| Name | Flags | Card. | Type | Description & Constraints![]() |
|---|---|---|---|---|
| DomainResource | Eligibility request | |||
| 0..* | Identifier | Business Identifier | ||
| ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error EligibilityRequestStatus (Required) | |
| 0..1 | Coding | Resource version Ruleset Codes (Example) | ||
| 0..1 | Coding | Original version Ruleset Codes (Example) | ||
| 0..1 | dateTime | Creation date | ||
| 0..1 | Target | |||
| Identifier | ||||
| Reference(Organization) | ||||
| 0..1 | Responsible practitioner | |||
| Identifier | ||||
| Reference(Practitioner) | ||||
| 0..1 | Responsible organization | |||
| Identifier | ||||
| Reference(Organization) | ||||
| 0..1 | Coding | Desired processing priority Priority Codes (Example) | ||
| 0..1 | Author | |||
| Identifier | ||||
| Reference(Practitioner) | ||||
| 0..1 | Servicing Facility | |||
| Identifier | ||||
| Reference(Location) | ||||
| 0..1 | The subject of the Products and Services | |||
| Identifier | ||||
| Reference(Patient) | ||||
| 0..1 | Insurance or medical plan | |||
| Identifier | ||||
| Reference(Coverage) | ||||
| 0..1 | string | Business agreement | ||
| 0..1 | Estimated date or dates of Service | |||
| date | ||||
| Period | ||||
| 0..1 | Coding | Benefit Category Benefit Category Codes (Example) | ||
| 0..1 | Coding | Benefit SubCategory Benefit SubCategory Codes (Example) | ||
Documentation for this format | ||||