HL7 FHIR JP Core ImplementationGuide - Local Development build (v1.1.1). See the Directory of published versions
Active as of 2022-10-24 |
XML representation of the jp-coverage resource profile.
<StructureDefinition xmlns="http://hl7.org/fhir">
<id value="jp-coverage"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Additional information about the element">Description & Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_resource.png" alt="." style="background-color: white; background-color: inherit" title="Resource" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage" title="Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment.
ヘルスケア製品およびサービスの償還または支払いに使用される可能性のある金融商品。 保険と自己負担の両方が含まれる。">Coverage</a><a name="Coverage"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/coverage.html">Coverage</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Insurance or medical plan or a payment agreement 保険または医療費支払いプラン、または合意された支払い方法</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck12.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_extension_simple.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Simple Extension" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.extension">Slices for extension</a><a name="Coverage.extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/extensibility.html#Extension">Extension</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Extension</span><br/><span style="font-weight:bold">Slice: </span>Unordered, Open by value:url</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck14.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: white; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.extension:insuredPersonSymbol" title="Extension URL = http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Coverage_InsuredPersonSymbol">insuredPersonSymbol</a><a name="Coverage.extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">健康保険における被保険者証記号</span><br/><span style="font-weight:bold">URL: </span><a href="http://hl7.org/fhir/R4/StructureDefinition-jp-coverage-insuredpersonsymbol.html">http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Coverage_InsuredPersonSymbol</a><br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck14.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.extension:insuredPersonNumber" title="Extension URL = http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Coverage_InsuredPersonNumber">insuredPersonNumber</a><a name="Coverage.extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">健康保険における被保険者証番号</span><br/><span style="font-weight:bold">URL: </span><a href="http://hl7.org/fhir/R4/StructureDefinition-jp-coverage-insuredpersonnumber.html">http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Coverage_InsuredPersonNumber</a><br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck14.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: white; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.extension:insuredPersonSubNumber" title="Extension URL = http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Coverage_InsuredPersonSubNumber">insuredPersonSubNumber</a><a name="Coverage.extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">健康保険における被保険者証番号の枝番</span><br/><span style="font-weight:bold">URL: </span><a href="http://hl7.org/fhir/R4/StructureDefinition-jp-coverage-insuredpersonsubnumber.html">http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Coverage_InsuredPersonSubNumber</a><br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.identifier" title="A unique identifier assigned to this coverage.
このカバレッジに割り当てられた一意の識別子。">identifier</a><a name="Coverage.identifier"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#Identifier">Identifier</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Business Identifier for the coverage このカバレッジに割り当てられた一意の識別子。【詳細参照】</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.status" title="The status of the resource instance.
リソースインスタンスのステータス。">status</a><a name="Coverage.status"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#code">code</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">active | cancelled | draft | entered-in-error</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.type" title="The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization.
補償の種類:社会プログラム、医療計画、事故補償(労働者災害補償、自動車)、グループの健康、または個人または組織による支払い。">type</a><a name="Coverage.type"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Coverage category such as medical or accident 医療保険や事故補償のような分類</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: white; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.policyHolder" title="The party who 'owns' the insurance policy.
保険証券を「所有する」当事者。">policyHolder</a><a name="Coverage.policyHolder"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a href="StructureDefinition-jp-patient.html">JP Core Patient Profile</a> | <a href="http://hl7.org/fhir/R4/relatedperson.html">RelatedPerson</a> | <a href="StructureDefinition-jp-organization.html">JP Core Organization Profile</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Owner of the policy ポリシの所有者</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.subscriber" title="The party who has signed-up for or 'owns' the contractual relationship to the policy or to whom the benefit of the policy for services rendered to them or their family is due.
ポリシにサインアップした、またはポリシとの契約関係を「所有」している当事者、またはポリシの利益が彼らまたはその家族に提供されることになっている当事者。">subscriber</a><a name="Coverage.subscriber"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a href="StructureDefinition-jp-patient.html">JP Core Patient Profile</a> | <a href="http://hl7.org/fhir/R4/relatedperson.html">RelatedPerson</a>)</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Subscriber to the policy 被保険者</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.subscriberId" title="The insurer assigned ID for the Subscriber.
被保険者に保険者が割り当てたID">subscriberId</a><a name="Coverage.subscriberId"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">ID assigned to the subscriber 被保険者に割り当てられたID</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.beneficiary" title="The party who benefits from the insurance coverage; the patient when products and/or services are provided.
保険適用から利益を得る当事者、製品および/またはサービスが提供される際の患者。">beneficiary</a><a name="Coverage.beneficiary"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a href="StructureDefinition-jp-patient.html">JP Core Patient Profile</a>)</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Plan beneficiary</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.dependent" title="A unique identifier for a dependent under the coverage.
被保険者証の枝番。">dependent</a><a name="Coverage.dependent"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">被保険者証 枝番</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.relationship" title="The relationship of beneficiary (patient) to the subscriber.
受益者(患者)と加入者の関係。">relationship</a><a name="Coverage.relationship"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Beneficiary relationship to the subscriber 加入者との受益者関係</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.period" title="Time period during which the coverage is in force. A missing start date indicates the start date isn't known, a missing end date means the coverage is continuing to be in force.
補償範囲が有効である期間。開始日が欠落している場合は、開始日が不明であることを示す。終了日が欠落している場合は、補償範囲が引き続き有効であることを意味する。">period</a><a name="Coverage.period"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#Period">Period</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Coverage start and end dates</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.payor" title="The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements.
患者負担契約などの保険契約と保険外契約の両方を含むプログラムまたはプランの引受人または支払人。">payor</a><a name="Coverage.payor"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a href="StructureDefinition-jp-organization.html">JP Core Organization Profile</a> | <a href="StructureDefinition-jp-patient.html">JP Core Patient Profile</a> | <a href="http://hl7.org/fhir/R4/relatedperson.html">RelatedPerson</a>)</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Issuer of the policy</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.class" title="A suite of underwriter specific classifiers.
保険事業者の分類子">class</a><a name="Coverage.class"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Additional coverage classifications</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.class.type" title="The type of classification for which an insurer-specific class label or number and optional name is provided, for example may be used to identify a class of coverage or employer group, Policy, Plan.
保険者固有のクラスラベルまたは番号、任意の名前が提供されている分類のタイプを表す。例えば、保険のクラスまたは雇用者グループ、保険契約、Planを識別するために使用することができる。">type</a><a name="Coverage.class.type"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Type of class such as 'group' or 'plan'</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.class.value" title="The alphanumeric string value associated with the insurer issued label.
保険者が発行したラベルに関連付けられた英数字の文字列値。">value</a><a name="Coverage.class.value"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Value associated with the type</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.class.name" title="A short description for the class.
保険種類の簡単な説明。">name</a><a name="Coverage.class.name"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Human readable description of the type and value</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.order" title="The order of applicability of this coverage relative to other coverages which are currently in force. Note, there may be gaps in the numbering and this does not imply primary, secondary etc. as the specific positioning of coverages depends upon the episode of care.
現在適用されている他の保障と比較して、この保障の適用可能性が高い順に記載されている。なお、ナンバリングにギャップがある場合があり、カバーの具体的な位置づけはケアのエピソードに依存するため、一次、二次などを意味するものではない。">order</a><a name="Coverage.order"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#positiveInt">positiveInt</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Relative order of the coverage</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.network" title="The insurer-specific identifier for the insurer-defined network of providers to which the beneficiary may seek treatment which will be covered at the 'in-network' rate, otherwise 'out of network' terms and conditions apply.
保険者が定義したプロバイダの保険者定義ネットワークの保険者固有の識別子で、被保険者が「ネットワーク内」の料金でカバーされる治療を受けることができるが、そうでなければ「ネットワーク外」の条件が適用される。">network</a><a name="Coverage.network"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Insurer network</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.costToBeneficiary" title="A suite of codes indicating the cost category and associated amount which have been detailed in the policy and may have been included on the health card.
ポリシに詳細が記載されており、ヘルスカードに含まれている可能性のあるコストカテゴリと関連する金額を示す一連のコード。">costToBeneficiary</a><a name="Coverage.costToBeneficiary"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Patient payments for services/products サービスやプロダクトに対する患者支払い</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.costToBeneficiary.type" title="The category of patient centric costs associated with treatment.
治療に伴う患者中心の費用のカテゴリー。">type</a><a name="Coverage.costToBeneficiary.type"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Cost category</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1101.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.costToBeneficiary.type.coding">coding</a><a name="Coverage.costToBeneficiary.type.coding"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.costToBeneficiary.type.coding.system">system</a><a name="Coverage.costToBeneficiary.type.coding.system"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#uri">uri</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Identity of the terminology system</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11000.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.costToBeneficiary.type.coding.code">code</a><a name="Coverage.costToBeneficiary.type.coding.code"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#code">code</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Symbol in syntax defined by the system</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.costToBeneficiary.value[x]" title="The amount due from the patient for the cost category.
