Release 5

This page is part of the FHIR Specification (v5.0.0: R5 - STU). This is the current published version. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4

Example CoverageEligibilityRequest/52346 (JSON)

Financial Management Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Patient, Practitioner

Raw JSON (canonical form + also see JSON Format Specification)

Primary Coverage specifying Benefit Example

{
  "resourceType" : "CoverageEligibilityRequest",
  "id" : "52346",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the CoverageEligibilityRequest</div>"
  },
  "identifier" : [{
    "system" : "http://happyvalley.com/coverageelegibilityrequest",
    "value" : "52346"
  }],
  "status" : "active",
  "priority" : {
    "coding" : [{
      "code" : "normal"
    }]
  },
  "purpose" : ["validation",
  "benefits"],
  "patient" : {
    "reference" : "Patient/pat1"
  },
  "servicedDate" : "2014-09-17",
  "created" : "2014-08-16",
  "enterer" : {
    "identifier" : {
      "system" : "http://happyvalleyclinic.com/staff",
      "value" : "14"
    }
  },
  "provider" : {
    "reference" : "Organization/1"
  },
  "insurer" : {
    "reference" : "Organization/2"
  },
  "facility" : {
    "identifier" : {
      "system" : "http://statecliniclicensor.com/clinicid",
      "value" : "G35B9"
    }
  },
  "insurance" : [{
    "coverage" : {
      "reference" : "Coverage/9876B1"
    },
    "businessArrangement" : "NB8742"
  }],
  "item" : [{
    "category" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/ex-benefitcategory",
        "code" : "69",
        "display" : "Maternity"
      }]
    }
  }]
}

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.