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

This page is part of the Health Care Surveys Reporting (v2.0.0: STU 2) 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

Example Coverage: Coverage - Blue Cross Blue Shield HMO

Page standards status: Informative

status: Active

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

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

subscriberId: XYZ123456789

beneficiary: Dominique Ledner 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