CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®)
2.1.0 - STU 2.1 flag

This page is part of the CARIN Blue Button Implementation Guide (v2.1.0: STU 2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: Coverage Example 1 - TTL Representation

Page standards status: Informative

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@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 "Coverage1"] ; # 
  fhir:meta [
fhir:lastUpdated [ fhir:v "2020-10-30T09:48:01.8462752-04:00"^^xsd:dateTime ] ;
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage|2.1.0"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage|2.1.0>     ] )
  ] ; # 
  fhir:language [ fhir:v "en-US"] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en-US\" lang=\"en-US\"><p class=\"res-header-id\"><b>Generated Narrative: Coverage Coverage1</b></p><a name=\"Coverage1\"> </a><a name=\"hcCoverage1\"> </a><a name=\"Coverage1-en-US\"> </a><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\">Last updated: 2020-10-30 09:48:01-0400; Language: en-US</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-C4BB-Coverage.html\">C4BB Coverageversion: null2.1.0)</a></p></div><p><b>identifier</b>: An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier./88800933501</p><p><b>status</b>: Active</p><p><b>policyHolder</b>: <a href=\"Patient-Patient1.html\">Johnny Example1  Male, DoB: 1986-01-01 ( Member Number)</a></p><p><b>subscriber</b>: <a href=\"Patient-Patient1.html\">Johnny Example1  Male, DoB: 1986-01-01 ( Member Number)</a></p><p><b>subscriberId</b>: 888009335</p><p><b>beneficiary</b>: <a href=\"Patient-Patient1.html\">Johnny Example1  Male, DoB: 1986-01-01 ( Member Number)</a></p><p><b>dependent</b>: 01</p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}\">Self</span></p><p><b>period</b>: 2020-01-01 --&gt; (ongoing)</p><p><b>payor</b>: <a href=\"Organization-Payer2.html\">UPMC Health Plan</a></p><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class group}\">An employee group</span></p><p><b>value</b>: MCHMO1</p><p><b>name</b>: MEDICARE HMO PLAN</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class plan}\">A specific suite of benefits.</span></p><p><b>value</b>: GR5</p><p><b>name</b>: GR5-HMO DEDUCTIBLE</p></blockquote><p><b>network</b>: GR5-HMO DEDUCTIBLE</p></div>"^^rdf:XMLLiteral
  ] ; # 
  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:text [ fhir:v "An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier." ]     ] ;
fhir:system [ fhir:v "https://www.upmchealthplan.com/fhir/memberidentifier"^^xsd:anyURI ] ;
fhir:value [ fhir:v "88800933501" ] ;
fhir:assigner [
fhir:reference [ fhir:v "Organization/Payer2" ] ;
fhir:display [ fhir:v "UPMC Health Plan" ]     ]
  ] ) ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:policyHolder [
fhir:reference [ fhir:v "Patient/Patient1" ]
  ] ; # 
  fhir:subscriber [
fhir:reference [ fhir:v "Patient/Patient1" ]
  ] ; # 
  fhir:subscriberId [ fhir:v "888009335"] ; # 
  fhir:beneficiary [
fhir:reference [ fhir:v "Patient/Patient1" ]
  ] ; # 
  fhir:dependent [ fhir:v "01"] ; # 
  fhir:relationship [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/subscriber-relationship"^^xsd:anyURI ] ;
fhir:code [ fhir:v "self" ]     ] ) ;
fhir:text [ fhir:v "Self" ]
  ] ; # 
  fhir:period [
fhir:start [ fhir:v "2020-01-01"^^xsd:date ]
  ] ; # 
  fhir:payor ( [
fhir:reference [ fhir:v "Organization/Payer2" ] ;
fhir:display [ fhir:v "UPMC Health Plan" ]
  ] ) ; # 
  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:display [ fhir:v "Group" ]       ] ) ;
fhir:text [ fhir:v "An employee group" ]     ] ;
fhir:value [ fhir:v "MCHMO1" ] ;
fhir:name [ fhir:v "MEDICARE HMO PLAN" ]
  ] [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "plan" ] ;
fhir:display [ fhir:v "Plan" ]       ] ) ;
fhir:text [ fhir:v "A specific suite of benefits." ]     ] ;
fhir:value [ fhir:v "GR5" ] ;
fhir:name [ fhir:v "GR5-HMO DEDUCTIBLE" ]
  ] ) ; # 
  fhir:network [ fhir:v "GR5-HMO DEDUCTIBLE"] . #