This page is part of the FHIR Specification (v3.2.0: R4 Ballot 1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions 
| Patient Administration Work Group | Maturity Level: N/A | Ballot Status: Informative | Compartments: Not linked to any defined compartments |
A general product plan example with benefit detail
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
<http://hl7.org/fhir/ProductPlan/example-onc> a fhir:ProductPlan;
fhir:nodeRole fhir:treeRoot;
fhir:Resource.id [ fhir:value "example-onc"];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n Sample Plan\n </div>"
];
fhir:ProductPlan.status [ fhir:value "active"];
fhir:ProductPlan.name [ fhir:value "Sample Plan"];
fhir:ProductPlan.alias [
fhir:value "PPO Sample Plan";
fhir:index 0
];
fhir:ProductPlan.period [
fhir:Period.start [ fhir:value "2017-01-01"^^xsd:date ]
];
fhir:ProductPlan.ownedBy [
fhir:link <http://hl7.org/fhir/Organization/Test>;
fhir:Reference.reference [ fhir:value "Organization/Test" ];
fhir:Reference.display [ fhir:value "Test" ]
];
fhir:ProductPlan.administeredBy [
fhir:link <http://hl7.org/fhir/Organization/Test>;
fhir:Reference.reference [ fhir:value "Organization/Test" ];
fhir:Reference.display [ fhir:value "Test" ]
];
fhir:ProductPlan.address [
fhir:index 0;
fhir:Address.line [
fhir:value "123 Fake Street";
fhir:index 0
];
fhir:Address.city [ fhir:value "Washington" ];
fhir:Address.state [ fhir:value "DC" ];
fhir:Address.postalCode [ fhir:value "20005" ];
fhir:Address.country [ fhir:value "USA" ]
];
fhir:ProductPlan.coverageArea [
fhir:link <http://hl7.org/fhir/Location/2>;
fhir:Reference.reference [ fhir:value "Location/2" ];
fhir:Reference.display [ fhir:value "National" ]
];
fhir:ProductPlan.coverage [
fhir:index 0;
fhir:ProductPlan.coverage.type [
fhir:CodeableConcept.text [ fhir:value "Medical" ]
];
fhir:ProductPlan.coverage.benefit [
fhir:index 0;
fhir:ProductPlan.coverage.benefit.type [
fhir:CodeableConcept.text [ fhir:value "Diagnostic and treatment services" ]
];
fhir:ProductPlan.coverage.benefit.item [
fhir:index 0;
fhir:ProductPlan.coverage.benefit.item.code [
fhir:CodeableConcept.text [ fhir:value "primary care visit" ]
]
], [
fhir:index 1;
fhir:ProductPlan.coverage.benefit.item.code [
fhir:CodeableConcept.text [ fhir:value "specialty care visit" ]
]
]
]
];
fhir:ProductPlan.plan [
fhir:index 0;
fhir:ProductPlan.plan.type [
fhir:CodeableConcept.text [ fhir:value "Standard" ]
];
fhir:ProductPlan.plan.premium [
fhir:Quantity.value [ fhir:value "2000"^^xsd:decimal ];
fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ];
fhir:Quantity.code [ fhir:value "USD" ]
];
fhir:ProductPlan.plan.category [
fhir:index 0;
fhir:ProductPlan.plan.category.code [
fhir:CodeableConcept.text [ fhir:value "Medical" ]
];
fhir:ProductPlan.plan.category.benefit [
fhir:index 0;
fhir:ProductPlan.plan.category.benefit.type [
fhir:CodeableConcept.text [ fhir:value "primary care office visit" ]
];
fhir:ProductPlan.plan.category.benefit.cost [
fhir:index 0;
fhir:ProductPlan.plan.category.benefit.cost.type [
fhir:CodeableConcept.text [ fhir:value "copay" ]
];
fhir:ProductPlan.plan.category.benefit.cost.applicability [
fhir:index 0;
fhir:Coding.code [ fhir:value "preferred" ]