費用区分の患者からの支払額。">value[x]</a><a name="Coverage.costToBeneficiary.value_x_"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#SimpleQuantity" title="Quantity">SimpleQuantity</a><span style="opacity: 0.5">, </span><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#Money">Money</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">The amount or percentage due from the beneficiary</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck101.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.costToBeneficiary.exception" title="A suite of codes indicating exceptions or reductions to patient costs and their effective periods.
患者費用の例外または削減を示すコードとその有効期間を示すコード群。">exception</a><a name="Coverage.costToBeneficiary.exception"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Exceptions for patient payments</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.costToBeneficiary.exception.type" title="The code for the specific exception.
特定の例外のコード。">type</a><a name="Coverage.costToBeneficiary.exception.type"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Exception category</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1000.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.costToBeneficiary.exception.period" title="The timeframe during when the exception is in force.
例外が発生している間の時間枠。">period</a><a name="Coverage.costToBeneficiary.exception.period"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#Period">Period</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">The effective period of the exception</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.subrogation" title="When 'subrogation=true' this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs.
subrogation=trueの場合、この保険インスタンスは裁定のためではなく、保険者に費用回収のための詳細を提供するために含まれている。 (subrogation=代位、subrogation payment=代位納付)">subrogation</a><a name="Coverage.subrogation"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Reimbursement to insurer 保険者への償還</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-jp-coverage-definitions.html#Coverage.contract" title="The policy(s) which constitute this insurance coverage.
この保険の適用範囲を構成するポリシ。">contract</a><a name="Coverage.contract"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a style="opacity: 0.5" href="http://hl7.org/fhir/R4/contract.html">Contract</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Contract details 契約の詳細</td></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-category">
<valueString value="Financial.Support"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category">
<valueCode value="patient"/>
</extension>
<url value="http://jpfhir.jp/fhir/core/StructureDefinition/JP_Coverage"/>
<version value="1.1.1"/>
<name value="JP_Coverage"/>
<title value="JP Core Coverage Profile"/>
<status value="active"/>
<date value="2022-10-24"/>
<publisher
value="FHIR Japanese implementation research working group in Japan Association of Medical Informatics (JAMI)"/>
<contact>
<name
value="FHIR Japanese implementation research working group in Japan Association of Medical Informatics (JAMI)"/>
<telecom>
<system value="url"/>
<value value="http://jpfhir.jp"/>
</telecom>
<telecom>
<system value="email"/>
<value value="office@hlfhir.jp"/>
</telecom>
</contact>
<description
value="このプロファイルはCoverageリソースに対して、保険・公費のデータを送受信するための基礎となる制約と拡張を定めたものである。"/>
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="JP"/>
</coding>
</jurisdiction>
<copyright
value="Copyright FHIR Japanese implementation research working group in Japan Association of Medical Informatics (JAMI) 一般社団法人日本医療情報学会NeXEHRS課題研究会FHIR日本実装検討WG"/>
<fhirVersion value="4.0.1"/>
<mapping>
<identity value="workflow"/>
<uri value="http://hl7.org/fhir/workflow"/>
<name value="Workflow Pattern"/>
</mapping>
<mapping>
<identity value="rim"/>
<uri value="http://hl7.org/v3"/>
<name value="RIM Mapping"/>
</mapping>
<mapping>
<identity value="w5"/>
<uri value="http://hl7.org/fhir/fivews"/>
<name value="FiveWs Pattern Mapping"/>
</mapping>
<mapping>
<identity value="cdanetv4"/>
<uri value="http://www.cda-adc.ca/en/services/cdanet/"/>
<name value="Canadian Dental Association eclaims standard"/>
</mapping>
<mapping>
<identity value="v2"/>
<uri value="http://hl7.org/v2"/>
<name value="HL7 v2 Mapping"/>
</mapping>
<mapping>
<identity value="cpha3pharm"/>
<uri value="http://www.pharmacists.ca/"/>
<name value="Canadian Pharmacy Associaiton eclaims standard"/>
</mapping>
<kind value="resource"/>
<abstract value="false"/>
<type value="Coverage"/>
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Coverage"/>
<derivation value="constraint"/>
<snapshot>
<element id="Coverage">
<path value="Coverage"/>
<short
value="Insurance or medical plan or a payment agreement 保険または医療費支払いプラン、または合意された支払い方法"/>
<definition
value="Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment.
ヘルスケア製品およびサービスの償還または支払いに使用される可能性のある金融商品。 保険と自己負担の両方が含まれる。"/>
<comment
value="The Coverage resource contains the insurance card level information, which is customary to provide on claims and other communications between providers and insurers.
Coverageには、保険証レベルの情報が含まれている。これは、保険金請求やプロバイダと保険会社間のその他の通信で提供するのが通例である。"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Coverage"/>
<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-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 in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()"/>
<xpath
value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))"/>
<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-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>
<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>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="Entity. Role, or Act"/>
</mapping>
<mapping>
<identity value="workflow"/>
<map value="Event"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="Coverage"/>
</mapping>
</element>
<element id="Coverage.id">
<path value="Coverage.id"/>
<short value="Logical id of this artifact"/>
<definition
value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
<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="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="true"/>
</element>
<element id="Coverage.meta">
<path value="Coverage.meta"/>
<short value="Metadata about the resource"/>
<definition
value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content 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>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
</element>
<element id="Coverage.implicitRules">
<path value="Coverage.implicitRules"/>
<short value="A set of rules under which this content was created"/>
<definition
value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. 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>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<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"/>
</element>
<element id="Coverage.language">
<path value="Coverage.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>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<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>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
<valueBoolean value="true"/>
</extension>
<strength value="preferred"/>
<description value="A human language."/>
<valueSet value="http://hl7.org/fhir/ValueSet/languages"/>
</binding>
</element>
<element id="Coverage.text">
<path value="Coverage.text"/>
<short value="Text summary of the resource, for human interpretation"/>
<definition
value="A human-readable narrative that contains a summary of the resource and 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>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="Act.text?"/>
</mapping>
</element>
<element id="Coverage.contained">
<path value="Coverage.contained"/>
<short value="Contained, inline Resources"/>
<definition
value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope."/>
<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>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Coverage.extension">
<path value="Coverage.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<rules value="open"/>
</slicing>
<short value="Extension"/>
<definition value="An Extension"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="DomainResource.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<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="false"/>
<isSummary value="false"/>
</element>
<element id="Coverage.extension:insuredPersonSymbol">
<path value="Coverage.extension"/>
<sliceName value="insuredPersonSymbol"/>
<short value="健康保険における被保険者証記号"/>
<definition value="健康保険における被保険者証記号を示す拡張"/>
<comment value="健康保険における被保険者証記号を示す拡張。被保険者記号の全角文字列。"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="DomainResource.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
<profile
value="http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Coverage_InsuredPersonSymbol"/>
</type>
<condition value="ele-1"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<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="false"/>
</element>
<element id="Coverage.extension:insuredPersonNumber">
<path value="Coverage.extension"/>
<sliceName value="insuredPersonNumber"/>
<short value="健康保険における被保険者証番号"/>
<definition value="健康保険における被保険者証番号を示す拡張"/>
<comment value="健康保険における被保険者証番号を示す拡張。被保険者記号の全角文字列。"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="DomainResource.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
<profile
value="http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Coverage_InsuredPersonNumber"/>
</type>
<condition value="ele-1"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<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="false"/>
</element>
<element id="Coverage.extension:insuredPersonSubNumber">
<path value="Coverage.extension"/>
<sliceName value="insuredPersonSubNumber"/>
<short value="健康保険における被保険者証番号の枝番"/>
<definition value="健康保険における被保険者証番号の枝番を示す拡張"/>
<comment value="健康保険における被保険者証番号を示す拡張。2桁の全角数字文字列。一桁の場合には先頭に0をつけて2桁にする。"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="DomainResource.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
<profile
value="http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Coverage_InsuredPersonSubNumber"/>
</type>
<condition value="ele-1"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<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="false"/>
</element>
<element id="Coverage.modifierExtension">
<path value="Coverage.modifierExtension"/>
<short value="Extensions that cannot be ignored"/>
<definition
value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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](http://hl7.org/fhir/R4/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>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<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 resource that contains them"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Coverage.identifier">
<path value="Coverage.identifier"/>
<short
value="Business Identifier for the coverage このカバレッジに割り当てられた一意の識別子。【詳細参照】"/>
<definition
value="A unique identifier assigned to this coverage.
