USCDI+ Quality Element Support Expectations

Systems are expected to support this profile as part of implementing USCDI+ Quality V1 in FHIR and meeting the conformance requirements of this guide.

The following elements are specifically relevant to USCDI+ Quality V1 data classes and elements. Systems are expected to support these elements as applicable to their role in US Quality Core data exchange. See the Must Support section of this guide for more information. These elements are tagged as (USCDI+ Quality) in the formal profile views.

USCDI+ Quality Elements:

• identifier: (USCDI+ Quality) An identifier for the person as this agent
• identifier.system: (USCDI+ Quality) The namespace for the identifier value
• identifier.value: (USCDI+ Quality) The value that is unique
• identifier:NPI: (USCDI+ Quality) An identifier for the person as this agent
• identifier:NPI.system: (USCDI+ Quality) The namespace for the identifier value
• identifier:NPI.value: (USCDI+ Quality) The value that is unique
• identifier:ein: (USCDI+ Quality) There is not a general Tax Identifier Numer (TIN) OID. There is an SSN, a PTIN, and an ITIN, but no TIN generally. So the only slice specified here is EIN, if consumers determine a need for an SSN, submit a comment to that effect.
• identifier:ein.value: (USCDI+ Quality) The value that is unique
• name: (USCDI+ Quality) The name(s) associated with the practitioner
• name.family: (USCDI+ Quality) Family name (often called 'Surname')
• telecom: (USCDI+ Quality) A contact detail for the practitioner (that apply to all roles)
• telecom.system: (USCDI+ Quality) phone | fax | email | pager | url | sms | other
• telecom.value: (USCDI+ Quality) The actual contact point details
• address: (USCDI+ Quality) Address(es) of the practitioner
• address.line: (USCDI+ Quality) Street name, number, direction & P.O. Box etc.
• address.city: (USCDI+ Quality) Name of city, town etc.
• address.state: (USCDI+ Quality) Sub-unit of country (abbreviations ok)
• address.postalCode: (USCDI+ Quality) US Zip Codes
• address.country: (USCDI+ Quality) Country (e.g. can be ISO 3166 2 or 3 letter code)

Because this profile is derived from US Core, systems are also expected to support Must Support requirements and (USCDI) tagged elements inherited from US Core. The Formal Views section also provides the formal summary, definitions, terminology requirements, and mandatory element requirements.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Practitioner		0..*	USCorePractitionerProfile(6.1.0)	A person with a formal responsibility in the provisioning of healthcare or related services
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	1..*	Identifier	(USCDI+ Quality) An identifier for the person as this agent Slice: Unordered, Open by pattern:$this
identifier:All Slices				Content/Rules for all slices
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	(USCDI+ Quality) The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	(USCDI+ Quality) The value that is unique Example General: 123456
identifier:NPI	SΣC	0..*	Identifier	(USCDI+ Quality) An identifier for the person as this agent Constraints: us-core-16, us-core-17 Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
type		0..1	CodeableConcept	Description of identifier
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	(USCDI+ Quality) The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
value	Σ	1..1	string	(USCDI+ Quality) The value that is unique Example General: 123456
identifier:ein	SΣ	0..1	Identifier	(USCDI+ Quality) There is not a general Tax Identifier Numer (TIN) OID. There is an SSN, a PTIN, and an ITIN, but no TIN generally. So the only slice specified here is EIN, if consumers determine a need for an SSN, submit a comment to that effect. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
type		0..1	CodeableConcept	Description of identifier
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
use	?!Σ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	(USCDI+ Quality) The namespace for the identifier value Fixed Value: urn:oid:2.16.840.1.113883.4.4
value	Σ	1..1	string	(USCDI+ Quality) The value that is unique Example General: 123456
name	SΣ	1..*	HumanName	(USCDI+ Quality) The name(s) associated with the practitioner
use	?!Σ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
family	SΣ	1..1	string	(USCDI+ Quality) Family name (often called 'Surname')
telecom	SΣ	0..*	ContactPoint	(USCDI+ Quality) A contact detail for the practitioner (that apply to all roles)
system	SΣC	0..1	code	(USCDI+ Quality) phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	0..1	string	(USCDI+ Quality) The actual contact point details
use	?!Σ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
address	SΣ	0..*	Address	(USCDI+ Quality) Address(es) of the practitioner
use	?!Σ	0..1	code	home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
line	SΣ	0..4	string	(USCDI+ Quality) Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street
city	SΣ	0..1	string	(USCDI+ Quality) Name of city, town etc. Example General: Erewhon
state	SΣ	0..1	string	(USCDI+ Quality) Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.
postalCode	SΣ	0..1	string	(USCDI+ Quality) US Zip Codes Example General: 9132
country	SΣ	0..1	string	(USCDI+ Quality) Country (e.g. can be ISO 3166 2 or 3 letter code)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Practitioner.identifier.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Practitioner.identifier:NPI.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Practitioner.identifier:ein.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Practitioner.name.use	Base	required	NameUse	📍4.0.1	FHIR Std.
Practitioner.telecom.​system	Base	required	ContactPointSystem	📍4.0.1	FHIR Std.
Practitioner.telecom.​use	Base	required	ContactPointUse	📍4.0.1	FHIR Std.
Practitioner.address.​use	Base	required	AddressUse	📍4.0.1	FHIR Std.
Practitioner.address.​state	Base	extensible	USPS Two Letter Alphabetic Codes	📦7.0.0	US Core v7.0

