{
  "resourceType": "StructureDefinition",
  "id": "ext-Coverage-NotPayingPeriod",
  "url": "https://bpcs.exchange/fhir/StructureDefinition/ext-Coverage-NotPayingPeriod",
  "name": "CoverageNotPayingPeriod",
  "title": "Coverage Not Paying Period",
  "status": "active",
  "experimental": false,
  "description": "Indicates the period of time over which the member's private coverage is not contributing to drug costs - typically because the patient has reached their maximum for the benefit period.  Coverage will reset when the private plan starts a new coverage period.",
  "fhirVersion": "5.0.0",
  "mapping": [
    {
      "identity": "BPCS",
      "name": "Internal BPCS API"
    }
  ],
  "kind": "complex-type",
  "abstract": false,
  "context": [
    {
      "type": "element",
      "expression": "Coverage.period"
    }
  ],
  "type": "Extension",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
  "derivation": "constraint",
  "snapshot": {
    "element": [
      {
        "id": "Extension",
        "path": "Extension",
        "short": "Coverage not paying period",
        "definition": "Indicates the period of time over which the member's private coverage is not contributing to drug costs - typically because the patient has reached their maximum for the benefit period.  Coverage will reset when the private plan starts a new coverage period.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Extension",
          "min": 0,
          "max": "*"
        },
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Extension.id",
        "path": "Extension.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "Unique id for inter-element referencing",
        "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": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "string"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "condition": [
          "ele-1"
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "Extension.extension",
        "path": "Extension.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "description": "Extensions are always sliced by (at least) url",
          "rules": "open"
        },
        "short": "Additional content defined by implementations",
        "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Extension.url",
        "path": "Extension.url",
        "representation": [
          "xmlAttr"
        ],
        "short": "identifies the meaning of the extension",
        "definition": "Source of the definition for the extension code - a logical name or a URL.",
        "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Extension.url",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "uri"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "fixedUri": "https://bpcs.exchange/fhir/StructureDefinition/ext-Coverage-NotPayingPeriod",
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Extension.value[x]",
        "path": "Extension.value[x]",
        "short": "Value of extension",
        "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Extension.value[x]",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Period"
          }
        ],
        "condition": [
          "ext-1"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Extension.value[x].id",
        "path": "Extension.value[x].id",
        "representation": [
          "xmlAttr"
        ],
        "short": "Unique id for inter-element referencing",
        "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": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "string"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "condition": [
          "ele-1"
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "Extension.value[x].extension",
        "path": "Extension.value[x].extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "description": "Extensions are always sliced by (at least) url",
          "rules": "open"
        },
        "short": "Additional content defined by implementations",
        "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Extension.value[x].start",
        "path": "Extension.value[x].start",
        "short": "maximumReachedDate",
        "definition": "The most recent date within the overall coverage period for the private insurance when its maximum covered amount is reached.  I.e. after this date, this private insurance will no longer reimburse for eligible costs.",
        "comment": "If the low element is missing, the meaning is that the low boundary is not known.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Period.start",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "condition": [
          "per-1"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "DR.1"
          },
          {
            "identity": "rim",
            "map": "./low"
          },
          {
            "identity": "BPCS",
            "map": "RecipientInsuranceDTO/FamilyMemberHistoryDTO.maximumReachedDate1 or maximumReachedDate2, FamilyMemberInsuranceDTO.maximumReachedDate, InsuranceDTO.maximumReachedDate"
          }
        ]
      },
      {
        "id": "Extension.value[x].end",
        "path": "Extension.value[x].end",
        "short": "reinstatementDate",
        "definition": "The first date when the private insurance max reached is reset and coverage will be resumed.  For example, if the coverage limits to $2000 within a year and the maximum had been exceeded, when the renewal date is reached, the counter starts again at zero and the private insurance will again make payments for receipts after that date.",
        "comment": "The end value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Period.end",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "meaningWhenMissing": "If the end of the period is missing, it means that the period is ongoing",
        "condition": [
          "per-1"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "DR.2"
          },
          {
            "identity": "rim",
            "map": "./high"
          },
          {
            "identity": "BPCS",
            "map": "RecipientInsuranceDTO/FamilyMemberHistoryDTO.reinstatementDate1 or reinstatementDate2, FamilyMemberInsuranceDTO.reinstatementDate, InsuranceDTO.reinstatementDate"
          }
        ]
      }
    ]
  },
  "differential": {
    "element": [
      {
        "id": "Extension",
        "path": "Extension",
        "short": "Coverage not paying period",
        "definition": "Indicates the period of time over which the member's private coverage is not contributing to drug costs - typically because the patient has reached their maximum for the benefit period.  Coverage will reset when the private plan starts a new coverage period.",
        "max": "1"
      },
      {
        "id": "Extension.url",
        "path": "Extension.url",
        "fixedUri": "https://bpcs.exchange/fhir/StructureDefinition/ext-Coverage-NotPayingPeriod"
      },
      {
        "id": "Extension.value[x]",
        "path": "Extension.value[x]",
        "type": [
          {
            "code": "Period"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Extension.value[x].start",
        "path": "Extension.value[x].start",
        "short": "maximumReachedDate",
        "definition": "The most recent date within the overall coverage period for the private insurance when its maximum covered amount is reached.  I.e. after this date, this private insurance will no longer reimburse for eligible costs.",
        "min": 1,
        "mustSupport": true,
        "mapping": [
          {
            "identity": "BPCS",
            "map": "RecipientInsuranceDTO/FamilyMemberHistoryDTO.maximumReachedDate1 or maximumReachedDate2, FamilyMemberInsuranceDTO.maximumReachedDate, InsuranceDTO.maximumReachedDate"
          }
        ]
      },
      {
        "id": "Extension.value[x].end",
        "path": "Extension.value[x].end",
        "short": "reinstatementDate",
        "definition": "The first date when the private insurance max reached is reset and coverage will be resumed.  For example, if the coverage limits to $2000 within a year and the maximum had been exceeded, when the renewal date is reached, the counter starts again at zero and the private insurance will again make payments for receipts after that date.",
        "mustSupport": true,
        "mapping": [
          {
            "identity": "BPCS",
            "map": "RecipientInsuranceDTO/FamilyMemberHistoryDTO.reinstatementDate1 or reinstatementDate2, FamilyMemberInsuranceDTO.reinstatementDate, InsuranceDTO.reinstatementDate"
          }
        ]
      }
    ]
  }
}