This page is part of the Da Vinci Payer Data Exchange (v2.1.0: STU2.1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

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: coveragein2 - JSON Representation

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{
  "resourceType" : "Coverage",
  "id" : "coverage-2",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-coverage"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Default Generated text for resource.</div>"
  },
  "identifier" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "MB"
          }
        ]
      },
      "system" : "http://example.org/old-payer",
      "value" : "DH10001235"
    }
  ],
  "status" : "draft",
  "subscriberId" : "9876543789",
  "beneficiary" : {
    "reference" : "Patient/2"
  },
  "relationship" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
        "code" : "self"
      }
    ]
  },
  "period" : {
    "start" : "2011-05-23",
    "end" : "2012-05-23"
  },
  "payor" : [
    {
      "identifier" : {
        "system" : "http://hl7.org/fhir/sid/us-npi",
        "value" : "9876543210"
      },
      "display" : "Old Health Plan"
    }
  ],
  "class" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "group"
          },
          {
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "subplan"
          }
        ]
      },
      "value" : "P7"
    },
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "plan"
          },
          {
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "class"
          }
        ]
      },
      "value" : "SILVER"
    }
  ]
}