beneficiary-fhir-data/apps/bfd-model/bfd-model-idr/dictionary-support-files/Coverage.yaml at b7da379ae76d2dd62db16bd3b1ca9fb0f2044034 · CMSgov/beneficiary-fhir-data · GitHub

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
- inputPath: Coverage-Base.coveragePart
  appliesTo:
    - PartA
    - PartB
  fhirPath: Coverage.class.where(type.coding.code='plan').value
  bfdDerived: True
- inputPath: Coverage-Base.BENE_MBI_ID
  appliesTo:
    - PartA
    - PartB
  fhirPath: Coverage.subscriberId
  sourceView: V2_MDCR_BENE
  sourceColumn: BENE_MBI_ID
- inputPath: Coverage-Base.XREF_EFCTV_BENE_SK
  appliesTo:
    - PartA
    - PartB
  fhirPath: Coverage.beneficiary.reference.substring(8)
  sourceView: V2_MDCR_BENE
  sourceColumn: BENE_SK
- inputPath: Coverage-Base.BENE_MDCR_STUS_CD
  appliesTo:
    - PartA
    - PartB
  fhirPath: Coverage.extension.where(url='https://bluebutton.cms.gov/fhir/StructureDefinition/BENE-MDCR-STUS-CD').value.code
  referenceTable: BENE_MDCR_STUS_CD
  sourceView: V2_MDCR_BENE_MDCR_STUS
  sourceColumn: BENE_MDCR_STUS_CD
- inputPath: Coverage-Base.BENE_MDCR_ENTLMT_STUS_CD
  appliesTo:
    - PartA
    - PartB
  fhirPath: Coverage.extension.where(url='https://bluebutton.cms.gov/fhir/StructureDefinition/BENE-MDCR-ENTLMT-STUS-CD').value.code
  referenceTable: BENE_MDCR_ENTLMT_STUS_CD
  sourceView: V2_MDCR_BENE_MDCR_ENTLMT
  sourceColumn: BENE_MDCR_ENTLMT_STUS_CD
- inputPath: Coverage-Base.BENE_BUYIN_CD
  appliesTo:
    - PartA
    - PartB
  fhirPath: Coverage.extension.where(url='https://bluebutton.cms.gov/fhir/StructureDefinition/BENE-BUYIN-CD').value.code
  referenceTable: BENE_BUYIN_CD
  sourceView: V2_MDCR_BENE_TP
  sourceColumn: BENE_BUYIN_CD
- inputPath: Coverage-Base.BENE_RNG_BGN_DT
  appliesTo:
    - PartA
    - PartB
  fhirPath: Coverage.period.start
  sourceView: V2_MDCR_BENE_MDCR_ENTLMT
  sourceColumn: BENE_RNG_BGN_DT
- inputPath: Coverage-Base.BENE_RNG_END_DT
  appliesTo:
    - PartA
    - PartB
  fhirPath: Coverage.period.end
  sourceView: V2_MDCR_BENE_MDCR_ENTLMT
  sourceColumn: BENE_RNG_END_DT
- inputPath: Coverage-Base.lastUpdated
  appliesTo:
    - PartA
    - PartB
  fhirPath: Coverage.meta.lastUpdated
  bfdDerived: True
  notes: This should represent the latest update time of any of the constituent rows.
