<status value="active" /> <date value="2024-01-01" /> <description value="Defines the ID Core constraints and extensions on the CoverageEligibilityResponse resource for the minimal set of data to communicate coverage information." /> <fhirVersion value="4.0.1" /> <kind value="resource" /> <abstract value="false" /> <type value="CoverageEligibilityResponse" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse" /> <derivation value="constraint" /> <snapshot> <element id="CoverageEligibilityResponse"> <path value="CoverageEligibilityResponse" /> <short value="CoverageEligibilityResponse resource" /> <definition value="This resource provides eligibility and plan details from the processing of an CoverageEligibilityRequest resource." /> <min value="0" /> <max value="*" /> <base> <path value="CoverageEligibilityResponse" /> <min value="0" /> <max value="*" /> </base> <constraint> <key value="dom-2" /> <severity value="error" /> <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" /> <expression value="contained.contained.empty()" /> <xpath value="not(parent::f:contained and f:contained)" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <constraint> <key value="dom-4" /> <severity value="error" /> <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" /> <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" /> <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <constraint> <key value="dom-3" /> <severity value="error" /> <human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource" /> <expression value="contained.where(((id.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()" /> <xpath value="not(exists(for $contained in f:contained return $contained[not(exists(parent::*/descendant::f:reference/@value=concat('#', $contained/*/f:id/@value)) or exists(descendant::f:reference[@value='#']))]))" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <constraint> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation"> <valueMarkdown value="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." /> </extension> <key value="dom-6" /> <severity value="warning" /> <human value="A resource should have narrative for robust management" /> <expression value="text.`div`.exists()" /> <xpath value="exists(f:text/h:div)" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <constraint> <key value="dom-5" /> <severity value="error" /> <human value="If a resource is contained in another resource, it SHALL NOT have a security label" /> <expression value="contained.meta.security.empty()" /> <xpath value="not(exists(f:contained/*/f:meta/f:security))" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <mapping> <identity value="rim" /> <map value="Entity. Role, or Act" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event" /> </mapping> <mapping> <identity value="w5" /> <map value="financial.support" /> </mapping> </element> <element id="CoverageEligibilityResponse.id"> <path value="CoverageEligibilityResponse.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." /> <comment 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." /> <min value="0" /> <max value="1" /> <base> <path value="Resource.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="id" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.meta"> <path value="CoverageEligibilityResponse.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 might 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="1" /> </base> <type> <code value="Meta" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.implicitRules"> <path value="CoverageEligibilityResponse.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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc." /> <comment 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. 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 value="0" /> <max value="1" /> <base> <path value="Resource.implicitRules" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="true" /> <isModifierReason value="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 value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.language"> <path value="CoverageEligibilityResponse.language" /> <short value="Language of the resource content" /> <definition value="The base language in which the resource is written." /> <comment 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="1" /> </base> <type> <code value="code" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet"> <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Language" /> </extension> <strength value="preferred" /> <description value="IETF language tag" /> <valueSet value="http://hl7.org/fhir/ValueSet/languages" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.text"> <path value="CoverageEligibilityResponse.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 can 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 "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." /> <comment value="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 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="1" /> </base> <type> <code value="Narrative" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="Act.text?" /> </mapping> </element> <element id="CoverageEligibilityResponse.contained"> <path value="CoverageEligibilityResponse.contained" /> <short value="Contained, inline Resources" /> <definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope." /> <comment value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels." /> <alias value="inline resources" /> <alias value="anonymous resources" /> <alias value="contained resources" /> <min value="0" /> <max value="*" /> <base> <path value="DomainResource.contained" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Resource" /> </type> <constraint> <key value="dom-r4b" /> <severity value="warning" /> <human value="Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems" /> <expression value="($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)" /> <xpath value="not(f:Citation|f:Evidence|f:EvidenceReport|f:EvidenceVariable|f:MedicinalProductDefinition|f:PackagedProductDefinition|f:AdministrableProductDefinition|f:Ingredient|f:ClinicalUseDefinition|f:RegulatedAuthorization|f:SubstanceDefinition|f:SubscriptionStatus|f:SubscriptionTopic) or not(parent::f:Citation|parent::f:Evidence|parent::f:EvidenceReport|parent::f:EvidenceVariable|parent::f:MedicinalProductDefinition|parent::f:PackagedProductDefinition|parent::f:AdministrableProductDefinition|parent::f:Ingredient|parent::f:ClinicalUseDefinition|parent::f:RegulatedAuthorization|parent::f:SubstanceDefinition|f:SubscriptionStatus|f:SubscriptionTopic)" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="Entity. Role, or Act" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.extension"> <path value="CoverageEligibilityResponse.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <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. 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 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> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.extension:policyClass"> <path value="CoverageEligibilityResponse.extension" /> <sliceName value="policyClass" /> <short value="Policy Class" /> <definition value="Berisi data kode policy Class peserta asuransi dengan tipe data CodeableConcept." /> <comment 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="1" /> <base> <path value="DomainResource.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> <profile value="https://fhir.kemkes.go.id/r4/StructureDefinition/PolicyClass" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.extension:eligibilityStatus"> <path value="CoverageEligibilityResponse.extension" /> <sliceName value="eligibilityStatus" /> <short value="Eligibility Status" /> <definition value="Berisi data kode status eligibilitas dari permintaan eligibilitas peserta asuransi dengan tipe data CodeableConcept." /> <comment 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="1" /> <base> <path value="DomainResource.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> <profile value="https://fhir.kemkes.go.id/r4/StructureDefinition/EligibilityStatus" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.extension:excessPolicyClass"> <path value="CoverageEligibilityResponse.extension" /> <sliceName value="excessPolicyClass" /> <short value="Excess Policy Class" /> <definition value="Berisi data kode excess policy Class peserta asuransi dengan tipe data CodeableConcept." /> <comment 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="1" /> <base> <path value="DomainResource.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> <profile value="https://fhir.kemkes.go.id/r4/StructureDefinition/ExcessPolicyClass" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.extension:excessStatement"> <path value="CoverageEligibilityResponse.extension" /> <sliceName value="excessStatement" /> <short value="Excess Statement" /> <definition value="Berisi data kode pernyataan excess, seperti detail dari dijaminkan dahulu dengan tipe data CodeableConcept." /> <comment 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="1" /> <base> <path value="DomainResource.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> <profile value="https://fhir.kemkes.go.id/r4/StructureDefinition/ExcessStatement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.modifierExtension"> <path value="CoverageEligibilityResponse.modifierExtension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <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 and/or the understanding of the containing element's descendants. