Consolidated CDA (C-CDA)
3.0.0 - STU3 United States of America flag

This page is part of the CCDA: Consolidated CDA Release (v3.0.0: CCDA 3.0) generated with FHIR (HL7® FHIR® Standard) v5.0.0. This is the current published version. For a full list of available versions, see the Directory of published versions

Example Binary: Planned Coverage Example

This content is an example of the Planned Coverage Logical Model and is not a FHIR Resource

    
<act classCode="ACT" moodCode="INT" xmlns="urn:hl7-org:v3">
  <templateId root="2.16.840.1.113883.10.20.22.4.129" extension="2024-05-01"/>
  <id root="03f5e10b-7e79-4610-9626-d2984ff10cc1" />
  <code code="52556-8" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment Sources" />
  <statusCode code="active" />
  <entryRelationship typeCode="COMP">
    <act classCode="ACT" moodCode="INT">
      <!-- These act/identifiers are unique identifiers 
        for the policy or program providing the coverage. -->
      <id root="4c9a3be1-5f09-46dd-88e7-14c8ec612e4c" />
      <code code="111" displayName="Medicare HMO"
                      codeSystemName="Source of Payment Typology (PHDSC)"
                      codeSystem="2.16.840.1.113883.3.221.5" />
      <statusCode code="active" />
    </act>
  </entryRelationship>
</act>