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Practitioner	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Practitioner	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Practitioner	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Practitioner	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Practitioner	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
us-core-16	error	Practitioner.identifier:NPI	NPI must be 10 digits	value.matches('^[0-9]{10}$')
us-core-17	error	Practitioner.identifier:NPI	NPI check digit must be valid (Luhn algorithm check)	(((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger()) + 24)mod 10=0)

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Practitioner		0..*	USCorePractitionerProfile(6.1.0)	A person with a formal responsibility in the provisioning of healthcare or related services
Slices for identifier		1..*	Identifier	(USCDI+ Quality) An identifier for the person as this agent Slice: Unordered, Open by pattern:$this
identifier:All Slices				Content/Rules for all slices
system		1..1	uri	(USCDI+ Quality) The namespace for the identifier value
value		1..1	string	(USCDI+ Quality) The value that is unique
identifier:NPI	C	0..*	Identifier	(USCDI+ Quality) An identifier for the person as this agent Required Pattern: At least the following
system		1..1	uri	(USCDI+ Quality) The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
value		1..1	string	(USCDI+ Quality) The value that is unique
identifier:ein		0..1	Identifier	(USCDI+ Quality) There is not a general Tax Identifier Numer (TIN) OID. There is an SSN, a PTIN, and an ITIN, but no TIN generally. So the only slice specified here is EIN, if consumers determine a need for an SSN, submit a comment to that effect. Required Pattern: At least the following
system		1..1	uri	The namespace for the identifier value Fixed Value: urn:oid:2.16.840.1.113883.4.4
use		1..1	code	usual | official | temp | secondary | old (If known)
value		1..1	string	(USCDI+ Quality) The value that is unique
name		1..*	HumanName	(USCDI+ Quality) The name(s) associated with the practitioner
family		1..1	string	(USCDI+ Quality) Family name (often called 'Surname')
telecom		0..*	ContactPoint	(USCDI+ Quality) A contact detail for the practitioner (that apply to all roles)
system		0..1	code	(USCDI+ Quality) phone | fax | email | pager | url | sms | other
value		0..1	string	(USCDI+ Quality) The actual contact point details
address		0..*	Address	(USCDI+ Quality) Address(es) of the practitioner
line		0..4	string	(USCDI+ Quality) Street name, number, direction & P.O. Box etc.
city		0..1	string	(USCDI+ Quality) Name of city, town etc.
state		0..1	string	(USCDI+ Quality) Sub-unit of country (abbreviations ok)
postalCode		0..1	string	(USCDI+ Quality) US Zip Codes
country		0..1	string	(USCDI+ Quality) Country (e.g. can be ISO 3166 2 or 3 letter code)
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Practitioner		0..*	USCorePractitionerProfile(6.1.0)	A person with a formal responsibility in the provisioning of healthcare or related services
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	1..*	Identifier	(USCDI+ Quality) An identifier for the person as this agent Slice: Unordered, Open by pattern:$this
identifier:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	(USCDI+ Quality) The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	(USCDI+ Quality) The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:NPI	SΣC	0..*	Identifier	(USCDI+ Quality) An identifier for the person as this agent Constraints: us-core-16, us-core-17 Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	(USCDI+ Quality) The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
value	Σ	1..1	string	(USCDI+ Quality) The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:ein	SΣ	0..1	Identifier	(USCDI+ Quality) There is not a general Tax Identifier Numer (TIN) OID. There is an SSN, a PTIN, and an ITIN, but no TIN generally. So the only slice specified here is EIN, if consumers determine a need for an SSN, submit a comment to that effect. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	(USCDI+ Quality) The namespace for the identifier value Fixed Value: urn:oid:2.16.840.1.113883.4.4
value	Σ	1..1	string	(USCDI+ Quality) The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
active	Σ	0..1	boolean	Whether this practitioner's record is in active use
name	SΣ	1..*	HumanName	(USCDI+ Quality) The name(s) associated with the practitioner
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text	Σ	0..1	string	Text representation of the full name
