StructureDefinition-coverage-v14.xml

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="Coveragev14"/>
    <meta>
      <lastUpdated value="2016-03-31T08:01:25.570+11:00"/>
    </meta>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
      </div>
    </text>
    <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
      <valueInteger value="0"/>
    </extension>
    <url value="http://example.org/fhir/StructureDefinition/Coveragev14"/>
    <name value="Coveragev14"/>
    <status value="draft"/>
    <publisher value="Health Level Seven International (Financial Management)"/>
    <contact>
      <telecom>
        <system value="other"/>
        <value value="http://hl7.org/fhir"/>
      </telecom>
    </contact>
    <contact>
      <telecom>
        <system value="other"/>
        <value value="http://www.hl7.org/Special/committees/fm/index.cfm"/>
      </telecom>
    </contact>
    <date value="2016-03-31T08:01:25+11:00"/>
    <description value="Base StructureDefinition for Coverage Resource"/>
    <requirements value="Health care programs and insurers are significant payors of health service costs."/>
    <fhirVersion value="1.4.0"/>
    <mapping>
      <identity value="rim"/>
      <uri value="http://hl7.org/v3"/>
      <name value="RIM"/>
    </mapping>
    <mapping>
      <identity value="w5"/>
      <uri value="http://hl7.org/fhir/w5"/>
      <name value="W5 Mapping"/>
    </mapping>
    <mapping>
      <identity value="cpha3pharm"/>
      <uri value="http://www.pharmacists.ca/"/>
      <name value="Canadian Pharmacy Associaiton eclaims standard"/>
    </mapping>
    <mapping>
      <identity value="v2"/>
      <uri value="http://hl7.org/v2"/>
      <name value="HL7 v2"/>
    </mapping>
    <mapping>
      <identity value="cdanetv4"/>
      <uri value="http://www.cda-adc.ca/en/services/cdanet/"/>
      <name value="Canadian Dental Association eclaims standard"/>
    </mapping>
    <kind value="resource"/>
    <abstract value="false"/>
    <baseType value="DomainResource"/>
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
    <derivation value="specialization"/>
    <snapshot>
      <element>
        <path value="Coverage"/>
        <short value="Insurance or medical plan"/>
        <definition value="Financial instrument which may be used to pay for or reimburse health care products and
         services."/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="DomainResource"/>
        </type>
        <mapping>
          <identity value="rim"/>
          <map value="Coverage"/>
        </mapping>
        <mapping>
          <identity value="w5"/>
          <map value="financial.support"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.id"/>
        <short value="Logical id of this artifact"/>
        <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this
         value never changes."/>
        <comments value="The only time that a resource does not have an id is when it is being submitted to the
         server using a create operation. Bundles always have an id, though it is usually a generated
         UUID."/>
        <min value="0"/>
        <max value="1"/>
        <base>
          <path value="Resource.id"/>
          <min value="0"/>
          <max value="*"/>
        </base>
        <type>
          <code value="id"/>
        </type>
        <isSummary value="true"/>
      </element>
      <element>
        <path value="Coverage.meta"/>
        <short value="Metadata about the resource"/>
        <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.
