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<StructureDefinition xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ../../input-cache/schemas/R5/fhir-single.xsd">
  <id value="profile-ExplanationOfBenefit-expenses-quarterly" />
  <url value="https://bpcs.exchange/fhir/StructureDefinition/profile-ExplanationOfBenefit-expenses-quarterly" />
  <name value="ExplanationOfBenefitExpensesQuarterly" />
  <title value="Recipient Quarterly Expenses" />
  <status value="active" />
  <experimental value="false" />
  <description value="A profile on the EOB resources that allows reporting the total of eligible expenses for a quarter" />
  <fhirVersion value="5.0.0" />
  <mapping>
    <identity value="BPCS" />
    <name value="Internal BPCS API" />
  </mapping>
  <kind value="resource" />
  <abstract value="false" />
  <type value="ExplanationOfBenefit" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit" />
  <derivation value="constraint" />
  <differential>
    <element id="ExplanationOfBenefit.id">
      <path value="ExplanationOfBenefit.id" />
      <comment value="This id will always be a random UUID, which will change each time a query is done - because the calculation is performed anew each time" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="ExplanationOfBenefit.status">
      <path value="ExplanationOfBenefit.status" />
      <patternCode value="active" />
    </element>
    <element id="ExplanationOfBenefit.type">
      <path value="ExplanationOfBenefit.type" />
      <patternCodeableConcept>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/claim-type" />
          <code value="pharmacy" />
        </coding>
      </patternCodeableConcept>
    </element>
    <element id="ExplanationOfBenefit.use">
      <path value="ExplanationOfBenefit.use" />
      <patternCode value="claim" />
    </element>
    <element id="ExplanationOfBenefit.patient">
      <path value="ExplanationOfBenefit.patient" />
      <type>
        <code value="Reference" />
        <profile value="https://bpcs.exchange/fhir/StructureDefinition/profile-Reference-rest" />
        <targetProfile value="https://bpcs.exchange/fhir/StructureDefinition/profile-Patient-search" />
      </type>
      <mustSupport value="true" />
      <mapping>
        <identity value="BPCS" />
        <map value="RecipientExpensesDTO.odbNum" />
      </mapping>
    </element>
    <element id="ExplanationOfBenefit.created">
      <path value="ExplanationOfBenefit.created" />
      <comment value="This will be the date/time the operation was executed" />
      <mustSupport value="true" />
    </element>
    <element id="ExplanationOfBenefit.insurer">
      <path value="ExplanationOfBenefit.insurer" />
      <patternReference>
        <reference value="Organization/bpcs" />
      </patternReference>
    </element>
    <element id="ExplanationOfBenefit.outcome">
      <path value="ExplanationOfBenefit.outcome" />
      <patternCode value="complete" />
    </element>
    <element id="ExplanationOfBenefit.total">
      <path value="ExplanationOfBenefit.total" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="category" />
        </discriminator>
        <rules value="open" />
      </slicing>
    </element>
    <element id="ExplanationOfBenefit.total:eligible">
      <path value="ExplanationOfBenefit.total" />
      <sliceName value="eligible" />
      <short value="Total eligible expenses submitted" />
      <definition value="This is the total eligible amounts from submitted drug expenses for the specified coverage year" />
      <mustSupport value="true" />
    </element>
    <element id="ExplanationOfBenefit.total:eligible.category">
      <path value="ExplanationOfBenefit.total.category" />
      <mustSupport value="true" />
      <binding>
        <strength value="required" />
        <valueSet value="https://bpcs.exchange/fhir/ValueSet/vs-EOBIndividualCategories" />
      </binding>
    </element>
    <element id="ExplanationOfBenefit.total:eligible.amount">
      <path value="ExplanationOfBenefit.total.amount" />
      <mustSupport value="true" />
      <mapping>
        <identity value="BPCS" />
        <map value="RecipientExpensesDTO.accumulatedAllowedExpenseCurrent or accumulatedAllowedExpensePrevious (depending on benefit year)" />
      </mapping>
    </element>
    <element id="ExplanationOfBenefit.benefitPeriod">
      <path value="ExplanationOfBenefit.benefitPeriod" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="ExplanationOfBenefit.benefitPeriod.start">
      <path value="ExplanationOfBenefit.benefitPeriod.start" />
      <definition value="This is the start of the quarter (Aug. 1, Nov. 1, Feb 1, or May 1) for which the totals are being reported" />
      <min value="1" />
      <type>
        <code value="dateTime" />
        <profile value="https://bpcs.exchange/fhir/StructureDefinition/profile-dateTime-date" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="ExplanationOfBenefit.benefitPeriod.end">
      <path value="ExplanationOfBenefit.benefitPeriod.end" />
      <definition value="This is the end of the quarter (Oct 31, Jan 31, Apr 30, or Jul 31) for which the totals are being reported" />
      <min value="1" />
      <type>
        <code value="dateTime" />
        <profile value="https://bpcs.exchange/fhir/StructureDefinition/profile-dateTime-date" />
      </type>
      <mustSupport value="true" />
    </element>
  </differential>
</StructureDefinition>

name : ExplanationOfBenefitExpensesQuarterly

{

}

<name value="ExplanationOfBenefitExpensesQuarterly" />