logical-coverage
type: StructureDefinition
node role: treeRoot
id:
  v: logical-coverage
text:
  status:
    v: extensions
  div:
    v: Gegenereerde narrative: StructureDefinition logical-coverage Naam Markeringen Kard. Type Omschrijving & constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> logical-coverage 0..* Element Logical Model: Coverage Elementen gedefinieerd in ancestors:@id, <a href="http://hl7.org/fhir/R4/datatypes.html#Element" title="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.">extension #xD; sourceProfile 0..1 uri source Profile #xD; targetProfile 0..1 uri target Profile #xD; sourceResourceType 0..1 code FHIR source resource type accepted on the source side. #xD; targetResourceType 0..1 code FHIR target resource type produced on the target side. #xD; identifier 0..* Identifier Coverage identifiers. #xD; status 0..1 code Coverage status. #xD; type 0..1 CodeableConcept Coverage type. #xD; policyHolder 0..1 Reference() Policy holder. #xD; subscriber 0..1 Reference() Subscriber. #xD; subscriberId 0..1 string Subscriber id. #xD; beneficiary 0..1 Reference() Beneficiary. #xD; dependent 0..1 string Dependent id. #xD; relationship 0..1 CodeableConcept Relationship. #xD; period 0..1 Period Coverage period. #xD; payor 0..* Reference() Payors. #xD; order 0..1 positiveInt Order. #xD; network 0..1 string Network. #xD; class 0..* logical-coverage-class Coverage class and plan identifiers. #xD; costToBeneficiary 0..* logical-coverage-cost-to-beneficiary Patient cost-sharing rules. #xD; subrogation 0..1 boolean Whether insurer recovery rights apply. #xD; contract 0..* Reference(Contract) Contracts governing the coverage. #xD; <img src="[binary]" alt="doco" style="background-color: inherit"/> Documentatie voor dit formaat
url:
  v: https://translate-ig.cumuluz.dev/ig/StructureDefinition/logical-coverage
  l: logical-coverage
version:
  v: 0.1.0
name:
  v: LogicalCoverage
title:
  v: Logical Model: Coverage
status:
  v: draft
date:
  v: 2026-07-11T10:05:40+02:00
publisher:
  v: Cumuluz
description:
  v: Canonical intermediate logical model for Coverage-shaped nl-core routes.
fhir version:
  v: 4.0.1
mapping:
  identity:
    v: rim
  uri:
    v: http://hl7.org/v3
    l: v3
  name:
    v: RIM Mapping
kind:
  v: logical
abstract:
  v: false
type:
  v: https://translate-ig.cumuluz.dev/ig/StructureDefinition/logical-coverage
  l: logical-coverage
base definition:
  v: http://hl7.org/fhir/StructureDefinition/Element
  l: Element
derivation:
  v: specialization
snapshot:
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version
      l: snapshot-base-version
    value: String
      v: 4.0.1
  element:
    id:
      v: logical-coverage
    path:
      v: logical-coverage
    short:
      v: Logical Model: Coverage
    definition:
      v: Canonical intermediate logical model for Coverage-shaped nl-core routes.
    min:
      v: 0
    max:
      v: *
    base:
      path:
        v: Element
      min:
        v: 0
      max:
        v: *
    condition:
      v: ele-1
    constraint:
      key:
        v: ele-1
      severity:
        v: error
      human:
        v: All FHIR elements must have a @value or children
      expression:
        v: hasValue() or (children().count() > id.count())
      xpath:
        v: @value|f:*|h:div
      source:
        v: http://hl7.org/fhir/StructureDefinition/Element
        l: Element
    is modifier:
      v: false
    mapping:
      identity:
        v: rim
      map:
        v: n/a
  element:
    id:
      v: logical-coverage.id
    path:
      v: logical-coverage.id
    representation:
      v: xmlAttr
    short:
      v: Unique id for inter-element referencing
    definition:
      v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
    min:
      v: 0
    max:
      v: 1
    base:
      path:
        v: Element.id
      min:
        v: 0
      max:
        v: 1
    type:
      extension:
        value: Url
      code:
        v: http://hl7.org/fhirpath/System.String
        l: System.String
    is modifier:
      v: false
    is summary:
      v: false
    mapping:
      identity:
        v: rim
      map:
        v: n/a
  element:
    id:
      v: logical-coverage.extension
    path:
      v: logical-coverage.extension
    slicing:
      description:
        v: Extensions are always sliced by (at least) url
      rules:
        v: open
    short:
      v: Additional content defined by implementations
    definition:
      v: 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:
      v: 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:
      v: extensions
    alias:
      v: user content
    min:
      v: 0
    max:
      v: *
    base:
      path:
        v: Element.extension
      min:
        v: 0
      max:
        v: *
    type:
      code:
        v: Extension
        l: Extension
    constraint:
      key:
        v: ele-1
      severity:
        v: error
      human:
        v: All FHIR elements must have a @value or children
      expression:
        v: hasValue() or (children().count() > id.count())
      xpath:
        v: @value|f:*|h:div
      source:
        v: http://hl7.org/fhir/StructureDefinition/Element
        l: Element
    constraint:
      key:
        v: ext-1
      severity:
        v: error
      human:
        v: Must have either extensions or value[x], not both
      expression:
        v: extension.exists() != value.exists()
      xpath:
        v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
      source:
        v: http://hl7.org/fhir/StructureDefinition/Extension
        l: Extension
    is modifier:
      v: false
    is summary:
      v: false