family	SΣ	1..1	string	(USCDI+ Quality) Family name (often called 'Surname')
given	Σ	0..*	string	Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix	Σ	0..*	string	Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix	Σ	0..*	string	Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period	Σ	0..1	Period	Time period when name was/is in use
telecom	SΣ	0..*	ContactPoint	(USCDI+ Quality) A contact detail for the practitioner (that apply to all roles)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣC	0..1	code	(USCDI+ Quality) phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	0..1	string	(USCDI+ Quality) The actual contact point details
use	?!Σ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
rank	Σ	0..1	positiveInt	Specify preferred order of use (1 = highest)
period	Σ	0..1	Period	Time period when the contact point was/is in use
address	SΣ	0..*	Address	(USCDI+ Quality) Address(es) of the practitioner
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
type	Σ	0..1	code	postal | physical | both Binding: AddressType (required): The type of an address (physical / postal). Example General: both
text	Σ	0..1	string	Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132
line	SΣ	0..4	string	(USCDI+ Quality) Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street
city	SΣ	0..1	string	(USCDI+ Quality) Name of city, town etc. Example General: Erewhon
district	Σ	0..1	string	District name (aka county) Example General: Madison
state	SΣ	0..1	string	(USCDI+ Quality) Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.
postalCode	SΣ	0..1	string	(USCDI+ Quality) US Zip Codes Example General: 9132
country	SΣ	0..1	string	(USCDI+ Quality) Country (e.g. can be ISO 3166 2 or 3 letter code)
period	Σ	0..1	Period	Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
gender	Σ	0..1	code	male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate	Σ	0..1	date	The date on which the practitioner was born
photo		0..*	Attachment	Image of the person
qualification		0..*	BackboneElement	Certification, licenses, or training pertaining to the provision of care
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
identifier		0..*	Identifier	An identifier for this qualification for the practitioner
code		1..1	CodeableConcept	Coded representation of the qualification Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.
period		0..1	Period	Period during which the qualification is valid
issuer		0..1	Reference(Organization)	Organization that regulates and issues the qualification
communication		0..*	CodeableConcept	A language the practitioner can use in patient communication Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Practitioner.language	Base	preferred	Common Languages	📦4.0.1	FHIR Std.
Practitioner.identifier.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Practitioner.identifier.​type	Base	extensible	IdentifierType	📦4.0.1	FHIR Std.
Practitioner.identifier:NPI.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Practitioner.identifier:NPI.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Practitioner.identifier:ein.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Practitioner.identifier:ein.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Practitioner.name.use	Base	required	NameUse	📍4.0.1	FHIR Std.
Practitioner.telecom.​system	Base	required	ContactPointSystem	📍4.0.1	FHIR Std.
Practitioner.telecom.​use	Base	required	ContactPointUse	📍4.0.1	FHIR Std.
Practitioner.address.​use	Base	required	AddressUse	📍4.0.1	FHIR Std.
Practitioner.address.​type	Base	required	AddressType	📍4.0.1	FHIR Std.
Practitioner.address.​state	Base	extensible	USPS Two Letter Alphabetic Codes	📦7.0.0	US Core v7.0
Practitioner.gender	Base	required	AdministrativeGender	📍4.0.1	FHIR Std.
Practitioner.qualification.​code	Base	example	v2 table 0360, Version 2.7	📦0360	FHIR Std.
Practitioner.communication	Base	preferred	Common Languages	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Practitioner	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Practitioner	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Practitioner	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Practitioner	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Practitioner	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
us-core-16	error	Practitioner.identifier:NPI	NPI must be 10 digits	value.matches('^[0-9]{10}$')
us-core-17	error	Practitioner.identifier:NPI	NPI check digit must be valid (Luhn algorithm check)	(((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger()) + 24)mod 10=0)

