http://hl7.org/fhir/fivews",
    "name" : "FiveWs Pattern"
  },
  {
    "identity" : "v2",
    "uri" : "http://hl7.org/v2",
    "name" : "HL7 v2 Mapping"
  },
  {
    "identity" : "rim",
    "uri" : "http://hl7.org/v3",
    "name" : "RIM Mapping"
  }],
  "kind" : "resource",
  "abstract" : false,
  "type" : "CoverageEligibilityRequest",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/DomainResource",
  "derivation" : "specialization",
  "snapshot" : {
    "element" : [{
      "id" : "CoverageEligibilityRequest",
      "path" : "CoverageEligibilityRequest",
      "short" : "CoverageEligibilityRequest resource",
      "definition" : "The CoverageEligibilityRequest provides patient and insurance coverage information to an insurer for them to respond, in the form of an CoverageEligibilityResponse, with information regarding whether the stated coverage is valid and in-force and optionally to provide the insurance details of the policy.",
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "CoverageEligibilityRequest",
        "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" : "Request"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.id",
      "path" : "CoverageEligibilityRequest.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" : "CoverageEligibilityRequest.meta",
      "path" : "CoverageEligibilityRequest.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" : "CoverageEligibilityRequest.implicitRules",
      "path" : "CoverageEligibilityRequest.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" : "CoverageEligibilityRequest.language",
      "path" : "CoverageEligibilityRequest.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" : "CoverageEligibilityRequest.text",
      "path" : "CoverageEligibilityRequest.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" : "CoverageEligibilityRequest.contained",
      "path" : "CoverageEligibilityRequest.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" : "CoverageEligibilityRequest.extension",
      "path" : "CoverageEligibilityRequest.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" : "CoverageEligibilityRequest.modifierExtension",
      "path" : "CoverageEligibilityRequest.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" : "CoverageEligibilityRequest.identifier",
      "path" : "CoverageEligibilityRequest.identifier",
      "short" : "Business Identifier for coverage eligiblity request",
      "definition" : "A unique identifier assigned to this coverage eligiblity request.",
      "requirements" : "Allows coverage eligibility requests to be distinguished and referenced.",
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "CoverageEligibilityRequest.identifier",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "Identifier"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Request.identifier"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.identifier"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.status",
      "path" : "CoverageEligibilityRequest.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 codes that mark the resource 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" : "CoverageEligibilityRequest.status",
        "min" : 1,
        "max" : "1"
      },
      "type" : [{
        "code" : "code"
      }],
      "isModifier" : true,
      "isModifierReason" : "This element is labeled 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" : "EligibilityRequestStatus"
        }],
        "strength" : "required",
        "description" : "A code specifying the state of the resource instance.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/fm-status"
      },
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Request.status"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.status"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.priority",
      "path" : "CoverageEligibilityRequest.priority",
      "short" : "Desired processing priority",
      "definition" : "When the requestor expects the processor to complete processing.",
      "requirements" : "Needed to advise the prossesor on the urgency of the request.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.priority",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "ProcessPriority"
        }],
        "strength" : "example",
        "description" : "The timeliness with which processing is required: STAT, normal, Deferred.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/process-priority"
      },
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Request.priority"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.class"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.purpose",
      "path" : "CoverageEligibilityRequest.purpose",
      "short" : "auth-requirements | benefits | discovery | validation",
      "definition" : "Code to specify whether requesting: prior authorization requirements for some service categories or billing codes; benefits for coverages specified or discovered; discovery and return of coverages for the patient; and/or validation that the specified coverage is in-force at the date/period specified or 'now' if not specified.",
      "requirements" : "To indicate the processing actions requested.",
      "min" : 1,
      "max" : "*",
      "base" : {
        "path" : "CoverageEligibilityRequest.purpose",
        "min" : 1,
        "max" : "*"
      },
      "type" : [{
        "code" : "code"
      }],
      "isModifier" : false,
      "isSummary" : true,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "EligibilityRequestPurpose"
        }],
        "strength" : "required",
        "description" : "A code specifying the types of information being requested.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/eligibilityrequest-purpose"
      },
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.class"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.patient",
      "path" : "CoverageEligibilityRequest.patient",
      "short" : "Intended recipient of products and services",
      "definition" : "The party who is the beneficiary of the supplied coverage and for whom eligibility is sought.",
      "comment" : "1..1.",
      "requirements" : "Required to provide context and coverage validation.",
      "min" : 1,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.patient",
        "min" : 1,
        "max" : "1"
      },
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Patient"]
      }],
      "isModifier" : false,
