Da Vinci - Documentation Templates and Rules, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-dtr/ and changes regularly. See the Directory of published versions

• Narrative Content
• XML
• JSON

: CoverageExample - JSON Representation

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{
  "resourceType" : "Coverage",
  "id" : "CoverageExample",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-coverage"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Coverage CoverageExample</b></p><a name=\"CoverageExample\"> </a><a name=\"hcCoverageExample\"> </a><a name=\"CoverageExample-en-US\"> </a><p><b>status</b>: Active</p><p><b>subscriber</b>: <a href=\"Patient-examplepatient.html\">Anonymous Patient Male, DoB: 1996-12-23</a></p><p><b>subscriberId</b>: PFP123450000</p><p><b>beneficiary</b>: <a href=\"Patient-examplepatient.html\">Anonymous Patient Male, DoB: 1996-12-23</a></p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}\">Self</span></p><p><b>period</b>: 2022-01-01 --&gt; 2023-01-01</p><p><b>payor</b>: <a href=\"#hcCoverageExample/OrgExample\">Organization Insurance Company</a></p><h3>Classes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Value</b></td><td><b>Name</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class plan}\">Plan</span></td><td>Premim Family Plus</td><td>Premim Family Plus Plan</td></tr></table><hr/><blockquote><p class=\"res-header-id\"><b>Generated Narrative: Organization #OrgExample</b></p><a name=\"CoverageExample/OrgExample\"> </a><a name=\"hcCoverageExample/OrgExample\"> </a><a name=\"CoverageExample/OrgExample-en-US\"> </a><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.3.0/NamingSystem-CLIA.html\" title=\"&quot;The Centers for Medicare &amp; Medicaid Services (CMS) regulates all laboratory testing (except research) performed on humans in the U.S. through the Clinical Laboratory Improvement Amendments (CLIA). In total, CLIA covers approximately 330,000 laboratory entities. The Division of Clinical Laboratory Improvement &amp; Quality, within the Quality, Safety &amp; Oversight Group, under the Center for Clinical Standards and Quality (CCSQ) has the responsibility for implementing the CLIA Program.\r\n\r\nThe objective of the CLIA program is to ensure quality laboratory testing. Although all clinical laboratories must be properly certified to receive Medicare or Medicaid payments, CLIA has no direct Medicare or Medicaid program responsibilities.&quot;\r\n\r\nCMS CLIA certified laboratories will be assigned a10-digit alphanumeric CLIA identification number, with the &quot;D&quot; in the third position identifying the provider/supplier as a laboratory certified under CLIA.&quot;\r\n\r\nCLIA is maintained by CMS. It is in the public domain and free to use without restriction.\r\n\r\nSee http://cms.gov/regulations-and-guidance/legislation/clia.\">Clinical Laboratory Improvement Amendments</a>/10D0202020</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type pay}\">Payer</span></p><p><b>name</b>: Insurance Company</p><p><b>telecom</b>: ph: 860-547-5001(Work)</p><p><b>address</b>: 680 Asylum Street Hartford CT 06155 US </p></blockquote></div>"
  },
  "contained" : [
    {
      "resourceType" : "Organization",
      "id" : "OrgExample",
      "meta" : {
        "profile" : [
          🔗 "http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-organization"
        ]
      },
      "identifier" : [
        {
          "system" : "urn:oid:2.16.840.1.113883.4.7",
          "value" : "10D0202020"
        }
      ],
      "active" : true,
      "type" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/organization-type",
              "code" : "pay",
              "display" : "Payer"
            }
          ]
        }
      ],
      "name" : "Insurance Company",
      "telecom" : [
        {
          "system" : "phone",
          "value" : "860-547-5001",
          "use" : "work"
        }
      ],
      "address" : [
        {
          "line" : [
            "680 Asylum Street"
          ],
          "city" : "Hartford",
          "state" : "CT",
          "postalCode" : "06155",
          "country" : "US"
        }
      ]
    }
  ],
  "status" : "active",
  "subscriber" : {
    🔗 "reference" : "Patient/examplepatient"
  },
  "subscriberId" : "PFP123450000",
  "beneficiary" : {
    🔗 "reference" : "Patient/examplepatient"
  },
  "relationship" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
        "code" : "self",
        "display" : "Self"
      }
    ]
  },
  "period" : {
    "start" : "2022-01-01",
    "end" : "2023-01-01"
  },
  "payor" : [
    {
      "reference" : "#OrgExample"
    }
  ],
  "class" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "plan",
            "display" : "Plan"
          }
        ]
      },
      "value" : "Premim Family Plus",
      "name" : "Premim Family Plus Plan"
    }
  ]
}