Url
v: string
l: string

v: value

v: url

identity:
  v: rim
map:
  v: n/a

id:
  v: logical-coverage.sourceProfile
path:
  v: logical-coverage.sourceProfile
short:
  v: source Profile
definition:
  v: Source profile used to populate this logical model.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: logical-coverage.sourceProfile
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
    l: uri

id:
  v: logical-coverage.targetProfile
path:
  v: logical-coverage.targetProfile
short:
  v: target Profile
definition:
  v: Target profile intended for this logical model instance.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: logical-coverage.targetProfile
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
    l: uri

id:
  v: logical-coverage.sourceResourceType
path:
  v: logical-coverage.sourceResourceType
short:
  v: FHIR source resource type accepted on the source side.
definition:
  v: FHIR source resource type accepted on the source side.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: logical-coverage.sourceResourceType
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code

id:
  v: logical-coverage.targetResourceType
path:
  v: logical-coverage.targetResourceType
short:
  v: FHIR target resource type produced on the target side.
definition:
  v: FHIR target resource type produced on the target side.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: logical-coverage.targetResourceType
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code

id:
  v: logical-coverage.identifier
path:
  v: logical-coverage.identifier
short:
  v: Coverage identifiers.
definition:
  v: Coverage identifiers.
min:
  v: 0
max:
  v: *
base:
  path:
    v: logical-coverage.identifier
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Identifier
    l: Identifier

id:
  v: logical-coverage.status
path:
  v: logical-coverage.status
short:
  v: Coverage status.
definition:
  v: Coverage status.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: logical-coverage.status
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code

id:
  v: logical-coverage.type
path:
  v: logical-coverage.type
short:
  v: Coverage type.
definition:
  v: Coverage type.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: logical-coverage.type
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: logical-coverage.policyHolder
path:
  v: logical-coverage.policyHolder
short:
  v: Policy holder.
definition:
  v: Policy holder.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: logical-coverage.policyHolder
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference

id:
  v: logical-coverage.subscriber
path:
  v: logical-coverage.subscriber
short:
  v: Subscriber.
definition:
  v: Subscriber.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: logical-coverage.subscriber
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference

id:
  v: logical-coverage.subscriberId
path:
  v: logical-coverage.subscriberId
short:
  v: Subscriber id.
definition:
  v: Subscriber id.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: logical-coverage.subscriberId
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string