      "isSummary" : true,
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Request.subject"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.subject[x]"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.subject"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.serviced[x]",
      "path" : "CoverageEligibilityRequest.serviced[x]",
      "short" : "Estimated date or dates of service",
      "definition" : "The date or dates when the enclosed suite of services were performed or completed.",
      "requirements" : "Required to provide time context for the request.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.serviced[x]",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "date"
      },
      {
        "code" : "Period"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.done[x]"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.created",
      "path" : "CoverageEligibilityRequest.created",
      "short" : "Creation date",
      "definition" : "The date when this resource was created.",
      "requirements" : "Need to record a timestamp for use by both the recipient and the issuer.",
      "min" : 1,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.created",
        "min" : 1,
        "max" : "1"
      },
      "type" : [{
        "code" : "dateTime"
      }],
      "isModifier" : false,
      "isSummary" : true,
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Request.authoredOn"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.recorded"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.enterer",
      "path" : "CoverageEligibilityRequest.enterer",
      "short" : "Author",
      "definition" : "Person who created the request.",
      "requirements" : "Some jurisdictions require the contact information for personnel completing eligibility requests.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.enterer",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Practitioner",
        "http://hl7.org/fhir/StructureDefinition/PractitionerRole"]
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.author"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.provider",
      "path" : "CoverageEligibilityRequest.provider",
      "short" : "Party responsible for the request",
      "definition" : "The provider which is responsible for the request.",
      "comment" : "Typically this field would be 1..1 where this party is responsible for the eligibility request but not necessarily professionally responsible for the provision of the individual products and services listed below.",
      "requirements" : "Needed to identify the requestor.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.provider",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Practitioner",
        "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
        "http://hl7.org/fhir/StructureDefinition/Organization"]
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Request.requester"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.source"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.insurer",
      "path" : "CoverageEligibilityRequest.insurer",
      "short" : "Coverage issuer",
      "definition" : "The Insurer who issued the coverage in question and is the recipient of the request.",
      "requirements" : "Need to identify the recipient.",
      "min" : 1,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.insurer",
        "min" : 1,
        "max" : "1"
      },
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Organization"]
      }],
      "isModifier" : false,
      "isSummary" : true,
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Request.performer"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.who"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.facility",
      "path" : "CoverageEligibilityRequest.facility",
      "short" : "Servicing facility",
      "definition" : "Facility where the services are intended to be provided.",
      "requirements" : "Insurance adjudication can be dependant on where services were delivered.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.facility",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Location"]
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.where[x]"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.supportingInfo",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "SupportingInformation"
      }],
      "path" : "CoverageEligibilityRequest.supportingInfo",
      "short" : "Supporting information",
      "definition" : "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.",
      "comment" : "Often there are multiple jurisdiction specific valuesets which are required.",
      "requirements" : "Typically these information codes are required to support the services rendered or the adjudication of the services rendered.",
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "CoverageEligibilityRequest.supportingInfo",
        "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" : "CoverageEligibilityRequest.supportingInfo.id",
      "path" : "CoverageEligibilityRequest.supportingInfo.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" : "CoverageEligibilityRequest.supportingInfo.extension",
      "path" : "CoverageEligibilityRequest.supportingInfo.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" : "CoverageEligibilityRequest.supportingInfo.modifierExtension",
      "path" : "CoverageEligibilityRequest.supportingInfo.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" : "CoverageEligibilityRequest.supportingInfo.sequence",
      "path" : "CoverageEligibilityRequest.supportingInfo.sequence",
      "short" : "Information instance identifier",
      "definition" : "A number to uniquely identify supporting information entries.",
      "requirements" : "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.",
      "min" : 1,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.supportingInfo.sequence",
        "min" : 1,
        "max" : "1"
      },
      "type" : [{
        "code" : "positiveInt"
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "CoverageEligibilityRequest.supportingInfo.information",
      "path" : "CoverageEligibilityRequest.supportingInfo.information",
      "short" : "Data to be provided",
      "definition" : "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.",
      "comment" : "Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.",
