Bidirectional Services eReferral (BSeR)
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This page is part of the Bidirectional Services eReferrals (BSeR) (v2.0.0-ballot: STU 2) 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 - Baby Everybaby - TTL Representation

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@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 -------------------------------------------------------------------

 a fhir:Coverage ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "coverage-bser-coverage-baby-everybaby"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-Coverage"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-Coverage>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Coverage</b><a name=\"coverage-bser-coverage-baby-everybaby\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Coverage &quot;coverage-bser-coverage-baby-everybaby&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-BSeR-Coverage.html\">BSeR Coverage</a></p></div><p><b>identifier</b>: Member Number: 12345</p><p><b>status</b>: active</p><p><b>type</b>: extended healthcare <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-ActCode.html\">ActCode</a>#EHCPOL)</span></p><p><b>subscriber</b>: <a href=\"RelatedPerson-relatedperson-us-core-relatedperson-mom-everymom.html\">RelatedPerson/relatedperson-us-core-relatedperson-mom-everymom: Mom Everymom</a> &quot; EVERYMOM&quot;</p><p><b>beneficiary</b>: <a href=\"Patient-patient-us-core-patient-baby-everybaby.html\">Patient/patient-us-core-patient-baby-everybaby: Baby Everybaby</a> &quot; EVERYBABY&quot;</p><p><b>relationship</b>: gestational mother <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-RoleCode.html\">RoleCode</a>#GESTM)</span></p><p><b>period</b>: 2019-05-23 --&gt; 2020-05-23</p><p><b>payor</b>: <a href=\"Organization-organization-us-core-organization-saint-luke.html\">Organization/organization-us-core-organization-saint-luke</a> &quot;Saint Luke's Hospital of Kansas City&quot;</p><blockquote><p><b>class</b></p><p><b>type</b>: Group <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#group; <a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#subgroup)</span></p><p><b>value</b>: 123</p><p><b>name</b>: Trainee Part-time Benefits</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: Plan <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#plan; <a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#subplan)</span></p><p><b>value</b>: P7</p><p><b>name</b>: Includes afterlife benefits</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: Class <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#class)</span></p><p><b>value</b>: SILVER</p><p><b>name</b>: Silver: Family Plan spouse only</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: SubClass <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#subclass)</span></p><p><b>value</b>: Tier2</p><p><b>name</b>: Low deductable, max $20 copay</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: Sequence <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#sequence)</span></p><p><b>value</b>: 9</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: RX Id <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#rxid)</span></p><p><b>value</b>: MDF12345</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: RX BIN <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#rxbin)</span></p><p><b>value</b>: 987654</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: RX Group <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#rxgroup)</span></p><p><b>value</b>: M35PT</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: RX PCN <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#rxpcn)</span></p><p><b>value</b>: 234516</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: Sequence <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#sequence)</span></p><p><b>value</b>: 9</p></blockquote></div>"
  ] ; # 
  fhir:identifier ( [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "MB" ] ;
fhir:display [ fhir:v "Member Number" ]       ] )     ] ;
fhir:system [ fhir:v "http://benefitsinc.com/certificate"^^xsd:anyURI ] ;
fhir:value [ fhir:v "12345" ]
  ] ) ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:type [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:code [ fhir:v "EHCPOL" ] ;
fhir:display [ fhir:v "extended healthcare" ]     ] )
  ] ; # 
  fhir:subscriber [
fhir:reference [ fhir:v "RelatedPerson/relatedperson-us-core-relatedperson-mom-everymom" ] ;
fhir:display [ fhir:v "Mom Everymom" ]
  ] ; # 
  fhir:beneficiary [
fhir:reference [ fhir:v "Patient/patient-us-core-patient-baby-everybaby" ] ;
fhir:display [ fhir:v "Baby Everybaby" ]
  ] ; # 
  fhir:relationship [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-RoleCode"^^xsd:anyURI ] ;
fhir:code [ fhir:v "GESTM" ] ;
fhir:display [ fhir:v "gestational mother" ]     ] ) ;
fhir:text [ fhir:v "gestational mother" ]
  ] ; # 
  fhir:period [
fhir:start [ fhir:v "2019-05-23"^^xsd:date ] ;
fhir:end [ fhir:v "2020-05-23"^^xsd:date ]
  ] ; # 
  fhir:payor ( [
fhir:reference [ fhir:v "Organization/organization-us-core-organization-saint-luke" ]
  ] ) ; # 
  fhir:class ( [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "group" ]       ] [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "subgroup" ]       ] )     ] ;
fhir:value [ fhir:v "123" ] ;
fhir:name [ fhir:v "Trainee Part-time Benefits" ]
  ] [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "plan" ]       ] [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "subplan" ]       ] )     ] ;
fhir:value [ fhir:v "P7" ] ;
fhir:name [ fhir:v "Includes afterlife benefits" ]
  ] [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "class" ]       ] )     ] ;
fhir:value [ fhir:v "SILVER" ] ;
fhir:name [ fhir:v "Silver: Family Plan spouse only" ]
  ] [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "subclass" ]       ] )     ] ;
fhir:value [ fhir:v "Tier2" ] ;
fhir:name [ fhir:v "Low deductable, max $20 copay" ]
  ] [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "sequence" ]       ] )     ] ;
fhir:value [ fhir:v "9" ]
  ] [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "rxid" ]       ] )     ] ;
fhir:value [ fhir:v "MDF12345" ]
  ] [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "rxbin" ]       ] )     ] ;
fhir:value [ fhir:v "987654" ]
  ] [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "rxgroup" ]       ] )     ] ;
fhir:value [ fhir:v "M35PT" ]
  ] [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "rxpcn" ]       ] )     ] ;
fhir:value [ fhir:v "234516" ]
  ] [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "sequence" ]       ] )     ] ;
fhir:value [ fhir:v "9" ]
  ] ) . #