Vital Records Birth and Fetal Death Reporting
0.1.0 - STU 1 Ballot

This page is part of the Vital Records Birth and Fetal Death Reporting (v0.1.0: STU 1 on FHIR R4 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

: Coverage - Principal Payer for Delivery example [Jada Ann Quinn] - JSON Representation

Raw json | Download


{
  "resourceType" : "Coverage",
  "id" : "coverage-principal-payer-for-delivery-jada-ann-quinn",
  "meta" : {
    "versionId" : "5",
    "lastUpdated" : "2020-08-20T22:25:03.520+00:00",
    "source" : "#ugCsruFS3H9MAPz3",
    "profile" : [
      "http://hl7.org/fhir/us/bfdr/StructureDefinition/Coverage-principal-payer-for-delivery"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>status</b>: active</p><p><b>type</b>: <span title=\"Codes: {urn:oid:2.16.840.1.113883.3.221.5 5}\">Private Health Insurance</span></p><p><b>beneficiary</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn). Generated Summary: Social Security number: 132225986 (USUAL), Medical Record Number: 1032702 (USUAL); Jada Ann Quinn (OFFICIAL), Jada Ann King (MAIDEN); Phone: 1-(404)555-1212, jadaann.quinn@example.com; gender: female; birthDate: 1985-01-15</a></p><p><b>payor</b>: <span>Not asked</span></p></div>"
  },
  "status" : "active",
  "type" : {
    "coding" : [
      {
        "system" : "urn:oid:2.16.840.1.113883.3.221.5",
        "code" : "5",
        "display" : "Private Health Insurance"
      }
    ],
    "text" : "Private Health Insurance"
  },
  "beneficiary" : {
    "reference" : "Patient/patient-mother-jada-ann-quinn",
    "display" : "Patient - Mother (Jada Ann Quinn)"
  },
  "payor" : [
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
          "valueCode" : "not-asked"
        }
      ],
      "display" : "Not asked"
    }
  ]
}