This page is part of the FHIR Specification (v3.2.0: R4 Ballot 1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions
Patient Administration Work Group | Maturity Level: N/A | Ballot Status: Informative | Compartments: Not linked to any defined compartments |
A general product plan example with benefit detail
@prefix fhir: <http://hl7.org/fhir/> . @prefix owl: <http://www.w3.org/2002/07/owl#> . @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> . @prefix xsd: <http://www.w3.org/2001/XMLSchema#> . # - resource ------------------------------------------------------------------- <http://hl7.org/fhir/ProductPlan/example-onc> a fhir:ProductPlan; fhir:nodeRole fhir:treeRoot; fhir:Resource.id [ fhir:value "example-onc"]; fhir:DomainResource.text [ fhir:Narrative.status [ fhir:value "generated" ]; fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n Sample Plan\n </div>" ]; fhir:ProductPlan.status [ fhir:value "active"]; fhir:ProductPlan.name [ fhir:value "Sample Plan"]; fhir:ProductPlan.alias [ fhir:value "PPO Sample Plan"; fhir:index 0 ]; fhir:ProductPlan.period [ fhir:Period.start [ fhir:value "2017-01-01"^^xsd:date ] ]; fhir:ProductPlan.ownedBy [ fhir:link <http://hl7.org/fhir/Organization/Test>; fhir:Reference.reference [ fhir:value "Organization/Test" ]; fhir:Reference.display [ fhir:value "Test" ] ]; fhir:ProductPlan.administeredBy [ fhir:link <http://hl7.org/fhir/Organization/Test>; fhir:Reference.reference [ fhir:value "Organization/Test" ]; fhir:Reference.display [ fhir:value "Test" ] ]; fhir:ProductPlan.address [ fhir:index 0; fhir:Address.line [ fhir:value "123 Fake Street"; fhir:index 0 ]; fhir:Address.city [ fhir:value "Washington" ]; fhir:Address.state [ fhir:value "DC" ]; fhir:Address.postalCode [ fhir:value "20005" ]; fhir:Address.country [ fhir:value "USA" ] ]; fhir:ProductPlan.coverageArea [ fhir:link <http://hl7.org/fhir/Location/2>; fhir:Reference.reference [ fhir:value "Location/2" ]; fhir:Reference.display [ fhir:value "National" ] ]; fhir:ProductPlan.coverage [ fhir:index 0; fhir:ProductPlan.coverage.type [ fhir:CodeableConcept.text [ fhir:value "Medical" ] ]; fhir:ProductPlan.coverage.benefit [ fhir:index 0; fhir:ProductPlan.coverage.benefit.type [ fhir:CodeableConcept.text [ fhir:value "Diagnostic and treatment services" ] ]; fhir:ProductPlan.coverage.benefit.item [ fhir:index 0; fhir:ProductPlan.coverage.benefit.item.code [ fhir:CodeableConcept.text [ fhir:value "primary care visit" ] ] ], [ fhir:index 1; fhir:ProductPlan.coverage.benefit.item.code [ fhir:CodeableConcept.text [ fhir:value "specialty care visit" ] ] ] ] ]; fhir:ProductPlan.plan [ fhir:index 0; fhir:ProductPlan.plan.type [ fhir:CodeableConcept.text [ fhir:value "Standard" ] ]; fhir:ProductPlan.plan.premium [ fhir:Quantity.value [ fhir:value "2000"^^xsd:decimal ]; fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ]; fhir:Quantity.code [ fhir:value "USD" ] ]; fhir:ProductPlan.plan.category [ fhir:index 0; fhir:ProductPlan.plan.category.code [ fhir:CodeableConcept.text [ fhir:value "Medical" ] ]; fhir:ProductPlan.plan.category.benefit [ fhir:index 0; fhir:ProductPlan.plan.category.benefit.type [ fhir:CodeableConcept.text [ fhir:value "primary care office visit" ] ]; fhir:ProductPlan.plan.category.benefit.cost [ fhir:index 0; fhir:ProductPlan.plan.category.benefit.cost.type [ fhir:CodeableConcept.text [ fhir:value "copay" ] ]; fhir:ProductPlan.plan.category.benefit.cost.applicability [ fhir:index 0; fhir:Coding.code [ fhir:value "preferred" ] ]; fhir:ProductPlan.plan.category.benefit.cost.value [ fhir:Quantity.value [ fhir:value "25"^^xsd:decimal ]; fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ]; fhir:Quantity.code [ fhir:value "USD" ] ] ], [ fhir:index 1; fhir:ProductPlan.plan.category.benefit.cost.type [ fhir:CodeableConcept.text [ fhir:value "coinsurance" ] ]; fhir:ProductPlan.plan.category.benefit.cost.applicability [ fhir:index 0; fhir:Coding.code [ fhir:value "participating" ] ]; fhir:ProductPlan.plan.category.benefit.cost.value [ fhir:Quantity.value [ fhir:value "35"^^xsd:decimal ]; fhir:Quantity.unit [ fhir:value "%" ] ] ], [ fhir:index 2; fhir:ProductPlan.plan.category.benefit.cost.type [ fhir:CodeableConcept.text [ fhir:value "coinsurance" ] ]; fhir:ProductPlan.plan.category.benefit.cost.applicability [ fhir:index 0; fhir:Coding.code [ fhir:value "non-participating" ] ]; fhir:ProductPlan.plan.category.benefit.cost.value [ fhir:Quantity.value [ fhir:value "35"^^xsd:decimal ]; fhir:Quantity.unit [ fhir:value "%" ] ] ] ], [ fhir:index 1; fhir:ProductPlan.plan.category.benefit.type [ fhir:CodeableConcept.text [ fhir:value "specialty care office visit" ] ]; fhir:ProductPlan.plan.category.benefit.cost [ fhir:index 0; fhir:ProductPlan.plan.category.benefit.cost.type [ fhir:CodeableConcept.text [ fhir:value "copay" ] ]; fhir:ProductPlan.plan.category.benefit.cost.applicability [ fhir:index 0; fhir:Coding.code [ fhir:value "preferred" ] ]; fhir:ProductPlan.plan.category.benefit.cost.value [ fhir:Quantity.value [ fhir:value "35"^^xsd:decimal ]; fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ]; fhir:Quantity.code [ fhir:value "USD" ] ] ], [ fhir:index 1; fhir:ProductPlan.plan.category.benefit.cost.type [ fhir:CodeableConcept.text [ fhir:value "coinsurance" ] ]; fhir:ProductPlan.plan.category.benefit.cost.applicability [ fhir:index 0; fhir:Coding.code [ fhir:value "participating" ] ]; fhir:ProductPlan.plan.category.benefit.cost.value [ fhir:Quantity.value [ fhir:value "35"^^xsd:decimal ]; fhir:Quantity.unit [ fhir:value "%" ] ] ], [ fhir:index 2; fhir:ProductPlan.plan.category.benefit.cost.type [ fhir:CodeableConcept.text [ fhir:value "coinsurance" ] ]; fhir:ProductPlan.plan.category.benefit.cost.applicability [ fhir:index 0; fhir:Coding.code [ fhir:value "non-participating" ] ]; fhir:ProductPlan.plan.category.benefit.cost.value [ fhir:Quantity.value [ fhir:value "35"^^xsd:decimal ]; fhir:Quantity.unit [ fhir:value "%" ] ] ] ] ] ]; fhir:ProductPlan.endpoint [ fhir:index 0; fhir:link <http://hl7.org/fhir/Endpoint/example>; fhir:Reference.reference [ fhir:value "Endpoint/example" ] ] . <http://hl7.org/fhir/Organization/Test> a fhir:Organization . <http://hl7.org/fhir/Location/2> a fhir:Location . <http://hl7.org/fhir/Endpoint/example> a fhir:Endpoint . # - ontology header ------------------------------------------------------------ <http://hl7.org/fhir/ProductPlan/example-onc.ttl> a owl:Ontology; owl:imports fhir:fhir.ttl; owl:versionIRI <http://build.fhir.org/ProductPlan/example-onc.ttl> . # -------------------------------------------------------------------------------------
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.