このカバレッジに割り当てられた一意の識別子。"/>
<comment
value="The main (and possibly only) identifier for the coverage - often referred to as a Member Id, Certificate number, Personal Health Number or Case ID. May be constructed as the concatenation of the Coverage.SubscriberID and the Coverage.dependent.
カバレッジのメイン(および場合によっては唯一の)識別子-多くの場合、メンバID、証明書番号、個人の健康番号、またはケースIDと呼ばれる。
【JP Core仕様】被保険者記号と番号と枝番を全角にした上でダブルコーテーションで囲い、カンマ区切りで連結する。
ルール:"{被保険者記号}","{被保険者番号}","{枝番}"
例:"12-34","5678","00""/>
<requirements
value="Allows coverages to be distinguished and referenced.
カバレッジを区別して参照できるようにする。"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Coverage.identifier"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Identifier"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="workflow"/>
<map value="Event.identifier"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.identifier"/>
</mapping>
<mapping>
<identity value="cdanetv4"/>
<map value="C02"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="IN1-2"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value=".id"/>
</mapping>
<mapping>
<identity value="cpha3pharm"/>
<map value="C.32, C.33, C.39"/>
</mapping>
</element>
<element id="Coverage.status">
<path value="Coverage.status"/>
<short value="active | cancelled | draft | entered-in-error"/>
<definition
value="The status of the resource instance.
リソースインスタンスのステータス。"/>
<comment
value="This element is labeled as a modifier because the status contains the code entered-in-error that marks the coverage as not currently valid.
ステータスには、カバレッジが現在無効であることを示すエラー入力されたコードが含まれているため、この要素は修飾子としてラベル付けされる。"/>
<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'.
「ドラフト」リソースはさらに編集される可能性があり、「アクティブ」リソースは不変であり、ステータスが「キャンセル」に変更されるだけである可能性があるため、リソースのステータスを追跡する必要がある。"/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coverage.status"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="true"/>
<isModifierReason
value="This element is labelled 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="CoverageStatus"/>
</extension>
<strength value="required"/>
<description
value="A code specifying the state of the resource instance."/>
<valueSet value="http://hl7.org/fhir/ValueSet/fm-status|4.0.1"/>
</binding>
<mapping>
<identity value="workflow"/>
<map value="Event.status"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.status"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="Act.status"/>
</mapping>
</element>
<element id="Coverage.type">
<path value="Coverage.type"/>
<short
value="Coverage category such as medical or accident 医療保険や事故補償のような分類"/>
<definition
value="The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization.
補償の種類:社会プログラム、医療計画、事故補償(労働者災害補償、自動車)、グループの健康、または個人または組織による支払い。"/>
<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.
すべてのターミノロジの使用がこの一般的なパターンに適合するわけではない。場合によっては、モデルはCodeableConceptを使用せず、コーディングを直接使用して、テキスト、コーディング、翻訳、および要素間の関係とpre-coordinationとpost-coordinationの用語関係を管理するための独自の構造を提供する必要がある。
【JP Core仕様】「[処方情報 HL7FHIR 記述仕様](https://std.jpfhir.jp/stddoc/ePrescriptionDataFHIR_v1x.pdf)」等で使用される保険種別コード(system=”urn:oid:1.2.392.100495.20.2.61”)として、https://www.mhlw.go.jp/content/10800000/000342368.pdf の別表11が使用している例があげられている。JP Coreとして本項目に対する用語のバインドは現時点では定義するまでに至っていない。"/>
<requirements
value="The order of application of coverages is dependent on the types of coverage.
カバレッジの適用順序は、カバレッジのタイプによって異なる。"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coverage.type"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CoverageType"/>
</extension>
<strength value="preferred"/>
<description
value="The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization."/>
<valueSet value="http://hl7.org/fhir/ValueSet/coverage-type"/>
</binding>
<mapping>
<identity value="w5"/>
<map value="FiveWs.class"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="IN1-15"/>
</mapping>
</element>
<element id="Coverage.policyHolder">
<path value="Coverage.policyHolder"/>
<short value="Owner of the policy ポリシの所有者"/>
<definition
value="The party who 'owns' the insurance policy.
保険証券を「所有する」当事者。"/>
<comment
value="For example: may be an individual, corporation or the subscriber's employer.
例:個人、企業、または加入者の雇用主である可能性がある。"/>
<requirements
value="This provides employer information in the case of Worker's Compensation and other policies.
これは、労働者災害補償およびその他のポリシの場合に雇用者情報を提供する。"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coverage.policyHolder"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://jpfhir.jp/fhir/core/StructureDefinition/JP_Patient"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
<targetProfile
value="http://jpfhir.jp/fhir/core/StructureDefinition/JP_Organization"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="w5"/>
<map value="FiveWs.subject[x]"/>
</mapping>
<mapping>
<identity value="cdanetv4"/>
<map value="D01 through D09"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="IN1-16, 18, 19-name of insured, address, date of birth"/>
</mapping>
<mapping>
<identity value="cpha3pharm"/>
<map value="C.35"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.subject"/>
</mapping>
</element>
<element id="Coverage.subscriber">
<path value="Coverage.subscriber"/>
<short value="Subscriber to the policy 被保険者"/>
<definition
value="The party who has signed-up for or 'owns' the contractual relationship to the policy or to whom the benefit of the policy for services rendered to them or their family is due.
ポリシにサインアップした、またはポリシとの契約関係を「所有」している当事者、またはポリシの利益が彼らまたはその家族に提供されることになっている当事者。"/>
<comment
value="May be self or a parent in the case of dependents.
扶養家族の場合、自己または親である可能性がある。"/>
<requirements
value="This is the party who is entitled to the benefits under the policy.
これは、ポリシに基づいて給付を受ける権利を有する当事者である。"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coverage.subscriber"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://jpfhir.jp/fhir/core/StructureDefinition/JP_Patient"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="w5"/>
<map value="FiveWs.subject[x]"/>
</mapping>
<mapping>
<identity value="cdanetv4"/>
<map value="D01 through D09"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="IN1-16, 18, 19-name of insured, address, date of birth"/>
</mapping>
<mapping>
<identity value="cpha3pharm"/>
<map value="C.35"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.subject"/>
</mapping>
</element>
<element id="Coverage.subscriberId">
<path value="Coverage.subscriberId"/>
<short value="ID assigned to the subscriber 被保険者に割り当てられたID"/>
<definition
value="The insurer assigned ID for the Subscriber.
被保険者に保険者が割り当てたID"/>
<requirements
value="The insurer requires this identifier on correspondence and claims (digital and otherwise).
保険者は、連絡や請求(デジタルおよびその他)でこの識別子を要求する。
保険会社は、通信および請求(デジタルおよびその他)でこの識別子を要求する。
【JP Core仕様】被保険者記号と番号を全角にした上でダブルコーテーションで囲い、カンマ区切りで連結する。
ルール:"{被保険者記号}","{被保険者番号}"
例:"12-34","5678""/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coverage.subscriberId"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="w5"/>
<map value="FiveWs.subject[x]"/>
</mapping>
<mapping>
<identity value="cdanetv4"/>
<map value="D01 through D09"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="IN1-16, 18, 19-name of insured, address, date of birth"/>
</mapping>
<mapping>
<identity value="cpha3pharm"/>
<map value="C.35"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.subject"/>
</mapping>
</element>
<element id="Coverage.beneficiary">
<path value="Coverage.beneficiary"/>
<short value="Plan beneficiary"/>
<definition
value="The party who benefits from the insurance coverage; the patient when products and/or services are provided.
保険適用から利益を得る当事者、製品および/またはサービスが提供される際の患者。"/>
<comment
value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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.
参照は、実際のFHIRリソースへの参照である必要があり、解決可能(内容に到達可能)である必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。
【JP Core仕様】患者Patientリソースへの参照。"/>
<requirements
value="This is the party who receives treatment for which the costs are reimbursed under the coverage.
これは、補償の下で費用が償還される治療を受ける側のことである。"/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coverage.beneficiary"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://jpfhir.jp/fhir/core/StructureDefinition/JP_Patient"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<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="D01 through D09"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="IN1-16, 18, 19-name of insured, address, date of birth"/>
</mapping>
<mapping>
<identity value="cpha3pharm"/>
<map value="C.35"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.subject"/>
</mapping>
</element>
<element id="Coverage.dependent">
<path value="Coverage.dependent"/>
<short value="被保険者証 枝番"/>
<definition
value="A unique identifier for a dependent under the coverage.
被保険者証の枝番。"/>
<comment
value="Periodically the member number is constructed from the subscriberId and the dependent number.
