davinci_pdex_test_kit 0.11.0 → 0.12.0

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Files changed (65) hide show
  1. checksums.yaml +4 -4
  2. data/config/presets/pdex_payer_server_fhir_foundry_ri_preset.json +2 -2
  3. data/config/presets/pdex_payer_server_inferno_ri_preset.json +2 -2
  4. data/lib/davinci_pdex_test_kit/pdex_payer_client/client_member_match_tests/client_member_match_validation_test.rb +7 -5
  5. data/lib/davinci_pdex_test_kit/pdex_payer_client/client_workflow_interaction_test.rb +8 -7
  6. data/lib/davinci_pdex_test_kit/pdex_payer_client_suite.rb +8 -10
  7. data/lib/davinci_pdex_test_kit/pdex_payer_server/device/device_must_support_test.rb +50 -0
  8. data/lib/davinci_pdex_test_kit/pdex_payer_server/device/device_patient_search_test.rb +68 -0
  9. data/lib/davinci_pdex_test_kit/pdex_payer_server/device/device_patient_type_search_test.rb +54 -0
  10. data/lib/davinci_pdex_test_kit/pdex_payer_server/{explanation_of_benefit/explanation_of_benefit_provenance_revinclude_search_test.rb → device/device_provenance_revinclude_search_test.rb} +7 -7
  11. data/lib/davinci_pdex_test_kit/pdex_payer_server/device/device_read_test.rb +26 -0
  12. data/lib/davinci_pdex_test_kit/pdex_payer_server/device/device_reference_resolution_test.rb +42 -0
  13. data/lib/davinci_pdex_test_kit/pdex_payer_server/device/device_validation_test.rb +39 -0
  14. data/lib/davinci_pdex_test_kit/pdex_payer_server/device/metadata.yml +154 -0
  15. data/lib/davinci_pdex_test_kit/pdex_payer_server/device_group.rb +88 -0
  16. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_id_search_test.rb +7 -24
  17. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_identifier_search_test.rb +10 -24
  18. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_must_support_test.rb +37 -5
  19. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_patient_lastupdated_search_test.rb +48 -0
  20. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_patient_search_test.rb +62 -0
  21. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_patient_service_date_search_test.rb +7 -23
  22. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_patient_type_search_test.rb +6 -23
  23. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_reference_resolution_test.rb +7 -4
  24. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_validation_test.rb +9 -10
  25. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/metadata.yml +276 -264
  26. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit_group.rb +62 -64
  27. data/lib/davinci_pdex_test_kit/pdex_payer_server/export_patient_group.rb +8 -9
  28. data/lib/davinci_pdex_test_kit/pdex_payer_server/export_validation_group.rb +1 -2
  29. data/lib/davinci_pdex_test_kit/pdex_payer_server/medication_dispense/medication_dispense_must_support_test.rb +42 -0
  30. data/lib/davinci_pdex_test_kit/pdex_payer_server/medication_dispense/medication_dispense_patient_search_test.rb +64 -0
  31. data/lib/davinci_pdex_test_kit/pdex_payer_server/medication_dispense/medication_dispense_patient_status_search_test.rb +54 -0
  32. data/lib/davinci_pdex_test_kit/pdex_payer_server/medication_dispense/medication_dispense_patient_status_type_search_test.rb +55 -0
  33. data/lib/davinci_pdex_test_kit/pdex_payer_server/medication_dispense/medication_dispense_provenance_revinclude_search_test.rb +54 -0
  34. data/lib/davinci_pdex_test_kit/pdex_payer_server/medication_dispense/medication_dispense_read_test.rb +26 -0
  35. data/lib/davinci_pdex_test_kit/pdex_payer_server/medication_dispense/medication_dispense_reference_resolution_test.rb +42 -0
  36. data/lib/davinci_pdex_test_kit/pdex_payer_server/medication_dispense/medication_dispense_validation_test.rb +39 -0
  37. data/lib/davinci_pdex_test_kit/pdex_payer_server/medication_dispense/metadata.yml +206 -0
  38. data/lib/davinci_pdex_test_kit/pdex_payer_server/medication_dispense_group.rb +69 -0
  39. data/lib/davinci_pdex_test_kit/pdex_payer_server/multiple_member_matches_group.rb +36 -36
  40. data/lib/davinci_pdex_test_kit/pdex_payer_server/no_member_matches_group.rb +30 -30
  41. data/lib/davinci_pdex_test_kit/pdex_payer_server/patient_operation_in_capability_statement_validation.rb +15 -13
  42. data/lib/davinci_pdex_test_kit/pdex_payer_server/provenance/metadata.yml +173 -0
  43. data/lib/davinci_pdex_test_kit/pdex_payer_server/provenance/provenance_must_support_test.rb +51 -0
  44. data/lib/davinci_pdex_test_kit/pdex_payer_server/provenance/provenance_read_test.rb +26 -0
  45. data/lib/davinci_pdex_test_kit/pdex_payer_server/provenance/provenance_reference_resolution_test.rb +46 -0
  46. data/lib/davinci_pdex_test_kit/pdex_payer_server/provenance/provenance_validation_test.rb +39 -0
  47. data/lib/davinci_pdex_test_kit/pdex_payer_server/provenance_group.rb +59 -0
  48. data/lib/davinci_pdex_test_kit/pdex_payer_server/workflow_clinical_data_group.rb +22 -11
  49. data/lib/davinci_pdex_test_kit/pdex_payer_server/workflow_everything_group.rb +19 -6
  50. data/lib/davinci_pdex_test_kit/pdex_payer_server/workflow_export_group.rb +22 -16
  51. data/lib/davinci_pdex_test_kit/pdex_payer_server/workflow_member_match_group.rb +44 -25
  52. data/lib/davinci_pdex_test_kit/pdex_payer_server_suite.rb +123 -110
  53. data/lib/davinci_pdex_test_kit/pdex_provider_client_suite.rb +8 -8
  54. data/lib/davinci_pdex_test_kit/requirements/davinci-pdex-test-kit_out_of_scope_requirements.csv +1 -0
