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.xml

Raw XML (canonical form)

General Person Primary Coverage Example (id = "9876B1")

<Coverage xmlns="http://hl7.org/fhir">
 <id value="9876B1"/>

 <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="2011-05-23"/>
   <end value="2012-05-23"/>
 </period>

 <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="EHCPOL"/>
      <display value="extended healthcare"/>
 </type>
 
 <planholderReference>
  <reference value="Patient/4"/>
 </planholderReference>
 
 <beneficiaryReference>
  <reference value="Patient/4"/>
 </beneficiaryReference>
 
 <relationship>
      <code value="self"/>
 </relationship>
 
 <identifier>
    <system value="http://benefitsinc.com/certificate"/>
    <value value="12345"/>
 </identifier>
 
 <plan value="CBI35"/>
 
 <subPlan value="123"/>
 
 <dependent value="1"/>
 
 <sequence 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.