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Practitioner		0..*	USCorePractitionerProfile(6.1.0)	A person with a formal responsibility in the provisioning of healthcare or related services
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	1..*	Identifier	(USCDI+ Quality) An identifier for the person as this agent Slice: Unordered, Open by pattern:$this
identifier:All Slices				Content/Rules for all slices
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	(USCDI+ Quality) The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	(USCDI+ Quality) The value that is unique Example General: 123456
identifier:NPI	SΣC	0..*	Identifier	(USCDI+ Quality) An identifier for the person as this agent Constraints: us-core-16, us-core-17 Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
type		0..1	CodeableConcept	Description of identifier
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	(USCDI+ Quality) The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
value	Σ	1..1	string	(USCDI+ Quality) The value that is unique Example General: 123456
identifier:ein	SΣ	0..1	Identifier	(USCDI+ Quality) There is not a general Tax Identifier Numer (TIN) OID. There is an SSN, a PTIN, and an ITIN, but no TIN generally. So the only slice specified here is EIN, if consumers determine a need for an SSN, submit a comment to that effect. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
type		0..1	CodeableConcept	Description of identifier
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
use	?!Σ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	(USCDI+ Quality) The namespace for the identifier value Fixed Value: urn:oid:2.16.840.1.113883.4.4
value	Σ	1..1	string	(USCDI+ Quality) The value that is unique Example General: 123456
name	SΣ	1..*	HumanName	(USCDI+ Quality) The name(s) associated with the practitioner
use	?!Σ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
family	SΣ	1..1	string	(USCDI+ Quality) Family name (often called 'Surname')
telecom	SΣ	0..*	ContactPoint	(USCDI+ Quality) A contact detail for the practitioner (that apply to all roles)
system	SΣC	0..1	code	(USCDI+ Quality) phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	0..1	string	(USCDI+ Quality) The actual contact point details
use	?!Σ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
address	SΣ	0..*	Address	(USCDI+ Quality) Address(es) of the practitioner
use	?!Σ	0..1	code	home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
line	SΣ	0..4	string	(USCDI+ Quality) Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street
city	SΣ	0..1	string	(USCDI+ Quality) Name of city, town etc. Example General: Erewhon
state	SΣ	0..1	string	(USCDI+ Quality) Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.
postalCode	SΣ	0..1	string	(USCDI+ Quality) US Zip Codes Example General: 9132
country	SΣ	0..1	string	(USCDI+ Quality) Country (e.g. can be ISO 3166 2 or 3 letter code)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Practitioner.identifier.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Practitioner.identifier:NPI.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Practitioner.identifier:ein.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Practitioner.name.use	Base	required	NameUse	📍4.0.1	FHIR Std.
Practitioner.telecom.​system	Base	required	ContactPointSystem	📍4.0.1	FHIR Std.
Practitioner.telecom.​use	Base	required	ContactPointUse	📍4.0.1	FHIR Std.
Practitioner.address.​use	Base	required	AddressUse	📍4.0.1	FHIR Std.
Practitioner.address.​state	Base	extensible	USPS Two Letter Alphabetic Codes	📦7.0.0	US Core v7.0

