R6 Ballot (3rd Draft) FHIR CI-Build

This page is part of the FHIR Specification v6.0.0-ballot3: Release 6 Ballot (3rd Draft) (see Ballot Notes ). The current version is 5.0.0 . For a full list Continuous Integration Build of available versions, see FHIR (will be incorrect/inconsistent at times).
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4.4.1.458 4.4.1.122 ValueSet http://hl7.org/fhir/ValueSet/insuranceplan-applicability

Responsible Owner: Patient Administration icon Work Group   Maturity Level : 1 Trial Use Use Context : Country: World
Official URL : http://hl7.org/fhir/ValueSet/insuranceplan-applicability Version : 6.0.0-ballot3
draft as of 2018-06-06 2018-06-05 Computable Name : BenefitCostApplicability
Flags : Immutable OID : 2.16.840.1.113883.4.642.3.0

This value set is used in the following places:

4.4.1.458.1 4.4.1.122.1 Definition

Whether the cost applies to in-network or out-of-network providers.

4.4.1.458.2 4.4.1.122.2 Content Logical Definition

Generated Narrative: ValueSet insuranceplan-applicability

Last updated: 2025-04-01T12:16:37.966+11:00 Profile: Shareable ValueSet 2025-11-10T15:17:08.817Z

 

4.4.1.458.3 4.4.1.122.3 Expansion

This expansion generated 01 Apr 10 Nov 2025

ValueSet

Expansion performed internally based on codesystem Benefit cost applicability v1.0.1 (CodeSystem) icon

This value set contains 3 concepts

Code System System Code Display Definition
http://terminology.hl7.org/CodeSystem/applicability    in-network icon http://terminology.hl7.org/CodeSystem/applicability In Network Provider is contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates
http://terminology.hl7.org/CodeSystem/applicability    out-of-network icon http://terminology.hl7.org/CodeSystem/applicability Out of Network Provider is not contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates
http://terminology.hl7.org/CodeSystem/applicability    other icon http://terminology.hl7.org/CodeSystem/applicability Other Other applicability

 

See the full registry of value sets defined as part of FHIR.

Explanation of the columns that may appear on this page:

Lvl A few code lists that FHIR defines are hierarchical - each code is assigned a level. For value sets, levels are mostly used to organize codes for user convenience, but may follow code system hierarchy - see Code System for further information
Source The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance). If the code is in italics, this indicates that the code is not selectable ('Abstract')
Display The display (used in the display element of a Coding ). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code