被保険者証の枝番を全角で格納する。"/>
<requirements
value="For some coverages a single identifier is issued to the Subscriber and then a unique dependent number is issued to each beneficiary.
一部の補償では、単一の識別子が加入者に発行され、次に一意の従属番号が各受益者に発行される。
一部の保険では、単一の識別子が加入者に発行され、その後、各受益者に固有の扶養番号が発行される。
【JP Core仕様】医療保険で本リソースを使用する場合には、この要素に拡張 InsuredPersonSubNumberに設定した値と同じ、被保険者番号の枝番号全角2桁を設定する。
例:"00""/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coverage.dependent"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="cdanetv4"/>
<map value="C17"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="- No exact HL7 v2 equivalent concept seems to exist;"/>
</mapping>
</element>
<element id="Coverage.relationship">
<path value="Coverage.relationship"/>
<short value="Beneficiary relationship to the subscriber 加入者との受益者関係"/>
<definition
value="The relationship of beneficiary (patient) to the subscriber.
受益者(患者)と加入者の関係。"/>
<comment
value="Typically, an individual uses policies which are theirs (relationship='self') before policies owned by others.
一般的に、個人は、他人が所有するポリシよりも、自分のポリシ(relationship='self')を使用する。"/>
<requirements
value="To determine relationship between the patient and the subscriber to determine coordination of benefits.
患者と加入者の関係を決定し、給付の調整を決定する。
【JP Core仕様】「[処方情報 HL7FHIR 記述仕様](https://std.jpfhir.jp/stddoc/ePrescriptionDataFHIR_v1x.pdf)」等で使用される被保険者区分コード(system=”urn:oid:1.2.392.100495.20.2.62”)として、https://www.mhlw.go.jp/content/10800000/000342368.pdf の別表12が使用できる。
1 被保険者
2 被扶養者"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coverage.relationship"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="Relationship"/>
</extension>
<strength value="extensible"/>
<description
value="The relationship between the Subscriber and the Beneficiary (insured/covered party/patient)."/>
<valueSet
value="http://hl7.org/fhir/ValueSet/subscriber-relationship"/>
</binding>
<mapping>
<identity value="cdanetv4"/>
<map value="C03"/>
</mapping>
</element>
<element id="Coverage.period">
<path value="Coverage.period"/>
<short value="Coverage start and end dates"/>
<definition
value="Time period during which the coverage is in force. A missing start date indicates the start date isn't known, a missing end date means the coverage is continuing to be in force.
補償範囲が有効である期間。開始日が欠落している場合は、開始日が不明であることを示す。終了日が欠落している場合は、補償範囲が引き続き有効であることを意味する。"/>
<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](http://hl7.org/fhir/R4/datatypes.html#Duration).
Period(期間)は時間の範囲を指定する。使用状況は、範囲全体が適用されるか(たとえば、「患者はこの時間範囲で入院していた」)、範囲から1つの値が適用されるか(たとえば、「この2回の間に患者に投与する」)を指定する。
Period(期間)は、Duration(時間区間=経過時間の測定値)には使用されない。 [Duration](datatypes.html#Duration)を参照のこと。
This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. 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"). If duration is required, specify the type as Interval|Duration.
これはDuration(時間区間)ではない- Durationは時間の尺度(別のタイプ)だが、時間の固定値で発生する時間区間である。Period(期間)は時間の範囲を指定する。使用状況は、範囲全体が適用されるか(たとえば、「患者はこの時間範囲で入院していた」)、範囲から1つの値が適用されるか(たとえば、「この2回の間に患者に投与する」)を指定する。もし、Duration(時間区間)が必要な場合は、タイプをInterval | Durationとして指定する。
これは期間ではなく-これは時間の尺度(別のタイプ)あるが、時間の固定値で発生する期間である。期間は時間の範囲を指定する。使用状況は、範囲全体が適用されるか(たとえば、「患者はこの時間範囲で入院していた」)、または範囲から1つの値が適用されるか(たとえば、「これら2回の間に患者に与える」)を指定する。期間が必要な場合は、タイプをInterval | Durationとして指定する。
【JP Core仕様】医療保険、公費で本リソースを使用する場合には、保険証または公費の有効期間の開始日、終了日をstart とendに yyyy-mm-dd形式で設定する。"/>
<requirements
value="Some insurers require the submission of the coverage term.
保険会社によっては、補償期間の提出を義務付けているところもある。"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coverage.period"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Period"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="workflow"/>
<map value="Event.occurrence[x]"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.done[x]"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="IN1-12 / IN1-13"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="Act.effectiveTime"/>
</mapping>
</element>
<element id="Coverage.payor">
<path value="Coverage.payor"/>
<short value="Issuer of the policy"/>
<definition
value="The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements.
患者負担契約などの保険契約と保険外契約の両方を含むプログラムまたはプランの引受人または支払人。"/>
<comment
value="May provide multiple identifiers such as insurance company identifier or business identifier (BIN number).
For selfpay it may provide multiple paying persons and/or organizations.
保険会社の識別子や事業者の識別子(BIN番号)など、複数の識別子を提供してもよい。自己負担の場合は、複数の支払者および/または組織を提供してもよい。"/>
<requirements
value="Need to identify the issuer to target for claim processing and for coordination of benefit processing.
請求処理および給付処理の調整の対象となる発行者を特定する必要がある。
【JP Core仕様】医療保険で本リソースを使用する場合には、保険者組織Organizationリソースへの参照。自費の場合には、患者Patientリソースへの参照。公費の場合には、公費負担者組織Organizationリソースへの参照。"/>
<min value="1"/>
<max value="*"/>
<base>
<path value="Coverage.payor"/>
<min value="1"/>
<max value="*"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://jpfhir.jp/fhir/core/StructureDefinition/JP_Organization"/>
<targetProfile
value="http://jpfhir.jp/fhir/core/StructureDefinition/JP_Patient"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="w5"/>
<map value="FiveWs.author"/>
</mapping>
<mapping>
<identity value="cdanetv4"/>
<map value="A05"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="IN1-3"/>
</mapping>
<mapping>
<identity value="cpha3pharm"/>
<map value="C.30"/>
</mapping>
</element>
<element id="Coverage.class">
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Class"/>
</extension>
<path value="Coverage.class"/>
<short value="Additional coverage classifications"/>
<definition
value="A suite of underwriter specific classifiers.
保険事業者の分類子"/>
<comment
value="For example may be used to identify a class of coverage or employer group, Policy, Plan.
例えば、保険の種類または雇用者グループ、保険契約、Planを識別するために使用することができる。"/>
<requirements
value="The codes provided on the health card which identify or confirm the specific policy for the insurer.
健康カードに記載されているコードで、保険者の特定の保険契約を識別または確認するもの。"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Coverage.class"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="BackboneElement"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
</element>
<element id="Coverage.class.id">
<path value="Coverage.class.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="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Coverage.class.extension">
<path value="Coverage.class.extension"/>
<short value="Additional content defined by implementations"/>
<definition
value="May be used to represent additional information that is not part of the basic definition of the 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>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<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="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Coverage.class.modifierExtension">
<path value="Coverage.class.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](http://hl7.org/fhir/R4/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>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<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>
</element>
<element id="Coverage.class.type">
<path value="Coverage.class.type"/>
<short value="Type of class such as 'group' or 'plan'"/>
<definition
value="The type of classification for which an insurer-specific class label or number and optional name is provided, for example may be used to identify a class of coverage or employer group, Policy, Plan.
保険者固有のクラスラベルまたは番号、任意の名前が提供されている分類のタイプを表す。例えば、保険のクラスまたは雇用者グループ、保険契約、Planを識別するために使用することができる。"/>
<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.
すべての用語の使用がこの一般的なパターンに適合するわけではない。いくつかのケースでは、モデルはCodeableConceptを使用せず、Codingを直接使用し、テキスト、コーディング、翻訳、要素間の関係、および前後の調整を管理するための独自の構造を提供することが望ましい。"/>
<requirements
value="The insurer issued label for a specific health card value.
保険者が発行した特定の健康カード番号のラベル。"/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coverage.class.type"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CoverageClass"/>
</extension>
<strength value="extensible"/>
<description
value="The policy classifications, eg. Group, Plan, Class, etc."/>
<valueSet value="http://hl7.org/fhir/ValueSet/coverage-class"/>
</binding>
</element>
<element id="Coverage.class.value">
<path value="Coverage.class.value"/>
<short value="Value associated with the type"/>
<definition
value="The alphanumeric string value associated with the insurer issued label.
保険者が発行したラベルに関連付けられた英数字の文字列値。"/>
<comment
value="For example, the Group or Plan number.
例えば、グループ番号やプラン番号など。"/>
<requirements
value="The insurer issued label and value are necessary to identify the specific policy.