      "requirements" : "To convey the data content to be provided when the information is more than a simple code or period.",
      "min" : 1,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.supportingInfo.information",
        "min" : 1,
        "max" : "1"
      },
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Resource"]
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "CoverageEligibilityRequest.supportingInfo.appliesToAll",
      "path" : "CoverageEligibilityRequest.supportingInfo.appliesToAll",
      "short" : "Applies to all items",
      "definition" : "The supporting materials are applicable for all detail items, product/servce categories and specific billing codes.",
      "requirements" : "Needed to convey that the information is universal to the request.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.supportingInfo.appliesToAll",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "boolean"
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "CoverageEligibilityRequest.insurance",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "Insurance"
      }],
      "path" : "CoverageEligibilityRequest.insurance",
      "short" : "Patient insurance information",
      "definition" : "Financial instruments for reimbursement for the health care products and services.",
      "comment" : "All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim.",
      "requirements" : "There must be at least one coverage for which eligibility is requested.",
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "CoverageEligibilityRequest.insurance",
        "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" : "CoverageEligibilityRequest.insurance.id",
      "path" : "CoverageEligibilityRequest.insurance.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" : "CoverageEligibilityRequest.insurance.extension",
      "path" : "CoverageEligibilityRequest.insurance.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" : "CoverageEligibilityRequest.insurance.modifierExtension",
      "path" : "CoverageEligibilityRequest.insurance.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" : "CoverageEligibilityRequest.insurance.focal",
      "path" : "CoverageEligibilityRequest.insurance.focal",
      "short" : "Applicable coverage",
      "definition" : "A flag to indicate that this Coverage is to be used for evaluation of this request when set to true.",
      "comment" : "A patient may (will) have multiple insurance policies which provide reimburement for healthcare services and products. For example a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for evaluating this request. Other requests would be created to request evaluation against the other listed policies.",
      "requirements" : "To identify which coverage in the list is being used to evaluate this request.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.insurance.focal",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "boolean"
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "CoverageEligibilityRequest.insurance.coverage",
      "path" : "CoverageEligibilityRequest.insurance.coverage",
      "short" : "Insurance information",
      "definition" : "Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system.",
      "requirements" : "Required to allow the adjudicator to locate the correct policy and history within their information system.",
      "min" : 1,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.insurance.coverage",
        "min" : 1,
        "max" : "1"
      },
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Coverage"]
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "CoverageEligibilityRequest.insurance.businessArrangement",
      "path" : "CoverageEligibilityRequest.insurance.businessArrangement",
      "short" : "Additional provider contract number",
      "definition" : "A business agreement number established between the provider and the insurer for special business processing purposes.",
      "requirements" : "Providers may have multiple business arrangements with a given insurer and must supply the specific contract number for adjudication.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.insurance.businessArrangement",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "string"
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "CoverageEligibilityRequest.item",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "Details"
      }],
      "path" : "CoverageEligibilityRequest.item",
      "short" : "Item to be evaluated for eligibiity",
      "definition" : "Service categories or billable services for which benefit details and/or an authorization prior to service delivery may be required by the payor.",
      "requirements" : "The items to be processed for the request.",
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "CoverageEligibilityRequest.item",
        "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" : "CoverageEligibilityRequest.item.id",
      "path" : "CoverageEligibilityRequest.item.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" : "CoverageEligibilityRequest.item.extension",
      "path" : "CoverageEligibilityRequest.item.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" : "CoverageEligibilityRequest.item.modifierExtension",
      "path" : "CoverageEligibilityRequest.item.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" : "CoverageEligibilityRequest.item.supportingInfoSequence",
      "path" : "CoverageEligibilityRequest.item.supportingInfoSequence",
      "short" : "Applicable exception or supporting information",
      "definition" : "Exceptions, special conditions and supporting information applicable for this service or product line.",
      "requirements" : "Needed to support or inform the consideration for eligibility.",
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "CoverageEligibilityRequest.item.supportingInfoSequence",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "positiveInt"
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "CoverageEligibilityRequest.item.category",
      "path" : "CoverageEligibilityRequest.item.category",
      "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.",
      "requirements" : "Needed to convey the category of service or product for which eligibility is sought.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.item.category",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "BenefitCategory"
        }],
        "strength" : "example",