         Changes to the content may not always be associated with version changes to the resource."/>
        <min value="0"/>
        <max value="1"/>
        <base>
          <path value="Resource.meta"/>
          <min value="0"/>
          <max value="*"/>
        </base>
        <type>
          <code value="Meta"/>
        </type>
        <isSummary value="true"/>
      </element>
      <element>
        <path value="Coverage.implicitRules"/>
        <short value="A set of rules under which this content was created"/>
        <definition value="A reference to a set of rules that were followed when the resource was constructed, and
         which must be understood when processing the content."/>
        <comments value="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 as much as possible."/>
        <min value="0"/>
        <max value="1"/>
        <base>
          <path value="Resource.implicitRules"/>
          <min value="0"/>
          <max value="*"/>
        </base>
        <type>
          <code value="uri"/>
        </type>
        <isModifier value="true"/>
        <isSummary value="true"/>
      </element>
      <element>
        <path value="Coverage.language"/>
        <short value="Language of the resource content"/>
        <definition value="The base language in which the resource is written."/>
        <comments value="Language is provided to support indexing and accessibility (typically, services such as
         text to speech use the language tag). The html language tag in the narrative applies 
         to the narrative. The language tag on the resource may be used to specify the language
         of other presentations generated from the data in the resource  Not all the content has
         to be in the base language. The Resource.language should not be assumed to apply to the
         narrative automatically. If a language is specified, it should it also be specified on
         the div element in the html (see rules in HTML5 for information about the relationship
         between xml:lang and the html lang attribute)."/>
        <min value="0"/>
        <max value="1"/>
        <base>
          <path value="Resource.language"/>
          <min value="0"/>
          <max value="*"/>
        </base>
        <type>
          <code value="code"/>
        </type>
        <binding>
          <strength value="required"/>
          <description value="A human language."/>
          <valueSetUri value="http://tools.ietf.org/html/bcp47"/>
        </binding>
      </element>
      <element>
        <path value="Coverage.text"/>
        <short value="Text summary of the resource, for human interpretation"/>
        <definition value="A human-readable narrative that contains a summary of the resource, and may be used to
         represent the content of the resource to a human. The narrative need not encode all the
         structured data, but is required to contain sufficient detail to make it &quot;clinically
         safe&quot; for a human to just read the narrative. Resource definitions may define what
         content should be represented in the narrative to ensure clinical safety."/>
        <comments value="Contained resources do not have narrative. Resources that are not contained SHOULD have
         a narrative."/>
        <alias value="narrative"/>
        <alias value="html"/>
        <alias value="xhtml"/>
        <alias value="display"/>
        <min value="0"/>
        <max value="1"/>
        <base>
          <path value="DomainResource.text"/>
          <min value="0"/>
          <max value="*"/>
        </base>
        <type>
          <code value="Narrative"/>
        </type>
        <condition value="dom-1"/>
        <mapping>
          <identity value="rim"/>
          <map value="Act.text?"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.contained"/>
        <short value="Contained, inline Resources"/>
        <definition value="These resources do not have an independent existence apart from the resource that contains
         them - they cannot be identified independently, and nor can they have their own independent
         transaction scope."/>
        <comments value="This should never be done when the content can be identified properly, as once identification
         is lost, it is extremely difficult (and context dependent) to restore it again."/>
        <alias value="inline resources"/>
        <alias value="anonymous resources"/>
        <alias value="contained resources"/>
        <min value="0"/>
        <max value="*"/>
        <base>
          <path value="DomainResource.contained"/>
          <min value="0"/>
          <max value="*"/>
        </base>
        <type>
          <code value="Resource"/>
        </type>
        <mapping>
          <identity value="rim"/>
          <map value="N/A"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.extension"/>
        <short value="Additional Content defined by implementations"/>
        <definition value="May be used to represent additional information that is not part of the basic definition
         of the resource. In order to make the use of extensions safe and manageable, there is
         a strict set of governance  applied to the definition and use of extensions. Though any
         implementer is allowed to define an extension, there is a set of requirements that SHALL
         be met as part of the definition of the extension."/>
        <comments value="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 value="extensions"/>
        <alias value="user content"/>
        <min value="0"/>
        <max value="*"/>
        <base>
          <path value="DomainResource.extension"/>
          <min value="0"/>
          <max value="*"/>
        </base>
        <type>
          <code value="Extension"/>
        </type>
        <mapping>
          <identity value="rim"/>
          <map value="N/A"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.modifierExtension"/>
        <short value="Extensions that cannot be ignored"/>
        <definition value="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. In order to make the use
         of extensions safe and manageable, there is a strict set of governance applied to the
         definition and use of extensions. Though any implementer is allowed to define an extension,
         there is a set of requirements that SHALL be met as part of the definition of the extension.
