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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 "CoverageDental1"] ; #
fhir:meta [
fhir:lastUpdated [ fhir:v "2021-01-01T14:22:01.0314215+00:00"^^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 CoverageDental1</b></p><a name=\"CoverageDental1\"> </a><a name=\"hcCoverageDental1\"> </a><a name=\"CoverageDental1-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: 2021-01-01 14:22:01+0000; 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>: Member Number/210300002</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode DENTAL}\">dental care policy</span></p><p><b>policyHolder</b>: <a href=\"Patient-Patient2.html\">Member 01 Test Male, DoB: 1943-01-01 ( An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier.: 88800933501)</a></p><p><b>subscriber</b>: <a href=\"Patient-Patient2.html\">Member 01 Test Male, DoB: 1943-01-01 ( An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier.: 88800933501)</a></p><p><b>subscriberId</b>: 10300007</p><p><b>beneficiary</b>: <a href=\"Patient-Patient2.html\">Member 01 Test Male, DoB: 1943-01-01 ( An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier.: 88800933501)</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>: 2021-01-01 --> 2021-12-31</p><p><b>payor</b>: <a href=\"Organization-DentalPayer1.html\">Organization INSURANCE COMPANY XYZ</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>: 10300007</p><p><b>name</b>: Transcorp - dental</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class plan}\">Plan</span></p><p><b>value</b>: 66783JJT</p><p><b>name</b>: INSURANCE COMPANY XYZ - PRIME</p></blockquote><p><b>network</b>: INSURANCE COMPANY XYZ - PRIME</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:system [ fhir:v "https://www.xxxhealthplan.com/fhir/memberidentifier"^^xsd:anyURI ] ;
fhir:value [ fhir:v "210300002" ]
] ) ; #
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 "DENTAL" ] ] ) ;
fhir:text [ fhir:v "dental care policy" ]
] ; #
fhir:policyHolder [
fhir:reference [ fhir:v "Patient/Patient2" ]
] ; #
fhir:subscriber [
fhir:reference [ fhir:v "Patient/Patient2" ]
] ; #
fhir:subscriberId [ fhir:v "10300007"] ; #
fhir:beneficiary [
fhir:reference [ fhir:v "Patient/Patient2" ]
] ; #
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:period [
fhir:start [ fhir:v "2021-01-01"^^xsd:date ] ;
fhir:end [ fhir:v "2021-12-31"^^xsd:date ]
] ; #
fhir:payor ( [
fhir:reference [ fhir:v "Organization/DentalPayer1" ]
] ) ; #
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:text [ fhir:v "An employee group" ] ] ;
fhir:value [ fhir:v "10300007" ] ;
fhir:name [ fhir:v "Transcorp - dental" ]
] [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "plan" ] ] ) ;
fhir:text [ fhir:v "Plan" ] ] ;
fhir:value [ fhir:v "66783JJT" ] ;
fhir:name [ fhir:v "INSURANCE COMPANY XYZ - PRIME" ]
] ) ; #
fhir:network [ fhir:v "INSURANCE COMPANY XYZ - PRIME"] . #
IG © 2024+ HL7 International / Financial Management. Package hl7.fhir.us.carin-bb#2.1.0 based on FHIR 4.0.1. Generated 2025-02-18
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