特定健診
0.8.0 - CI Build

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## Resource Profile: 保険・被保険者情報

Defining URL: | https://igs.healthdataworks.net/jp-rezept-medication/StructureDefinition-JP-REZEPT-Coverage.html
Version: | 0.8.0
Name: | Coverage
Title: | 保険・被保険者情報
Status: | Draft as of 2021-09-14T21:55:06+00:00
Definition: | 保険情報、公費情報です。 医療サービスや調剤等の請求額と自己負担金の両方が含まれます。
Publisher: | HealthDataWorks
Source Resource: | XML / JSON / Turtle

このプロファイルの公式URL:

    https://igs.healthdataworks.net/jp-rezept-medication/StructureDefinition-JP-REZEPT-Coverage.html

### プロファイルの内容の正式なビュー

プロファイル、差分、スナップショット、およびその他の表示内容について説明します。

- 概要
- 差分
- スナップショット
- スナップショット(Must Support)
- All

この構造は Coverage から派生しています

Summary

Must-Support: 40 elements
Fixed Value: 3 elements

Extensions

This structure refers to these extensions:

- https://igs.healthdataworks.net/jp-rezept-medication/StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonSymbol.html
- https://igs.healthdataworks.net/jp-rezept-medication/StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonNo.html

この構造は Coverage から派生しています

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Coverage |  | 0..* | Coverage | 保険情報、公費情報
id | S | 0..1 | string | このリソースのID
text | S | 0..1 | Narrative | このリソースの概要
status | S | 1..1 | code | generated | extensions | additional | empty Fixed Value: generated
div | S | 1..1 | xhtml | このリソースの概要
Slices for extension | S | 0..* | Extension | Extension Slice: Unordered, Open by value:url
StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonSymbol.html | S | 0..* | string | 被保険者証記号を表す拡張 URL: https://igs.healthdataworks.net/jp-rezept-medication/StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonSymbol.html
StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonNo.html | S | 0..* | string | 被保険者証番号を表す拡張 URL: https://igs.healthdataworks.net/jp-rezept-medication/StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonNo.html
status | S | 1..1 | code | 保険情報、公費情報の状態
type | S | 0..1 | CodeableConcept | 保険種別
coding | S | 0..* | Coding | 保険種別
system | S | 0..1 | uri | 保険種別のOID
code | S | 0..1 | code | 保険種別コード
display | S | 0..1 | string | 保険種別の名称
subscriber | S | 0..1 | Reference(Patient | RelatedPerson) | 被保険者(患者)情報の参照
reference | S | 0..1 | string | 被保険者(患者)情報の参照
subscriberId | S | 0..1 | string | 受診券整理番号
beneficiary | S | 1..1 | Reference(Patient) | 患者の参照
reference | S | 0..1 | string | この保険で給付される患者の参照
dependent | S | 0..1 | string | 被保険者の枝番号
relationship | S | 0..1 | CodeableConcept | 患者との関係区分
coding | S | 0..* | Coding | 患者との関係区分
system | S | 0..1 | uri | 患者との関係区分のOID Fixed Value: urn:oid:1.2.392.100495.20.2.62
code | S | 0..1 | code | 患者との関係区分コード
display | S | 0..1 | string | 患者との関係区分コードの名称
period | S | 0..1 | Period | 保険証の有効期間
start | S | 0..1 | dateTime | 保険証の有効開始日
end | S | 0..1 | dateTime | 保険証の有効期限日
payor | S | 1..* | Reference(Organization | Patient | RelatedPerson) | 保険者の参照
reference | S | 0..1 | string | 保険者の参照
class | S | 0..* | BackboneElement | 保険(公費)区分
type | S | 1..1 | CodeableConcept | 保険(公費)区分
coding | S | 0..* | Coding | 保険(公費)区分
system | S | 0..1 | uri | 保険(公費)区分のOID
code | S | 0..1 | code | 保険(公費)区分コード Binding: 負担者種別コード (required)
display | S | 0..1 | string | 保険(公費)区分コードの名称
value | S | 1..1 | string | 保険(公費)番号
name | S | 0..1 | string | 保険(公費)名称 Fixed Value: 公費負担者番号
order | S | 0..1 | positiveInt | 保険適用順序
costToBeneficiary | S | 0..* | BackboneElement | Patient payments for services/products
value[x] | S | 1..1 | SimpleQuantity, Money | The amount or percentage due from the beneficiary Example Example for Quantity: {"unit":"%"}
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Coverage |  | 0..* | Coverage | 保険情報、公費情報
id | S Σ | 0..1 | string | このリソースのID
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language.
text | S | 0..1 | Narrative | このリソースの概要
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
status | S | 1..1 | code | generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative. Fixed Value: generated
div | S I | 1..1 | xhtml | このリソースの概要
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension | S | 0..* | Extension | Extension Slice: Unordered, Open by value:url
StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonSymbol.html | S | 0..* | string | 被保険者証記号を表す拡張 URL: https://igs.healthdataworks.net/jp-rezept-medication/StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonSymbol.html
StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonNo.html | S | 0..* | string | 被保険者証番号を表す拡張 URL: https://igs.healthdataworks.net/jp-rezept-medication/StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonNo.html
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Business Identifier for the coverage
status | ?!S Σ | 1..1 | code | 保険情報、公費情報の状態 Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type | S Σ | 0..1 | CodeableConcept | 保険種別 Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | S Σ | 0..* | Coding | 保険種別
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 0..1 | uri | 保険種別のOID
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 0..1 | code | 保険種別コード
display | S Σ | 0..1 | string | 保険種別の名称
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
policyHolder | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy
subscriber | S Σ | 0..1 | Reference(Patient | RelatedPerson) | 被保険者(患者)情報の参照
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | S Σ I | 0..1 | string | 被保険者(患者)情報の参照