         Applications processing a resource are required to check for modifier extensions."/>
        <comments value="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 value="extensions"/>
        <alias value="user content"/>
        <min value="0"/>
        <max value="*"/>
        <base>
          <path value="DomainResource.modifierExtension"/>
          <min value="0"/>
          <max value="*"/>
        </base>
        <type>
          <code value="Extension"/>
        </type>
        <isModifier value="true"/>
        <mapping>
          <identity value="rim"/>
          <map value="N/A"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.issuer[x]"/>
        <short value="Identifier for the plan issuer"/>
        <definition value="The program or plan underwriter or payor."/>
        <requirements value="Need to identify the issuer to target for processing and for coordination of benefit processing."/>
        <min value="1"/>
        <max value="1"/>
        <type>
          <code value="Identifier"/>
        </type>
        <type>
          <code value="Reference"/>
          <profile value="http://hl7.org/fhir/StructureDefinition/Organization"/>
        </type>
        <isSummary value="true"/>
        <mapping>
          <identity value="cpha3pharm"/>
          <map value="C.30"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="IN1-3"/>
        </mapping>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="A05"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.bin"/>
        <short value="BIN Number"/>
        <definition value="Business Identification Number (BIN number) used to identify the routing  of eClaims."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="string"/>
        </type>
      </element>
      <element>
        <path value="Coverage.period"/>
        <short value="Coverage start and end dates"/>
        <definition value="Time period during which the coverage is in force. A missing start date indicates the
         start date isn't known, a missing end date means the coverage is continuing to be in force."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="Period"/>
        </type>
        <isSummary value="true"/>
        <mapping>
          <identity value="v2"/>
          <map value="IN1-12 / IN1-13"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.type"/>
        <short value="Type of coverage"/>
        <definition value="The type of coverage: social program, medical plan, accident coverage (workers compensation,
         auto), group health."/>
        <requirements value="The order of application of coverages is dependent on the types of coverage."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="Coding"/>
        </type>
        <isSummary value="true"/>
        <binding>
          <strength value="example"/>
          <description value="The type of insurance: public health, worker compensation; private accident, auto, private
           health, etc.)."/>
          <valueSetReference>
            <reference value="http://hl7.org/fhir/ValueSet/v3-ActCoverageTypeCode"/>
          </valueSetReference>
        </binding>
        <mapping>
          <identity value="v2"/>
          <map value="IN1-15"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.planholder[x]"/>
        <short value="Plan holder"/>
        <definition value="The party who 'owns' the insurance contractual relationship to the policy or to whom the
         benefit of the policy is due."/>
        <min value="1"/>
        <max value="1"/>
        <type>
          <code value="Identifier"/>
        </type>
        <type>
          <code value="Reference"/>
          <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
        </type>
        <type>
          <code value="Reference"/>
          <profile value="http://hl7.org/fhir/StructureDefinition/Organization"/>
        </type>
        <isModifier value="true"/>
        <mapping>
          <identity value="cpha3pharm"/>
          <map value="C.35"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="IN1-16, 18,  19-name of insured, address, date of birth"/>
        </mapping>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="D01 through D09"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.beneficiary[x]"/>
        <short value="Plan Beneficiary"/>
        <definition value="The party who benefits from the insurance coverage."/>
        <min value="1"/>
        <max value="1"/>
        <type>
          <code value="Identifier"/>
        </type>
        <type>
          <code value="Reference"/>
          <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
        </type>
        <isModifier value="true"/>
        <mapping>
          <identity value="cpha3pharm"/>
          <map value="C.35"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="IN1-16, 18,  19-name of insured, address, date of birth"/>
        </mapping>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="D01 through D09"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.relationship"/>
        <short value="Patient relationship to planholder"/>
        <definition value="The relationship of the patient to the planholdersubscriber)."/>
        <requirements value="To determine relationship between the patient and the subscriber."/>
        <min value="1"/>
        <max value="1"/>
        <type>
          <code value="Coding"/>
        </type>
        <binding>
          <strength value="example"/>
          <description value="The code for the relationship of the patient to the subscriber."/>
          <valueSetReference>
            <reference value="http://hl7.org/fhir/ValueSet/relationship"/>
          </valueSetReference>
        </binding>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="C03"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.identifier"/>
        <short value="The primary coverage ID"/>
        <definition value="The main (and possibly only) identifier for the coverage - often referred to as a Member
         Id, Subscriber Id, Certificate number or Personal Health Number or Case ID."/>
