This page is part of the Da Vinci Data Exchange for Quality Measures (DEQM) FHIR IG (v1.0.0: STU 1) based on FHIR R3. The current version which supercedes this version is 3.1.0. For a full list of available versions, see the Directory of published versions

• Narrative Content
• XML
• JSON

XML Format: Coverage-coverage02

Download Raw xml

<Coverage xmlns="http://hl7.org/fhir">
  <id value="coverage02"/>
  <meta>
    <versionId value="2"/>
    <lastUpdated value="2019-03-06T19:03:03.000+00:00"/>
    <profile
             value="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/coverage-deqm"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: coverage02</p><p><b>meta</b>: </p><p><b>policyHolder</b>: <a href="Patient-patient02.html">Generated Summary: id: patient02; Medical record number = 23456 (USUAL); active; Darien Bernard (OFFICIAL); gender: male; birthDate: 1967-06-13; <span title="Codes: {http://hl7.org/fhir/v3/MaritalStatus M}">Married</span></a></p><p><b>subscriber</b>: <a href="Patient-patient02.html">Generated Summary: id: patient02; Medical record number = 23456 (USUAL); active; Darien Bernard (OFFICIAL); gender: male; birthDate: 1967-06-13; <span title="Codes: {http://hl7.org/fhir/v3/MaritalStatus M}">Married</span></a></p><p><b>subscriberId</b>: B123456789</p><p><b>beneficiary</b>: <a href="Patient-patient02.html">Generated Summary: id: patient02; Medical record number = 23456 (USUAL); active; Darien Bernard (OFFICIAL); gender: male; birthDate: 1967-06-13; <span title="Codes: {http://hl7.org/fhir/v3/MaritalStatus M}">Married</span></a></p><p><b>relationship</b>: self <span style="background: LightGoldenRodYellow">(Details : {[not stated] code 'self' = 'self)</span></p><p><b>payor</b>: <a href="Organization-organization04.html">Generated Summary: id: organization04; Tax ID number = 456789123 (OFFICIAL); active; <span title="Codes: {http://hl7.org/fhir/organization-type ins}">Insurance Company</span>; name: DVPayer04; ph: (+1) 616-555-1212</a></p></div>
  </text>
  <policyHolder>
    <reference value="Patient/patient02"/>
  </policyHolder>
  <subscriber>
    <reference value="Patient/patient02"/>
  </subscriber>
  <subscriberId value="B123456789"/>
  <beneficiary>
    <reference value="Patient/patient02"/>
  </beneficiary>
  <relationship>
    <coding>
      <code value="self"/>
    </coding>
  </relationship>
  <payor>
    <reference value="Organization/organization04"/>
  </payor>
</Coverage>