This page is part of the Quality Improvement Core Framework (v3.1.0: STU 3) based on FHIR R3. The current version which supercedes this version is 4.1.1. For a full list of available versions, see the Directory of published versions

Coverage example

Formats: Narrative, XML, JSON, Turtle

Raw ttl

@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:Resource.id [ fhir:value "example"];
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage";
       fhir:index 0     ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: example</p><p><b>meta</b>: </p><p><b>identifier</b>: 12345</p><p><b>status</b>: active</p><p><b>type</b>: extended healthcare <span style=\"background: LightGoldenRodYellow\">(Details : {http://hl7.org/fhir/v3/ActCode code 'EHCPOL' = 'extended healthcare', given as 'extended healthcare'})</span></p><p><b>policyHolder</b>: <a href=\"Patient-example.html\">Generated Summary: id: example; Medical record number = 12345 (USUAL); active; Peter James Chalmers (OFFICIAL), Jim Chalmers , Peter James Windsor (MAIDEN); -unknown-(HOME), ph: (03) 5555 6473(WORK), ph: (03) 3410 5613(MOBILE), ph: (03) 5555 8834(OLD); gender: male; birthDate: 25/12/1974; </a></p><p><b>subscriber</b>: <a href=\"Patient-example.html\">Generated Summary: id: example; Medical record number = 12345 (USUAL); active; Peter James Chalmers (OFFICIAL), Jim Chalmers , Peter James Windsor (MAIDEN); -unknown-(HOME), ph: (03) 5555 6473(WORK), ph: (03) 3410 5613(MOBILE), ph: (03) 5555 8834(OLD); gender: male; birthDate: 25/12/1974; </a></p><p><b>beneficiary</b>: <a href=\"Patient-example.html\">Generated Summary: id: example; Medical record number = 12345 (USUAL); active; Peter James Chalmers (OFFICIAL), Jim Chalmers , Peter James Windsor (MAIDEN); -unknown-(HOME), ph: (03) 5555 6473(WORK), ph: (03) 3410 5613(MOBILE), ph: (03) 5555 8834(OLD); gender: male; birthDate: 25/12/1974; </a></p><p><b>relationship</b>: self <span style=\"background: LightGoldenRodYellow\">(Details : {[not stated] code 'self' = 'self)</span></p><p><b>period</b>: 23/05/2011 12:00:00 AM --&gt; 23/05/2012 12:00:00 AM</p><p><b>payor</b>: <a href=\"Organization-example.html\">Generated Summary: id: example; ??; active; <span title=\"Codes: {http://hl7.org/fhir/organization-type team}\">Organizational team</span>; name: Health Level Seven International; ph: (+1) 734-677-7777, fax: (+1) 734-677-6622, hq@HL7.org</a></p><h3>Groupings</h3><table class=\"grid\"><tr><td>-</td><td><b>Group</b></td><td><b>GroupDisplay</b></td><td><b>SubGroup</b></td><td><b>SubGroupDisplay</b></td><td><b>Plan</b></td><td><b>PlanDisplay</b></td><td><b>SubPlan</b></td><td><b>SubPlanDisplay</b></td><td><b>Class</b></td><td><b>ClassDisplay</b></td><td><b>SubClass</b></td><td><b>SubClassDisplay</b></td></tr><tr><td>*</td><td>CBI35</td><td>Corporate Baker's Inc. Local #35</td><td>123</td><td>Trainee Part-time Benefits</td><td>B37FC</td><td>Full Coverage: Medical, Dental, Pharmacy, Vision, EHC</td><td>P7</td><td>Includes afterlife benefits</td><td>SILVER</td><td>Silver: Family Plan spouse only</td><td>Tier2</td><td>Low deductable, max $20 copay</td></tr></table><p><b>dependent</b>: 0</p><p><b>sequence</b>: 9</p></div>"
  ];
  fhir:Coverage.identifier [
     fhir:index 0;
     fhir:Identifier.system [ fhir:value "http://benefitsinc.com/certificate" ];
     fhir:Identifier.value [ fhir:value "12345" ]
  ];
  fhir:Coverage.status [ fhir:value "active"];
  fhir:Coverage.type [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://hl7.org/fhir/v3/ActCode" ];
       fhir:Coding.code [ fhir:value "EHCPOL" ];
       fhir:Coding.display [ fhir:value "extended healthcare" ]     ]
  ];
  fhir:Coverage.policyHolder [
     fhir:Reference.reference [ fhir:value "Patient/example" ]
  ];
  fhir:Coverage.subscriber [
     fhir:Reference.reference [ fhir:value "Patient/example" ]
  ];
  fhir:Coverage.beneficiary [
     fhir:Reference.reference [ fhir:value "Patient/example" ]
  ];
  fhir:Coverage.relationship [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.code [ fhir:value "self" ]     ]
  ];
  fhir:Coverage.period [
     fhir:Period.start [ fhir:value "2011-05-23"^^xsd:date ];
     fhir:Period.end [ fhir:value "2012-05-23"^^xsd:date ]
  ];
  fhir:Coverage.payor [
     fhir:index 0;
     fhir:Reference.reference [ fhir:value "Organization/example" ]
  ];
  fhir:Coverage.grouping [
     fhir:Coverage.grouping.group [ fhir:value "CBI35" ];
     fhir:Coverage.grouping.groupDisplay [ fhir:value "Corporate Baker's Inc. Local #35" ];
     fhir:Coverage.grouping.subGroup [ fhir:value "123" ];
     fhir:Coverage.grouping.subGroupDisplay [ fhir:value "Trainee Part-time Benefits" ];
     fhir:Coverage.grouping.plan [ fhir:value "B37FC" ];
     fhir:Coverage.grouping.planDisplay [ fhir:value "Full Coverage: Medical, Dental, Pharmacy, Vision, EHC" ];
     fhir:Coverage.grouping.subPlan [ fhir:value "P7" ];
     fhir:Coverage.grouping.subPlanDisplay [ fhir:value "Includes afterlife benefits" ];
     fhir:Coverage.grouping.class [ fhir:value "SILVER" ];
     fhir:Coverage.grouping.classDisplay [ fhir:value "Silver: Family Plan spouse only" ];
     fhir:Coverage.grouping.subClass [ fhir:value "Tier2" ];
     fhir:Coverage.grouping.subClassDisplay [ fhir:value "Low deductable, max $20 copay" ]
  ];
  fhir:Coverage.dependent [ fhir:value "0"];
  fhir:Coverage.sequence [ fhir:value "9"].

# - ontology header ------------------------------------------------------------

 a owl:Ontology;
  owl:imports fhir:fhir.ttl.