  55. data/lib/davinci_pdex_test_kit/requirements/davinci-pdex-test-kit_requirements.csv +64 -0
  56. data/lib/davinci_pdex_test_kit/requirements/generated/davinci-pdex-test-kit_requirements_coverage.csv +64 -0
  57. data/lib/davinci_pdex_test_kit/version.rb +2 -2
  58. data/lib/davinci_pdex_test_kit.rb +1 -0
  59. data/lib/inferno_requirements_tools/ext/inferno_core/runnable.rb +22 -0
  60. data/lib/inferno_requirements_tools/rake/rakefile_template +19 -0
  61. data/lib/inferno_requirements_tools/tasks/requirements_coverage.rb +284 -0
  62. data/lib/requirements_config.yaml +17 -0
  63. metadata +56 -11
  64. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_patient_last_updated_search_test.rb +0 -64
  65. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_patient_use_search_test.rb +0 -69
data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/metadata.yml CHANGED
@@ -1,103 +1,85 @@
1
1
  ---
2
- :name: pdex_prior_authorization
3
- :class_name: PDexExplanationOfBenefitSequence
2
+ :name: pdex_priorauthorization
3
+ :class_name: PdexPriorauthorizationSequence
4
4
  :version: v2.0.0
5
5
  :reformatted_version: v200
6
6
  :resource: ExplanationOfBenefit
7
- :profile_url: https://hl7.org/fhir/us/davinci-pdex/STU2/CapabilityStatement-pdex-server
7
+ :profile_url: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-priorauthorization
8
8
  :profile_name: PDex Prior Authorization
9
9
  :profile_version: 2.0.0
10
10
  :title: PDex Prior Authorization
11
- :short_description: Verify support for the server capabilities required by the PDex Prior Authorization Profile.
11
+ :short_description: Verify support for the server capabilities required by the PDex
12
+ Prior Authorization.
12
13
  :is_delayed: false
13
14
  :interactions:
14
- - :code: create
15
- :expectation: MAY # Unspecified expectations are defaulted to MAY here
16
15
  - :code: search-type
17
16
  :expectation: SHALL
18
17
  - :code: read
19
18
  :expectation: SHALL
20
- - :code: vread
21
- :expectation: MAY
22
- - :code: update
23
- :expectation: MAY
24
- - :code: patch
25
- :expectation: MAY
26
- - :code: delete
27
- :expectation: MAY
28
- - :code: history-instance
29
- :expectation: SHOULD
30
- - :code: history-type
31
- :expectation: MAY
32
19
  :operations: []
33
20
  :searches:
34
- - :expectation: SHALL
35
- :names:
21
+ - :names:
36
22
  - patient
37
- - use
23
+ :expectation: SHALL
38
24
  :names_not_must_support_or_mandatory: []
39
25
  :must_support_or_mandatory: true
40
- - :expectation: SHALL
41
- :names:
26
+ - :names:
42
27
  - _id
28
+ :expectation: SHALL
43
29
  :names_not_must_support_or_mandatory: []
44
30
  :must_support_or_mandatory: true
45
- - :expectation: SHALL
46
- :names:
31
+ - :names:
47
32
  - patient
48
33
  - _lastUpdated
49
- :names_not_must_support_or_mandatory: []
50
- :must_support_or_mandatory: true
51
- - :expectation: SHALL
52
- :names:
53
- - patient
54
- - service-date
55
- :names_not_must_support_or_mandatory: []
56
- :must_support_or_mandatory: true
57
- - :expectation: SHALL
58
- :names:
34
+ :expectation: SHALL
35
+ :names_not_must_support_or_mandatory:
36
+ - _lastUpdated
37
+ :must_support_or_mandatory: false
38
+ - :names:
59
39
  - patient
60
40
  - type
41
+ :expectation: SHALL
61
42
  :names_not_must_support_or_mandatory: []
62
43
  :must_support_or_mandatory: true
63
- - :expectation: SHALL
64
- :names:
44
+ - :names:
65
45
  - identifier
66
- :names_not_must_support_or_mandatory: []
67
- :must_support_or_mandatory: true
68
-
46
+ :expectation: SHALL
47
+ :names_not_must_support_or_mandatory:
48
+ - identifier
49
+ :must_support_or_mandatory: false
50
+ - :names:
51
+ - patient
52
+ - service-date
53
+ :expectation: SHALL
54
+ :names_not_must_support_or_mandatory:
55
+ - service-date
56
+ :must_support_or_mandatory: false
69
57
  :search_definitions:
70
- :patient:
58
+ :_id:
71
59
  :paths:
72
- - patient
60
+ - id
73
61
  :full_paths:
74
- - ExplanationOfBenefit.patient
62
+ - ExplanationOfBenefit.id
75
63
  :comparators: {}
76
64
  :values: []
77
- :type: Reference
65
+ :type: http://hl7.org/fhirpath/System.String
78
66
  :contains_multiple: false
79
67
  :multiple_or: MAY
80
- :identifier:
68
+ :patient:
81
69
  :paths:
82
- - identifier
70
+ - patient
83
71
  :full_paths:
84
- - ExplanationOfBenefit.identifier
72
+ - ExplanationOfBenefit.patient
85
73
  :comparators: {}
86
74
  :values: []
87
- :type: Identifier
88
- :contains_multiple: true
75
+ :type: Reference
76
+ :contains_multiple: false
89
77
  :multiple_or: MAY
90
- # The service-date search parameter paths are not clear in the JSON, but explicit in its narrative
91
- # https://hl7.org/fhir/us/davinci-pdex/STU2/SearchParameter-explanationofbenefit-service-date
92
- :service-date:
78
+ :_lastUpdated:
93
79
  :paths:
94
- - billablePeriod.period.start
95
- - item.servicedDate
96
- - item.servicedPeriod.period.start
80
+ - meta.lastUpdated
97
81
  :full_paths:
98
- - ExplanationOfBenefit.billablePeriod.period.start
99
- - ExplanationOfBenefit.item.serviced.servicedDate
100
- - ExplanationOfBenefit.item.servicedPeriod.period.start
82
+ - ExplanationOfBenefit.meta.lastUpdated
101
83
  :comparators:
102
84
  :eq: MAY
103
85
  :ne: MAY
@@ -109,7 +91,7 @@
109
91
  :eb: MAY
110
92
  :ap: MAY
111
93
  :values: []
112
- :type: date
94
+ :type: instant
113
95
  :contains_multiple: false
114
96
  :multiple_or: MAY
115
97
  :type:
@@ -122,34 +104,27 @@
122
104
  :type: CodeableConcept
123
105
  :contains_multiple: false