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment 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." /> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." /> <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> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mustSupport value="false" /> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.identifier"> <path value="CoverageEligibilityResponse.identifier" /> <short value="Business Identifier for coverage eligiblity request" /> <definition value="Berisi data ID lokal yang ditetapkan untuk respon kelayakan cakupan dengan tipe data Identifier." /> <requirements value="Allows coverage eligibility requests to be distinguished and referenced." /> <min value="0" /> <max value="*" /> <base> <path value="CoverageEligibilityResponse.identifier" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Identifier" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" /> </mapping> <mapping> <identity value="rim" /> <map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" /> </mapping> <mapping> <identity value="servd" /> <map value="Identifier" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.identifier" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.identifier" /> </mapping> </element> <element id="CoverageEligibilityResponse.status"> <path value="CoverageEligibilityResponse.status" /> <short value="active | cancelled | draft | entered-in-error" /> <definition value="Berisi data yang menyatakan status CoverageEligibilityResponse dengan tipe data code, yang nilainya mengacu pada data terminologi Financial Resource Status Codes." /> <comment value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid." /> <requirements value="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 value="1" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.status" /> <min value="1" /> <max value="1" /> </base> <type> <code value="code" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="true" /> <isModifierReason value="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 value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="EligibilityResponseStatus" /> </extension> <strength value="required" /> <description value="A code specifying the state of the resource instance." /> <valueSet value="http://hl7.org/fhir/ValueSet/fm-status|4.3.0" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.status" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.status" /> </mapping> </element> <element id="CoverageEligibilityResponse.purpose"> <path value="CoverageEligibilityResponse.purpose" /> <short value="auth-requirements | benefits | discovery | validation" /> <definition value="Berisi data kode untuk menentukan tujuan permintaan: persyaratan otorisasi sebelumnya untuk beberapa kategori layanan atau kode tagihan; manfaat untuk pertanggungan yang ditentukan atau ditemukan; penemuan dan pengembalian pertanggungan untuk pasien; dan/atau validasi bahwa pertanggungan yang ditentukan berlaku pada tanggal/ periode yang ditentukan atau 'sekarang' jika tidak ditentukan. dengan tipe data code, yang nilainya mengacu pada data terminologi EligibilityResponsePurpose." /> <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" /> <requirements value="To indicate the processing actions requested." /> <min value="1" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.purpose" /> <min value="1" /> <max value="*" /> </base> <type> <code value="code" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="EligibilityResponsePurpose" /> </extension> <strength value="required" /> <description value="A code specifying the types of information being requested." /> <valueSet value="http://hl7.org/fhir/ValueSet/eligibilityresponse-purpose|4.3.0" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.class" /> </mapping> </element> <element id="CoverageEligibilityResponse.patient"> <path value="CoverageEligibilityResponse.patient" /> <short value="Intended recipient of products and services" /> <definition value="Berisi data pihak yang yang mendapat manfaat dari pertanggungan asuransi dan untuk siapa kelayakan sedang dicari dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Patient." /> <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." /> <requirements value="Required to provide context and coverage validation." /> <min value="1" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.patient" /> <min value="1" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.subject" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.subject[x]" /> </mapping> <mapping> <identity value="cdanetv4" /> <map value="C06,C07,C08, C05, C04" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.subject" /> </mapping> </element> <element id="CoverageEligibilityResponse.serviced[x]"> <path value="CoverageEligibilityResponse.serviced[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Estimated date or dates of service" /> <definition value="Berisi data tanggal atau rentang tanggal ketika rangkaian layanan yang dilampirkan telah dilaksanakan atau selesai dilakukan." /> <requirements value="Required to provide time context for the request." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.serviced[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="date" /> </type> <type> <code value="Period" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.done[x]" /> </mapping> <mapping> <identity value="cdanetv4" /> <map value="F09" /> </mapping> </element> <element id="CoverageEligibilityResponse.serviced[x]:servicedDate"> <path value="CoverageEligibilityResponse.serviced[x]" /> <sliceName value="servicedDate" /> <short value="Estimated date or dates of service" /> <definition value="Berisi data tanggal atau rentang tanggal ketika rangkaian layanan yang dilampirkan telah dilaksanakan atau selesai dilakukan date." /> <requirements value="Required to provide time context for the request." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.serviced[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="date" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.done[x]" /> </mapping> <mapping> <identity value="cdanetv4" /> <map value="F09" /> </mapping> </element> <element id="CoverageEligibilityResponse.serviced[x]:servicedPeriod"> <path value="CoverageEligibilityResponse.serviced[x]" /> <sliceName value="servicedPeriod" /> <short value="Estimated date or dates of service" /> <definition value="Berisi data tanggal atau rentang tanggal ketika rangkaian layanan yang dilampirkan telah dilaksanakan atau selesai dilakukan Period." /> <requirements value="Required to provide time context for the request." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.serviced[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Period" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.done[x]" /> </mapping> <mapping> <identity value="cdanetv4" /> <map value="F09" /> </mapping> </element> <element id="CoverageEligibilityResponse.created"> <path value="CoverageEligibilityResponse.created" /> <short value="Response creation date" /> <definition value="Berisi data tanggal ketika CoverageEligibilityResponse dibuat dengan tipe data dateTime, dengan format yang diperbolehkan YYYY, YYYY-MM, YYYY-MM-DD atau YYYY-MM-DDThh:mm:ss+zz:zz." /> <requirements value="Need to record a timestamp for use by both the recipient and the issuer." /> <min value="1" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.created" /> <min value="1" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.recorded" /> </mapping> </element> <element id="CoverageEligibilityResponse.requestor"> <path value="CoverageEligibilityResponse.requestor" /> <short value="Party responsible for the request" /> <definition value="Berisi data penyedia yang bertanggung jawab atas permintaan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Practitioner | PractitionerRole | Organization." /> <comment value="Typically this field would be 1..1 where this party is responsible for the claim but not necessarily professionally responsible for the provision of the individual products and services listed below." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.requestor" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.source" /> </mapping> <mapping> <identity value="cdanetv4" /> <map value="B01" /> </mapping> </element> <element id="CoverageEligibilityResponse.request"> <path value="CoverageEligibilityResponse.request" /> <short value="Eligibility request reference" /> <definition value="Berisi data referensi ke sumber permintaan asli dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource CoverageEligibilityRequest." /> <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." /> <requirements value="Needed to allow the response to be linked to the request." /> <min value="1" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.request" /> <min value="1" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CoverageEligibilityRequest" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.basedOn" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.why[x]" /> </mapping> <mapping> <identity value="cdanetv4" /> <map value="A02|G01" /> </mapping> </element> <element id="CoverageEligibilityResponse.outcome"> <path value="CoverageEligibilityResponse.outcome" /> <short value="queued | complete | error | partial" /> <definition value="Berisi data hasil dari pemrosesan permintaan dengan tipe data code yang nilainya mengacu pada data terminologi RemittanceOutcome." /> <comment value="The resource may be used to indicate that: the request has been held (queued) for processing; that it has been processed and errors found (error); that no errors were found and that some of the adjudication has been undertaken (partial) or that all of the adjudication has been undertaken (complete)." /> <requirements value="To advise the requestor of an overall processing outcome." /> <min value="1" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.outcome" /> <min value="1" /> <max value="1" /> </base> <type> <code value="code" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="RemittanceOutcome" /> </extension> <strength value="required" /> <description value="The outcome of the processing." /> <valueSet value="http://hl7.org/fhir/ValueSet/remittance-outcome|4.3.0" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.disposition"> <path value="CoverageEligibilityResponse.disposition" /> <short value="Disposition Message" /> <definition value="Berisi data gambaran yang dapat dibaca manusia tentang status ajudikasi dengan tipe data string." /> <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" /> <requirements value="Provided for user display." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.disposition" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.note" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurer"> <path value="CoverageEligibilityResponse.insurer" /> <short value="Coverage issuer" /> <definition value="Berisi data penanggung yang mengeluarkan pertanggungan yang dipermasalahkan dan merupakan penulis tanggapan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Organization." /> <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." /> <requirements value="Need to identify the author." /> <min value="1" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurer" /> <min value="1" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint"> <valueString value="380;0" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Insurance" /> </extension> <path value="CoverageEligibilityResponse.insurance" /> <short value="Patient insurance information" /> <definition value="Berisi data instrumen keuangan untuk penggantian produk dan layanan perawatan kesehatan dengan tipe data BackboneElement." /> <comment value="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 value="There must be at least one coverage for which eligibility is requested." /> <min value="0" /> <max value="*" /> <base> <path value="CoverageEligibilityResponse.insurance" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.id"> <path value="CoverageEligibilityResponse.insurance.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.extension"> <path value="CoverageEligibilityResponse.insurance.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <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 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 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="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.modifierExtension"> <path value="CoverageEligibilityResponse.insurance.modifierExtension" /> <short value="Extensions that cannot be ignored even if unrecognized" /> <definition value="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 and/or the understanding of the containing element's descendants. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment 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." /> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.coverage"> <path value="CoverageEligibilityResponse.insurance.coverage" /> <short value="Insurance information" /> <definition value="Berisi data referensi ke informasi tingkat kartu asuransi yang terdapat pada resource Coverage. Perusahaan asuransi yang mengeluarkan pertanggungan akan menggunakan perincian ini untuk menemukan pertanggungan aktual pasien dalam sistem informasi perusahaan asuransi dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Coverage." /> <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." /> <requirements value="Required to allow the adjudicator to locate the correct policy and history within their information system." /> <min value="1" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.coverage" /> <min value="1" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Coverage" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.inforce"> <path value="CoverageEligibilityResponse.insurance.inforce" /> <short value="Coverage inforce indicator" /> <definition value="Berisi data tanda yang menunjukkan apakah pertanggungan yang diberikan berlaku saat ini jika tidak ada tanggal layanan yang ditentukan atau untuk seluruh durasi tanggal layanan dengan tipe data booelan." /> <requirements value="Needed to convey the answer to the eligibility validation request." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.inforce" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.benefitPeriod"> <path value="CoverageEligibilityResponse.insurance.benefitPeriod" /> <short value="When the benefits are applicable" /> <definition value="Berisi data jangka waktu manfaat yang didokumentasikan pada respon dengan tipe data Period." /> <comment value="A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration)." /> <requirements value="Needed as coverages may be multi-year while benefits tend to be annual therefore a separate expression of the benefit period is needed." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.benefitPeriod" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Period" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="per-1" /> <severity value="error" /> <human value="If present, start SHALL have a lower value than end" /> <expression value="start.hasValue().not() or end.hasValue().not() or (start <= end)" /> <xpath value="not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))" /> <source value="http://hl7.org/fhir/StructureDefinition/Period" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="DR" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint"> <valueString value="340;120" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Items" /> </extension> <path value="CoverageEligibilityResponse.insurance.item" /> <short value="Benefits and authorization details" /> <definition value="Berisi data manfaat dan saldo opsional saat ini serta detail otorisasi berdasarkan kategori atau layanan dengan tipe data BackboneElement." /> <min value="0" /> <max value="*" /> <base> <path value="CoverageEligibilityResponse.insurance.item" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ces-1" /> <severity value="error" /> <human value="SHALL contain a category or a billcode but not both." /> <expression value="category.exists() xor productOrService.exists()" /> <xpath value="exists(f:category) or exists(f:productOrService)" /> <source value="http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.id"> <path value="CoverageEligibilityResponse.insurance.item.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.extension"> <path value="CoverageEligibilityResponse.insurance.item.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <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 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 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="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.modifierExtension"> <path value="CoverageEligibilityResponse.insurance.item.modifierExtension" /> <short value="Extensions that cannot be ignored even if unrecognized" /> <definition value="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 and/or the understanding of the containing element's descendants. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment 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." /> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.category"> <path value="CoverageEligibilityResponse.insurance.item.category" /> <short value="Benefit classification" /> <definition value="Berisi data kode untuk mengidentifikasi jenis manfaat umum dari produk dan layanan dengan tipe data CodeableConcept." /> <comment value="Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage." /> <requirements value="Needed to convey the category of service or product for which eligibility is sought." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.item.category" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BenefitCategory" /> </extension> <strength value="example" /> <description value="Benefit categories such as: oral, medical, vision etc." /> <valueSet value="http://hl7.org/fhir/ValueSet/ex-benefitcategory" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.category.id"> <path value="CoverageEligibilityResponse.insurance.item.category.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.category.extension"> <path value="CoverageEligibilityResponse.insurance.item.category.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <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 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 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="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.category.coding"> <path value="CoverageEligibilityResponse.insurance.item.category.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data kode untuk mengidentifikasi jenis manfaat umum dari produk dan layanan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Benefit Category Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.category.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="CoverageEligibilityResponse.insurance.item.category.