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
subscriberId | S Σ | 0..1 | string | 受診券整理番号
beneficiary | S Σ | 1..1 | Reference(Patient) | 患者の参照
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | S Σ I | 0..1 | string | この保険で給付される患者の参照
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
dependent | S Σ | 0..1 | string | 被保険者の枝番号
relationship | S | 0..1 | CodeableConcept | 患者との関係区分 Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | S Σ | 0..* | Coding | 患者との関係区分
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 0..1 | uri | 患者との関係区分のOID Fixed Value: urn:oid:1.2.392.100495.20.2.62
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 0..1 | code | 患者との関係区分コード
display | S Σ | 0..1 | string | 患者との関係区分コードの名称
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
period | S Σ | 0..1 | Period | 保険証の有効期間
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
start | S Σ I | 0..1 | dateTime | 保険証の有効開始日
end | S Σ I | 0..1 | dateTime | 保険証の有効期限日
payor | S Σ | 1..* | Reference(Organization | Patient | RelatedPerson) | 保険者の参照
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | S Σ I | 0..1 | string | 保険者の参照
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
class | S | 0..* | BackboneElement | 保険(公費)区分
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 1..1 | CodeableConcept | 保険(公費)区分 Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | S Σ | 0..* | Coding | 保険(公費)区分
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 0..1 | uri | 保険(公費)区分のOID
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 0..1 | code | 保険(公費)区分コード Binding: 負担者種別コード (required)
display | S Σ | 0..1 | string | 保険(公費)区分コードの名称
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
value | S Σ | 1..1 | string | 保険(公費)番号
name | S Σ | 0..1 | string | 保険(公費)名称 Fixed Value: 公費負担者番号
order | S Σ | 0..1 | positiveInt | 保険適用順序
network | Σ | 0..1 | string | Insurer network
costToBeneficiary | S | 0..* | BackboneElement | Patient payments for services/products
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | Σ | 0..1 | CodeableConcept | Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified.
value[x] | S Σ | 1..1 |  | The amount or percentage due from the beneficiary Example Example for Quantity: {"unit":"%"}
valueQuantity |  |  | Quantity(SimpleQuantity) |
valueMoney |  |  | Money |
exception |  | 0..* | BackboneElement | Exceptions for patient payments
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | Σ | 1..1 | CodeableConcept | Exception category Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays.
period | Σ | 0..1 | Period | The effective period of the exception
subrogation |  | 0..1 | boolean | Reimbursement to insurer
contract |  | 0..* | Reference(Contract) | Contract details
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Coverage |  | 0..* | Coverage | 保険情報、公費情報
id | Σ | 0..1 | string | このリソースのID
text |  | 0..1 | Narrative | このリソースの概要
status |  | 1..1 | code | generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative. Fixed Value: generated
div | I | 1..1 | xhtml | このリソースの概要
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonSymbol.html |  | 0..* | string | 被保険者証記号を表す拡張 URL: https://igs.healthdataworks.net/jp-rezept-medication/StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonSymbol.html
StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonNo.html |  | 0..* | string | 被保険者証番号を表す拡張 URL: https://igs.healthdataworks.net/jp-rezept-medication/StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonNo.html
status | ?!Σ | 1..1 | code | 保険情報、公費情報の状態 Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type | Σ | 0..1 | CodeableConcept | 保険種別 Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.
coding | Σ | 0..* | Coding | 保険種別
system | Σ | 0..1 | uri | 保険種別のOID
code | Σ | 0..1 | code | 保険種別コード
display | Σ | 0..1 | string | 保険種別の名称
subscriber | Σ | 0..1 | Reference(Patient | RelatedPerson) | 被保険者(患者)情報の参照
reference | Σ I | 0..1 | string | 被保険者(患者)情報の参照
subscriberId | Σ | 0..1 | string | 受診券整理番号
beneficiary | Σ | 1..1 | Reference(Patient) | 患者の参照
reference | Σ I | 0..1 | string | この保険で給付される患者の参照
dependent | Σ | 0..1 | string | 被保険者の枝番号
relationship |  | 0..1 | CodeableConcept | 患者との関係区分 Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
coding | Σ | 0..* | Coding | 患者との関係区分
system | Σ | 0..1 | uri | 患者との関係区分のOID Fixed Value: urn:oid:1.2.392.100495.20.2.62
code | Σ | 0..1 | code | 患者との関係区分コード
display | Σ | 0..1 | string | 患者との関係区分コードの名称
period | Σ | 0..1 | Period | 保険証の有効期間
start | Σ I | 0..1 | dateTime | 保険証の有効開始日
end | Σ I | 0..1 | dateTime | 保険証の有効期限日
payor | Σ | 1..* | Reference(Organization | Patient | RelatedPerson) | 保険者の参照
reference | Σ I | 0..1 | string | 保険者の参照
class |  | 0..* | BackboneElement | 保険(公費)区分
type | Σ | 1..1 | CodeableConcept | 保険(公費)区分 Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
coding | Σ | 0..* | Coding | 保険(公費)区分
system | Σ | 0..1 | uri | 保険(公費)区分のOID
code | Σ | 0..1 | code | 保険(公費)区分コード Binding: 負担者種別コード (required)
display | Σ | 0..1 | string | 保険(公費)区分コードの名称
value | Σ | 1..1 | string | 保険(公費)番号
name | Σ | 0..1 | string | 保険(公費)名称 Fixed Value: 公費負担者番号
order | Σ | 0..1 | positiveInt | 保険適用順序
costToBeneficiary |  | 0..* | BackboneElement | Patient payments for services/products
value[x] | Σ | 1..1 |  | The amount or percentage due from the beneficiary
valueQuantity |  |  | Quantity(SimpleQuantity) |
valueMoney |  |  | Money |
Documentation for this format

