Specialty Medication Enrollment
0.1.0 - STU1 Ballot

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## Resource Profile: SpecialtyRxCoverage - Mappings

Mappings for the specialty-rx-coverage resource profile.

### Mappings for Workflow Pattern (http://hl7.org/fhir/workflow)

SpecialtyRxCoverage
Coverage | Event
identifier | Event.identifier
status | Event.status
beneficiary | Event.subject
period | Event.occurrence[x]

### Mappings for RIM Mapping (http://hl7.org/v3)

SpecialtyRxCoverage
Coverage | Entity. Role, or Act, Coverage
text | Act.text?
contained | N/A
extension | N/A
modifierExtension | N/A
identifier | .id
status | Act.status
period | Act.effectiveTime
class |
id | n/a
extension | n/a
modifierExtension | N/A
class (bin) |
id | n/a
extension | n/a
modifierExtension | N/A
class (pcn) |
id | n/a
extension | n/a
modifierExtension | N/A
class (rxgroup-id) |
id | n/a
extension | n/a
modifierExtension | N/A
class (pbm-member-id) |
id | n/a
extension | n/a
modifierExtension | N/A
costToBeneficiary |
id | n/a
extension | n/a
modifierExtension | N/A
exception |
id | n/a
extension | n/a
modifierExtension | N/A
contract | n/a

### Mappings for FiveWs Pattern Mapping (http://hl7.org/fhir/fivews)

SpecialtyRxCoverage
Coverage |
identifier | FiveWs.identifier
status | FiveWs.status
type | FiveWs.class
policyHolder | FiveWs.subject[x], FiveWs.subject
subscriber | FiveWs.subject[x], FiveWs.subject
subscriberId | FiveWs.subject[x], FiveWs.subject
beneficiary | FiveWs.subject[x], FiveWs.subject
period | FiveWs.done[x]
payor | FiveWs.author

### Mappings for Canadian Dental Association eclaims standard (http://www.cda-adc.ca/en/services/cdanet/)

SpecialtyRxCoverage
Coverage |
identifier | C02
policyHolder | D01 through D09
subscriber | D01 through D09
subscriberId | D01 through D09
beneficiary | D01 through D09
dependent | C17
relationship | C03
payor | A05
class |
value | C11 (Division,Section)
name | C11 (Division,Section)
class (bin) |
value | C11 (Division,Section)
name | C11 (Division,Section)
class (pcn) |
value | C11 (Division,Section)
name | C11 (Division,Section)
class (rxgroup-id) |
value | C11 (Division,Section)
name | C11 (Division,Section)
class (pbm-member-id) |
value | C11 (Division,Section)
name | C11 (Division,Section)
network | D10
costToBeneficiary |
value[x] | C11 (Division,Section)
contract | D01 through D09

### Mappings for HL7 v2 Mapping (http://hl7.org/v2)

SpecialtyRxCoverage
Coverage |
identifier | IN1-2
type | IN1-15
policyHolder | IN1-16, 18, 19-name of insured, address, date of birth
subscriber | IN1-16, 18, 19-name of insured, address, date of birth
subscriberId | IN1-16, 18, 19-name of insured, address, date of birth
beneficiary | IN1-16, 18, 19-name of insured, address, date of birth
dependent | - No exact HL7 v2 equivalent concept seems to exist;
period | IN1-12 / IN1-13
payor | IN1-3
class |
value | IN1-8
name | IN1-8
class (bin) |
value | IN1-8
name | IN1-8
class (pcn) |
value | IN1-8
name | IN1-8
class (rxgroup-id) |
value | IN1-8
name | IN1-8
class (pbm-member-id) |
value | IN1-8
name | IN1-8
order | - No exact HL7 v2 equivalent concept seems to exist;
costToBeneficiary |
value[x] | IN1-8
contract | IN1-16, 18, 19

### Mappings for Canadian Pharmacy Associaiton eclaims standard (http://www.pharmacists.ca/)

SpecialtyRxCoverage
Coverage |
identifier | C.32, C.33, C.39
policyHolder | C.35
subscriber | C.35
subscriberId | C.35
beneficiary | C.35
payor | C.30
class |
value | C.31
name | C.31
class (bin) |
value | C.31
name | C.31
class (pcn) |
value | C.31
name | C.31
class (rxgroup-id) |
value | C.31
name | C.31
class (pbm-member-id) |
value | C.31
name | C.31
costToBeneficiary |
value[x] | C.31
contract | C.35