        <requirements value="This value may uniquely identify the coverage or it may be used in conjunction with the
         additional identifiers below."/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="Identifier"/>
        </type>
        <isSummary value="true"/>
        <mapping>
          <identity value="cpha3pharm"/>
          <map value="C.32, C.33, C.39"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="IN1-2"/>
        </mapping>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="C02"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.group"/>
        <short value="An identifier for the group"/>
        <definition value="Identifies a style or collective of coverage issues by the underwriter, for example may
         be used to identify a class of coverage or employer group. May also be referred to as
         a Policy or Group ID."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="string"/>
        </type>
        <isSummary value="true"/>
        <mapping>
          <identity value="cpha3pharm"/>
          <map value="C.31"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="IN1-8"/>
        </mapping>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="C11 (Division,Section)"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.plan"/>
        <short value="An identifier for the plan"/>
        <definition value="Identifies a style or collective of coverage issues by the underwriter, for example may
         be used to identify a class of coverage or employer group. May also be referred to as
         a Policy or Group ID."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="string"/>
        </type>
        <isSummary value="true"/>
        <mapping>
          <identity value="v2"/>
          <map value="IN1-35"/>
        </mapping>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="C01"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.subPlan"/>
        <short value="An identifier for the subsection of the plan"/>
        <definition value="Identifies a sub-style or sub-collective of coverage issues by the underwriter, for example
         may be used to identify a specific employer group within a class of employers. May be
         referred to as a Section or Division ID."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="string"/>
        </type>
        <isSummary value="true"/>
        <mapping>
          <identity value="v2"/>
          <map value="IN1-10"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.dependent"/>
        <short value="Dependent number"/>
        <definition value="A unique identifier for a dependent under the coverage."/>
        <requirements value="For some coverage a single identifier is issued to the PolicyHolder and a dependent number
         issued to each beneficiary."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="positiveInt"/>
        </type>
        <isSummary value="true"/>
        <mapping>
          <identity value="v2"/>
          <map value="- No exact HL7 v2 equivalent concept seems to exist;"/>
        </mapping>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="C17"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.sequence"/>
        <short value="The plan instance or sequence counter"/>
        <definition value="An optional counter for a particular instance of the identified coverage which increments
         upon each renewal."/>
        <requirements value="Some coverage, for example social plans, may be offered in short time increments, for
         example for a week or a month at a time, so while the rest of the plan details and identifiers
         may remain constant over time, the instance is incremented with each renewal and provided
         to the covered party on their 'card'."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="positiveInt"/>
        </type>
        <isSummary value="true"/>
        <mapping>
          <identity value="v2"/>
          <map value="No HL7 v2 equivalent concept seems to exist"/>
        </mapping>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="D11"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.exception"/>
        <short value="Eligibility exceptions"/>
        <definition value="Factors which may influence the applicability of coverage."/>
        <requirements value="To determine extenuating circumstances for coverage."/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="Coding"/>
        </type>
        <binding>
          <strength value="example"/>
          <description value="The eligibility exception codes."/>
          <valueSetReference>
            <reference value="http://hl7.org/fhir/ValueSet/coverage-exception"/>
          </valueSetReference>
        </binding>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="C09"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.school"/>
        <short value="Name of School"/>
        <definition value="Name of school for over-aged dependants."/>
        <requirements value="Often required for over-age dependents."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="string"/>
        </type>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="C10"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.network"/>
        <short value="Insurer network"/>
        <definition value="The identifier for a community of providers."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="string"/>
        </type>
        <isSummary value="true"/>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="D10"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.contract"/>
        <short value="Contract details"/>
        <definition value="The policy(s) which constitute this insurance coverage."/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="Reference"/>
          <profile value="http://hl7.org/fhir/StructureDefinition/Contract"/>
        </type>
        <mapping>
          <identity value="cpha3pharm"/>
          <map value="C.35"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="IN1-16, 18,  19"/>
        </mapping>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="D01 through D09"/>
        </mapping>
      </element>
    </snapshot>