124
106
  :multiple_or: MAY
125
- :use:
126
- :paths:
127
- - use
128
- :full_paths:
129
- - ExplanationOfBenefit.use
130
- :comparators: {}
131
- :values:
132
- - preauthorization
133
- :type: code
134
- :contains_multiple: false
135
- :multiple_or: MAY
136
- # I'm assuming metadata needs _id, even though its defined in FHIR Core
137
- :_id:
107
+ :identifier:
138
108
  :paths:
139
- - id
109
+ - identifier
140
110
  :full_paths:
141
- - ExplanationOfBenefit.id
111
+ - ExplanationOfBenefit.identifier
142
112
  :comparators: {}
143
113
  :values: []
144
- :type: http://hl7.org/fhirpath/System.String
145
- :contains_multiple: false
114
+ :type: Identifier
115
+ :contains_multiple: true
146
116
  :multiple_or: MAY
147
- # Likewise assuming metadata needs _lastUpdated
148
- :_lastUpdated:
117
+ # The service-date search parameter paths are not clear in the JSON, but explicit in its narrative
118
+ # https://hl7.org/fhir/us/davinci-pdex/STU2/SearchParameter-explanationofbenefit-service-date
119
+ :service-date:
149
120
  :paths:
150
- - meta.lastUpdated
121
+ - billablePeriod.period.start
122
+ - item.servicedDate
123
+ - item.servicedPeriod.period.start
151
124
  :full_paths:
152
- - ExplanationOfBenefit.meta.lastUpdated
125
+ - ExplanationOfBenefit.billablePeriod.period.start
126
+ - ExplanationOfBenefit.item.serviced.servicedDate
127
+ - ExplanationOfBenefit.item.servicedPeriod.period.start
153
128
  :comparators:
154
129
  :eq: MAY
155
130
  :ne: MAY
@@ -165,44 +140,40 @@
165
140
  :contains_multiple: false
166
141
  :multiple_or: MAY
167
142
  :include_params:
168
- - ExplanationOfBenefit:patient:Patient
169
- - ExplanationOfBenefit:provider:Practitioner
170
- - ExplanationOfBenefit:provider:PractitionerRole
171
- - ExplanationOfBenefit:provider:Organization
172
- # 'care-team' search parameter maps to ExplanationOfBenefit.careTeam.provider
173
- - ExplanationOfBenefit:care-team:Practitioner
174
- - ExplanationOfBenefit:care-team:PractitionerRole
175
- - ExplanationOfBenefit:care-team:Organization
176
- - ExplanationOfBenefit:coverage:Coverage
177
- - ExplanationOfBenefit:insurer:Organization
178
- # Asserting '*' search parameter makes a lot of the above redundant
179
- - ExplanationOfBenefit:*
180
-
181
- :revincludes:
182
- - Provenance:target
183
- :required_concepts: []
184
-
185
- ## TODO: must supports
143
+ - ExplanationOfBenefit:patient
144
+ - ExplanationOfBenefit:provider
145
+ - ExplanationOfBenefit:care-team
146
+ - ExplanationOfBenefit:coverage
147
+ - ExplanationOfBenefit:insurer
148
+ - ExplanationOfBenefit:*
149
+ :revincludes: []
150
+ :required_concepts:
151
+ - priority
152
+ - item.category
153
+ - item.productOrService
154
+ - item.adjudication.category
155
+ - item.adjudication.reason
156
+ - adjudication.category
186
157
  :must_supports:
187
158
  :extensions:
188
159
  - :id: ExplanationOfBenefit.extension:levelOfServiceType
189
160
  :path: extension
190
- :url: https://hl7.org/fhir/us/davinci-pdex/StructureDefinition-extension-levelOfServiceCode
161
+ :url: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/extension-levelOfServiceCode
191
162
  - :id: ExplanationOfBenefit.item.extension:itemTraceNumber
192
163
  :path: item.extension
193
- :url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition-extension-itemTraceNumber
164
+ :url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber
194
165
  - :id: ExplanationOfBenefit.item.extension:preAuthIssueDate
195
166
  :path: item.extension
196
- :url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition-extension-itemPreAuthIssueDate
197
- - :id: ExplanationOfBenefit.item.extension:preAuthIssuePeriod
167
+ :url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate
168
+ - :id: ExplanationOfBenefit.item.extension:preAuthPeriod
198
169
  :path: item.extension
199
- :url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition-extension-itemPreAuthPeriod
170
+ :url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod
200
171
  - :id: ExplanationOfBenefit.item.extension:previousAuthorizationNumber
201
172
  :path: item.extension
202
- :url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition-extension-authorizationNumber
173
+ :url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber
203
174
  - :id: ExplanationOfBenefit.item.extension:administrationReferenceNumber
204
175
  :path: item.extension
205
- :url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition-extension-administrationReferenceNumber
176
+ :url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber
206
177
  - :id: ExplanationOfBenefit.item.extension:authorizedItemDetail
207
178
  :path: item.extension
208
179
  :url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDetail
@@ -212,16 +183,12 @@
212
183
  - :id: ExplanationOfBenefit.item.adjudication.extension:reviewAction
213
184
  :path: item.adjudication.extension
214
185
  :url: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/extension-reviewAction
215
- # TODO item.detail.adjudication
216
- # TODO item.detail.subdetail.adjudication
217
- # TODO addItem
218
186
  - :id: ExplanationOfBenefit.adjudication.extension:reviewAction
219
187
  :path: adjudication.extension
220
188
  :url: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/extension-reviewAction
221
189
  - :id: ExplanationOfBenefit.total.extension:priorauth-utilization
222
190
  :path: total.extension
223
191
