This page is part of the Quality Improvement Core Framework (v5.0.0: STU5 (v5.0.0)) based on FHIR R4. The current version which supercedes this version is 4.1.1. For a full list of available versions, see the Directory of published versions

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: 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><b>Generated Narrative: Coverage</b><a name=\"example-new\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Coverage &quot;example-new&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-qicore-coverage.html\">QICore Coverage</a></p></div><p><b>identifier</b>: id:\u00a012345</p><p><b>status</b>: active</p><p><b>type</b>: Other Private Insurance <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-SOPT.html\">Source of Payment Typology</a>#59)</span></p><p><b>policyHolder</b>: <a href=\"Patient-example.html\">Patient/example</a> &quot; CHALMERS&quot;</p><p><b>subscriber</b>: <a href=\"Patient-example.html\">Patient/example</a> &quot; CHALMERS&quot;</p><p><b>subscriberId</b>: 12191</p><p><b>beneficiary</b>: <a href=\"Patient-example.html\">Patient/example</a> &quot; CHALMERS&quot;</p><p><b>dependent</b>: 0</p><p><b>relationship</b>: Self <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-subscriber-relationship.html\">SubscriberPolicyholder Relationship Codes</a>#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/example</a> &quot;Health Level Seven International&quot;</p><p><b>order</b>: 9</p></div>"
  },
  "identifier" : [
    {
      "system" : "http://benefitsinc.com/certificate",
      "value" : "12345"
    }
  ],
  "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
}