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.productOrService"> <path value="CoverageEligibilityResponse.insurance.item.productOrService" /> <short value="Billing, service, product, or drug code" /> <definition value="Berisi data produk, layanan, obat, atau kode tagihan lainnya untuk item tersebut dengan tipe data CodeableConcept." /> <comment value="Code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI)." /> <requirements value="Needed to convey the actual service or product for which eligibility is sought." /> <alias value="Drug Code" /> <alias value="Bill Code" /> <alias value="Service Code" /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.item.productOrService" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ServiceProduct" /> </extension> <strength value="example" /> <description value="Allowable service and product codes." /> <valueSet value="http://hl7.org/fhir/ValueSet/service-uscls" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.productOrService.id"> <path value="CoverageEligibilityResponse.insurance.item.productOrService.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.productOrService.extension"> <path value="CoverageEligibilityResponse.insurance.item.productOrService.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <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 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 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="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.productOrService.coding"> <path value="CoverageEligibilityResponse.insurance.item.productOrService.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data produk, layanan, obat, atau kode tagihan lainnya untuk item tersebut dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi USCLS Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.productOrService.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="CoverageEligibilityResponse.insurance.item.productOrService.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.modifier"> <path value="CoverageEligibilityResponse.insurance.item.modifier" /> <short value="Product or service billing modifiers" /> <definition value="Berisi data tipifikasi item atau pengubah kode untuk menyatakan konteks tambahan untuk produk atau layanan dengan tipe data CodeableConcept." /> <comment value="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 value="To support provision of the item or to charge an elevated fee." /> <min value="0" /> <max value="*" /> <base> <path value="CoverageEligibilityResponse.insurance.item.modifier" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Modifiers" /> </extension> <strength value="example" /> <description value="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 value="http://hl7.org/fhir/ValueSet/claim-modifiers" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.modifier.id"> <path value="CoverageEligibilityResponse.insurance.item.modifier.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.modifier.extension"> <path value="CoverageEligibilityResponse.insurance.item.modifier.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <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 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 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="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.modifier.coding"> <path value="CoverageEligibilityResponse.insurance.item.modifier.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data tipifikasi item atau pengubah kode untuk menyatakan konteks tambahan untuk produk atau layanan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Modifier types Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.modifier.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="CoverageEligibilityResponse.insurance.item.modifier.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.provider"> <path value="CoverageEligibilityResponse.insurance.item.provider" /> <short value="Performing practitioner" /> <definition value="Berisi data praktisi yang memenuhi syarat untuk penyediaan produk atau layanan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Practitioner | Coverage." /> <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." /> <requirements value="Needed to convey the eligible provider." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.item.provider" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.source" /> </mapping> <mapping> <identity value="cdanetv4" /> <map value="B01" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.excluded"> <path value="CoverageEligibilityResponse.insurance.item.excluded" /> <short value="Excluded from the plan" /> <definition value="Berisi data Benar jika kelas layanan yang ditunjukkan dikecualikan dari paket, hilang atau salah menunjukkan produk atau layanan termasuk dalam pertanggungan dengan tipe data booelan." /> <requirements value="Needed to identify items that are specifically excluded from the coverage." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.item.excluded" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.name"> <path value="CoverageEligibilityResponse.insurance.item.name" /> <short value="Short name for the benefit" /> <definition value="Berisi data Nama pendek atau tag untuk keuntungan dengan tipe data string." /> <comment value="For example: MED01, or DENT2." /> <requirements value="Required to align with other plan names." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.item.name" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.description"> <path value="CoverageEligibilityResponse.insurance.item.description" /> <short value="Description of the benefit or services covered" /> <definition value="Berisi data deskripsi yang lebih detail tentang manfaat atau layanan yang dicakup dengan tipe data string." /> <comment value="For example 'DENT2 covers 100% of basic, 50% of major but excludes Ortho, Implants and Cosmetic services'." /> <requirements value="Needed for human readable reference." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.item.description" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.network"> <path value="CoverageEligibilityResponse.insurance.item.network" /> <short value="In or out of network" /> <definition value="Berisi data tanda untuk menunjukkan apakah manfaat mengacu pada penyedia dalam jaringan atau penyedia di luar jaringan dengan tipe data CodeableConcept." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="Needed as in or out of network providers are treated differently under the coverage." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.item.network" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BenefitNetwork" /> </extension> <strength value="example" /> <description value="Code to classify in or out of network services." /> <valueSet value="http://hl7.org/fhir/ValueSet/benefit-network" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.network.id"> <path value="CoverageEligibilityResponse.insurance.item.network.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.network.extension"> <path value="CoverageEligibilityResponse.insurance.item.network.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <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 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 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="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.network.coding"> <path value="CoverageEligibilityResponse.insurance.item.network.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data tanda untuk menunjukkan apakah manfaat mengacu pada penyedia dalam jaringan atau penyedia di luar jaringan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Network Type Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.network.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="CoverageEligibilityResponse.insurance.item.network.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.unit"> <path value="CoverageEligibilityResponse.insurance.item.unit" /> <short value="Individual or family" /> <definition value="Berisi data yang menunjukkan apakah manfaat berlaku untuk individu atau keluarga dengan tipe data CodeableConcept." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="Needed for the understanding of the benefits." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.item.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BenefitUnit" /> </extension> <strength value="example" /> <description value="Unit covered/serviced - individual or family." /> <valueSet value="http://hl7.org/fhir/ValueSet/benefit-unit" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.unit.id"> <path value="CoverageEligibilityResponse.insurance.item.unit.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.unit.extension"> <path value="CoverageEligibilityResponse.insurance.item.unit.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <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 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 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="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.unit.coding"> <path value="CoverageEligibilityResponse.insurance.item.unit.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data yang menunjukkan apakah manfaat berlaku untuk individu atau keluarga dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Unit Type Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.unit.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="CoverageEligibilityResponse.insurance.item.unit.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.term"> <path value="CoverageEligibilityResponse.insurance.item.term" /> <short value="Annual or lifetime" /> <definition value="Berisi data jangka waktu atau periode nilai seperti 'manfaat seumur hidup maksimum' atau 'kunjungan tahunan maksimum' dengan tipe data CodeableConcept." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="Needed for the understanding of the benefits." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.item.term" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BenefitTerm" /> </extension> <strength value="example" /> <description value="Coverage unit - annual, lifetime." /> <valueSet value="http://hl7.org/fhir/ValueSet/benefit-term" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.term.id"> <path value="CoverageEligibilityResponse.insurance.item.term.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.term.extension"> <path value="CoverageEligibilityResponse.insurance.item.term.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <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 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 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="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.term.coding"> <path value="CoverageEligibilityResponse.insurance.item.term.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data jangka waktu atau periode nilai seperti 'manfaat seumur hidup maksimum' atau 'kunjungan tahunan maksimum' dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Benefit Term Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.term.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="CoverageEligibilityResponse.insurance.item.term.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint"> <valueString value="340;320" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Benefit" /> </extension> <path value="CoverageEligibilityResponse.insurance.item.benefit" /> <short value="Benefit Summary" /> <definition value="Berisi data manfaat yang digunakan sampai saat ini dengan tipe data BackboneElement." /> <min value="0" /> <max value="*" /> <base> <path value="CoverageEligibilityResponse.insurance.item.benefit" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.id"> <path value="CoverageEligibilityResponse.insurance.item.benefit.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.extension"> <path value="CoverageEligibilityResponse.insurance.item.benefit.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <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 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 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="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.modifierExtension"> <path value="CoverageEligibilityResponse.insurance.item.benefit.modifierExtension" /> <short value="Extensions that cannot be ignored even if unrecognized" /> <definition value="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 and/or the understanding of the containing element's descendants. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment 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." /> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.type"> <path value="CoverageEligibilityResponse.insurance.item.benefit.type" /> <short value="Benefit classification" /> <definition value="Berisi data klasifikasi manfaat yang diberikan dengan tipe data CodeableConcept." /> <comment value="For example: deductible, visits, benefit amount." /> <requirements value="Needed to convey the nature of the benefit." /> <min value="1" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.item.benefit.type" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BenefitType" /> </extension> <strength value="example" /> <description value="Deductable, visits, co-pay, etc." /> <valueSet value="http://hl7.org/fhir/ValueSet/benefit-type" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.type.id"> <path value="CoverageEligibilityResponse.insurance.item.benefit.type.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.type.extension"> <path value="CoverageEligibilityResponse.insurance.item.benefit.type.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <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 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 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="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.type.coding"> <path value="CoverageEligibilityResponse.insurance.item.benefit.type.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data klasifikasi manfaat yang diberikan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Benefit Type Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.type.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="CoverageEligibilityResponse.insurance.item.benefit.type.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.allowed[x]"> <path value="CoverageEligibilityResponse.insurance.item.benefit.allowed[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Benefits allowed" /> <definition value="Berisi data kuantitas manfaat yang diizinkan berdasarkan pertanggungan." /> <requirements value="Needed to convey the benefits offered under the coverage." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.item.benefit.allowed[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="unsignedInt" /> </type> <type> <code value="string" /> </type> <type> <code value="Money" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.allowed[x]:allowedUnsignedInt"> <path value="CoverageEligibilityResponse.insurance.item.benefit.allowed[x]" /> <sliceName value="allowedUnsignedInt" /> <short value="Benefits allowed" /> <definition value="Berisi data kuantitas manfaat yang diizinkan berdasarkan pertanggungan dengan tipe data unsignedInt." /> <requirements value="Needed to convey the benefits offered under the coverage." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.item.benefit.allowed[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="unsignedInt" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.allowed[x]:allowedString"> <path value="CoverageEligibilityResponse.insurance.item.benefit.allowed[x]" /> <sliceName value="allowedString" /> <short value="Benefits allowed" /> <definition value="Berisi data kuantitas manfaat yang diizinkan berdasarkan pertanggungan dengan tipe data string." /> <requirements value="Needed to convey the benefits offered under the coverage." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.item.benefit.allowed[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.allowed[x]:allowedMoney"> <path value="CoverageEligibilityResponse.insurance.item.benefit.allowed[x]" /> <sliceName value="allowedMoney" /> <short value="Benefits allowed" /> <definition value="Berisi data kuantitas manfaat yang diizinkan berdasarkan pertanggungan dengan tipe data Money." /> <requirements value="Needed to convey the benefits offered under the coverage." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.item.benefit.allowed[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Money" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.used[x]"> <path value="CoverageEligibilityResponse.insurance.item.benefit.used[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Benefits used" /> <definition value="Berisi data kuantitas manfaat yang telah dikonsumsi hingga saat ini." /> <requirements value="Needed to convey the benefits consumed to date." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.item.benefit.used[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="unsignedInt" /> </type> <type> <code value="string" /> </type> <type> <code value="Money" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.used[x]:usedUnsignedInt"> <path value="CoverageEligibilityResponse.insurance.item.benefit.used[x]" /> <sliceName value="usedUnsignedInt" /> <short value="Benefits used" /> <definition value="Berisi data kuantitas manfaat yang telah dikonsumsi hingga saat ini dengan tipe data unsignedInt." /> <requirements value="Needed to convey the benefits consumed to date." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.item.benefit.used[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="unsignedInt" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.used[x]:usedString"> <path value="CoverageEligibilityResponse.insurance.item.benefit.used[x]" /> <sliceName value="usedString" /> <short value="Benefits used" /> <definition value="Berisi data kuantitas manfaat yang telah dikonsumsi hingga saat ini dengan tipe data string." /> <requirements value="Needed to convey the benefits consumed to date." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.item.benefit.used[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.used[x]:usedMoney"> <path value="CoverageEligibilityResponse.insurance.item.benefit.used[x]" /> <sliceName value="usedMoney" /> <short value="Benefits used" /> <definition value="Berisi data kuantitas manfaat yang telah dikonsumsi hingga saat ini dengan tipe data Money." /> <requirements value="Needed to convey the benefits consumed to date." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.item.benefit.used[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Money" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.authorizationRequired"> <path value="CoverageEligibilityResponse.insurance.item.authorizationRequired" /> <short value="Authorization required flag" /> <definition value="Berisi data tanda boolean yang menunjukkan apakah praotorisasi diperlukan sebelum pengiriman layanan yang sebenarnya dengan tipe data boolean." /> <requirements value="Needed to convey that preauthorization is required." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.item.authorizationRequired" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.authorizationSupporting"> <path value="CoverageEligibilityResponse.insurance.item.authorizationSupporting" /> <short value="Type of required supporting materials" /> <definition value="Berisi data kode atau komentar mengenai informasi atau tindakan yang terkait dengan praotorisasi dengan tipe data CodeableConcept." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="Needed to inform the provider of collateral materials or actions needed for preauthorization." /> <min value="0" /> <max value="*" /> <base> <path value="CoverageEligibilityResponse.insurance.item.authorizationSupporting" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AuthSupporting" /> </extension> <strength value="example" /> <description value="Type of supporting information to provide with a preauthorization." /> <valueSet value="http://hl7.org/fhir/ValueSet/coverageeligibilityresponse-ex-auth-support" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.authorizationSupporting.id"> <path value="CoverageEligibilityResponse.insurance.item.authorizationSupporting.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.authorizationSupporting.extension"> <path value="CoverageEligibilityResponse.insurance.item.authorizationSupporting.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <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 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 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="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.authorizationSupporting.coding"> <path value="CoverageEligibilityResponse.insurance.item.authorizationSupporting.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data kode atau komentar mengenai informasi atau tindakan yang terkait dengan praotorisasi dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi CoverageEligibilityResponse Auth Support Codes." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.authorizationSupporting.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="CoverageEligibilityResponse.insurance.item.authorizationSupporting.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="CoverageEligibilityResponse.insurance.item.authorizationUrl"> <path value="CoverageEligibilityResponse.insurance.item.authorizationUrl" /> <short value="Preauthorization requirements endpoint" /> <definition value="Berisi data lokasi web untuk memperoleh persyaratan atau informasi deskriptif mengenai praotorisasi dengan tipe data uri." /> <comment value="see http://en.wikipedia.org/wiki/Uniform_resource_identifier" /> <requirements value="Needed to enable insurers to advise providers of informative information." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.insurance.item.authorizationUrl" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.preAuthRef"> <path value="CoverageEligibilityResponse.preAuthRef" /> <short value="Preauthorization reference" /> <definition value="Berisi data referensi dari penanggung yang terkait dengan layanan untuk dikomunikasikan lebih lanjut dan sebagai bukti bahwa permintaan tersebut terjadi dengan tipe data string." /> <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" /> <requirements value="To provide any preauthorization reference for provider use." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.preAuthRef" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="cdanetv4" /> <map value="F03" /> </mapping> <mapping> <identity value="rim" /> <map value="23" /> </mapping> </element> <element id="CoverageEligibilityResponse.form"> <path value="CoverageEligibilityResponse.form" /> <short value="Printed form identifier" /> <definition value="Berisi data kode untuk formulir yang akan digunakan untuk mencetak konten dengan tipe data CodeableConcept." /> <comment value="May be needed to identify specific jurisdictional forms." /> <requirements value="Needed to specify the specific form used for producing output for this response." /> <min value="0" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.form" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Forms" /> </extension> <strength value="example" /> <description value="The forms codes." /> <valueSet value="http://hl7.org/fhir/ValueSet/forms" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="cdanetv4" /> <map value="G42" /> </mapping> </element> <element id="CoverageEligibilityResponse.form.id"> <path value="CoverageEligibilityResponse.form.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.form.extension"> <path value="CoverageEligibilityResponse.form.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <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 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 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="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.form.coding"> <path value="CoverageEligibilityResponse.form.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data kode untuk formulir yang akan digunakan untuk mencetak konten dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Forms." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="CoverageEligibilityResponse.form.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="CoverageEligibilityResponse.form.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="CoverageEligibilityResponse.error"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Errors" /> </extension> <path value="CoverageEligibilityResponse.error" /> <short value="Processing errors" /> <definition value="Berisi data kesalahan yang ditemui selama pemrosesan permintaan dengan tipe data BackboneElement." /> <requirements value="Need to communicate processing issues to the requestor." /> <min value="0" /> <max value="*" /> <base> <path value="CoverageEligibilityResponse.error" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.error.id"> <path value="CoverageEligibilityResponse.error.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.error.extension"> <path value="CoverageEligibilityResponse.error.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <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 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 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="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.error.modifierExtension"> <path value="CoverageEligibilityResponse.error.modifierExtension" /> <short value="Extensions that cannot be ignored even if unrecognized" /> <definition value="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 and/or the understanding of the containing element's descendants. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment 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." /> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.error.code"> <path value="CoverageEligibilityResponse.error.code" /> <short value="Error code detailing processing issues" /> <definition value="Berisi data kode kesalahan, dari sistem kode tertentu, yang merinci mengapa pemeriksaan kelayakan tidak dapat dilakukan dengan tipe data CodeableConcept." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="Required to convey processing errors." /> <min value="1" /> <max value="1" /> <base> <path value="CoverageEligibilityResponse.error.code" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="false" /> <isModifier value="false" /> <isSummary value="false" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AdjudicationError" /> </extension> <strength value="example" /> <description value="The error codes for adjudication processing." /> <valueSet value="http://hl7.org/fhir/ValueSet/adjudication-error" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="CoverageEligibilityResponse.error.code.id"> <path value="CoverageEligibilityResponse.error.code.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="CoverageEligibilityResponse.error.code.extension"> <path value="CoverageEligibilityResponse.error.code.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <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 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 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="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="CoverageEligibilityResponse.error.code.coding"> <path value="CoverageEligibilityResponse.error.code.coding" /> <short value="Code defined by a terminology system" /> <definition value="Berisi data kode kesalahan, dari sistem kode tertentu, yang merinci mengapa pemeriksaan kelayakan tidak dapat dilakukan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi AdjudicationError." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="CoverageEligibilityResponse.error.code.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="CoverageEligibilityResponse.error.code.