  :url: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/PriorAuthorizationUtilization
224
-
225
192
  :slices:
226
193
  - :slice_id: ExplanationOfBenefit.item.adjudication:adjudicationamounttype
227
194
  :slice_name: adjudicationamounttype
@@ -230,32 +197,34 @@
230
197
  :type: requiredBinding
231
198
  :path: category
232
199
  :values:
233
- - :system: http://terminology.hl7.org/5.0.0/CodeSystem-adjudication
200
+ - :system: http://terminology.hl7.org/CodeSystem/adjudication
234
201
  :code: submitted
235
- - :system: http://terminology.hl7.org/5.0.0/CodeSystem-adjudication
202
+ - :system: http://terminology.hl7.org/CodeSystem/adjudication
236
203
  :code: copay
237
- - :system: http://terminology.hl7.org/5.0.0/CodeSystem-adjudication
204
+ - :system: http://terminology.hl7.org/CodeSystem/adjudication
238
205
  :code: eligible
239
- - :system: http://terminology.hl7.org/5.0.0/CodeSystem-adjudication
206
+ - :system: http://terminology.hl7.org/CodeSystem/adjudication
240
207
  :code: deductible
241
- - :system: http://terminology.hl7.org/5.0.0/CodeSystem-adjudication
208
+ - :system: http://terminology.hl7.org/CodeSystem/adjudication
242
209
  :code: benefit
243
- - :system: https://hl7.org/fhir/us/davinci-pdex/STU2/CodeSystem-PDexAdjudicationCS
210
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
244
211
  :code: coinsurance
245
- - :system: https://hl7.org/fhir/us/davinci-pdex/STU2/CodeSystem-PDexAdjudicationCS
212
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
246
213
  :code: noncovered
247
- - :system: https://hl7.org/fhir/us/davinci-pdex/STU2/CodeSystem-PDexAdjudicationCS
214
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
248
215
  :code: priorpayerpaid
249
- - :sysstem: https://hl7.org/fhir/us/davinci-pdex/STU2/CodeSystem-PDexAdjudicationCS
216
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
250
217
  :code: paidbypatient
251
- - :system: https://hl7.org/fhir/us/davinci-pdex/STU2/CodeSystem-PDexAdjudicationCS
218
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
252
219
  :code: paidtopatient
253
- - :system: https://hl7.org/fhir/us/davinci-pdex/STU2/CodeSystem-PDexAdjudicationCS
220
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
254
221
  :code: paidtoprovider
255
- - :system: https://hl7.org/fhir/us/davinci-pdex/STU2/CodeSystem-PDexAdjudicationCS
222
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
256
223
  :code: memberliability
257
- - :system: https://hl7.org/fhir/us/davinci-pdex/STU2/CodeSystem-PDexAdjudicationCS
224
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
258
225
  :code: discount
226
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
227
+ :code: drugcost
259
228
  - :slice_id: ExplanationOfBenefit.item.adjudication:allowedunits
260
229
  :slice_name: allowedunits
261
230
  :path: item.adjudication
@@ -280,9 +249,6 @@
280
249
  :path: category
281
250
  :code: consumedunits
282
251
  :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationDiscriminator
283
- # TODO item.detail.adjudication
284
- # TODO item.detail.subdetail.adjudication
285
- # TODO addItem
286
252
  - :slice_id: ExplanationOfBenefit.adjudication:adjudicationamounttype
287
253
  :slice_name: adjudicationamounttype
288
254
  :path: adjudication
@@ -290,41 +256,75 @@
290
256
  :type: requiredBinding
291
257
  :path: category
292
258
  :values:
293
- - :system: http://terminology.hl7.org/5.0.0/CodeSystem-adjudication
259
+ - :system: http://terminology.hl7.org/CodeSystem/adjudication
294
260
  :code: submitted
295
- - :system: http://terminology.hl7.org/5.0.0/CodeSystem-adjudication
261
+ - :system: http://terminology.hl7.org/CodeSystem/adjudication
296
262
  :code: copay
297
- - :system: http://terminology.hl7.org/5.0.0/CodeSystem-adjudication
263
+ - :system: http://terminology.hl7.org/CodeSystem/adjudication
298
264
  :code: eligible
299
- - :system: http://terminology.hl7.org/5.0.0/CodeSystem-adjudication
265
+ - :system: http://terminology.hl7.org/CodeSystem/adjudication
300
266
  :code: deductible
301
- - :system: http://terminology.hl7.org/5.0.0/CodeSystem-adjudication
267
+ - :system: http://terminology.hl7.org/CodeSystem/adjudication
302
268
  :code: benefit
303
- - :system: https://hl7.org/fhir/us/davinci-pdex/STU2/CodeSystem-PDexAdjudicationCS
269
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
304
270
  :code: coinsurance
305
- - :system: https://hl7.org/fhir/us/davinci-pdex/STU2/CodeSystem-PDexAdjudicationCS
271
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
306
272
  :code: noncovered
307
- - :system: https://hl7.org/fhir/us/davinci-pdex/STU2/CodeSystem-PDexAdjudicationCS
273
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
308
274
  :code: priorpayerpaid
309
- - :sysstem: https://hl7.org/fhir/us/davinci-pdex/STU2/CodeSystem-PDexAdjudicationCS
275
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
310
276
  :code: paidbypatient
311
- - :system: https://hl7.org/fhir/us/davinci-pdex/STU2/CodeSystem-PDexAdjudicationCS
277
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
312
278
  :code: paidtopatient
313
- - :system: https://hl7.org/fhir/us/davinci-pdex/STU2/CodeSystem-PDexAdjudicationCS
279
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
314
280
  :code: paidtoprovider
315
- - :system: https://hl7.org/fhir/us/davinci-pdex/STU2/CodeSystem-PDexAdjudicationCS
281
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
316
282
  :code: memberliability
317
- - :system: https://hl7.org/fhir/us/davinci-pdex/STU2/CodeSystem-PDexAdjudicationCS
