Productplan-example-onc.json

A general product plan example with benefit detail

{
  "resourceType": "ProductPlan",
  "id": "example-onc",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n\t\t\tSample Plan\n\t\t</div>"
  },
  "status": "active",
  "name": "Sample Plan",
  "alias": [
    "PPO Sample Plan"
  ],
  "period": {
    "start": "2017-01-01"
  },
  "ownedBy": {
    "reference": "Organization/Test",
    "display": "Test"
  },
  "administeredBy": {
    "reference": "Organization/Test",
    "display": "Test"
  },
  "address": [
    {
      "line": [
        "123 Fake Street"
      ],
      "city": "Washington",
      "state": "DC",
      "postalCode": "20005",
      "country": "USA"
    }
  ],
  "coverageArea": {
    "reference": "Location/2",
    "display": "National"
  },
  "coverage": [
    {
      "type": {
        "text": "Medical"
      },
      "benefit": [
        {
          "type": {
            "text": "Diagnostic and treatment services"
          },
          "item": [
            {
              "code": {
                "text": "primary care visit"
              }
            },
            {
              "code": {
                "text": "specialty care visit"
              }
            }
          ]
        }
      ]
    }
  ],
  "plan": [
    {
      "type": {
        "text": "Standard"
      },
      "premium": {
        "value": 2000,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "category": [
        {
          "code": {
            "text": "Medical"
          },
          "benefit": [
            {
              "type": {
                "text": "primary care office visit"
              },
              "cost": [
                {
                  "type": {
                    "text": "copay"
                  },
                  "applicability": [
                    {
                      "code": "preferred"
                    }
                  ],
                  "value": {
                    "value": 25,
                    "system": "urn:iso:std:iso:4217",
                    "code": "USD"
                  }
                },
                {
                  "type": {
                    "text": "coinsurance"
                  },
                  "applicability": [
                    {
                      "code": "participating"
                    }
                  ],
                  "value": {
                    "value": 35,
                    "unit": "%"
                  }
                },
                {
                  "type": {
                    "text": "coinsurance"
                  },
                  "applicability": [
                    {
                      "code": "non-participating"
                    }
                  ],
                  "value": {
                    "value": 35,
                    "unit": "%"
                  }
                }
              ]
            },
            {
              "type": {
                "text": "specialty care office visit"
              },
              "cost": [
                {
                  "type": {
                    "text": "copay"
                  },
                  "applicability": [
                    {
                      "code": "preferred"
                    }
                  ],
                  "value": {
                    "value": 35,
                    "system": "urn:iso:std:iso:4217",
                    "code": "USD"
                  }
                },
                {
                  "type": {
                    "text": "coinsurance"
                  },
                  "applicability": [
                    {
                      "code": "participating"
                    }
                  ],
                  "value": {
                    "value": 35,
                    "unit": "%"
                  }
                },
                {
                  "type": {
                    "text": "coinsurance"
                  },
                  "applicability": [
                    {
                      "code": "non-participating"
                    }
                  ],
                  "value": {
                    "value": 35,
                    "unit": "%"
                  }
                }
              ]
            }
          ]
        }
      ]
    }
  ],
  "endpoint": [
    {
      "reference": "Endpoint/example"
    }
  ]
}