US Core Implementation Guide
7.0.0 - STU7 United States of America flag

This page is part of the US Core (v7.0.0: STU7) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions. Page versions: STU6.1 STU6

: Coverage Example - TTL Representation

Page standards status: Informative

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@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 -------------------------------------------------------------------

 a fhir:Coverage ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "coverage-example"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage|7.0.0"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage|7.0.0>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Coverage</b><a name=\"coverage-example\"> </a><a name=\"hccoverage-example\"> </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;coverage-example&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-us-core-coverage.html\">US Core Coverage Profile (version 7.0.0)</a></p></div><p><b>identifier</b>: Member Number/88800933501</p><p><b>status</b>: active</p><p><b>type</b>: PPO <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://nahdo.org/sopt\">Source of Payment Typology</a>#3712; <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html\">ActCode</a>#PPO &quot;preferred provider organization policy&quot;)</span></p><p><b>subscriberId</b>: 888009335</p><p><b>beneficiary</b>: <a href=\"Patient-example.html\">Patient/example</a> &quot; SHAW&quot;</p><p><b>relationship</b>: Self <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-subscriber-relationship.html\">SubscriberPolicyholder Relationship Codes</a>#self)</span></p><p><b>period</b>: 2020-01-01 --&gt; (ongoing)</p><p><b>payor</b>: <a href=\"Organization-acme-payer.html\">Organization/acme-payer: Acme Health Plan</a> &quot;Acme Health Plan&quot;</p><blockquote><p><b>class</b></p><p><b>type</b>: An employee group <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#group &quot;Group&quot;)</span></p><p><b>value</b>: xyz</p><p><b>name</b>: XYZ employee Group Plan</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: A specific suite of benefits. <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#plan &quot;Plan&quot;)</span></p><p><b>value</b>: gold</p><p><b>name</b>: Acme Gold Plan</p></blockquote></div>"
  ] ; # 
  fhir:identifier ( [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "MB" ] ;
fhir:display [ fhir:v "Member Number" ]       ] )     ] ;
fhir:system [ fhir:v "http://example.org/fhir/memberidentifier"^^xsd:anyURI ] ;
fhir:value [ fhir:v "88800933501" ]
  ] ) ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:type [
    ( fhir:coding [
fhir:system [ fhir:v "https://nahdo.org/sopt"^^xsd:anyURI ] ;
fhir:code [ fhir:v "3712" ] ;
fhir:display [ fhir:v "PPO" ]     ] [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:code [ fhir:v "PPO" ] ;
fhir:display [ fhir:v "preferred provider organization policy" ]     ] ) ;
fhir:text [ fhir:v "PPO" ]
  ] ; # 
  fhir:subscriberId [ fhir:v "888009335"] ; # 
  fhir:beneficiary [
fhir:reference [ fhir:v "Patient/example" ]
  ] ; # 
  fhir:relationship [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/subscriber-relationship"^^xsd:anyURI ] ;
fhir:code [ fhir:v "self" ]     ] ) ;
fhir:text [ fhir:v "Self" ]
  ] ; # 
  fhir:period [
fhir:start [ fhir:v "2020-01-01"^^xsd:date ]
  ] ; # 
  fhir:payor ( [
fhir:reference [ fhir:v "Organization/acme-payer" ] ;
fhir:display [ fhir:v "Acme Health Plan" ]
  ] ) ; # 
  fhir:class ( [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "group" ] ;
fhir:display [ fhir:v "Group" ]       ] ) ;
fhir:text [ fhir:v "An employee group" ]     ] ;
fhir:value [ fhir:v "xyz" ] ;
fhir:name [ fhir:v "XYZ employee Group Plan" ]
  ] [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "plan" ] ;
fhir:display [ fhir:v "Plan" ]       ] ) ;
fhir:text [ fhir:v "A specific suite of benefits." ]     ] ;
fhir:value [ fhir:v "gold" ] ;
fhir:name [ fhir:v "Acme Gold Plan" ]
  ] ) . #