283
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
318
284
  :code: discount
285
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
286
+ :code: drugcost
319
287
  - :slice_id: ExplanationOfBenefit.adjudication:denialreason
320
288
  :slice_name: denialreason
321
289
  :path: adjudication
322
290
  :discriminator:
323
- :type: patternCodeableConcept
291
+ :type: requiredBinding
324
292
  :path: category
325
- :code: denialreason
326
- :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationDiscriminator
327
-
293
+ :values:
294
+ - :system: http://terminology.hl7.org/CodeSystem/adjudication
295
+ :code: submitted
296
+ - :system: http://terminology.hl7.org/CodeSystem/adjudication
297
+ :code: copay
298
+ - :system: http://terminology.hl7.org/CodeSystem/adjudication
299
+ :code: eligible
300
+ - :system: http://terminology.hl7.org/CodeSystem/adjudication
301
+ :code: deductible
302
+ - :system: http://terminology.hl7.org/CodeSystem/adjudication
303
+ :code: benefit
304
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
305
+ :code: coinsurance
306
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
307
+ :code: noncovered
308
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
309
+ :code: priorpayerpaid
310
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
311
+ :code: paidbypatient
312
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
313
+ :code: paidtopatient
314
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
315
+ :code: paidtoprovider
316
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
317
+ :code: memberliability
318
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
319
+ :code: discount
320
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS
321
+ :code: drugcost
322
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexPayerAdjudicationStatus
323
+ :code: innetwork
324
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexPayerAdjudicationStatus
325
+ :code: outofnetwork
326
+ - :system: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexPayerAdjudicationStatus
327
+ :code: other
328
328
  :elements:
329
329
  - :path: status
330
330
  - :path: type
@@ -333,53 +333,50 @@
333
333
  :types:
334
334
  - Reference
335
335
  :target_profiles:
336
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-patient
336
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient
337
337
  - :path: enterer
338
338
  :types:
339
339
  - Reference
340
340
  :target_profiles:
341
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-practitioner
342
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-practitionerrole
341
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner
342
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole
343
343
  - :path: insurer
344
344
  :types:
345
345
  - Reference
346
346
  :target_profiles:
347
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-organization
347
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization
348
348
  - :path: provider
349
349
  :types:
350
350
  - Reference
351
- :target_profiles:
352
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-practitioner
353
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-practitionerrole
354
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-organization
351
+ target_profiles:
352
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner
353
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole
354
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization
355
355
  - :path: facility
356
356
  :types:
357
357
  - Reference
358
358
  :target_profiles:
359
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-location
359
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-location
360
360
  - :path: preAuthRefPeriod
361
361
  - :path: careTeam.provider
362
362
  :types:
363
363
  - Reference
364
364
  :target_profiles:
365
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-practitioner
366
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-practitionerrole
367
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-organization
365
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner
366
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole
367
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization
368
368
  - :path: item.category
369
369
  - :path: item.adjudication:adjudicationamounttype.amount
370
370
  - :path: item.adjudication:allowedunits.value
371
371
  - :path: item.adjudication:denialreason.reason
372
372
  - :path: item.adjudication:consumedunits.value
373
- # TODO item.detail.adjudication
374
- # TODO item.detail.subdetail.adjudication
375
- # TODO addItem
373
+ - :path: adjudication
376
374
  - :path: adjudication.category
377
375
  # Header-level adjudication denialreason slice points to item-level adjudication for content reference,
378
376
  # however, header-level adjudication amounttype slice does not (and has no MS subelements).
379
377
  # Is this intentional by PDex authors?
380
378
  - :path: adjudication:denialreason.reason
381
379
  - :path: total.category
382
-
383
380
  :mandatory_elements:
384
381
  - ExplanationOfBenefit.meta.profile
385
382
  - ExplanationOfBenefit.status
@@ -404,189 +401,204 @@
404
401
  - ExplanationOfBenefit.item.sequence
405
402
  - ExplanationOfBenefit.item.productOrService
406
403
  - ExplanationOfBenefit.item.adjudication.category
407
- # Do slices count as mandatory elements?
