Health Care Surveys Reporting
2.0.0-ballot - STU 2 - Ballot United States of America flag

Health Care Surveys Reporting - Downloaded Version 2.0.0-ballot See the Directory of published versions

Example Coverage: Coverage Example

Page standards status: Informative

status: Active

policyHolder: Dominique369 Ledner144 Female, DoB: 1965-06-22 ( MRN: Alaska Driver's License#abc123 (use: usual, ))

subscriber: Dominique369 Ledner144 Female, DoB: 1965-06-22 ( MRN: Alaska Driver's License#abc123 (use: usual, ))

subscriberId: XYZ123456789

beneficiary: Dominique369 Ledner144 Female, DoB: 1965-06-22 ( MRN: Alaska Driver's License#abc123 (use: usual, ))

dependent: 0

relationship: Self

period: 2025-01-01 --> 2025-12-31

payor: Organization Blue Cross Blue Shield

class

type: Group

value: ABC987

name: Group Name

class

type: Plan

value: HMO

name: Health Maintenance Organization