        "description" : "Benefit categories such as: oral, medical, vision etc.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/ex-benefitcategory"
      }
    },
    {
      "id" : "CoverageEligibilityRequest.item.productOrService",
      "path" : "CoverageEligibilityRequest.item.productOrService",
      "short" : "Billing, service, product, or drug code",
      "definition" : "This contains the product, service, drug or other billing code for the item.",
      "comment" : "Code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI).",
      "requirements" : "Needed to convey the actual service or product for which eligibility is sought.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.item.productOrService",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "ServiceProduct"
        }],
        "strength" : "example",
        "description" : "Allowable service and product codes.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/service-uscls"
      }
    },
    {
      "id" : "CoverageEligibilityRequest.item.modifier",
      "path" : "CoverageEligibilityRequest.item.modifier",
      "short" : "Product or service billing modifiers",
      "definition" : "Item typification or modifiers codes to convey additional context for the product or service.",
      "comment" : "For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.",
      "requirements" : "To support provision of the item or to charge an elevated fee.",
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "CoverageEligibilityRequest.item.modifier",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "Modifiers"
        }],
        "strength" : "example",
        "description" : "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/claim-modifiers"
      }
    },
    {
      "id" : "CoverageEligibilityRequest.item.provider",
      "path" : "CoverageEligibilityRequest.item.provider",
      "short" : "Perfoming practitioner",
      "definition" : "The practitioner who is responsible for the product or service to be rendered to the patient.",
      "requirements" : "Needed to support the evaluation of the eligibility.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.item.provider",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Practitioner",
        "http://hl7.org/fhir/StructureDefinition/PractitionerRole"]
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Request.requester"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.source"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.item.quantity",
      "path" : "CoverageEligibilityRequest.item.quantity",
      "short" : "Count of products or services",
      "definition" : "The number of repetitions of a service or product.",
      "requirements" : "Required when the product or service code does not convey the quantity provided.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.item.quantity",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "Quantity",
        "profile" : ["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "CoverageEligibilityRequest.item.unitPrice",
      "path" : "CoverageEligibilityRequest.item.unitPrice",
      "short" : "Fee, charge or cost per item",
      "definition" : "The amount charged to the patient by the provider for a single unit.",
      "requirements" : "Needed to support the evaluation of the eligibility.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.item.unitPrice",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "Money"
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "CoverageEligibilityRequest.item.facility",
      "path" : "CoverageEligibilityRequest.item.facility",
      "short" : "Servicing facility",
      "definition" : "Facility where the services will be provided.",
      "requirements" : "Needed to support the evaluation of the eligibility.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.item.facility",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Location",
        "http://hl7.org/fhir/StructureDefinition/Organization"]
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "CoverageEligibilityRequest.item.diagnosis",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "Diagnosis"
      }],
      "path" : "CoverageEligibilityRequest.item.diagnosis",
      "short" : "Applicable diagnosis",
      "definition" : "Patient diagnosis for which care is sought.",
      "requirements" : "Needed to support the evaluation of the eligibility.",
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "CoverageEligibilityRequest.item.diagnosis",
        "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,
      "mapping" : [{
        "identity" : "v2",
        "map" : "Request.reasonReference"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.item.diagnosis.id",
      "path" : "CoverageEligibilityRequest.item.diagnosis.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" : "CoverageEligibilityRequest.item.diagnosis.extension",
      "path" : "CoverageEligibilityRequest.item.diagnosis.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" : "CoverageEligibilityRequest.item.diagnosis.modifierExtension",
      "path" : "CoverageEligibilityRequest.item.diagnosis.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" : "CoverageEligibilityRequest.item.diagnosis.diagnosis[x]",
      "path" : "CoverageEligibilityRequest.item.diagnosis.diagnosis[x]",
      "short" : "Nature of illness or problem",
      "definition" : "The nature of illness or problem in a coded form or as a reference to an external defined Condition.",
      "requirements" : "Provides health context for the evaluation of the products and/or services.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "CoverageEligibilityRequest.item.diagnosis.diagnosis[x]",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "CodeableConcept"
      },
      {
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Condition"]
      }],
      "isModifier" : false,
      "isSummary" : false,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "ICD10"
        }],
        "strength" : "example",
        "description" : "ICD10 Diagnostic codes.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/icd-10"
      }
    },
    {
      "id" : "CoverageEligibilityRequest.item.detail",
      "path" : "CoverageEligibilityRequest.item.detail",
      "short" : "Product or service details",
      "definition" : "The plan/proposal/order describing the proposed service in detail.",