id:
  v: logical-coverage.beneficiary
path:
  v: logical-coverage.beneficiary
short:
  v: Beneficiary.
definition:
  v: Beneficiary.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: logical-coverage.beneficiary
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference

id:
  v: logical-coverage.dependent
path:
  v: logical-coverage.dependent
short:
  v: Dependent id.
definition:
  v: Dependent id.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: logical-coverage.dependent
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string

id:
  v: logical-coverage.relationship
path:
  v: logical-coverage.relationship
short:
  v: Relationship.
definition:
  v: Relationship.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: logical-coverage.relationship
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: logical-coverage.period
path:
  v: logical-coverage.period
short:
  v: Coverage period.
definition:
  v: Coverage period.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: logical-coverage.period
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Period
    l: Period

id:
  v: logical-coverage.payor
path:
  v: logical-coverage.payor
short:
  v: Payors.
definition:
  v: Payors.
min:
  v: 0
max:
  v: *
base:
  path:
    v: logical-coverage.payor
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Reference
    l: Reference

id:
  v: logical-coverage.order
path:
  v: logical-coverage.order
short:
  v: Order.
definition:
  v: Order.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: logical-coverage.order
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: positiveInt
    l: positiveInt

id:
  v: logical-coverage.network
path:
  v: logical-coverage.network
short:
  v: Network.
definition:
  v: Network.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: logical-coverage.network
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string

id:
  v: logical-coverage.class
path:
  v: logical-coverage.class
short:
  v: Coverage class and plan identifiers.
definition:
  v: Coverage class and plan identifiers.
min:
  v: 0
max:
  v: *
base:
  path:
    v: logical-coverage.class
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: https://translate-ig.cumuluz.dev/ig/StructureDefinition/logical-coverage-class
    l: logical-coverage-class

id:
  v: logical-coverage.costToBeneficiary
path:
  v: logical-coverage.costToBeneficiary
short:
  v: Patient cost-sharing rules.
definition:
  v: Patient cost-sharing rules.
min:
  v: 0
max:
  v: *
base:
  path:
    v: logical-coverage.costToBeneficiary
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: https://translate-ig.cumuluz.dev/ig/StructureDefinition/logical-coverage-cost-to-beneficiary
    l: logical-coverage-cost-to-beneficiary

id:
  v: logical-coverage.subrogation
path:
  v: logical-coverage.subrogation
short:
  v: Whether insurer recovery rights apply.
definition:
  v: Whether insurer recovery rights apply.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: logical-coverage.subrogation
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
    l: boolean

id:
  v: logical-coverage.contract
path:
  v: logical-coverage.contract
short:
  v: Contracts governing the coverage.
definition:
  v: Contracts governing the coverage.
min:
  v: 0
max:
  v: *
base:
  path:
    v: logical-coverage.contract
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Contract
    l: Contract