この構造は Coverage から派生しています

Summary

Must-Support: 40 elements
Fixed Value: 3 elements

Extensions

This structure refers to these extensions:

- https://igs.healthdataworks.net/jp-rezept-medication/StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonSymbol.html
- https://igs.healthdataworks.net/jp-rezept-medication/StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonNo.html

差分

この構造は Coverage から派生しています

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Coverage |  | 0..* | Coverage | 保険情報、公費情報
id | S | 0..1 | string | このリソースのID
text | S | 0..1 | Narrative | このリソースの概要
status | S | 1..1 | code | generated | extensions | additional | empty Fixed Value: generated
div | S | 1..1 | xhtml | このリソースの概要
Slices for extension | S | 0..* | Extension | Extension Slice: Unordered, Open by value:url
StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonSymbol.html | S | 0..* | string | 被保険者証記号を表す拡張 URL: https://igs.healthdataworks.net/jp-rezept-medication/StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonSymbol.html
StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonNo.html | S | 0..* | string | 被保険者証番号を表す拡張 URL: https://igs.healthdataworks.net/jp-rezept-medication/StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonNo.html
status | S | 1..1 | code | 保険情報、公費情報の状態
type | S | 0..1 | CodeableConcept | 保険種別
coding | S | 0..* | Coding | 保険種別
system | S | 0..1 | uri | 保険種別のOID
code | S | 0..1 | code | 保険種別コード
display | S | 0..1 | string | 保険種別の名称
subscriber | S | 0..1 | Reference(Patient | RelatedPerson) | 被保険者(患者)情報の参照
reference | S | 0..1 | string | 被保険者(患者)情報の参照
subscriberId | S | 0..1 | string | 受診券整理番号
beneficiary | S | 1..1 | Reference(Patient) | 患者の参照
reference | S | 0..1 | string | この保険で給付される患者の参照
dependent | S | 0..1 | string | 被保険者の枝番号
relationship | S | 0..1 | CodeableConcept | 患者との関係区分
coding | S | 0..* | Coding | 患者との関係区分
system | S | 0..1 | uri | 患者との関係区分のOID Fixed Value: urn:oid:1.2.392.100495.20.2.62
code | S | 0..1 | code | 患者との関係区分コード
display | S | 0..1 | string | 患者との関係区分コードの名称
period | S | 0..1 | Period | 保険証の有効期間
start | S | 0..1 | dateTime | 保険証の有効開始日
end | S | 0..1 | dateTime | 保険証の有効期限日
payor | S | 1..* | Reference(Organization | Patient | RelatedPerson) | 保険者の参照
reference | S | 0..1 | string | 保険者の参照
class | S | 0..* | BackboneElement | 保険(公費)区分
type | S | 1..1 | CodeableConcept | 保険(公費)区分
coding | S | 0..* | Coding | 保険(公費)区分
system | S | 0..1 | uri | 保険(公費)区分のOID
code | S | 0..1 | code | 保険(公費)区分コード Binding: 負担者種別コード (required)
display | S | 0..1 | string | 保険(公費)区分コードの名称
value | S | 1..1 | string | 保険(公費)番号
name | S | 0..1 | string | 保険(公費)名称 Fixed Value: 公費負担者番号
order | S | 0..1 | positiveInt | 保険適用順序
costToBeneficiary | S | 0..* | BackboneElement | Patient payments for services/products
value[x] | S | 1..1 | SimpleQuantity, Money | The amount or percentage due from the beneficiary Example Example for Quantity: {"unit":"%"}
Documentation for this format

スナップショット

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Coverage |  | 0..* | Coverage | 保険情報、公費情報
id | S Σ | 0..1 | string | このリソースのID
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language.
text | S | 0..1 | Narrative | このリソースの概要
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
status | S | 1..1 | code | generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative. Fixed Value: generated
div | S I | 1..1 | xhtml | このリソースの概要
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension | S | 0..* | Extension | Extension Slice: Unordered, Open by value:url
StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonSymbol.html | S | 0..* | string | 被保険者証記号を表す拡張 URL: https://igs.healthdataworks.net/jp-rezept-medication/StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonSymbol.html
StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonNo.html | S | 0..* | string | 被保険者証番号を表す拡張 URL: https://igs.healthdataworks.net/jp-rezept-medication/StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonNo.html
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Business Identifier for the coverage
status | ?!S Σ | 1..1 | code | 保険情報、公費情報の状態 Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type | S Σ | 0..1 | CodeableConcept | 保険種別 Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | S Σ | 0..* | Coding | 保険種別
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 0..1 | uri | 保険種別のOID
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 0..1 | code | 保険種別コード
display | S Σ | 0..1 | string | 保険種別の名称
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
policyHolder | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy
subscriber | S Σ | 0..1 | Reference(Patient | RelatedPerson) | 被保険者(患者)情報の参照
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | S Σ I | 0..1 | string | 被保険者(患者)情報の参照
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
subscriberId | S Σ | 0..1 | string | 受診券整理番号
beneficiary | S Σ | 1..1 | Reference(Patient) | 患者の参照
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | S Σ I | 0..1 | string | この保険で給付される患者の参照
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
dependent | S Σ | 0..1 | string | 被保険者の枝番号
relationship | S | 0..1 | CodeableConcept | 患者との関係区分 Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | S Σ | 0..* | Coding | 患者との関係区分
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 0..1 | uri | 患者との関係区分のOID Fixed Value: urn:oid:1.2.392.100495.20.2.62
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 0..1 | code | 患者との関係区分コード
display | S Σ | 0..1 | string | 患者との関係区分コードの名称
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
period | S Σ | 0..1 | Period | 保険証の有効期間
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
start | S Σ I | 0..1 | dateTime | 保険証の有効開始日
end | S Σ I | 0..1 | dateTime | 保険証の有効期限日
payor | S Σ | 1..* | Reference(Organization | Patient | RelatedPerson) | 保険者の参照
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | S Σ I | 0..1 | string | 保険者の参照
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
class | S | 0..* | BackboneElement | 保険(公費)区分
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 1..1 | CodeableConcept | 保険(公費)区分 Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | S Σ | 0..* | Coding | 保険(公費)区分
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 0..1 | uri | 保険(公費)区分のOID
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 0..1 | code | 保険(公費)区分コード Binding: 負担者種別コード (required)
display | S Σ | 0..1 | string | 保険(公費)区分コードの名称
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
value | S Σ | 1..1 | string | 保険(公費)番号
name | S Σ | 0..1 | string | 保険(公費)名称 Fixed Value: 公費負担者番号
order | S Σ | 0..1 | positiveInt | 保険適用順序
network | Σ | 0..1 | string | Insurer network
costToBeneficiary | S | 0..* | BackboneElement | Patient payments for services/products
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | Σ | 0..1 | CodeableConcept | Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified.
value[x] | S Σ | 1..1 |  | The amount or percentage due from the beneficiary Example Example for Quantity: {"unit":"%"}
valueQuantity |  |  | Quantity(SimpleQuantity) |
valueMoney |  |  | Money |
exception |  | 0..* | BackboneElement | Exceptions for patient payments
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | Σ | 1..1 | CodeableConcept | Exception category Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays.
period | Σ | 0..1 | Period | The effective period of the exception
subrogation |  | 0..1 | boolean | Reimbursement to insurer
contract |  | 0..* | Reference(Contract) | Contract details
Documentation for this format

