This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v1.1.0-ballot: STU 1.1 Ballot 1) 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
{
"resourceType" : "Coverage",
"id" : "example",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></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 \"example\" </p></div><p><b>identifier</b>: id: 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/3.0.0/CodeSystem-v3-ActCode.html\">ActCode</a>#EHCPOL)</span></p><p><b>policyHolder</b>: <a href=\"http://example.org/FHIR/Organization/CBI35\">http://example.org/FHIR/Organization/CBI35</a></p><p><b>subscriber</b>: <a href=\"Patient-example.html\">Patient/example</a> \" SHAW\"</p><p><b>beneficiary</b>: <a href=\"Patient-example.html\">Patient/example</a> \" SHAW\"</p><p><b>dependent</b>: 0</p><p><b>relationship</b>: Self <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.0.0/CodeSystem-subscriber-relationship.html\">SubscriberPolicyholder Relationship Codes</a>#self)</span></p><p><b>period</b>: 2011-05-23 --> 2012-05-23</p><p><b>payor</b>: <a href=\"http://example.org/fhir/Organization/example-payer\">http://example.org/fhir/Organization/example-payer: Payer XYZ</a></p><h3>Classes</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td><td><b>Name</b></td></tr><tr><td>*</td><td>Group <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.0.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#group)</span></td><td>CB135</td><td>Corporate Baker's Inc. Local #35</td></tr></table></div>"
},
"identifier" : [
{
"system" : "http://example.com/fhir/NampingSystem/certificate",
"value" : "12345"
}
],
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code" : "EHCPOL",
"display" : "extended healthcare"
}
]
},
"policyHolder" : {
"reference" : "http://example.org/FHIR/Organization/CBI35"
},
"subscriber" : {
"reference" : "Patient/example"
},
"beneficiary" : {
"reference" : "Patient/example"
},
"dependent" : "0",
"relationship" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
"code" : "self"
}
]
},
"period" : {
"start" : "2011-05-23",
"end" : "2012-05-23"
},
"payor" : [
{
"reference" : "http://example.org/fhir/Organization/example-payer",
"display" : "Payer XYZ"
}
],
"class" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
"code" : "group"
}
]
},
"value" : "CB135",
"name" : "Corporate Baker's Inc. Local #35"
}
]
}