保険者が発行したラベルと値は、特定の保険契約を識別するために必要なものである。"/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coverage.class.value"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="cdanetv4"/>
<map value="C11 (Division,Section)"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="IN1-8"/>
</mapping>
<mapping>
<identity value="cpha3pharm"/>
<map value="C.31"/>
</mapping>
</element>
<element id="Coverage.class.name">
<path value="Coverage.class.name"/>
<short value="Human readable description of the type and value"/>
<definition value="A short description for the class.
保険種類の簡単な説明。"/>
<requirements
value="Used to provide a meaningful description in correspondence to the patient.
患者に対応するのに意味のある説明をするために使用する。"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coverage.class.name"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="cdanetv4"/>
<map value="C11 (Division,Section)"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="IN1-8"/>
</mapping>
<mapping>
<identity value="cpha3pharm"/>
<map value="C.31"/>
</mapping>
</element>
<element id="Coverage.order">
<path value="Coverage.order"/>
<short value="Relative order of the coverage"/>
<definition
value="The order of applicability of this coverage relative to other coverages which are currently in force. Note, there may be gaps in the numbering and this does not imply primary, secondary etc. as the specific positioning of coverages depends upon the episode of care.
現在適用されている他の保障と比較して、この保障の適用可能性が高い順に記載されている。なお、ナンバリングにギャップがある場合があり、カバーの具体的な位置づけはケアのエピソードに依存するため、一次、二次などを意味するものではない。"/>
<comment
value="32 bit number; for values larger than this, use decimal
32 ビットの数値、これより大きい値の場合は 10 進数を使用する。"/>
<requirements
value="Used in managing the coordination of benefits.
保険給付の調整管理に使用する。
【JP Core仕様】公費情報で本リソースを使用する場合で、複数の公費負担情報がある場合に、その適用順序番号を示す1,2,3...を設定する。"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coverage.order"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="positiveInt"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="- No exact HL7 v2 equivalent concept seems to exist;"/>
</mapping>
</element>
<element id="Coverage.network">
<path value="Coverage.network"/>
<short value="Insurer network"/>
<definition
value="The insurer-specific identifier for the insurer-defined network of providers to which the beneficiary may seek treatment which will be covered at the 'in-network' rate, otherwise 'out of network' terms and conditions apply.
保険者が定義したプロバイダの保険者定義ネットワークの保険者固有の識別子で、被保険者が「ネットワーク内」の料金でカバーされる治療を受けることができるが、そうでなければ「ネットワーク外」の条件が適用される。"/>
<requirements
value="Used in referral for treatment and in claims processing.
治療のための紹介や請求処理の際に使用する。"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coverage.network"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="cdanetv4"/>
<map value="D10"/>
</mapping>
</element>
<element id="Coverage.costToBeneficiary">
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="CostToBeneficiary"/>
</extension>
<path value="Coverage.costToBeneficiary"/>
<short
value="Patient payments for services/products サービスやプロダクトに対する患者支払い"/>
<definition
value="A suite of codes indicating the cost category and associated amount which have been detailed in the policy and may have been included on the health card.
ポリシに詳細が記載されており、ヘルスカードに含まれている可能性のあるコストカテゴリと関連する金額を示す一連のコード。"/>
<comment
value="For example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment.
例えば、患者の訪問時の自己負担額を知ることで、医療提供者は治療を行う前にその金額を回収することができる。
【JP Core仕様】公費の場合には自己負担率。判明している場合のみ設定する。"/>
<requirements
value="Required by providers to manage financial transaction with the patient.
事業者が患者との金銭的な取引を管理するために必要となる。"/>
<alias value="CoPay"/>
<alias value="Deductible"/>
<alias value="Exceptions"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Coverage.costToBeneficiary"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="BackboneElement"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
</element>
<element id="Coverage.costToBeneficiary.id">
<path value="Coverage.costToBeneficiary.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="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Coverage.costToBeneficiary.extension">
<path value="Coverage.costToBeneficiary.extension"/>
<short value="Additional content defined by implementations"/>
<definition
value="May be used to represent additional information that is not part of the basic definition of the 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>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<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="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Coverage.costToBeneficiary.modifierExtension">
<path value="Coverage.costToBeneficiary.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](http://hl7.org/fhir/R4/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>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<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>
</element>
<element id="Coverage.costToBeneficiary.type">
<path value="Coverage.costToBeneficiary.type"/>
<short value="Cost category"/>
<definition
value="The category of patient centric costs associated with treatment.
治療に伴う患者中心の費用のカテゴリー。"/>
<comment
value="For example visit, specialist visits, emergency, inpatient care, etc.
例えば、訪問診療、専門医の訪問診療、救急診療、入院診療など。"/>
<requirements
value="Needed to identify the category associated with the amount for the patient.
患者の金額に関連するカテゴリーを特定する必要がありました。"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coverage.costToBeneficiary.type"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CopayTypes"/>
</extension>
<strength value="extensible"/>
<description
value="The types of services to which patient copayments are specified."/>
<valueSet value="http://hl7.org/fhir/ValueSet/coverage-copay-type"/>
</binding>
</element>
<element id="Coverage.costToBeneficiary.type.id">
<path value="Coverage.costToBeneficiary.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="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Coverage.costToBeneficiary.type.extension">
<path value="Coverage.costToBeneficiary.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>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<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="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Coverage.costToBeneficiary.type.coding">
<path value="Coverage.costToBeneficiary.type.coding"/>
<short value="Code defined by a terminology system"/>
<definition
value="A reference to a code defined by a terminology system."/>
<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>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<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="Coverage.costToBeneficiary.type.coding.id">
<path value="Coverage.costToBeneficiary.type.coding.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="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Coverage.costToBeneficiary.type.coding.extension">
<path value="Coverage.costToBeneficiary.type.coding.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>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<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="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Coverage.costToBeneficiary.type.coding.system">
<path value="Coverage.costToBeneficiary.type.coding.system"/>
<short value="Identity of the terminology system"/>
<definition
value="The identification of the code system that defines the meaning of the symbol in the code."/>
<comment
value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
保険や公費における自己負担率の種別を識別するコード体系のコード。
"http://terminology.hl7.org/CodeSystem/coverage-copay-type""/>
<requirements
value="Need to be unambiguous about the source of the definition of the symbol."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.system"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.3"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystem"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
</mapping>
</element>
<element id="Coverage.costToBeneficiary.type.coding.version">
<path value="Coverage.costToBeneficiary.type.coding.version"/>
<short value="Version of the system - if relevant"/>
<definition
value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged."/>
<comment
value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.version"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystemVersion"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
</mapping>
</element>
<element id="Coverage.costToBeneficiary.type.coding.code">
<path value="Coverage.costToBeneficiary.type.coding.code"/>
<short value="Symbol in syntax defined by the system"/>
<definition
value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)."/>
<comment
value="Note that FHIR strings SHALL NOT exceed 1MB in size
自己負担率を表すコード "copaypct""/>
<requirements
value="Need to refer to a particular code in the system."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.code"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./code"/>
</mapping>
<mapping>
<identity value="orim"/>
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
</mapping>
</element>
<element id="Coverage.costToBeneficiary.type.coding.display">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Coverage.costToBeneficiary.type.coding.display"/>
<short value="Representation defined by the system"/>
<definition
value="A representation of the meaning of the code in the system, following the rules of the system."/>
<requirements
value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.display"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.2 - but note this is not well followed"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CV.displayName"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
</mapping>
</element>
<element id="Coverage.costToBeneficiary.type.coding.userSelected">
<path value="Coverage.costToBeneficiary.type.coding.userSelected"/>
<short value="If this coding was chosen directly by the user"/>
<definition
value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)."/>
<comment
value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/>
<requirements
value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.userSelected"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="boolean"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="Sometimes implied by being first"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CD.codingRationale"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/>
</mapping>
</element>
<element id="Coverage.costToBeneficiary.type.text">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Coverage.costToBeneficiary.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>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<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="Coverage.costToBeneficiary.value[x]">
<path value="Coverage.costToBeneficiary.value[x]"/>
<short value="The amount or percentage due from the beneficiary"/>
<definition
value="The amount due from the patient for the cost category.
費用区分の患者からの支払額。"/>
<comment
value="Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency.
金額は、サービス/製品のコストに対する割合で表現される場合と、通貨の固定額で表現される場合がある。"/>
<requirements
value="Needed to identify the amount for the patient associated with the category.