他のプロファイルの表現: Schematron

#### Terminology Bindings

Path | Conformance | ValueSet / Code
Coverage.language | preferred | CommonLanguages Max Binding: AllLanguages
Coverage.text.status | required | Fixed Value: generated
Coverage.status | required | FinancialResourceStatusCodes
Coverage.type | preferred | CoverageTypeAndSelf-PayCodes
Coverage.subscriber.type | extensible | ResourceType
Coverage.beneficiary.type | extensible | ResourceType
Coverage.relationship | extensible | SubscriberRelationshipCodes
Coverage.payor.type | extensible | ResourceType
Coverage.class.type | extensible | CoverageClassCodes
Coverage.class.type.coding.code | required | BearerType
Coverage.costToBeneficiary.type | extensible | CoverageCopayTypeCodes
Coverage.costToBeneficiary.exception.type | example | ExampleCoverageFinancialExceptionCodes

#### Constraints

Id | Path | Details | Requirements
dom-2 | Coverage | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | Coverage | 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 : 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() |
dom-4 | Coverage | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | Coverage | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | Coverage | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | Coverage.meta | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.implicitRules | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.language | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.text.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.text.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.text.status | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.text.div | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
txt-1 | Coverage.text.div | The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes : htmlChecks() |
txt-2 | Coverage.text.div | The narrative SHALL have some non-whitespace content : htmlChecks() |
ele-1 | Coverage.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.extension:InsuredPersonSymbol | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.extension:InsuredPersonSymbol | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.extension:InsuredPersonNumber | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.extension:InsuredPersonNumber | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.identifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.status | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.type.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.type.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.type.coding | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.type.coding.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.type.coding.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.type.coding.system | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.type.coding.version | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.type.coding.code | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.type.coding.display | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.type.coding.userSelected | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.type.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.policyHolder | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.subscriber | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.subscriber.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.subscriber.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.subscriber.reference | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.subscriber.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.subscriber.identifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.subscriber.display | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.subscriberId | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.beneficiary | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.beneficiary.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.beneficiary.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.beneficiary.reference | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.beneficiary.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.beneficiary.identifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.beneficiary.display | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.dependent | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.relationship | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.relationship.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.relationship.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.relationship.coding | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.relationship.coding.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.relationship.coding.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.relationship.coding.system | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.relationship.coding.version | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.relationship.coding.code | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.relationship.coding.display | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.relationship.coding.userSelected | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.relationship.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.period | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.period.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.period.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.period.start | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.period.end | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.payor | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.payor.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.payor.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.payor.reference | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.payor.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.payor.identifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.payor.display | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.class | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.class.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.class.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.class.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.class.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.class.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.class.type.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.class.type.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.class.type.coding | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.class.type.coding.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.class.type.coding.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.class.type.coding.system | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.class.type.coding.version | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.class.type.coding.code | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.class.type.coding.display | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.class.type.coding.userSelected | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.class.type.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.class.value | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.class.name | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.order | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.network | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.costToBeneficiary | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.costToBeneficiary.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.costToBeneficiary.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.costToBeneficiary.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.costToBeneficiary.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.costToBeneficiary.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.costToBeneficiary.value[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.costToBeneficiary.exception | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.costToBeneficiary.exception.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.costToBeneficiary.exception.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.costToBeneficiary.exception.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Coverage.costToBeneficiary.exception.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Coverage.costToBeneficiary.exception.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.costToBeneficiary.exception.period | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.subrogation | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.contract | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |