Generated Narrative with Details

id: insuranceplan1

identifier: HIOS product ID = 1234567891 (OFFICIAL)

status: active

type: Bronze (Details : {http://hl7.org/fhir/uv/vhdir/CodeSystem/payercharacteristics code 'bronze' = 'Bronze', given as 'Bronze'})

name: Patriot PPO Standard

alias: Patriot Plus

period: Jun 6, 2018, 12:00:00 AM --> Jan 1, 2019, 12:00:00 AM

ownedBy: Homeland Health Insurance. Generated Summary: id: homeland; active; Health System; name: Homeland Health Insurance

administeredBy: Homeland Health Insurance. Generated Summary: id: homeland; active; Health System; name: Homeland Health Insurance

coverageArea: Washington, DC metro area. Generated Summary: id: wash-dc-metro; status: active; name: Washington, DC metro area; Area

Contacts

endpoint: patriot plan endpoint hub

network:

• Patriot Preferred Provider Network. Generated Summary: id: patriotppo; Healthcare.gov Network ID = DCN001 (SECONDARY); active; PPO; name: Patriot Preferred Provider Network; alias: Patriot PPO
• Patriot Dental Provider Network. Generated Summary: id: patriotdental; active; Health System; name: Patriot Dental Provider Network

coverage

type: Coverage related to medical inpatient, outpatient, diagnostic, and preventive care (Details : {[not stated] code 'medical' = 'medical', given as 'Medical'})

network: Patriot Preferred Provider Network. Generated Summary: id: patriotppo; Healthcare.gov Network ID = DCN001 (SECONDARY); active; PPO; name: Patriot Preferred Provider Network; alias: Patriot PPO

benefit

type: Primary care visit to treat an injury or illness (Details : {[not stated] code '001' = '001', given as 'Primary care visit to treat an injury or illness'})

requirement: N/A

Limits

-	Code
*	unlimited (Details )

coverage

type: Coverage related to dental care (Details : {[not stated] code 'dental' = 'dental', given as 'Dental'})

network: Patriot Dental Provider Network. Generated Summary: id: patriotdental; active; Health System; name: Patriot Dental Provider Network

benefit

type: Periodic oral checkup (Details : {[not stated] code '052' = '052', given as 'Basic Dental Care – Adult'})

requirement: N/A

Limits

-	Value	Code
*	2 visit/yr (Details: UCUM code {visit}/a = '{visit}/a')	biannual oral checkup (Details )

plan

identifier: HIOS plan ID = 123456789101112 (OFFICIAL)

type: Bronze (Details : {[not stated] code 'bronze' = 'bronze', given as 'Bronze'})

coverageArea: Washington, DC metro area. Generated Summary: id: wash-dc-metro; status: active; name: Washington, DC metro area; Area

network: Patriot Dental Provider Network. Generated Summary: id: patriotdental; active; Health System; name: Patriot Dental Provider Network

GeneralCosts

-	Type	GroupSize	Cost	Comment
*	Deductible (Details : {[not stated] code 'deductible' = 'deductible', given as 'Deductible'})	1		Includes all prescription and medical costs for in-network providers

specificCost

category: Medical (Details : {[not stated] code 'medical' = 'medical', given as 'Medical'})

benefit

type: Primary care visit to treat an injury or illness (Details : {[not stated] code '001' = '001', given as 'Primary care visit to treat an injury or illness'})

Costs

-	Type	Applicability	Qualifiers	Value
*	Copay (Details : {[not stated] code 'copay' = 'copay', given as 'Copay'})	In Network (Details : {http://terminology.hl7.org/CodeSystem/applicability code 'in-network' = 'In Network', given as 'In Network'})	in-network preferred provider (Details )	50 dollars (Details: urn:iso:std:iso:4217 code USD = 'United States dollar')

specificCost

category: Dental (Details : {[not stated] code 'dental' = 'dental', given as 'Dental'})

benefit

type: Basic Dental Care – Adult (Details : {[not stated] code '052' = '052', given as 'Basic Dental Care – Adult'})

Costs

-	Type	Applicability	Qualifiers	Value
*	Coinsurance (Details : {[not stated] code 'coinsurance' = 'coinsurance', given as 'Coinsurance'})	In Network (Details : {http://terminology.hl7.org/CodeSystem/applicability code 'in-network' = 'In Network', given as 'In Network'})	in-network provider (Details )	10 percent