カテゴリーに関連する患者の支払い金額を特定する必要がありました。"/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coverage.costToBeneficiary.value[x]"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="Quantity"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
</type>
<type>
<code value="Money"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="cdanetv4"/>
<map value="C11 (Division,Section)"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="IN1-8"/>
</mapping>
<mapping>
<identity value="cpha3pharm"/>
<map value="C.31"/>
</mapping>
</element>
<element id="Coverage.costToBeneficiary.exception">
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Exemption"/>
</extension>
<path value="Coverage.costToBeneficiary.exception"/>
<short value="Exceptions for patient payments"/>
<definition
value="A suite of codes indicating exceptions or reductions to patient costs and their effective periods.
患者費用の例外または削減を示すコードとその有効期間を示すコード群。"/>
<requirements
value="Required by providers to manage financial transaction with the patient.
事業者が患者との金銭的な取引を管理するために必要となる。"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Coverage.costToBeneficiary.exception"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="BackboneElement"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
</element>
<element id="Coverage.costToBeneficiary.exception.id">
<path value="Coverage.costToBeneficiary.exception.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="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Coverage.costToBeneficiary.exception.extension">
<path value="Coverage.costToBeneficiary.exception.extension"/>
<short value="Additional content defined by implementations"/>
<definition
value="May be used to represent additional information that is not part of the basic definition of the 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>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<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="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Coverage.costToBeneficiary.exception.modifierExtension">
<path value="Coverage.costToBeneficiary.exception.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](http://hl7.org/fhir/R4/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>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<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>
</element>
<element id="Coverage.costToBeneficiary.exception.type">
<path value="Coverage.costToBeneficiary.exception.type"/>
<short value="Exception category"/>
<definition value="The code for the specific exception.
特定の例外のコード。"/>
<requirements
value="Needed to identify the exception associated with the amount for the patient.
患者の金額に関連する例外を特定する必要があった。"/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coverage.costToBeneficiary.exception.type"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CoverageFinancialException"/>
</extension>
<strength value="example"/>
<description
value="The types of exceptions from the part or full value of financial obligations such as copays."/>
<valueSet
value="http://hl7.org/fhir/ValueSet/coverage-financial-exception"/>
</binding>
</element>
<element id="Coverage.costToBeneficiary.exception.period">
<path value="Coverage.costToBeneficiary.exception.period"/>
<short value="The effective period of the exception"/>
<definition
value="The timeframe during when the exception is in force.
例外が発生している間の時間枠。"/>
<requirements
value="Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs.
患者の費用を正しく計算するための例外の適用時期を特定する必要があった。"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coverage.costToBeneficiary.exception.period"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Period"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
</element>
<element id="Coverage.subrogation">
<path value="Coverage.subrogation"/>
<short value="Reimbursement to insurer 保険者への償還"/>
<definition
value="When 'subrogation=true' this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs.
subrogation=trueの場合、この保険インスタンスは裁定のためではなく、保険者に費用回収のための詳細を提供するために含まれている。 (subrogation=代位、subrogation payment=代位納付)"/>
<comment
value="Typically, automotive and worker's compensation policies would be flagged with 'subrogation=true' to enable healthcare payors to collect against accident claims.
一般的に、自動車保険や労災保険では、医療費支払い者が事故請求に対して回収できるように、subrogation=true というフラグが立てられている。"/>
<requirements
value="See definition for when to be used.
使用時期については定義を参照すること。"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coverage.subrogation"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="boolean"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
</element>
<element id="Coverage.contract">
<path value="Coverage.contract"/>
<short value="Contract details 契約の詳細"/>
<definition
value="The policy(s) which constitute this insurance coverage.
この保険の適用範囲を構成するポリシ。"/>
<comment
value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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.
参照は、実際のFHIRリソースへの参照である必要があり、解決可能(内容に到達可能)である必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。"/>
<requirements
value="To reference the legally binding contract between the policy holder and the insurer.
契約者と保険者との間の法的拘束力のある契約を参照するため。"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Coverage.contract"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Contract"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="cdanetv4"/>
<map value="D01 through D09"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="IN1-16, 18, 19"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
<mapping>
<identity value="cpha3pharm"/>
<map value="C.35"/>
</mapping>
</element>
</snapshot>
<differential>
<element id="Coverage">
<path value="Coverage"/>
<short
value="Insurance or medical plan or a payment agreement 保険または医療費支払いプラン、または合意された支払い方法"/>
<definition
value="Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment.
ヘルスケア製品およびサービスの償還または支払いに使用される可能性のある金融商品。 保険と自己負担の両方が含まれる。"/>
<comment
value="The Coverage resource contains the insurance card level information, which is customary to provide on claims and other communications between providers and insurers.
Coverageには、保険証レベルの情報が含まれている。これは、保険金請求やプロバイダと保険会社間のその他の通信で提供するのが通例である。"/>
</element>
<element id="Coverage.extension">
<path value="Coverage.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<rules value="open"/>
</slicing>
</element>
<element id="Coverage.extension:insuredPersonSymbol">
<path value="Coverage.extension"/>
<sliceName value="insuredPersonSymbol"/>
<min value="0"/>
<max value="*"/>
<type>
<code value="Extension"/>
<profile
value="http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Coverage_InsuredPersonSymbol"/>
</type>
</element>
<element id="Coverage.extension:insuredPersonNumber">
<path value="Coverage.extension"/>
<sliceName value="insuredPersonNumber"/>
<min value="0"/>
<max value="*"/>
<type>
<code value="Extension"/>
<profile
value="http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Coverage_InsuredPersonNumber"/>
</type>
</element>
<element id="Coverage.extension:insuredPersonSubNumber">
<path value="Coverage.extension"/>
<sliceName value="insuredPersonSubNumber"/>
<min value="0"/>
<max value="*"/>
<type>
<code value="Extension"/>
<profile
value="http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Coverage_InsuredPersonSubNumber"/>
</type>
</element>
<element id="Coverage.identifier">
<path value="Coverage.identifier"/>
<short
value="Business Identifier for the coverage このカバレッジに割り当てられた一意の識別子。【詳細参照】"/>
<definition
value="A unique identifier assigned to this coverage.
このカバレッジに割り当てられた一意の識別子。"/>
<comment
value="The main (and possibly only) identifier for the coverage - often referred to as a Member Id, Certificate number, Personal Health Number or Case ID. May be constructed as the concatenation of the Coverage.SubscriberID and the Coverage.dependent.
カバレッジのメイン(および場合によっては唯一の)識別子-多くの場合、メンバID、証明書番号、個人の健康番号、またはケースIDと呼ばれる。
【JP Core仕様】被保険者記号と番号と枝番を全角にした上でダブルコーテーションで囲い、カンマ区切りで連結する。
ルール:"{被保険者記号}","{被保険者番号}","{枝番}"
例:"12-34","5678","00""/>
<requirements
value="Allows coverages to be distinguished and referenced.
カバレッジを区別して参照できるようにする。"/>
</element>
<element id="Coverage.status">
<path value="Coverage.status"/>
<definition
value="The status of the resource instance.
リソースインスタンスのステータス。"/>
<comment
value="This element is labeled as a modifier because the status contains the code entered-in-error that marks the coverage as not currently valid.
ステータスには、カバレッジが現在無効であることを示すエラー入力されたコードが含まれているため、この要素は修飾子としてラベル付けされる。"/>
<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'.
「ドラフト」リソースはさらに編集される可能性があり、「アクティブ」リソースは不変であり、ステータスが「キャンセル」に変更されるだけである可能性があるため、リソースのステータスを追跡する必要がある。"/>
<isModifierReason
value="This element is labelled 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 / この要素は、エラーで入力されたステータスを含むステータス要素であるため、修飾子としてラベル付けされている。これは、リソースが有効として扱われるべきではないことを意味する。"/>
</element>
<element id="Coverage.type">
<path value="Coverage.type"/>
<short
value="Coverage category such as medical or accident 医療保険や事故補償のような分類"/>
<definition
value="The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization.
補償の種類:社会プログラム、医療計画、事故補償(労働者災害補償、自動車)、グループの健康、または個人または組織による支払い。"/>
<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.
すべてのターミノロジの使用がこの一般的なパターンに適合するわけではない。場合によっては、モデルはCodeableConceptを使用せず、コーディングを直接使用して、テキスト、コーディング、翻訳、および要素間の関係とpre-coordinationとpost-coordinationの用語関係を管理するための独自の構造を提供する必要がある。
【JP Core仕様】「[処方情報 HL7FHIR 記述仕様](https://std.jpfhir.jp/stddoc/ePrescriptionDataFHIR_v1x.pdf)」等で使用される保険種別コード(system=”urn:oid:1.2.392.100495.20.2.61”)として、https://www.mhlw.go.jp/content/10800000/000342368.pdf の別表11が使用している例があげられている。JP Coreとして本項目に対する用語のバインドは現時点では定義するまでに至っていない。"/>
<requirements
value="The order of application of coverages is dependent on the types of coverage.
カバレッジの適用順序は、カバレッジのタイプによって異なる。"/>
</element>
<element id="Coverage.policyHolder">
<path value="Coverage.policyHolder"/>
<short value="Owner of the policy ポリシの所有者"/>
<definition
value="The party who 'owns' the insurance policy.
保険証券を「所有する」当事者。"/>
<comment
value="For example: may be an individual, corporation or the subscriber's employer.
例:個人、企業、または加入者の雇用主である可能性がある。"/>
<requirements
value="This provides employer information in the case of Worker's Compensation and other policies.
これは、労働者災害補償およびその他のポリシの場合に雇用者情報を提供する。"/>
<type>
<code value="Reference"/>
<targetProfile
value="http://jpfhir.jp/fhir/core/StructureDefinition/JP_Patient"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
<targetProfile
value="http://jpfhir.jp/fhir/core/StructureDefinition/JP_Organization"/>
</type>
</element>
<element id="Coverage.subscriber">
<path value="Coverage.subscriber"/>
<short value="Subscriber to the policy 被保険者"/>
<definition
value="The party who has signed-up for or 'owns' the contractual relationship to the policy or to whom the benefit of the policy for services rendered to them or their family is due.
ポリシにサインアップした、またはポリシとの契約関係を「所有」している当事者、またはポリシの利益が彼らまたはその家族に提供されることになっている当事者。"/>
<comment
value="May be self or a parent in the case of dependents.
扶養家族の場合、自己または親である可能性がある。"/>
<requirements
value="This is the party who is entitled to the benefits under the policy.
これは、ポリシに基づいて給付を受ける権利を有する当事者である。"/>
<type>
<code value="Reference"/>
<targetProfile
value="http://jpfhir.jp/fhir/core/StructureDefinition/JP_Patient"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
</type>
</element>
<element id="Coverage.subscriberId">
<path value="Coverage.subscriberId"/>
<short value="ID assigned to the subscriber 被保険者に割り当てられたID"/>
<definition
value="The insurer assigned ID for the Subscriber.
被保険者に保険者が割り当てたID"/>
<requirements
value="The insurer requires this identifier on correspondence and claims (digital and otherwise).
保険者は、連絡や請求(デジタルおよびその他)でこの識別子を要求する。
保険会社は、通信および請求(デジタルおよびその他)でこの識別子を要求する。
【JP Core仕様】被保険者記号と番号を全角にした上でダブルコーテーションで囲い、カンマ区切りで連結する。
ルール:"{被保険者記号}","{被保険者番号}"
例:"12-34","5678""/>
</element>
<element id="Coverage.beneficiary">
<path value="Coverage.beneficiary"/>
<definition
value="The party who benefits from the insurance coverage; the patient when products and/or services are provided.
保険適用から利益を得る当事者、製品および/またはサービスが提供される際の患者。"/>
<comment
value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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.
参照は、実際のFHIRリソースへの参照である必要があり、解決可能(内容に到達可能)である必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。
【JP Core仕様】患者Patientリソースへの参照。"/>
<requirements
value="This is the party who receives treatment for which the costs are reimbursed under the coverage.
これは、補償の下で費用が償還される治療を受ける側のことである。"/>
<type>
<code value="Reference"/>
<targetProfile
value="http://jpfhir.jp/fhir/core/StructureDefinition/JP_Patient"/>
</type>
</element>
<element id="Coverage.dependent">
<path value="Coverage.dependent"/>
<short value="被保険者証 枝番"/>
<definition
value="A unique identifier for a dependent under the coverage.
被保険者証の枝番。"/>
<comment
value="Periodically the member number is constructed from the subscriberId and the dependent number.
被保険者証の枝番を全角で格納する。"/>
<requirements
value="For some coverages a single identifier is issued to the Subscriber and then a unique dependent number is issued to each beneficiary.
一部の補償では、単一の識別子が加入者に発行され、次に一意の従属番号が各受益者に発行される。
一部の保険では、単一の識別子が加入者に発行され、その後、各受益者に固有の扶養番号が発行される。
【JP Core仕様】医療保険で本リソースを使用する場合には、この要素に拡張 InsuredPersonSubNumberに設定した値と同じ、被保険者番号の枝番号全角2桁を設定する。
例:"00""/>
</element>
<element id="Coverage.relationship">
<path value="Coverage.relationship"/>
<short value="Beneficiary relationship to the subscriber 加入者との受益者関係"/>
<definition
value="The relationship of beneficiary (patient) to the subscriber.
受益者(患者)と加入者の関係。"/>
<comment
value="Typically, an individual uses policies which are theirs (relationship='self') before policies owned by others.
一般的に、個人は、他人が所有するポリシよりも、自分のポリシ(relationship='self')を使用する。"/>
<requirements
value="To determine relationship between the patient and the subscriber to determine coordination of benefits.
患者と加入者の関係を決定し、給付の調整を決定する。
【JP Core仕様】「[処方情報 HL7FHIR 記述仕様](https://std.jpfhir.jp/stddoc/ePrescriptionDataFHIR_v1x.pdf)」等で使用される被保険者区分コード(system=”urn:oid:1.2.392.100495.20.2.62”)として、https://www.mhlw.go.jp/content/10800000/000342368.pdf の別表12が使用できる。
1 被保険者
2 被扶養者"/>
</element>
<element id="Coverage.period">
<path value="Coverage.period"/>
<definition
value="Time period during which the coverage is in force. A missing start date indicates the start date isn't known, a missing end date means the coverage is continuing to be in force.
補償範囲が有効である期間。開始日が欠落している場合は、開始日が不明であることを示す。終了日が欠落している場合は、補償範囲が引き続き有効であることを意味する。"/>
<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](http://hl7.org/fhir/R4/datatypes.html#Duration).
Period(期間)は時間の範囲を指定する。使用状況は、範囲全体が適用されるか(たとえば、「患者はこの時間範囲で入院していた」)、範囲から1つの値が適用されるか(たとえば、「この2回の間に患者に投与する」)を指定する。
Period(期間)は、Duration(時間区間=経過時間の測定値)には使用されない。 [Duration](datatypes.html#Duration)を参照のこと。
This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. 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"). If duration is required, specify the type as Interval|Duration.
これはDuration(時間区間)ではない- Durationは時間の尺度(別のタイプ)だが、時間の固定値で発生する時間区間である。Period(期間)は時間の範囲を指定する。使用状況は、範囲全体が適用されるか(たとえば、「患者はこの時間範囲で入院していた」)、範囲から1つの値が適用されるか(たとえば、「この2回の間に患者に投与する」)を指定する。もし、Duration(時間区間)が必要な場合は、タイプをInterval | Durationとして指定する。
これは期間ではなく-これは時間の尺度(別のタイプ)あるが、時間の固定値で発生する期間である。期間は時間の範囲を指定する。使用状況は、範囲全体が適用されるか(たとえば、「患者はこの時間範囲で入院していた」)、または範囲から1つの値が適用されるか(たとえば、「これら2回の間に患者に与える」)を指定する。期間が必要な場合は、タイプをInterval | Durationとして指定する。
【JP Core仕様】医療保険、公費で本リソースを使用する場合には、保険証または公費の有効期間の開始日、終了日をstart とendに yyyy-mm-dd形式で設定する。"/>
<requirements
value="Some insurers require the submission of the coverage term.
保険会社によっては、補償期間の提出を義務付けているところもある。"/>
</element>
<element id="Coverage.payor">
<path value="Coverage.payor"/>
<definition
value="The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements.
患者負担契約などの保険契約と保険外契約の両方を含むプログラムまたはプランの引受人または支払人。"/>
<comment
value="May provide multiple identifiers such as insurance company identifier or business identifier (BIN number).
For selfpay it may provide multiple paying persons and/or organizations.
保険会社の識別子や事業者の識別子(BIN番号)など、複数の識別子を提供してもよい。自己負担の場合は、複数の支払者および/または組織を提供してもよい。"/>
<requirements
value="Need to identify the issuer to target for claim processing and for coordination of benefit processing.
請求処理および給付処理の調整の対象となる発行者を特定する必要がある。
【JP Core仕様】医療保険で本リソースを使用する場合には、保険者組織Organizationリソースへの参照。自費の場合には、患者Patientリソースへの参照。公費の場合には、公費負担者組織Organizationリソースへの参照。"/>
<type>
<code value="Reference"/>
<targetProfile
value="http://jpfhir.jp/fhir/core/StructureDefinition/JP_Organization"/>
<targetProfile
value="http://jpfhir.jp/fhir/core/StructureDefinition/JP_Patient"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
</type>
</element>
<element id="Coverage.class">
<path value="Coverage.class"/>
<definition
value="A suite of underwriter specific classifiers.