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children unless an empty Parameters resource" /> <expression value="hasValue() or (children().count() > id.count()) or $this is Parameters" /> <xpath value="@value|f:*|h:div|self::f:Parameters" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> </snapshot> <differential> <element id="CoverageEligibilityResponse.extension:policyClass"> <path value="CoverageEligibilityResponse.extension" /> <sliceName value="policyClass" /> <definition value="Berisi data kode policy Class peserta asuransi dengan tipe data CodeableConcept." /> <min value="0" /> <max value="1" /> <type> <code value="Extension" /> <profile value="https://fhir.kemkes.go.id/r4/StructureDefinition/PolicyClass" /> </type> </element> <element id="CoverageEligibilityResponse.extension:eligibilityStatus"> <path value="CoverageEligibilityResponse.extension" /> <sliceName value="eligibilityStatus" /> <definition value="Berisi data kode status eligibilitas dari permintaan eligibilitas peserta asuransi dengan tipe data CodeableConcept." /> <min value="0" /> <max value="1" /> <type> <code value="Extension" /> <profile value="https://fhir.kemkes.go.id/r4/StructureDefinition/EligibilityStatus" /> </type> </element> <element id="CoverageEligibilityResponse.extension:excessPolicyClass"> <path value="CoverageEligibilityResponse.extension" /> <sliceName value="excessPolicyClass" /> <definition value="Berisi data kode excess policy Class peserta asuransi dengan tipe data CodeableConcept." /> <min value="0" /> <max value="1" /> <type> <code value="Extension" /> <profile value="https://fhir.kemkes.go.id/r4/StructureDefinition/ExcessPolicyClass" /> </type> </element> <element id="CoverageEligibilityResponse.extension:excessStatement"> <path value="CoverageEligibilityResponse.extension" /> <sliceName value="excessStatement" /> <definition value="Berisi data kode pernyataan excess, seperti detail dari dijaminkan dahulu dengan tipe data CodeableConcept." /> <min value="0" /> <max value="1" /> <type> <code value="Extension" /> <profile value="https://fhir.kemkes.go.id/r4/StructureDefinition/ExcessStatement" /> </type> </element> <element id="CoverageEligibilityResponse.identifier"> <path value="CoverageEligibilityResponse.identifier" /> <definition value="Berisi data ID lokal yang ditetapkan untuk respon kelayakan cakupan dengan tipe data Identifier." /> </element> <element id="CoverageEligibilityResponse.status"> <path value="CoverageEligibilityResponse.status" /> <definition value="Berisi data yang menyatakan status CoverageEligibilityResponse dengan tipe data code, yang nilainya mengacu pada data terminologi Financial Resource Status Codes." /> </element> <element id="CoverageEligibilityResponse.purpose"> <path value="CoverageEligibilityResponse.purpose" /> <definition value="Berisi data kode untuk menentukan tujuan permintaan: persyaratan otorisasi sebelumnya untuk beberapa kategori layanan atau kode tagihan; manfaat untuk pertanggungan yang ditentukan atau ditemukan; penemuan dan pengembalian pertanggungan untuk pasien; dan/atau validasi bahwa pertanggungan yang ditentukan berlaku pada tanggal/ periode yang ditentukan atau 'sekarang' jika tidak ditentukan. dengan tipe data code, yang nilainya mengacu pada data terminologi EligibilityResponsePurpose." /> <max value="1" /> </element> <element id="CoverageEligibilityResponse.patient"> <path value="CoverageEligibilityResponse.patient" /> <definition value="Berisi data pihak yang yang mendapat manfaat dari pertanggungan asuransi dan untuk siapa kelayakan sedang dicari dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Patient." /> </element> <element id="CoverageEligibilityResponse.serviced[x]"> <path value="CoverageEligibilityResponse.serviced[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <definition value="Berisi data tanggal atau rentang tanggal ketika rangkaian layanan yang dilampirkan telah dilaksanakan atau selesai dilakukan." /> </element> <element id="CoverageEligibilityResponse.serviced[x]:servicedDate"> <path value="CoverageEligibilityResponse.serviced[x]" /> <sliceName value="servicedDate" /> <definition value="Berisi data tanggal atau rentang tanggal ketika rangkaian layanan yang dilampirkan telah dilaksanakan atau selesai dilakukan date." /> <min value="0" /> <max value="1" /> <type> <code value="date" /> </type> </element> <element id="CoverageEligibilityResponse.serviced[x]:servicedPeriod"> <path value="CoverageEligibilityResponse.serviced[x]" /> <sliceName value="servicedPeriod" /> <definition value="Berisi data tanggal atau rentang tanggal ketika rangkaian layanan yang dilampirkan telah dilaksanakan atau selesai dilakukan Period." /> <min value="0" /> <max value="1" /> <type> <code value="Period" /> </type> </element> <element id="CoverageEligibilityResponse.created"> <path value="CoverageEligibilityResponse.created" /> <definition value="Berisi data tanggal ketika CoverageEligibilityResponse dibuat dengan tipe data dateTime, dengan format yang diperbolehkan YYYY, YYYY-MM, YYYY-MM-DD atau YYYY-MM-DDThh:mm:ss+zz:zz." /> </element> <element id="CoverageEligibilityResponse.requestor"> <path value="CoverageEligibilityResponse.requestor" /> <definition value="Berisi data penyedia yang bertanggung jawab atas permintaan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Practitioner | PractitionerRole | Organization." /> </element> <element id="CoverageEligibilityResponse.request"> <path value="CoverageEligibilityResponse.request" /> <definition value="Berisi data referensi ke sumber permintaan asli dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource CoverageEligibilityRequest." /> </element> <element id="CoverageEligibilityResponse.outcome"> <path value="CoverageEligibilityResponse.outcome" /> <definition value="Berisi data hasil dari pemrosesan permintaan dengan tipe data code yang nilainya mengacu pada data terminologi RemittanceOutcome." /> </element> <element id="CoverageEligibilityResponse.disposition"> <path value="CoverageEligibilityResponse.disposition" /> <definition value="Berisi data gambaran yang dapat dibaca manusia tentang status ajudikasi dengan tipe data string." /> </element> <element id="CoverageEligibilityResponse.insurer"> <path value="CoverageEligibilityResponse.insurer" /> <definition value="Berisi data penanggung yang mengeluarkan pertanggungan yang dipermasalahkan dan merupakan penulis tanggapan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Organization." /> </element> <element id="CoverageEligibilityResponse.insurance"> <path value="CoverageEligibilityResponse.insurance" /> <definition value="Berisi data instrumen keuangan untuk penggantian produk dan layanan perawatan kesehatan dengan tipe data BackboneElement." /> </element> <element id="CoverageEligibilityResponse.insurance.coverage"> <path value="CoverageEligibilityResponse.insurance.coverage" /> <definition value="Berisi data referensi ke informasi tingkat kartu asuransi yang terdapat pada resource Coverage. Perusahaan asuransi yang mengeluarkan pertanggungan akan menggunakan perincian ini untuk menemukan pertanggungan aktual pasien dalam sistem informasi perusahaan asuransi dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Coverage." /> </element> <element id="CoverageEligibilityResponse.insurance.inforce"> <path value="CoverageEligibilityResponse.insurance.inforce" /> <definition value="Berisi data tanda yang menunjukkan apakah pertanggungan yang diberikan berlaku saat ini jika tidak ada tanggal layanan yang ditentukan atau untuk seluruh durasi tanggal layanan dengan tipe data booelan." /> </element> <element id="CoverageEligibilityResponse.insurance.benefitPeriod"> <path value="CoverageEligibilityResponse.insurance.benefitPeriod" /> <definition value="Berisi data jangka waktu manfaat yang didokumentasikan pada respon dengan tipe data Period." /> </element> <element id="CoverageEligibilityResponse.insurance.item"> <path value="CoverageEligibilityResponse.insurance.item" /> <definition value="Berisi data manfaat dan saldo opsional saat ini serta detail otorisasi berdasarkan kategori atau layanan dengan tipe data BackboneElement." /> </element> <element id="CoverageEligibilityResponse.insurance.item.category"> <path value="CoverageEligibilityResponse.insurance.item.category" /> <definition value="Berisi data kode untuk mengidentifikasi jenis manfaat umum dari produk dan layanan dengan tipe data CodeableConcept." /> </element> <element id="CoverageEligibilityResponse.insurance.item.category.coding"> <path value="CoverageEligibilityResponse.insurance.item.category.coding" /> <definition value="Berisi data kode untuk mengidentifikasi jenis manfaat umum dari produk dan layanan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Benefit Category Codes." /> </element> <element id="CoverageEligibilityResponse.insurance.item.productOrService"> <path value="CoverageEligibilityResponse.insurance.item.productOrService" /> <definition value="Berisi data produk, layanan, obat, atau kode tagihan lainnya untuk item tersebut dengan tipe data CodeableConcept." /> </element> <element id="CoverageEligibilityResponse.insurance.item.productOrService.coding"> <path value="CoverageEligibilityResponse.insurance.item.productOrService.coding" /> <definition value="Berisi data produk, layanan, obat, atau kode tagihan lainnya untuk item tersebut dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi USCLS Codes." /> </element> <element id="CoverageEligibilityResponse.insurance.item.modifier"> <path value="CoverageEligibilityResponse.insurance.item.modifier" /> <definition value="Berisi data tipifikasi item atau pengubah kode untuk menyatakan konteks tambahan untuk produk atau layanan dengan tipe data CodeableConcept." /> </element> <element id="CoverageEligibilityResponse.insurance.item.modifier.coding"> <path value="CoverageEligibilityResponse.insurance.item.modifier.coding" /> <definition value="Berisi data tipifikasi item atau pengubah kode untuk menyatakan konteks tambahan untuk produk atau layanan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Modifier types Codes." /> </element> <element id="CoverageEligibilityResponse.insurance.item.provider"> <path value="CoverageEligibilityResponse.insurance.item.provider" /> <definition value="Berisi data praktisi yang memenuhi syarat untuk penyediaan produk atau layanan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Practitioner | Coverage." /> </element> <element id="CoverageEligibilityResponse.insurance.item.excluded"> <path