STU 3 Ballot

This page is part of the FHIR Specification (v1.6.0: STU 3 Ballot 4). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Coverage-example-2.xml

Raw XML (canonical form)

General Person Secondary Coverage Example (id = "7546D")

<Coverage xmlns="http://hl7.org/fhir">
 <id value="7546D"/>

 <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the coverage</div>
  </text>

 <status value="active"/>
  
 <issuerReference>
  <reference value="Organization/2"/>
 </issuerReference>
 
 <period> 
   <start value="2011-03-17"/>
   <end value="2012-03-17"/>
 </period>

 <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="EHCPOL"/>
      <display value="extended healthcare"/>
 </type>

 <planholderReference>
  <reference value="Patient/5"/>
 </planholderReference>
 
 <beneficiaryReference>
  <reference value="Patient/5"/>
 </beneficiaryReference>
 
 <relationship>
      <code value="self"/>
 </relationship>

 <identifier>
    <system value="http://xyz.com/codes/identifier"/>
    <value value="AB9876"/>
 </identifier>
 
 <plan value="11024"/>
 
 <subPlan value="D15C9"/>
 
 <dependent value="1"/>
  
</Coverage>

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.