    <differential>
      <element>
        <path value="Coverage"/>
        <short value="Insurance or medical plan"/>
        <definition value="Financial instrument which may be used to pay for or reimburse health care products and
         services."/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="DomainResource"/>
        </type>
        <mapping>
          <identity value="rim"/>
          <map value="Coverage"/>
        </mapping>
        <mapping>
          <identity value="w5"/>
          <map value="financial.support"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.issuer[x]"/>
        <short value="Identifier for the plan issuer"/>
        <definition value="The program or plan underwriter or payor."/>
        <requirements value="Need to identify the issuer to target for processing and for coordination of benefit processing."/>
        <min value="1"/>
        <max value="1"/>
        <type>
          <code value="Identifier"/>
        </type>
        <type>
          <code value="Reference"/>
          <profile value="http://hl7.org/fhir/StructureDefinition/Organization"/>
        </type>
        <isSummary value="true"/>
        <mapping>
          <identity value="cpha3pharm"/>
          <map value="C.30"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="IN1-3"/>
        </mapping>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="A05"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.bin"/>
        <short value="BIN Number"/>
        <definition value="Business Identification Number (BIN number) used to identify the routing  of eClaims."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="string"/>
        </type>
      </element>
      <element>
        <path value="Coverage.period"/>
        <short value="Coverage start and end dates"/>
        <definition value="Time period during which the coverage is in force. A missing start date indicates the
         start date isn't known, a missing end date means the coverage is continuing to be in force."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="Period"/>
        </type>
        <isSummary value="true"/>
        <mapping>
          <identity value="v2"/>
          <map value="IN1-12 / IN1-13"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.type"/>
        <short value="Type of coverage"/>
        <definition value="The type of coverage: social program, medical plan, accident coverage (workers compensation,
         auto), group health."/>
        <requirements value="The order of application of coverages is dependent on the types of coverage."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="Coding"/>
        </type>
        <isSummary value="true"/>
        <binding>
          <strength value="example"/>
          <description value="The type of insurance: public health, worker compensation; private accident, auto, private
           health, etc.)."/>
          <valueSetReference>
            <reference value="http://hl7.org/fhir/ValueSet/v3-ActCoverageTypeCode"/>
          </valueSetReference>
        </binding>
        <mapping>
          <identity value="v2"/>
          <map value="IN1-15"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.planholder[x]"/>
        <short value="Plan holder"/>
        <definition value="The party who 'owns' the insurance contractual relationship to the policy or to whom the
         benefit of the policy is due."/>
        <min value="1"/>
        <max value="1"/>
        <type>
          <code value="Identifier"/>
        </type>
        <type>
          <code value="Reference"/>
          <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
        </type>
        <type>
          <code value="Reference"/>
          <profile value="http://hl7.org/fhir/StructureDefinition/Organization"/>
        </type>
        <isModifier value="true"/>
        <mapping>
          <identity value="cpha3pharm"/>
          <map value="C.35"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="IN1-16, 18,  19-name of insured, address, date of birth"/>
        </mapping>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="D01 through D09"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.beneficiary[x]"/>
        <short value="Plan Beneficiary"/>
        <definition value="The party who benefits from the insurance coverage."/>
        <min value="1"/>
        <max value="1"/>
        <type>
          <code value="Identifier"/>
        </type>
        <type>
          <code value="Reference"/>
          <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
        </type>
        <isModifier value="true"/>
        <mapping>
          <identity value="cpha3pharm"/>
          <map value="C.35"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="IN1-16, 18,  19-name of insured, address, date of birth"/>
        </mapping>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="D01 through D09"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.relationship"/>
        <short value="Patient relationship to planholder"/>
        <definition value="The relationship of the patient to the planholdersubscriber)."/>
        <requirements value="To determine relationship between the patient and the subscriber."/>
        <min value="1"/>
        <max value="1"/>
        <type>
          <code value="Coding"/>
        </type>
        <binding>
          <strength value="example"/>
          <description value="The code for the relationship of the patient to the subscriber."/>
          <valueSetReference>
            <reference value="http://hl7.org/fhir/ValueSet/relationship"/>
          </valueSetReference>
        </binding>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="C03"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.identifier"/>
        <short value="The primary coverage ID"/>
        <definition value="The main (and possibly only) identifier for the coverage - often referred to as a Member
         Id, Subscriber Id, Certificate number or Personal Health Number or Case ID."/>
        <requirements value="This value may uniquely identify the coverage or it may be used in conjunction with the