];
fhir:ProductPlan.plan.category.benefit.cost.value [
fhir:Quantity.value [ fhir:value "25"^^xsd:decimal ];
fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ];
fhir:Quantity.code [ fhir:value "USD" ]
]
], [
fhir:index 1;
fhir:ProductPlan.plan.category.benefit.cost.type [
fhir:CodeableConcept.text [ fhir:value "coinsurance" ]
];
fhir:ProductPlan.plan.category.benefit.cost.applicability [
fhir:index 0;
fhir:Coding.code [ fhir:value "participating" ]
];
fhir:ProductPlan.plan.category.benefit.cost.value [
fhir:Quantity.value [ fhir:value "35"^^xsd:decimal ];
fhir:Quantity.unit [ fhir:value "%" ]
]
], [
fhir:index 2;
fhir:ProductPlan.plan.category.benefit.cost.type [
fhir:CodeableConcept.text [ fhir:value "coinsurance" ]
];
fhir:ProductPlan.plan.category.benefit.cost.applicability [
fhir:index 0;
fhir:Coding.code [ fhir:value "non-participating" ]
];
fhir:ProductPlan.plan.category.benefit.cost.value [
fhir:Quantity.value [ fhir:value "35"^^xsd:decimal ];
fhir:Quantity.unit [ fhir:value "%" ]
]
]
], [
fhir:index 1;
fhir:ProductPlan.plan.category.benefit.type [
fhir:CodeableConcept.text [ fhir:value "specialty care office visit" ]
];
fhir:ProductPlan.plan.category.benefit.cost [
fhir:index 0;
fhir:ProductPlan.plan.category.benefit.cost.type [
fhir:CodeableConcept.text [ fhir:value "copay" ]
];
fhir:ProductPlan.plan.category.benefit.cost.applicability [
fhir:index 0;
fhir:Coding.code [ fhir:value "preferred" ]
];
fhir:ProductPlan.plan.category.benefit.cost.value [
fhir:Quantity.value [ fhir:value "35"^^xsd:decimal ];
fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ];
fhir:Quantity.code [ fhir:value "USD" ]
]
], [
fhir:index 1;
fhir:ProductPlan.plan.category.benefit.cost.type [
fhir:CodeableConcept.text [ fhir:value "coinsurance" ]
];
fhir:ProductPlan.plan.category.benefit.cost.applicability [
fhir:index 0;
fhir:Coding.code [ fhir:value "participating" ]
];
fhir:ProductPlan.plan.category.benefit.cost.value [
fhir:Quantity.value [ fhir:value "35"^^xsd:decimal ];
fhir:Quantity.unit [ fhir:value "%" ]
]
], [
fhir:index 2;
fhir:ProductPlan.plan.category.benefit.cost.type [
fhir:CodeableConcept.text [ fhir:value "coinsurance" ]
];
fhir:ProductPlan.plan.category.benefit.cost.applicability [
fhir:index 0;
fhir:Coding.code [ fhir:value "non-participating" ]
];
fhir:ProductPlan.plan.category.benefit.cost.value [
fhir:Quantity.value [ fhir:value "35"^^xsd:decimal ];
fhir:Quantity.unit [ fhir:value "%" ]
]
]
]
]
];
fhir:ProductPlan.endpoint [
fhir:index 0;
fhir:link <http://hl7.org/fhir/Endpoint/example>;
fhir:Reference.reference [ fhir:value "Endpoint/example" ]
] .
<http://hl7.org/fhir/Organization/Test> a fhir:Organization .
<http://hl7.org/fhir/Location/2> a fhir:Location .
<http://hl7.org/fhir/Endpoint/example> a fhir:Endpoint .
# - ontology header ------------------------------------------------------------
<http://hl7.org/fhir/ProductPlan/example-onc.ttl> a owl:Ontology;
owl:imports fhir:fhir.ttl;
owl:versionIRI <http://build.fhir.org/ProductPlan/example-onc.ttl> .
# -------------------------------------------------------------------------------------
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.