- inputPath: Coverage-Base.BENE_MDCR_ENRLMT_RSN_CD
  appliesTo:
    - PartA
    - PartB
  fhirPath: Coverage.extension.where(url='https://bluebutton.cms.gov/fhir/StructureDefinition/BENE-ENRLMT-RSN-CD').value.code
  referenceTable: BENE_MDCR_ENRLMT_RSN_CD
  sourceView: V2_MDCR_BENE_MDCR_ENTLMT
  sourceColumn: BENE_MDCR_ENRLMT_RSN_CD
- inputPath: Coverage-Base.BENE_MDCR_ENTLMT_RSN_CD
  appliesTo:
    - PartA
    - PartB
  fhirPath: Coverage.extension.where(url='https://bluebutton.cms.gov/fhir/StructureDefinition/BENE-MDCR-ENTLMT-RSN-CD').value.code
  referenceTable: BENE_MDCR_ENTLMT_RSN_CD
  sourceView: V2_MDCR_BENE_MDCR_ENTLMT_RSN
  sourceColumn: BENE_MDCR_ENTLMT_RSN_CD
- inputPath: Coverage-Base.BENE_ESRD_STUS_ID
  appliesTo:
    - PartA
    - PartB
  fhirPath: Coverage.extension.where(url='https://bluebutton.cms.gov/fhir/StructureDefinition/BENE-ESRD-STUS-ID').value.code
  referenceTable: BENE_ESRD_STUS_ID
  sourceView: V2_MDCR_BENE_MDCR_STUS_CD
  sourceColumn: BENE_ESRD_STUS_ID
  nameOverride: Beneficiary ESRD Status ID
- inputPath: Coverage-Base.BENE_DSBLD_STUS_ID
  appliesTo:
    - PartA
    - PartB
  referenceTable: BENE_DSBLD_STUS_ID
  fhirPath: Coverage.extension.where(url='https://bluebutton.cms.gov/fhir/StructureDefinition/BENE-DSBLD-STUS-ID').value.code
  sourceView: V2_MDCR_BENE_MDCR_STUS_CD
  sourceColumn: BENE_DSBLD_STUS_ID
  nameOverride: Beneficiary Disabled Status Code
- inputPath: Coverage-Base.BENE_DUAL_STUS_CD
  appliesTo:
    - DUAL
  fhirPath: Coverage.extension.where(url='https://bluebutton.cms.gov/fhir/StructureDefinition/BENE-DUAL-STUS-CD').value.code
  referenceTable: BENE_DUAL_STUS_CD
  sourceView: V2_MDCR_BENE_CMBND_DUAL_MDCR
  sourceColumn: BENE_DUAL_STUS_CD
- inputPath: Coverage-Base.BENE_DUAL_TYPE_CD
  appliesTo:
    - DUAL
  fhirPath: Coverage.extension.where(url='https://bluebutton.cms.gov/fhir/StructureDefinition/BENE-DUAL-TYPE-CD').value.code
  referenceTable: BENE_DUAL_TYPE_CD
  sourceView: V2_MDCR_BENE_CMBND_DUAL_MDCR
  sourceColumn: BENE_DUAL_TYPE_CD
- inputPath: Coverage-Base.GEO_USPS_STATE_CD
  appliesTo:
    - DUAL
  fhirPath: Coverage.extension.where(url='https://bluebutton.cms.gov/fhir/StructureDefinition/MEDICAID-STATE-CD').value.code
  sourceView: V2_MDCR_BENE_CMBND_DUAL_MDCR
  sourceColumn: GEO_USPS_STATE_CD
- inputPath: Coverage-Base.BENE_MDCD_ELGBLTY_BGN_DT
  appliesTo:
    - DUAL
  fhirPath: Coverage.period.start
  sourceView: V2_MDCR_BENE_CMBND_DUAL_MDCR
  sourceColumn: BENE_MDCD_ELGBLTY_BGN_DT
- inputPath: Coverage-Base.BENE_MDCD_ELGBLTY_END_DT
  appliesTo:
    - DUAL
  fhirPath: Coverage.period.end
  sourceView: V2_MDCR_BENE_CMBND_DUAL_MDCR
  sourceColumn: BENE_MDCD_ELGBLTY_END_DT
- inputPath: Coverage-Base.BENE_ENRLMT_BGN_DT
  appliesTo:
    - PartC
    - PartD
  fhirPath: Coverage.period.start
  sourceView: V2_MDCR_BENE_MAPD_ENRLMT
  sourceColumn: BENE_ENRLMT_BGN_DT
- inputPath: Coverage-Base.BENE_ENRLMT_END_DT
  appliesTo:
    - PartC
    - PartD
  fhirPath: Coverage.period.end
  sourceView: V2_MDCR_BENE_MAPD_ENRLMT
  sourceColumn: BENE_ENRLMT_END_DT
