This page is part of the US Core (v7.0.0: STU7) based on FHIR (HL7® FHIR® Standard) 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
Page standards status: Informative |
{
"resourceType" : "Coverage",
"id" : "coverage-example",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage|7.0.0"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Coverage</b><a name=\"coverage-example\"> </a><a name=\"hccoverage-example\"> </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 "coverage-example" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-us-core-coverage.html\">US Core Coverage Profile (version 7.0.0)</a></p></div><p><b>identifier</b>: Member Number/88800933501</p><p><b>status</b>: active</p><p><b>type</b>: PPO <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://nahdo.org/sopt\">Source of Payment Typology</a>#3712; <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html\">ActCode</a>#PPO "preferred provider organization policy")</span></p><p><b>subscriberId</b>: 888009335</p><p><b>beneficiary</b>: <a href=\"Patient-example.html\">Patient/example</a> " SHAW"</p><p><b>relationship</b>: Self <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-subscriber-relationship.html\">SubscriberPolicyholder Relationship Codes</a>#self)</span></p><p><b>period</b>: 2020-01-01 --> (ongoing)</p><p><b>payor</b>: <a href=\"Organization-acme-payer.html\">Organization/acme-payer: Acme Health Plan</a> "Acme Health Plan"</p><blockquote><p><b>class</b></p><p><b>type</b>: An employee group <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#group "Group")</span></p><p><b>value</b>: xyz</p><p><b>name</b>: XYZ employee Group Plan</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: A specific suite of benefits. <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#plan "Plan")</span></p><p><b>value</b>: gold</p><p><b>name</b>: Acme Gold Plan</p></blockquote></div>"
},
"identifier" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "MB",
"display" : "Member Number"
}
]
},
"system" : "http://example.org/fhir/memberidentifier",
"value" : "88800933501"
}
],
"status" : "active",
"type" : {
"coding" : [
{
"system" : "https://nahdo.org/sopt",
"code" : "3712",
"display" : "PPO"
},
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code" : "PPO",
"display" : "preferred provider organization policy"
}
],
"text" : "PPO"
},
"subscriberId" : "888009335",
"beneficiary" : {
🔗 "reference" : "Patient/example"
},
"relationship" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
"code" : "self"
}
],
"text" : "Self"
},
"period" : {
"start" : "2020-01-01"
},
"payor" : [
{
🔗 "reference" : "Organization/acme-payer",
"display" : "Acme Health Plan"
}
],
"class" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
"code" : "group",
"display" : "Group"
}
],
"text" : "An employee group"
},
"value" : "xyz",
"name" : "XYZ employee Group Plan"
},
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
"code" : "plan",
"display" : "Plan"
}
],
"text" : "A specific suite of benefits."
},
"value" : "gold",
"name" : "Acme Gold Plan"
}
]
}