value="CoverageEligibilityResponse.insurance.item.excluded" /> <definition value="Berisi data Benar jika kelas layanan yang ditunjukkan dikecualikan dari paket, hilang atau salah menunjukkan produk atau layanan termasuk dalam pertanggungan dengan tipe data booelan." /> </element> <element id="CoverageEligibilityResponse.insurance.item.name"> <path value="CoverageEligibilityResponse.insurance.item.name" /> <definition value="Berisi data Nama pendek atau tag untuk keuntungan dengan tipe data string." /> </element> <element id="CoverageEligibilityResponse.insurance.item.description"> <path value="CoverageEligibilityResponse.insurance.item.description" /> <definition value="Berisi data deskripsi yang lebih detail tentang manfaat atau layanan yang dicakup dengan tipe data string." /> </element> <element id="CoverageEligibilityResponse.insurance.item.network"> <path value="CoverageEligibilityResponse.insurance.item.network" /> <definition value="Berisi data tanda untuk menunjukkan apakah manfaat mengacu pada penyedia dalam jaringan atau penyedia di luar jaringan dengan tipe data CodeableConcept." /> </element> <element id="CoverageEligibilityResponse.insurance.item.network.coding"> <path value="CoverageEligibilityResponse.insurance.item.network.coding" /> <definition value="Berisi data tanda untuk menunjukkan apakah manfaat mengacu pada penyedia dalam jaringan atau penyedia di luar jaringan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Network Type Codes." /> </element> <element id="CoverageEligibilityResponse.insurance.item.unit"> <path value="CoverageEligibilityResponse.insurance.item.unit" /> <definition value="Berisi data yang menunjukkan apakah manfaat berlaku untuk individu atau keluarga dengan tipe data CodeableConcept." /> </element> <element id="CoverageEligibilityResponse.insurance.item.unit.coding"> <path value="CoverageEligibilityResponse.insurance.item.unit.coding" /> <definition value="Berisi data yang menunjukkan apakah manfaat berlaku untuk individu atau keluarga dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Unit Type Codes." /> </element> <element id="CoverageEligibilityResponse.insurance.item.term"> <path value="CoverageEligibilityResponse.insurance.item.term" /> <definition value="Berisi data jangka waktu atau periode nilai seperti 'manfaat seumur hidup maksimum' atau 'kunjungan tahunan maksimum' dengan tipe data CodeableConcept." /> </element> <element id="CoverageEligibilityResponse.insurance.item.term.coding"> <path value="CoverageEligibilityResponse.insurance.item.term.coding" /> <definition value="Berisi data jangka waktu atau periode nilai seperti 'manfaat seumur hidup maksimum' atau 'kunjungan tahunan maksimum' dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Benefit Term Codes." /> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit"> <path value="CoverageEligibilityResponse.insurance.item.benefit" /> <definition value="Berisi data manfaat yang digunakan sampai saat ini dengan tipe data BackboneElement." /> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.type"> <path value="CoverageEligibilityResponse.insurance.item.benefit.type" /> <definition value="Berisi data klasifikasi manfaat yang diberikan dengan tipe data CodeableConcept." /> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.type.coding"> <path value="CoverageEligibilityResponse.insurance.item.benefit.type.coding" /> <definition value="Berisi data klasifikasi manfaat yang diberikan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Benefit Type Codes." /> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.allowed[x]"> <path value="CoverageEligibilityResponse.insurance.item.benefit.allowed[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <definition value="Berisi data kuantitas manfaat yang diizinkan berdasarkan pertanggungan." /> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.allowed[x]:allowedUnsignedInt"> <path value="CoverageEligibilityResponse.insurance.item.benefit.allowed[x]" /> <sliceName value="allowedUnsignedInt" /> <definition value="Berisi data kuantitas manfaat yang diizinkan berdasarkan pertanggungan dengan tipe data unsignedInt." /> <min value="0" /> <max value="1" /> <type> <code value="unsignedInt" /> </type> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.allowed[x]:allowedString"> <path value="CoverageEligibilityResponse.insurance.item.benefit.allowed[x]" /> <sliceName value="allowedString" /> <definition value="Berisi data kuantitas manfaat yang diizinkan berdasarkan pertanggungan dengan tipe data string." /> <min value="0" /> <max value="1" /> <type> <code value="string" /> </type> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.allowed[x]:allowedMoney"> <path value="CoverageEligibilityResponse.insurance.item.benefit.allowed[x]" /> <sliceName value="allowedMoney" /> <definition value="Berisi data kuantitas manfaat yang diizinkan berdasarkan pertanggungan dengan tipe data Money." /> <min value="0" /> <max value="1" /> <type> <code value="Money" /> </type> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.used[x]"> <path value="CoverageEligibilityResponse.insurance.item.benefit.used[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <definition value="Berisi data kuantitas manfaat yang telah dikonsumsi hingga saat ini." /> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.used[x]:usedUnsignedInt"> <path value="CoverageEligibilityResponse.insurance.item.benefit.used[x]" /> <sliceName value="usedUnsignedInt" /> <definition value="Berisi data kuantitas manfaat yang telah dikonsumsi hingga saat ini dengan tipe data unsignedInt." /> <min value="0" /> <max value="1" /> <type> <code value="unsignedInt" /> </type> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.used[x]:usedString"> <path value="CoverageEligibilityResponse.insurance.item.benefit.used[x]" /> <sliceName value="usedString" /> <definition value="Berisi data kuantitas manfaat yang telah dikonsumsi hingga saat ini dengan tipe data string." /> <min value="0" /> <max value="1" /> <type> <code value="string" /> </type> </element> <element id="CoverageEligibilityResponse.insurance.item.benefit.used[x]:usedMoney"> <path value="CoverageEligibilityResponse.insurance.item.benefit.used[x]" /> <sliceName value="usedMoney" /> <definition value="Berisi data kuantitas manfaat yang telah dikonsumsi hingga saat ini dengan tipe data Money." /> <min value="0" /> <max value="1" /> <type> <code value="Money" /> </type> </element> <element id="CoverageEligibilityResponse.insurance.item.authorizationRequired"> <path value="CoverageEligibilityResponse.insurance.item.authorizationRequired" /> <definition value="Berisi data tanda boolean yang menunjukkan apakah praotorisasi diperlukan sebelum pengiriman layanan yang sebenarnya dengan tipe data boolean." /> </element> <element id="CoverageEligibilityResponse.insurance.item.authorizationSupporting"> <path value="CoverageEligibilityResponse.insurance.item.authorizationSupporting" /> <definition value="Berisi data kode atau komentar mengenai informasi atau tindakan yang terkait dengan praotorisasi dengan tipe data CodeableConcept." /> </element> <element id="CoverageEligibilityResponse.insurance.item.authorizationSupporting.coding"> <path value="CoverageEligibilityResponse.insurance.item.authorizationSupporting.coding" /> <definition value="Berisi data kode atau komentar mengenai informasi atau tindakan yang terkait dengan praotorisasi dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi CoverageEligibilityResponse Auth Support Codes." /> </element> <element id="CoverageEligibilityResponse.insurance.item.authorizationUrl"> <path value="CoverageEligibilityResponse.insurance.item.authorizationUrl" /> <definition value="Berisi data lokasi web untuk memperoleh persyaratan atau informasi deskriptif mengenai praotorisasi dengan tipe data uri." /> </element> <element id="CoverageEligibilityResponse.preAuthRef"> <path value="CoverageEligibilityResponse.preAuthRef" /> <definition value="Berisi data referensi dari penanggung yang terkait dengan layanan untuk dikomunikasikan lebih lanjut dan sebagai bukti bahwa permintaan tersebut terjadi dengan tipe data string." /> </element> <element id="CoverageEligibilityResponse.form"> <path value="CoverageEligibilityResponse.form" /> <definition value="Berisi data kode untuk formulir yang akan digunakan untuk mencetak konten dengan tipe data CodeableConcept." /> </element> <element id="CoverageEligibilityResponse.form.coding"> <path value="CoverageEligibilityResponse.form.coding" /> <definition value="Berisi data kode untuk formulir yang akan digunakan untuk mencetak konten dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Forms." /> </element> <element id="CoverageEligibilityResponse.error"> <path value="CoverageEligibilityResponse.error" /> <definition value="Berisi data kesalahan yang ditemui selama pemrosesan permintaan dengan tipe data BackboneElement." /> </element> <element id="CoverageEligibilityResponse.error.code"> <path value="CoverageEligibilityResponse.error.code" /> <definition value="Berisi data kode kesalahan, dari sistem kode tertentu, yang merinci mengapa pemeriksaan kelayakan tidak dapat dilakukan dengan tipe data CodeableConcept." /> </element> <element id="CoverageEligibilityResponse.error.code.coding"> <path value="CoverageEligibilityResponse.error.code.coding" /> <definition value="Berisi data kode kesalahan, dari sistem kode tertentu, yang merinci mengapa pemeriksaan kelayakan tidak dapat dilakukan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi AdjudicationError." /> </element> </differential> </StructureDefinition>