- inputPath: Coverage-Base.BENE_CNTRCT_NUM
  appliesTo:
    - PartC
    - PartD
  fhirPath: Coverage.extension.where(url='https://bluebutton.cms.gov/fhir/StructureDefinition/BENE-CNTRCT-NUM').value
  sourceView: V2_MDCR_BENE_MAPD_ENRLMT
  sourceColumn: BENE_CNTRCT_NUM
- inputPath: Coverage-Base.BENE_PBP_NUM
  appliesTo:
    - PartC
    - PartD
  fhirPath: Coverage.extension.where(url='https://bluebutton.cms.gov/fhir/StructureDefinition/BENE-PBP-NUM').value
  sourceView: V2_MDCR_BENE_MAPD_ENRLMT
  sourceColumn: BENE_PBP_NUM
- inputPath: Coverage-Base.BENE_CVRG_TYPE_CD
  appliesTo:
    - PartC
    - PartD
  fhirPath: Coverage.extension.where(url='https://bluebutton.cms.gov/fhir/StructureDefinition/BENE-CVRG-TYPE-CD').value.code
  referenceTable: BENE_CVRG_TYPE_CD
  sourceView: V2_MDCR_BENE_MAPD_ENRLMT
  sourceColumn: BENE_CVRG_TYPE_CD
- inputPath: Coverage-Base.CNTRCT_PBP_NAME
  appliesTo:
    - PartC
    - PartD
  fhirPath: Coverage.contained.where(resourceType='Organization').name
  sourceView: V2_MDCR_CNTRCT_PBP_NUM
  sourceColumn: CNTRCT_PBP_NAME
- inputPath: Coverage-Base.CNTRCT_PLAN_CNTCT_TEL_NUM
  appliesTo:
    - PartC
    - PartD
  fhirPath: Coverage.contained.where(resourceType='Organization').contact.telecom.where(system='phone').value
  sourceView: V2_MDCR_CNTRCT_PBP_CNTCT
  sourceColumn: CNTRCT_PLAN_CNTCT_TEL_NUM
- inputPath: Coverage-Base.BENE_PDP_ENRLMT_MMBR_ID_NUM
  appliesTo:
    - PartD
  fhirPath: Coverage.class.where(type.coding.code='rxid').value
  sourceView: V2_MDCR_BENE_MAPD_ENRLMT_RX
  sourceColumn: BENE_PDP_ENRLMT_MMBR_ID_NUM
- inputPath: Coverage-Base.BENE_PDP_ENRLMT_GRP_NUM
  appliesTo:
    - PartD
  fhirPath: Coverage.class.where(type.coding.code='rxgroup').value
  sourceView: V2_MDCR_BENE_MAPD_ENRLMT_RX
  sourceColumn: BENE_PDP_ENRLMT_GRP_NUM
- inputPath: Coverage-Base.BENE_PDP_ENRLMT_PRCSR_NUM
  appliesTo:
    - PartD
  fhirPath: Coverage.class.where(type.coding.code='rxpcn').value
  sourceView: V2_MDCR_BENE_MAPD_ENRLMT_RX
  sourceColumn: BENE_PDP_ENRLMT_PRCSR_NUM
- inputPath: Coverage-Base.BENE_PDP_ENRLMT_BANK_ID_NUM
  appliesTo:
    - PartD
  fhirPath: Coverage.class.where(type.coding.code='rxbin').value
  sourceView: V2_MDCR_BENE_MAPD_ENRLMT_RX
  sourceColumn: BENE_PDP_ENRLMT_BANK_ID_NUM
- inputPath: Coverage-Base.BENE_LIS_EFCTV_CD
  appliesTo:
    - PartD
  fhirPath: Coverage.extension.where(url='https://bluebutton.cms.gov/fhir/StructureDefinition/BENE-LIS-EFCTV-CD').value.code
  sourceView: V2_MDCR_BENE_LIS
  sourceColumn: BENE_LIS_EFCTV_CD
- inputPath: Coverage-Base.BENE_LIS_COPMT_LVL_CD
  appliesTo:
    - PartD
  fhirPath: Coverage.extension.where(url='https://bluebutton.cms.gov/fhir/StructureDefinition/BENE-LIS-COPMT-LVL-CD').value.code
  sourceView: V2_MDCR_BENE_LIS
  sourceColumn: BENE_LIS_COPMT_LVL_CD
- inputPath: Coverage-Base.BENE_LIS_PTD_PRM_PCT
  appliesTo:
    - PartD
  fhirPath: Coverage.extension.where(url='https://bluebutton.cms.gov/fhir/StructureDefinition/BENE-LIS-PTD-PRM-PCT').value
  sourceView: V2_MDCR_BENE_LIS
  sourceColumn: BENE_LIS_PTD_PRM_PCT