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Practitioner	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Practitioner	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Practitioner	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Practitioner	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Practitioner	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
us-core-16	error	Practitioner.identifier:NPI	NPI must be 10 digits	value.matches('^[0-9]{10}$')
us-core-17	error	Practitioner.identifier:NPI	NPI check digit must be valid (Luhn algorithm check)	(((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger()) + 24)mod 10=0)

Differential View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Practitioner		0..*	USCorePractitionerProfile(6.1.0)	A person with a formal responsibility in the provisioning of healthcare or related services
Slices for identifier		1..*	Identifier	(USCDI+ Quality) An identifier for the person as this agent Slice: Unordered, Open by pattern:$this
identifier:All Slices				Content/Rules for all slices
system		1..1	uri	(USCDI+ Quality) The namespace for the identifier value
value		1..1	string	(USCDI+ Quality) The value that is unique
identifier:NPI	C	0..*	Identifier	(USCDI+ Quality) An identifier for the person as this agent Required Pattern: At least the following
system		1..1	uri	(USCDI+ Quality) The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
value		1..1	string	(USCDI+ Quality) The value that is unique
identifier:ein		0..1	Identifier	(USCDI+ Quality) There is not a general Tax Identifier Numer (TIN) OID. There is an SSN, a PTIN, and an ITIN, but no TIN generally. So the only slice specified here is EIN, if consumers determine a need for an SSN, submit a comment to that effect. Required Pattern: At least the following
system		1..1	uri	The namespace for the identifier value Fixed Value: urn:oid:2.16.840.1.113883.4.4
use		1..1	code	usual | official | temp | secondary | old (If known)
value		1..1	string	(USCDI+ Quality) The value that is unique
name		1..*	HumanName	(USCDI+ Quality) The name(s) associated with the practitioner
family		1..1	string	(USCDI+ Quality) Family name (often called 'Surname')
telecom		0..*	ContactPoint	(USCDI+ Quality) A contact detail for the practitioner (that apply to all roles)
system		0..1	code	(USCDI+ Quality) phone | fax | email | pager | url | sms | other
value		0..1	string	(USCDI+ Quality) The actual contact point details
address		0..*	Address	(USCDI+ Quality) Address(es) of the practitioner
line		0..4	string	(USCDI+ Quality) Street name, number, direction & P.O. Box etc.
city		0..1	string	(USCDI+ Quality) Name of city, town etc.
state		0..1	string	(USCDI+ Quality) Sub-unit of country (abbreviations ok)
postalCode		0..1	string	(USCDI+ Quality) US Zip Codes
country		0..1	string	(USCDI+ Quality) Country (e.g. can be ISO 3166 2 or 3 letter code)
Documentation for this format

