Release 4B 5

This page is part of the FHIR Specification (v4.3.0: R4B (v5.0.0: R5 - STU ). The This is the current published version which supercedes in it's permanent home (it will always be available at this version is 5.0.0 . URL). For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R5 R4B R4

Using Codes Code Systems Value Sets Concept Maps Identifier Systems

4.4.1.111 4.4.1.436 Value Set ValueSet http://hl7.org/fhir/ValueSet/insuranceplan-applicability

Patient Administration icon Work Group   Maturity Level : 0 Trial Use Use Context : Country: World, Not yet ready for Production use
This is a value set defined by the FHIR project.
    Summary
  • Narrative Defining URL:
    • http://hl7.org/fhir/ValueSet/insuranceplan-applicability
  • XML Version:
    • 4.3.0
  • JSON Name:
    • BenefitCostApplicability
  • TTL Title:
Committee:
Official URL : http://hl7.org/fhir/ValueSet/insuranceplan-applicability Whether the cost applies to in-network or out-of-network providers. Version : 5.0.0
draft as of 2018-06-06 Patient Administration Computable Name : BenefitCostApplicability Work Group
OID: Flags : Experimental, Immutable 2.16.840.1.113883.4.642.3.0 (for OID based terminology systems) Source Resource XML / JSON : 2.16.840.1.113883.4.642.3.0

This value set is used in the following places:

4.4.1.111.1 4.4.1.436.1 Definition

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

4.4.1.436.2 Content Logical Definition

 

4.4.1.111.2 4.4.1.436.3 Expansion

This expansion generated 28 May 2022 26 Mar 2023

This value set contains 3 concepts

Expansion based on Benefit cost applicability v0.1.0 (CodeSystem) All codes in this table are from the system http://terminology.hl7.org/CodeSystem/applicability icon

Code System Display Definition
   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

   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

   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