408
- - ExplanationOfBenefit.item.adjudication:adjudicationamounttype.category
409
- - ExplanationOfBenefit.item.adjudication:adjudicationamounttype.amount
410
- - ExplanationOfBenefit.item.adjudication:adjudicationallowedunits.category
411
- - ExplanationOfBenefit.item.adjudication:adjudicationallowedunits.category.coding
412
- - ExplanationOfBenefit.item.adjudication:adjudicationallowedunits.category.coding.system
413
- - ExplanationOfBenefit.item.adjudication:adjudicationallowedunits.category.coding.code
414
- - ExplanationOfBenefit.item.adjudication:adjudicationallowedunits.value
415
- - ExplanationOfBenefit.item.adjudication:denialreason.category
416
- - ExplanationOfBenefit.item.adjudication:denialreason.category.coding
417
- - ExplanationOfBenefit.item.adjudication:denialreason.category.coding.system
418
- - ExplanationOfBenefit.item.adjudication:denialreason.category.coding.code
419
- - ExplanationOfBenefit.item.adjudication:denialreason.reason
420
- - ExplanationOfBenefit.item.adjudication:consumedunits.category
421
- - ExplanationOfBenefit.item.adjudication:consumedunits.category.coding
422
- - ExplanationOfBenefit.item.adjudication:consumedunits.category.coding.system
423
- - ExplanationOfBenefit.item.adjudication:consumedunits.category.coding.code
424
- - ExplanationOfBenefit.item.adjudication:consumedunits.value
425
- # TODO: ExplanationOfBenefit.item.detail.adjudication ... (== ExplanationOfBenefit.item.adjudication)
426
- # TODO: ExplanationOfBenefit.item.detail.subDetail
427
- # TODO: ExplanationOfBenefit.addItem
404
+ - ExplanationOfBenefit.item.adjudication.amount
405
+ - ExplanationOfBenefit.item.adjudication.value
406
+ - ExplanationOfBenefit.item.adjudication.reason
407
+ - ExplanationOfBenefit.item.detail.sequence
408
+ - ExplanationOfBenefit.item.detail.productOrService
409
+ - ExplanationOfBenefit.item.detail.subDetail.sequence
410
+ - ExplanationOfBenefit.item.detail.subDetail.productOrService
411
+ - ExplanationOfBenefit.addItem.productOrService
412
+ - ExplanationOfBenefit.addItem.detail.productOrService
413
+ - ExplanationOfBenefit.addItem.detail.subDetail.productOrService
428
414
  - ExplanationOfBenefit.adjudication.category
429
- - ExplanationOfBenefit.adjudication:adjudicationamounttype.category
430
- - ExplanationOfBenefit.adjudication:adjudicationamounttype.amount
431
- # TODO: ExplanationOfBenefit.adjudication:denialreason (== ExplanationOfBenefit.item.adjudication:denialreason)
415
+ - ExplanationOfBenefit.adjudication.amount
432
416
  - ExplanationOfBenefit.total.category
433
417
  - ExplanationOfBenefit.total.amount
434
-
418
+ - ExplanationOfBenefit.benefitBalance.category
419
+ - ExplanationOfBenefit.benefitBalance.financial.type
435
420
  :bindings:
436
- # Only differential bindings for PDex PriorAuthorization Profile are here
437
- # Example-strength bindings are excluded
438
- - :path: priority
439
- :type: CodeableConcept
421
+ - :type: code
422
+ :strength: required
423
+ :system: http://hl7.org/fhir/ValueSet/explanationofbenefit-status
424
+ :path: status
425
+ - :type: code
426
+ :strength: required
427
+ :system: http://hl7.org/fhir/ValueSet/claim-use
428
+ :path: use
429
+ - :type: CodeableConcept
440
430
  :strength: required
441
- :system: http://hl7.org/fhir/R4/valueset-process-priority
442
- - :path: item.category
443
- :type: CodeableConcept
431
+ :system: http://hl7.org/fhir/ValueSet/process-priority
432
+ :path: priority
433
+ - :type: code
444
434
  :strength: required
445
- :system: https://hl7.org/fhir/us/davinci-pdex/ValueSet-PriorAuthServiceTypeCodes
446
- - :path: item.productOrService
447
- :type: CodeableConcept
435
+ :system: http://hl7.org/fhir/ValueSet/remittance-outcome
436
+ :path: outcome
437
+ - :type: CodeableConcept
448
438
  :strength: required
449
- :system: https://hl7.org/fhir/us/davinci-pdex/ValueSet-PDexPAInstitutionalProcedureCodesVS
450
- - :path: item.adjudication.category
451
- :type: CodeableConcept
439
+ :system: http://hl7.org/fhir/us/davinci-pdex/ValueSet/PriorAuthServiceTypeCodes
440
+ :path: item.category
441
+ - :type: CodeableConcept
452
442
  :strength: required
453
- :system: https://hl7.org/fhir/us/davinci-pdex/ValueSet-PDexAdjudicationCategoryDiscriminator
454
- - :path: item.adjudication:adjudicationamounttype.category
455
- :type: CodeableConcept
443
+ :system: http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexPAInstitutionalProcedureCodesVS
444
+ :path: item.productOrService
445
+ - :type: CodeableConcept
456
446
  :strength: required
457
- :system: https://hl7.org/fhir/us/davinci-pdex/ValueSet-PDexAdjudication
458
- - :path: item.adjudication:denialreason.reason
459
- :type: CodeableConcept
447
+ :system: http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexAdjudicationCategoryDiscriminator
448
+ :path: item.adjudication.category
449
+ - :type: CodeableConcept
460
450
  :strength: required
461
- :system: https://hl7.org/fhir/us/davinci-pdex/ValueSet-X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes
462
- - :path: adjudication.category
463
- :type: CodeableConcept
451
+ :system: http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexAdjudication
452