保険事業者の分類子"/>
<comment
value="For example may be used to identify a class of coverage or employer group, Policy, Plan.
例えば、保険の種類または雇用者グループ、保険契約、Planを識別するために使用することができる。"/>
<requirements
value="The codes provided on the health card which identify or confirm the specific policy for the insurer.
健康カードに記載されているコードで、保険者の特定の保険契約を識別または確認するもの。"/>
</element>
<element id="Coverage.class.type">
<path value="Coverage.class.type"/>
<definition
value="The type of classification for which an insurer-specific class label or number and optional name is provided, for example may be used to identify a class of coverage or employer group, Policy, Plan.
保険者固有のクラスラベルまたは番号、任意の名前が提供されている分類のタイプを表す。例えば、保険のクラスまたは雇用者グループ、保険契約、Planを識別するために使用することができる。"/>
<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.
すべての用語の使用がこの一般的なパターンに適合するわけではない。いくつかのケースでは、モデルはCodeableConceptを使用せず、Codingを直接使用し、テキスト、コーディング、翻訳、要素間の関係、および前後の調整を管理するための独自の構造を提供することが望ましい。"/>
<requirements
value="The insurer issued label for a specific health card value.
保険者が発行した特定の健康カード番号のラベル。"/>
</element>
<element id="Coverage.class.value">
<path value="Coverage.class.value"/>
<definition
value="The alphanumeric string value associated with the insurer issued label.
保険者が発行したラベルに関連付けられた英数字の文字列値。"/>
<comment
value="For example, the Group or Plan number.
例えば、グループ番号やプラン番号など。"/>
<requirements
value="The insurer issued label and value are necessary to identify the specific policy.
保険者が発行したラベルと値は、特定の保険契約を識別するために必要なものである。"/>
</element>
<element id="Coverage.class.name">
<path value="Coverage.class.name"/>
<definition value="A short description for the class.
保険種類の簡単な説明。"/>
<requirements
value="Used to provide a meaningful description in correspondence to the patient.
患者に対応するのに意味のある説明をするために使用する。"/>
</element>
<element id="Coverage.order">
<path value="Coverage.order"/>
<definition
value="The order of applicability of this coverage relative to other coverages which are currently in force. Note, there may be gaps in the numbering and this does not imply primary, secondary etc. as the specific positioning of coverages depends upon the episode of care.
現在適用されている他の保障と比較して、この保障の適用可能性が高い順に記載されている。なお、ナンバリングにギャップがある場合があり、カバーの具体的な位置づけはケアのエピソードに依存するため、一次、二次などを意味するものではない。"/>
<comment
value="32 bit number; for values larger than this, use decimal
32 ビットの数値、これより大きい値の場合は 10 進数を使用する。"/>
<requirements
value="Used in managing the coordination of benefits.
保険給付の調整管理に使用する。
【JP Core仕様】公費情報で本リソースを使用する場合で、複数の公費負担情報がある場合に、その適用順序番号を示す1,2,3...を設定する。"/>
</element>
<element id="Coverage.network">
<path value="Coverage.network"/>
<definition
value="The insurer-specific identifier for the insurer-defined network of providers to which the beneficiary may seek treatment which will be covered at the 'in-network' rate, otherwise 'out of network' terms and conditions apply.
保険者が定義したプロバイダの保険者定義ネットワークの保険者固有の識別子で、被保険者が「ネットワーク内」の料金でカバーされる治療を受けることができるが、そうでなければ「ネットワーク外」の条件が適用される。"/>
<requirements
value="Used in referral for treatment and in claims processing.
治療のための紹介や請求処理の際に使用する。"/>
</element>
<element id="Coverage.costToBeneficiary">
<path value="Coverage.costToBeneficiary"/>
<short
value="Patient payments for services/products サービスやプロダクトに対する患者支払い"/>
<definition
value="A suite of codes indicating the cost category and associated amount which have been detailed in the policy and may have been included on the health card.
ポリシに詳細が記載されており、ヘルスカードに含まれている可能性のあるコストカテゴリと関連する金額を示す一連のコード。"/>
<comment
value="For example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment.
例えば、患者の訪問時の自己負担額を知ることで、医療提供者は治療を行う前にその金額を回収することができる。
【JP Core仕様】公費の場合には自己負担率。判明している場合のみ設定する。"/>
<requirements
value="Required by providers to manage financial transaction with the patient.
事業者が患者との金銭的な取引を管理するために必要となる。"/>
</element>
<element id="Coverage.costToBeneficiary.type">
<path value="Coverage.costToBeneficiary.type"/>
<definition
value="The category of patient centric costs associated with treatment.
治療に伴う患者中心の費用のカテゴリー。"/>
<comment
value="For example visit, specialist visits, emergency, inpatient care, etc.
例えば、訪問診療、専門医の訪問診療、救急診療、入院診療など。"/>
<requirements
value="Needed to identify the category associated with the amount for the patient.
患者の金額に関連するカテゴリーを特定する必要がありました。"/>
</element>
<element id="Coverage.costToBeneficiary.type.coding.system">
<path value="Coverage.costToBeneficiary.type.coding.system"/>
<comment
value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
保険や公費における自己負担率の種別を識別するコード体系のコード。
"http://terminology.hl7.org/CodeSystem/coverage-copay-type""/>
</element>
<element id="Coverage.costToBeneficiary.type.coding.code">
<path value="Coverage.costToBeneficiary.type.coding.code"/>
<comment
value="Note that FHIR strings SHALL NOT exceed 1MB in size
自己負担率を表すコード "copaypct""/>
</element>
<element id="Coverage.costToBeneficiary.value[x]">
<path value="Coverage.costToBeneficiary.value[x]"/>
<definition
value="The amount due from the patient for the cost category.
費用区分の患者からの支払額。"/>
<comment
value="Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency.
金額は、サービス/製品のコストに対する割合で表現される場合と、通貨の固定額で表現される場合がある。"/>
<requirements
value="Needed to identify the amount for the patient associated with the category.
カテゴリーに関連する患者の支払い金額を特定する必要がありました。"/>
</element>
<element id="Coverage.costToBeneficiary.exception">
<path value="Coverage.costToBeneficiary.exception"/>
<definition
value="A suite of codes indicating exceptions or reductions to patient costs and their effective periods.
患者費用の例外または削減を示すコードとその有効期間を示すコード群。"/>
<requirements
value="Required by providers to manage financial transaction with the patient.
事業者が患者との金銭的な取引を管理するために必要となる。"/>
</element>
<element id="Coverage.costToBeneficiary.exception.type">
<path value="Coverage.costToBeneficiary.exception.type"/>
<definition value="The code for the specific exception.
特定の例外のコード。"/>
<requirements
value="Needed to identify the exception associated with the amount for the patient.
患者の金額に関連する例外を特定する必要があった。"/>
</element>
<element id="Coverage.costToBeneficiary.exception.period">
<path value="Coverage.costToBeneficiary.exception.period"/>
<definition
value="The timeframe during when the exception is in force.
例外が発生している間の時間枠。"/>
<requirements
value="Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs.
患者の費用を正しく計算するための例外の適用時期を特定する必要があった。"/>
</element>
<element id="Coverage.subrogation">
<path value="Coverage.subrogation"/>
<short value="Reimbursement to insurer 保険者への償還"/>
<definition
value="When 'subrogation=true' this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs.
subrogation=trueの場合、この保険インスタンスは裁定のためではなく、保険者に費用回収のための詳細を提供するために含まれている。 (subrogation=代位、subrogation payment=代位納付)"/>
<comment
value="Typically, automotive and worker's compensation policies would be flagged with 'subrogation=true' to enable healthcare payors to collect against accident claims.
一般的に、自動車保険や労災保険では、医療費支払い者が事故請求に対して回収できるように、subrogation=true というフラグが立てられている。"/>
<requirements
value="See definition for when to be used.
使用時期については定義を参照すること。"/>
</element>
<element id="Coverage.contract">
<path value="Coverage.contract"/>
<short value="Contract details 契約の詳細"/>
<definition
value="The policy(s) which constitute this insurance coverage.
この保険の適用範囲を構成するポリシ。"/>
<comment
value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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.
参照は、実際のFHIRリソースへの参照である必要があり、解決可能(内容に到達可能)である必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。"/>
<requirements
value="To reference the legally binding contract between the policy holder and the insurer.
契約者と保険者との間の法的拘束力のある契約を参照するため。"/>
</element>
</differential>
</StructureDefinition>
IG © 2022+ FHIR Japanese implementation research working group in Japan Association of Medical Informatics (JAMI). Package hl7.fhir.jp.core#1.1.1 based on FHIR 4.0.1. Generated 2022-11-03
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