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Page standards status: Informative |
Generated Narrative: Coverage CoverageExample
status: Active
subscriber: Anonymous Patient Male, DoB: 1996-12-23
subscriberId: PFP123450000
beneficiary: Anonymous Patient Male, DoB: 1996-12-23
relationship: Self
period: 2022-01-01 --> 2023-01-01
payor: Organization Insurance Company
Type | Value | Name |
Plan | Premim Family Plus | Premim Family Plus Plan |
Generated Narrative: Organization #OrgExample
identifier: Clinical Laboratory Improvement Amendments/10D0202020
active: true
type: Payer
name: Insurance Company
telecom: ph: 860-547-5001(Work)
address: 680 Asylum Street Hartford CT 06155 US