Vital Records Birth and Fetal Death Reporting
1.0.0 - STU 1

This page is part of the Vital Records Birth and Fetal Death Reporting (v1.0.0: STU 1 on FHIR R4) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

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

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<Coverage xmlns="http://hl7.org/fhir">
  <id value="coverage-principal-payer-for-delivery-jada-ann-quinn"/>
  <meta>
    <versionId value="5"/>
    <lastUpdated value="2020-08-20T22:25:03.520+00:00"/>
    <source value="#ugCsruFS3H9MAPz3"/>
    <profile
             value="http://hl7.org/fhir/us/bfdr/StructureDefinition/Coverage-principal-payer-for-delivery"/>
  </meta>
  <text>
    <status value="generated"/>
    <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>
  </text>
  <status value="active"/>
  <type>
    <coding>
      <system value="urn:oid:2.16.840.1.113883.3.221.5"/>
      <code value="5"/>
      <display value="Private Health Insurance"/>
    </coding>
    <text value="Private Health Insurance"/>
  </type>
  <beneficiary>
    <reference value="Patient/patient-mother-jada-ann-quinn"/>
    <display value="Patient - Mother (Jada Ann Quinn)"/>
  </beneficiary>
  <payor>
    <extension url="http://hl7.org/fhir/StructureDefinition/data-absent-reason">
      <valueCode value="not-asked"/>
    </extension>
    <display value="Not asked"/>
  </payor>
</Coverage>