QI-Core Implementation Guide
7.0.0-ballot - STU7 Ballot United States of America flag

This page is part of the Quality Improvement Core Framework (v7.0.0-ballot: STU7 (v7.0.0) Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 6.0.0. For a full list of available versions, see the Directory of published versions

: Coverage example - Subscriber ID - JSON Representation

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{
  "resourceType" : "Coverage",
  "id" : "example-new",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Coverage example-new</b></p><a name=\"example-new\"> </a><a name=\"hcexample-new\"> </a><a name=\"example-new-en-US\"> </a><p><b>identifier</b>: Member Number/?ngen-9?</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{https://nahdo.org/sopt 59}\">Other Private Insurance</span></p><p><b>policyHolder</b>: <a href=\"Patient-example.html\">Jim Chalmers  Male, DoB: 1974-12-25 ( Medical record number\u00a0(use:\u00a0usual,\u00a0period:\u00a02001-05-06 --&gt; (ongoing)))</a></p><p><b>subscriber</b>: <a href=\"Patient-example.html\">Jim Chalmers  Male, DoB: 1974-12-25 ( Medical record number\u00a0(use:\u00a0usual,\u00a0period:\u00a02001-05-06 --&gt; (ongoing)))</a></p><p><b>subscriberId</b>: 12191</p><p><b>beneficiary</b>: <a href=\"Patient-example.html\">Jim Chalmers  Male, DoB: 1974-12-25 ( Medical record number\u00a0(use:\u00a0usual,\u00a0period:\u00a02001-05-06 --&gt; (ongoing)))</a></p><p><b>dependent</b>: 0</p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}\">Self</span></p><p><b>period</b>: 2011-05-23 --&gt; 2012-05-23</p><p><b>payor</b>: <a href=\"Organization-example.html\">Organization Health Level Seven International</a></p><p><b>order</b>: 9</p></div>"
  },
  "identifier" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "MB"
          }
        ]
      }
    }
  ],
  "status" : "active",
  "type" : {
    "coding" : [
      {
        "system" : "https://nahdo.org/sopt",
        "code" : "59",
        "display" : "Other Private Insurance"
      }
    ]
  },
  "policyHolder" : {
    🔗 "reference" : "Patient/example"
  },
  "subscriber" : {
    🔗 "reference" : "Patient/example"
  },
  "subscriberId" : "12191",
  "beneficiary" : {
    🔗 "reference" : "Patient/example"
  },
  "dependent" : "0",
  "relationship" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
        "code" : "self"
      }
    ]
  },
  "period" : {
    "start" : "2011-05-23",
    "end" : "2012-05-23"
  },
  "payor" : [
    {
      🔗 "reference" : "Organization/example"
    }
  ],
  "order" : 9
}