+ :path: item.adjudication:adjudicationamounttype.category
453
+ - :type: CodeableConcept
464
454
  :strength: required
465
- :system: https://hl7.org/fhir/us/davinci-pdex/ValueSet-PDexAdjudicationCategoryDiscriminator
466
- - :path: adjudication:adjudicationamounttype.category
467
- :type: CodeableConcept
455
+ :system: http://hl7.org/fhir/us/davinci-pdex/ValueSet/X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes
456
+ :path: ExplanationOfBenefit.item.adjudication:denialreason.reason
457
+ - :type: CodeableConcept
468
458
  :strength: required
469
- :system: https://hl7.org/fhir/us/davinci-pdex/ValueSet-PDexAdjudication
470
- - :path: total.category
471
- :type: CodeableConcept
459
+ :system: http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexAdjudicationCategoryDiscriminator
460
+ :path: adjudication.category
461
+ - :type: CodeableConcept
462
+ :strength: required
463
+ :system: http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexAdjudication
464
+ :path: adjudication:adjudicationamounttype.category
465
+ - :type: CodeableConcept
472
466
  :strength: extensible
473
467
  :system: https://hl7.org/fhir/us/davinci-pdex/ValueSet-PriorAuthorizationAmounts
474
-
468
+ :path: total.category
469
+ - :type: code
470
+ :strength: required
471
+ :system: http://hl7.org/fhir/ValueSet/note-type
472
+ :path: processNote.type
473
+ - :type: CodeableConcept
474
+ :strength: required
475
+ :system: https://valueset.x12.org/x217/005010/request/2000E/UM/1/06/00/1338
476
+ :path: levelOfServiceType
477
+ :extensions:
478
+ - http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/extension-levelOfServiceCode
479
+ - :type: CodeableConcept
480
+ :strength: required
481
+ :system: http://hl7.org/fhir/us/davinci-pdex/ValueSet/X12278ReviewDecisionReasonCode
482
+ :path: value
483
+ :extensions:
484
+ - http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/extension-reviewAction
485
+ - reasonCode
486
+ - :type: CodeableConcept
487
+ :strength: required
488
+ :system: http://hl7.org/fhir/us/davinci-pdex/ValueSet/X12278ReviewDecisionReasonCode
489
+ :path: value
490
+ :extensions:
491
+ - http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/extension-reviewAction
492
+ - reasonCode
475
493
  :references:
476
494
  - :path: ExplanationOfBenefit.patient
477
495
  :profiles:
478
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-patient
496
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient
479
497
  - :path: ExplanationOfBenefit.enterer
480
498
  :profiles:
481
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-practitioner
482
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-practitionerrole
499
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner
500
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole
483
501
  - :path: ExplanationOfBenefit.insurer
484
502
  :profiles:
485
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-organization
503
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization
486
504
  - :path: ExplanationOfBenefit.provider
487
505
  :profiles:
488
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-practitioner
489
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-practitionerrole
490
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-organization
506
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner
507
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole
508
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization
491
509
  - :path: ExplanationOfBenefit.related.claim
492
510
  :profiles:
493
- - http://hl7.org/fhir/R4/claim
511
+ - http://hl7.org/fhir/StructureDefinition/Claim
494
512
  - :path: ExplanationOfBenefit.prescription
495
513
  :profiles:
496
- - http://hl7.org/fhir/R4/medicationrequest
497
- - http://hl7.org/fhir/R4/visionprescription
514
+ - http://hl7.org/fhir/StructureDefinition/MedicationRequest
515
+ - http://hl7.org/fhir/StructureDefinition/VisionPrescription
498
516
  - :path: ExplanationOfBenefit.originalPrescription
499
517
  :profiles:
500
- - http://hl7.org/fhir/R4/medicationrequest
518
+ - http://hl7.org/fhir/StructureDefinition/MedicationRequest
501
519
  - :path: ExplanationOfBenefit.payee.party
502
520
  :profiles:
503
- - http://hl7.org/fhir/R4/practitioner
504
- - http://hl7.org/fhir/R4/practitionerrole
505
- - http://hl7.org/fhir/R4/organization
506
- - http://hl7.org/fhir/R4/patient
507
- - http://hl7.org/fhir/R4/relatedperson
521
+ - http://hl7.org/fhir/StructureDefinition/Practitioner
522
+ - http://hl7.org/fhir/StructureDefinition/PractitionerRole
523
+ - http://hl7.org/fhir/StructureDefinition/Organization
524
+ - http://hl7.org/fhir/StructureDefinition/Patient
525
+ - http://hl7.org/fhir/StructureDefinition/RelatedPerson
508
526
  - :path: ExplanationOfBenefit.referral
509
527
  :profiles:
510
- - http://hl7.org/fhir/R4/servicerequest
528
+ - http://hl7.org/fhir/StructureDefinition/ServiceRequest
511
529
  - :path: ExplanationOfBenefit.facility
512
530
  :profiles:
513
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-location
531
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-location
514
532
  - :path: ExplanationOfBenefit.claim
515
533
  :profiles:
516
- - http://hl7.org/fhir/R4/claim
534
+ - http://hl7.org/fhir/StructureDefinition/Claim
517
535
  - :path: ExplanationOfBenefit.claimResponse
518
536
  :profiles:
519
- - http://hl7.org/fhir/R4/claimresponse
537
+ - http://hl7.org/fhir/StructureDefinition/ClaimResponse
520
538
  - :path: ExplanationOfBenefit.careTeam.provider
521
539
  :profiles:
522
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-practitioner
523
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-practitionerrole
524
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-organization
540
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner
541
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole
542
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization
525
543
  - :path: ExplanationOfBenefit.supportingInfo.valueReference
526
544
  :profiles:
527
545
  - http://hl7.org/fhir/R4/resource
528
546
  - :path: ExplanationOfBenefit.diagnosis.diagnosisReference
529
547
  :profiles:
530
- - http://hl7.org/fhir/R4/condition
548
+ - http://hl7.org/fhir/StructureDefinition/Condition
531
549
  - :path: ExplanationOfBenefit.procedure.procedureReference
532
550
  :profiles:
533
- - http://hl7.org/fhir/R4/procedure
534
- - :path: ExplanationOfBenefit.insurance.coverage
535
- :profiles:
536
- - http://hl7.org/fhir/us/davinci-hrex/STU1/StructureDefinition-hrex-coverage
537
- - :path: ExplanationOfBenefit.acident.locationReference
551
+ - http://hl7.org/fhir/StructureDefinition/Procedure
552
+ - :path: ExplanationOfBenefit.accident.locationReference
538
553
  :profiles:
539
- - http://hl7.org/fhir/R4/location
554
+ - http://hl7.org/fhir/StructureDefinition/Location
540
555
  - :path: ExplanationOfBenefit.item.locationReference
541
556
  :profiles:
542
- - http://hl7.org/fhir/R4/location
543
- - :path: ExplanationOfBenefit.item.udi # Unique Device Identifier
557
+ - http://hl7.org/fhir/StructureDefinition/Location
558
+ - :path: ExplanationOfBenefit.procedure.udi
544
559
  :profiles:
545
- - http://hl7.org/fhir/R4/device
560
+ - http://hl7.org/fhir/StructureDefinition/Device
561
+ - :path: ExplanationOfBenefit.insurance.coverage
562
+ :profiles:
563
+ - http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-coverage
564
+ - :path: ExplanationOfBenefit.item.udi
565
+ :profiles:
566
+ - http://hl7.org/fhir/StructureDefinition/Device
546
567
  - :path: ExplanationOfBenefit.item.encounter
547
568
  :profiles:
548
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-encounter
569
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter
549
570
  - :path: ExplanationOfBenefit.item.detail.udi
550
571
  :profiles:
551
- - http://hl7.org/fhir/R4/device
572
+ - http://hl7.org/fhir/StructureDefinition/Device
552
573
  - :path: ExplanationOfBenefit.item.detail.subDetail.udi
553
574
  :profiles:
554
- - http://hl7.org/fhir/R4/device
575
+ - http://hl7.org/fhir/StructureDefinition/Device
555
576
  - :path: ExplanationOfBenefit.addItem.provider
556
577
  :profiles:
557
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-practitioner
558
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-practitionerrole
559
- - http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-organization
560
- - :path: ExplanationOfBenefit.addItem.locationReference
561
- :profiles:
562
- - http://hl7.org/fhir/R4/location
563
-
578
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner
579
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole
580
+ - http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization
564
581
  :tests:
565
- - :id: pdex_eob_patient_use_search
566
- :file_name: explanation_of_benefit_patient_use_search_test.rb
582
+ - :id: pdex_eob_patient_search
583
+ :file_name: explanation_of_benefit_patient_search_test.rb
567
584
  - :id: pdex_eob_id_search
568
585
  :file_name: explanation_of_benefit_id_search_test.rb
569
586
  - :id: pdex_eob_patient_last_updated_search
570
587
  :file_name: explanation_of_benefit_patient_last_updated_search_test.rb
571
- - :id: pdex_eob_service_date
572
- :file_name: explanation_of_benefit_service_date_search_test.rb
573
588
  - :id: pdex_eob_patient_type_search
574
589
  :file_name: explanation_of_benefit_patient_type_search_test.rb
575
590
  - :id: pdex_eob_identifier_search
576
591
  :file_name: explanation_of_benefit_identifier_search_test.rb
592
+ - :id: pdex_eob_patient_service_date_search
593
+ :file_name: explanation_of_benefit_patient_service_date_search_test.rb
577
594
  - :id: pdex_eob_read
578
595
  :file_name: explanation_of_benefit_read_test.rb
579
- - :id: pdex_eob_provenance_revinclude_search
580
- :file_name: explanation_of_benefit_provenance_revinclude_search_test.rb
581
596
  - :id: pdex_eob_validation
582
597
  :file_name: explanation_of_benefit_validation_test.rb
583
598
  - :id: pdex_eob_must_support
584
599
  :file_name: explanation_of_benefit_must_support_test.rb
585
600
  - :id: pdex_eob_ref_resolution
586
601
  :file_name: explanation_of_benefit_reference_resolution_test.rb
587
-
588
602
  :id: pdex_eob
589
603
  :file_name: explanation_of_benefit_group.rb
590
-
591
- # NOTE: delayed_references is set as false above
592
604
  :delayed_references: []