Snapshot ViewView

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Practitioner		0..*	USCorePractitionerProfile(6.1.0)	A person with a formal responsibility in the provisioning of healthcare or related services
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	1..*	Identifier	(USCDI+ Quality) An identifier for the person as this agent Slice: Unordered, Open by pattern:$this
identifier:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	(USCDI+ Quality) The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	(USCDI+ Quality) The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:NPI	SΣC	0..*	Identifier	(USCDI+ Quality) An identifier for the person as this agent Constraints: us-core-16, us-core-17 Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	(USCDI+ Quality) The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
value	Σ	1..1	string	(USCDI+ Quality) The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:ein	SΣ	0..1	Identifier	(USCDI+ Quality) There is not a general Tax Identifier Numer (TIN) OID. There is an SSN, a PTIN, and an ITIN, but no TIN generally. So the only slice specified here is EIN, if consumers determine a need for an SSN, submit a comment to that effect. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	(USCDI+ Quality) The namespace for the identifier value Fixed Value: urn:oid:2.16.840.1.113883.4.4
value	Σ	1..1	string	(USCDI+ Quality) The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
active	Σ	0..1	boolean	Whether this practitioner's record is in active use
name	SΣ	1..*	HumanName	(USCDI+ Quality) The name(s) associated with the practitioner
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text	Σ	0..1	string	Text representation of the full name
family	SΣ	1..1	string	(USCDI+ Quality) Family name (often called 'Surname')
given	Σ	0..*	string	Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix	Σ	0..*	string	Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix	Σ	0..*	string	Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period	Σ	0..1	Period	Time period when name was/is in use
telecom	SΣ	0..*	ContactPoint	(USCDI+ Quality) A contact detail for the practitioner (that apply to all roles)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣC	0..1	code	(USCDI+ Quality) phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	0..1	string	(USCDI+ Quality) The actual contact point details
use	?!Σ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
rank	Σ	0..1	positiveInt	Specify preferred order of use (1 = highest)
period	Σ	0..1	Period	Time period when the contact point was/is in use
address	SΣ	0..*	Address	(USCDI+ Quality) Address(es) of the practitioner
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
type	Σ	0..1	code	postal | physical | both Binding: AddressType (required): The type of an address (physical / postal). Example General: both
text	Σ	0..1	string	Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132
line	SΣ	0..4	string	(USCDI+ Quality) Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street
city	SΣ	0..1	string	(USCDI+ Quality) Name of city, town etc. Example General: Erewhon
district	Σ	0..1	string	District name (aka county) Example General: Madison
state	SΣ	0..1	string	(USCDI+ Quality) Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.
postalCode	SΣ	0..1	string	(USCDI+ Quality) US Zip Codes Example General: 9132
country	SΣ	0..1	string	(USCDI+ Quality) Country (e.g. can be ISO 3166 2 or 3 letter code)
period	Σ	0..1	Period	Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
gender	Σ	0..1	code	male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate	Σ	0..1	date	The date on which the practitioner was born
photo		0..*	Attachment	Image of the person
qualification		0..*	BackboneElement	Certification, licenses, or training pertaining to the provision of care
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
identifier		0..*	Identifier	An identifier for this qualification for the practitioner
code		1..1	CodeableConcept	Coded representation of the qualification Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.
period		0..1	Period	Period during which the qualification is valid
issuer		0..1	Reference(Organization)	Organization that regulates and issues the qualification
communication		0..*	CodeableConcept	A language the practitioner can use in patient communication Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Practitioner.language	Base	preferred	Common Languages	📦4.0.1	FHIR Std.
Practitioner.identifier.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Practitioner.identifier.​type	Base	extensible	IdentifierType	📦4.0.1	FHIR Std.
Practitioner.identifier:NPI.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Practitioner.identifier:NPI.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Practitioner.identifier:ein.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Practitioner.identifier:ein.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Practitioner.name.use	Base	required	NameUse	📍4.0.1	FHIR Std.
Practitioner.telecom.​system	Base	required	ContactPointSystem	📍4.0.1	FHIR Std.
Practitioner.telecom.​use	Base	required	ContactPointUse	📍4.0.1	FHIR Std.
Practitioner.address.​use	Base	required	AddressUse	📍4.0.1	FHIR Std.
Practitioner.address.​type	Base	required	AddressType	📍4.0.1	FHIR Std.
Practitioner.address.​state	Base	extensible	USPS Two Letter Alphabetic Codes	📦7.0.0	US Core v7.0
Practitioner.gender	Base	required	AdministrativeGender	📍4.0.1	FHIR Std.
Practitioner.qualification.​code	Base	example	v2 table 0360, Version 2.7	📦0360	FHIR Std.
Practitioner.communication	Base	preferred	Common Languages	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Practitioner	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Practitioner	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Practitioner	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Practitioner	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Practitioner	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
us-core-16	error	Practitioner.identifier:NPI	NPI must be 10 digits	value.matches('^[0-9]{10}$')
us-core-17	error	Practitioner.identifier:NPI	NPI check digit must be valid (Luhn algorithm check)	(((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger()) + 24)mod 10=0)

Summary

Mandatory: 2 elements(3 nested mandatory elements)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Practitioner.identifier