Da Vinci - Coverage Requirements Discovery - Downloaded Version 2.2.0-ballot See the Directory of published versions
| Page standards status: Informative |
identifier: Member Number/12345
status: Active
type: extended healthcare
policyHolder: http://example.org/FHIR/Organization/CBI35
subscriber: Amy V. Shaw Female, DoB: 1987-02-20 ( Medical Record Number: 1032702 (use: usual, ))
beneficiary: Amy V. Shaw Female, DoB: 1987-02-20 ( Medical Record Number: 1032702 (use: usual, ))
dependent: 0
relationship: Self
period: 2011-05-23 --> 2012-05-23
payor: Payer XYZ
| Type | Value | Name |
| Group | CB135 | Corporate Baker's Inc. Local #35 |