This page is part of the Da Vinci Data Exchange for Quality Measures (DEQM) FHIR IG (v3.0.0: STU 3) based on FHIR R4. The current version which supercedes this version is 3.1.0. For a full list of available versions, see the Directory of published versions
<Coverage xmlns="http://hl7.org/fhir">
<id value="coverage03"/>
<meta>
<versionId value="2"/>
<lastUpdated value="2019-02-07T18:47:34.000+00:00"/>
<source value="http://example.org/fhir/server"/>
<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</b></p><p><b>status</b>: active</p><p><b>policyHolder</b>: <a href="Patient-patient03.html">Generated Summary: Medical record number: 34567 (USUAL); active; Virginia Hartman (OFFICIAL); gender: female; birthDate: 1983-09-12; <span title="Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus U}">unmarried</span></a></p><p><b>subscriber</b>: <a href="Patient-patient03.html">Generated Summary: Medical record number: 34567 (USUAL); active; Virginia Hartman (OFFICIAL); gender: female; birthDate: 1983-09-12; <span title="Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus U}">unmarried</span></a></p><p><b>subscriberId</b>: C123456789</p><p><b>beneficiary</b>: <a href="Patient-patient03.html">Generated Summary: Medical record number: 34567 (USUAL); active; Virginia Hartman (OFFICIAL); gender: female; birthDate: 1983-09-12; <span title="Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus U}">unmarried</span></a></p><p><b>relationship</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/subscriber-relationship self}">Self</span></p><p><b>payor</b>: <a href="Organization-organization04.html">Generated Summary: Tax ID number: 456789123 (OFFICIAL); active; <span title="Codes: {http://terminology.hl7.org/CodeSystem/organization-type ins}">Insurance Company</span>; name: DVPayer04; Phone: (+1) 616-555-1212</a></p></div>
</text>
<status value="active"/>
<policyHolder>
<reference value="Patient/patient03"/>
</policyHolder>
<subscriber>
<reference value="Patient/patient03"/>
</subscriber>
<subscriberId value="C123456789"/>
<beneficiary>
<reference value="Patient/patient03"/>
</beneficiary>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
<code value="self"/>
</coding>
</relationship>
<payor>
<reference value="Organization/organization04"/>
</payor>
</Coverage>