         additional identifiers below."/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="Identifier"/>
        </type>
        <isSummary value="true"/>
        <mapping>
          <identity value="cpha3pharm"/>
          <map value="C.32, C.33, C.39"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="IN1-2"/>
        </mapping>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="C02"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.group"/>
        <short value="An identifier for the group"/>
        <definition value="Identifies a style or collective of coverage issues by the underwriter, for example may
         be used to identify a class of coverage or employer group. May also be referred to as
         a Policy or Group ID."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="string"/>
        </type>
        <isSummary value="true"/>
        <mapping>
          <identity value="cpha3pharm"/>
          <map value="C.31"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="IN1-8"/>
        </mapping>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="C11 (Division,Section)"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.plan"/>
        <short value="An identifier for the plan"/>
        <definition value="Identifies a style or collective of coverage issues by the underwriter, for example may
         be used to identify a class of coverage or employer group. May also be referred to as
         a Policy or Group ID."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="string"/>
        </type>
        <isSummary value="true"/>
        <mapping>
          <identity value="v2"/>
          <map value="IN1-35"/>
        </mapping>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="C01"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.subPlan"/>
        <short value="An identifier for the subsection of the plan"/>
        <definition value="Identifies a sub-style or sub-collective of coverage issues by the underwriter, for example
         may be used to identify a specific employer group within a class of employers. May be
         referred to as a Section or Division ID."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="string"/>
        </type>
        <isSummary value="true"/>
        <mapping>
          <identity value="v2"/>
          <map value="IN1-10"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.dependent"/>
        <short value="Dependent number"/>
        <definition value="A unique identifier for a dependent under the coverage."/>
        <requirements value="For some coverage a single identifier is issued to the PolicyHolder and a dependent number
         issued to each beneficiary."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="positiveInt"/>
        </type>
        <isSummary value="true"/>
        <mapping>
          <identity value="v2"/>
          <map value="- No exact HL7 v2 equivalent concept seems to exist;"/>
        </mapping>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="C17"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.sequence"/>
        <short value="The plan instance or sequence counter"/>
        <definition value="An optional counter for a particular instance of the identified coverage which increments
         upon each renewal."/>
        <requirements value="Some coverage, for example social plans, may be offered in short time increments, for
         example for a week or a month at a time, so while the rest of the plan details and identifiers
         may remain constant over time, the instance is incremented with each renewal and provided
         to the covered party on their 'card'."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="positiveInt"/>
        </type>
        <isSummary value="true"/>
        <mapping>
          <identity value="v2"/>
          <map value="No HL7 v2 equivalent concept seems to exist"/>
        </mapping>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="D11"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.exception"/>
        <short value="Eligibility exceptions"/>
        <definition value="Factors which may influence the applicability of coverage."/>
        <requirements value="To determine extenuating circumstances for coverage."/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="Coding"/>
        </type>
        <binding>
          <strength value="example"/>
          <description value="The eligibility exception codes."/>
          <valueSetReference>
            <reference value="http://hl7.org/fhir/ValueSet/coverage-exception"/>
          </valueSetReference>
        </binding>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="C09"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.school"/>
        <short value="Name of School"/>
        <definition value="Name of school for over-aged dependants."/>
        <requirements value="Often required for over-age dependents."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="string"/>
        </type>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="C10"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.network"/>
        <short value="Insurer network"/>
        <definition value="The identifier for a community of providers."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="string"/>
        </type>
        <isSummary value="true"/>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="D10"/>
        </mapping>
      </element>
      <element>
        <path value="Coverage.contract"/>
        <short value="Contract details"/>
        <definition value="The policy(s) which constitute this insurance coverage."/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="Reference"/>
          <profile value="http://hl7.org/fhir/StructureDefinition/Contract"/>
        </type>
        <mapping>
          <identity value="cpha3pharm"/>
          <map value="C.35"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="IN1-16, 18,  19"/>
        </mapping>
        <mapping>
          <identity value="cdanetv4"/>
          <map value="D01 through D09"/>
        </mapping>
      </element>
    </differential>
  </StructureDefinition>