      "requirements" : "Needed to provide complex service proposal such as a Device or a plan.",
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "CoverageEligibilityRequest.item.detail",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Resource"]
      }],
      "isModifier" : false,
      "isSummary" : false
    }]
  },
  "differential" : {
    "element" : [{
      "id" : "CoverageEligibilityRequest",
      "path" : "CoverageEligibilityRequest",
      "short" : "CoverageEligibilityRequest resource",
      "definition" : "The CoverageEligibilityRequest provides patient and insurance coverage information to an insurer for them to respond, in the form of an CoverageEligibilityResponse, with information regarding whether the stated coverage is valid and in-force and optionally to provide the insurance details of the policy.",
      "min" : 0,
      "max" : "*",
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Request"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.identifier",
      "path" : "CoverageEligibilityRequest.identifier",
      "short" : "Business Identifier for coverage eligiblity request",
      "definition" : "A unique identifier assigned to this coverage eligiblity request.",
      "requirements" : "Allows coverage eligibility requests to be distinguished and referenced.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "Identifier"
      }],
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Request.identifier"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.identifier"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.status",
      "path" : "CoverageEligibilityRequest.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 codes that mark the resource 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 labeled 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" : "EligibilityRequestStatus"
        }],
        "strength" : "required",
        "description" : "A code specifying the state of the resource instance.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/fm-status"
      },
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Request.status"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.status"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.priority",
      "path" : "CoverageEligibilityRequest.priority",
      "short" : "Desired processing priority",
      "definition" : "When the requestor expects the processor to complete processing.",
      "requirements" : "Needed to advise the prossesor on the urgency of the request.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "ProcessPriority"
        }],
        "strength" : "example",
        "description" : "The timeliness with which processing is required: STAT, normal, Deferred.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/process-priority"
      },
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Request.priority"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.class"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.purpose",
      "path" : "CoverageEligibilityRequest.purpose",
      "short" : "auth-requirements | benefits | discovery | validation",
      "definition" : "Code to specify whether requesting: prior authorization requirements for some service categories or billing codes; benefits for coverages specified or discovered; discovery and return of coverages for the patient; and/or validation that the specified coverage is in-force at the date/period specified or 'now' if not specified.",
      "requirements" : "To indicate the processing actions requested.",
      "min" : 1,
      "max" : "*",
      "type" : [{
        "code" : "code"
      }],
      "isSummary" : true,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "EligibilityRequestPurpose"
        }],
        "strength" : "required",
        "description" : "A code specifying the types of information being requested.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/eligibilityrequest-purpose"
      },
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.class"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.patient",
      "path" : "CoverageEligibilityRequest.patient",
      "short" : "Intended recipient of products and services",
      "definition" : "The party who is the beneficiary of the supplied coverage and for whom eligibility is sought.",
      "comment" : "1..1.",
      "requirements" : "Required to provide context and coverage validation.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Patient"]
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Request.subject"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.subject[x]"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.subject"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.serviced[x]",
      "path" : "CoverageEligibilityRequest.serviced[x]",
      "short" : "Estimated date or dates of service",
      "definition" : "The date or dates when the enclosed suite of services were performed or completed.",
      "requirements" : "Required to provide time context for the request.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "date"
      },
      {
        "code" : "Period"
      }],
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.done[x]"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.created",
      "path" : "CoverageEligibilityRequest.created",
      "short" : "Creation date",
      "definition" : "The date when this resource was created.",
      "requirements" : "Need to record a timestamp for use by both the recipient and the issuer.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "dateTime"
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Request.authoredOn"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.recorded"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.enterer",
      "path" : "CoverageEligibilityRequest.enterer",
      "short" : "Author",
      "definition" : "Person who created the request.",
      "requirements" : "Some jurisdictions require the contact information for personnel completing eligibility requests.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Practitioner",
        "http://hl7.org/fhir/StructureDefinition/PractitionerRole"]
      }],
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.author"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.provider",
      "path" : "CoverageEligibilityRequest.provider",
      "short" : "Party responsible for the request",
      "definition" : "The provider which is responsible for the request.",
      "comment" : "Typically this field would be 1..1 where this party is responsible for the eligibility request but not necessarily professionally responsible for the provision of the individual products and services listed below.",
      "requirements" : "Needed to identify the requestor.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Practitioner",
        "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
        "http://hl7.org/fhir/StructureDefinition/Organization"]
      }],
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Request.requester"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.source"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.insurer",
      "path" : "CoverageEligibilityRequest.insurer",
      "short" : "Coverage issuer",
      "definition" : "The Insurer who issued the coverage in question and is the recipient of the request.",
      "requirements" : "Need to identify the recipient.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Organization"]
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Request.performer"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.who"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.facility",
      "path" : "CoverageEligibilityRequest.facility",
      "short" : "Servicing facility",
      "definition" : "Facility where the services are intended to be provided.",
      "requirements" : "Insurance adjudication can be dependant on where services were delivered.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Location"]
      }],
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.where[x]"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.supportingInfo",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "SupportingInformation"
      }],
      "path" : "CoverageEligibilityRequest.supportingInfo",
      "short" : "Supporting information",
      "definition" : "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.",
      "comment" : "Often there are multiple jurisdiction specific valuesets which are required.",
      "requirements" : "Typically these information codes are required to support the services rendered or the adjudication of the services rendered.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "BackboneElement"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.supportingInfo.sequence",
      "path" : "CoverageEligibilityRequest.supportingInfo.sequence",
      "short" : "Information instance identifier",
      "definition" : "A number to uniquely identify supporting information entries.",
      "requirements" : "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "positiveInt"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.supportingInfo.information",
      "path" : "CoverageEligibilityRequest.supportingInfo.information",
      "short" : "Data to be provided",
      "definition" : "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.",
      "comment" : "Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.",
      "requirements" : "To convey the data content to be provided when the information is more than a simple code or period.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Resource"]
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.supportingInfo.appliesToAll",
      "path" : "CoverageEligibilityRequest.supportingInfo.appliesToAll",
      "short" : "Applies to all items",
      "definition" : "The supporting materials are applicable for all detail items, product/servce categories and specific billing codes.",
      "requirements" : "Needed to convey that the information is universal to the request.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "boolean"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.insurance",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "Insurance"
      }],
      "path" : "CoverageEligibilityRequest.insurance",
      "short" : "Patient insurance information",
      "definition" : "Financial instruments for reimbursement for the health care products and services.",
      "comment" : "All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim.",
      "requirements" : "There must be at least one coverage for which eligibility is requested.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "BackboneElement"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.insurance.focal",
      "path" : "CoverageEligibilityRequest.insurance.focal",
      "short" : "Applicable coverage",
      "definition" : "A flag to indicate that this Coverage is to be used for evaluation of this request when set to true.",
      "comment" : "A patient may (will) have multiple insurance policies which provide reimburement for healthcare services and products. For example a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for evaluating this request. Other requests would be created to request evaluation against the other listed policies.",
      "requirements" : "To identify which coverage in the list is being used to evaluate this request.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "boolean"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.insurance.coverage",
      "path" : "CoverageEligibilityRequest.insurance.coverage",
      "short" : "Insurance information",
      "definition" : "Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system.",
      "requirements" : "Required to allow the adjudicator to locate the correct policy and history within their information system.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Coverage"]
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.insurance.businessArrangement",
      "path" : "CoverageEligibilityRequest.insurance.businessArrangement",
      "short" : "Additional provider contract number",
      "definition" : "A business agreement number established between the provider and the insurer for special business processing purposes.",
      "requirements" : "Providers may have multiple business arrangements with a given insurer and must supply the specific contract number for adjudication.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "string"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.item",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "Details"
      }],
      "path" : "CoverageEligibilityRequest.item",
      "short" : "Item to be evaluated for eligibiity",
      "definition" : "Service categories or billable services for which benefit details and/or an authorization prior to service delivery may be required by the payor.",
      "requirements" : "The items to be processed for the request.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "BackboneElement"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.item.supportingInfoSequence",
      "path" : "CoverageEligibilityRequest.item.supportingInfoSequence",
      "short" : "Applicable exception or supporting information",
      "definition" : "Exceptions, special conditions and supporting information applicable for this service or product line.",
      "requirements" : "Needed to support or inform the consideration for eligibility.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "positiveInt"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.item.category",
      "path" : "CoverageEligibilityRequest.item.category",
      "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.",
      "requirements" : "Needed to convey the category of service or product for which eligibility is sought.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "BenefitCategory"
        }],
        "strength" : "example",
        "description" : "Benefit categories such as: oral, medical, vision etc.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/ex-benefitcategory"
      }
    },
    {
      "id" : "CoverageEligibilityRequest.item.productOrService",
      "path" : "CoverageEligibilityRequest.item.productOrService",
      "short" : "Billing, service, product, or drug code",
      "definition" : "This contains the product, service, drug or other billing code for the item.",
      "comment" : "Code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI).",
      "requirements" : "Needed to convey the actual service or product for which eligibility is sought.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "ServiceProduct"
        }],
        "strength" : "example",
        "description" : "Allowable service and product codes.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/service-uscls"
      }
    },
    {
      "id" : "CoverageEligibilityRequest.item.modifier",
      "path" : "CoverageEligibilityRequest.item.modifier",
      "short" : "Product or service billing modifiers",
      "definition" : "Item typification or modifiers codes to convey additional context for the product or service.",
      "comment" : "For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.",
      "requirements" : "To support provision of the item or to charge an elevated fee.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "Modifiers"
        }],
        "strength" : "example",
        "description" : "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/claim-modifiers"
      }
    },
    {
      "id" : "CoverageEligibilityRequest.item.provider",
      "path" : "CoverageEligibilityRequest.item.provider",
      "short" : "Perfoming practitioner",
      "definition" : "The practitioner who is responsible for the product or service to be rendered to the patient.",
      "requirements" : "Needed to support the evaluation of the eligibility.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Practitioner",
        "http://hl7.org/fhir/StructureDefinition/PractitionerRole"]
      }],
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Request.requester"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.source"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.item.quantity",
      "path" : "CoverageEligibilityRequest.item.quantity",
      "short" : "Count of products or services",
      "definition" : "The number of repetitions of a service or product.",
      "requirements" : "Required when the product or service code does not convey the quantity provided.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Quantity",
        "profile" : ["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.item.unitPrice",
      "path" : "CoverageEligibilityRequest.item.unitPrice",
      "short" : "Fee, charge or cost per item",
      "definition" : "The amount charged to the patient by the provider for a single unit.",
      "requirements" : "Needed to support the evaluation of the eligibility.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Money"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.item.facility",
      "path" : "CoverageEligibilityRequest.item.facility",
      "short" : "Servicing facility",
      "definition" : "Facility where the services will be provided.",
      "requirements" : "Needed to support the evaluation of the eligibility.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Location",
        "http://hl7.org/fhir/StructureDefinition/Organization"]
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.item.diagnosis",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "Diagnosis"
      }],
      "path" : "CoverageEligibilityRequest.item.diagnosis",
      "short" : "Applicable diagnosis",
      "definition" : "Patient diagnosis for which care is sought.",
      "requirements" : "Needed to support the evaluation of the eligibility.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "BackboneElement"
      }],
      "mapping" : [{
        "identity" : "v2",
        "map" : "Request.reasonReference"
      }]
    },
    {
      "id" : "CoverageEligibilityRequest.item.diagnosis.diagnosis[x]",
      "path" : "CoverageEligibilityRequest.item.diagnosis.diagnosis[x]",
      "short" : "Nature of illness or problem",
      "definition" : "The nature of illness or problem in a coded form or as a reference to an external defined Condition.",
      "requirements" : "Provides health context for the evaluation of the products and/or services.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      },
      {
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Condition"]
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "ICD10"
        }],
        "strength" : "example",
        "description" : "ICD10 Diagnostic codes.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/icd-10"
      }
    },
    {
      "id" : "CoverageEligibilityRequest.item.detail",
      "path" : "CoverageEligibilityRequest.item.detail",
      "short" : "Product or service details",
      "definition" : "The plan/proposal/order describing the proposed service in detail.",
      "requirements" : "Needed to provide complex service proposal such as a Device or a plan.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Resource"]
      }]
    }]
  }
}

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