element:
  id:
    v: logical-coverage
  path:
    v: logical-coverage
  short:
    v: Logical Model: Coverage
  definition:
    v: Canonical intermediate logical model for Coverage-shaped nl-core routes.
element:
  id:
    v: logical-coverage.sourceProfile
  path:
    v: logical-coverage.sourceProfile
  short:
    v: source Profile
  definition:
    v: Source profile used to populate this logical model.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: uri
      l: uri
element:
  id:
    v: logical-coverage.targetProfile
  path:
    v: logical-coverage.targetProfile
  short:
    v: target Profile
  definition:
    v: Target profile intended for this logical model instance.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: uri
      l: uri
element:
  id:
    v: logical-coverage.sourceResourceType
  path:
    v: logical-coverage.sourceResourceType
  short:
    v: FHIR source resource type accepted on the source side.
  definition:
    v: FHIR source resource type accepted on the source side.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: code
      l: code
element:
  id:
    v: logical-coverage.targetResourceType
  path:
    v: logical-coverage.targetResourceType
  short:
    v: FHIR target resource type produced on the target side.
  definition:
    v: FHIR target resource type produced on the target side.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: code
      l: code
element:
  id:
    v: logical-coverage.identifier
  path:
    v: logical-coverage.identifier
  short:
    v: Coverage identifiers.
  definition:
    v: Coverage identifiers.
  min:
    v: 0
  max:
    v: *
  type:
    code:
      v: Identifier
      l: Identifier
element:
  id:
    v: logical-coverage.status
  path:
    v: logical-coverage.status
  short:
    v: Coverage status.
  definition:
    v: Coverage status.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: code
      l: code
element:
  id:
    v: logical-coverage.type
  path:
    v: logical-coverage.type
  short:
    v: Coverage type.
  definition:
    v: Coverage type.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: CodeableConcept
      l: CodeableConcept
element:
  id:
    v: logical-coverage.policyHolder
  path:
    v: logical-coverage.policyHolder
  short:
    v: Policy holder.
  definition:
    v: Policy holder.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: Reference
      l: Reference
element:
  id:
    v: logical-coverage.subscriber
  path:
    v: logical-coverage.subscriber
  short:
    v: Subscriber.
  definition:
    v: Subscriber.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: Reference
      l: Reference
element:
  id:
    v: logical-coverage.subscriberId
  path:
    v: logical-coverage.subscriberId
  short:
    v: Subscriber id.
  definition:
    v: Subscriber id.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: string
      l: string
element:
  id:
    v: logical-coverage.beneficiary
  path:
    v: logical-coverage.beneficiary
  short:
    v: Beneficiary.
  definition:
    v: Beneficiary.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: Reference
      l: Reference
element:
  id:
    v: logical-coverage.dependent
  path:
    v: logical-coverage.dependent

v: Dependent id.

v: Dependent id.

v: 0

v: 1

code:
  v: string
  l: string

id:
  v: logical-coverage.relationship
path:
  v: logical-coverage.relationship
short:
  v: Relationship.
definition:
  v: Relationship.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: logical-coverage.period
path:
  v: logical-coverage.period
short:
  v: Coverage period.
definition:
  v: Coverage period.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: Period
    l: Period

id:
  v: logical-coverage.payor
path:
  v: logical-coverage.payor
short:
  v: Payors.
definition:
  v: Payors.
min:
  v: 0
max:
  v: *
type:
  code:
    v: Reference
    l: Reference

id:
  v: logical-coverage.order
path:
  v: logical-coverage.order
short:
  v: Order.
definition:
  v: Order.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: positiveInt
    l: positiveInt

id:
  v: logical-coverage.network
path:
  v: logical-coverage.network
short:
  v: Network.
definition:
  v: Network.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: string
    l: string

id:
  v: logical-coverage.class
path:
  v: logical-coverage.class
short:
  v: Coverage class and plan identifiers.
definition:
  v: Coverage class and plan identifiers.
min:
  v: 0
max:
  v: *
type:
  code:
    v: https://translate-ig.cumuluz.dev/ig/StructureDefinition/logical-coverage-class
    l: logical-coverage-class

id:
  v: logical-coverage.costToBeneficiary
path:
  v: logical-coverage.costToBeneficiary
short:
  v: Patient cost-sharing rules.
definition:
  v: Patient cost-sharing rules.
min:
  v: 0
max:
  v: *
type:
  code:
    v: https://translate-ig.cumuluz.dev/ig/StructureDefinition/logical-coverage-cost-to-beneficiary
    l: logical-coverage-cost-to-beneficiary

id:
  v: logical-coverage.subrogation
path:
  v: logical-coverage.subrogation
short:
  v: Whether insurer recovery rights apply.
definition:
  v: Whether insurer recovery rights apply.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: boolean
    l: boolean

id:
  v: logical-coverage.contract
path:
  v: logical-coverage.contract
short:
  v: Contracts governing the coverage.
definition:
  v: Contracts governing the coverage.
min:
  v: 0
max:
  v: *
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Contract
    l: Contract