Consolidated CDA (C-CDA), published by Health Level Seven. This guide is not an authorized publication; it is the continuous build for version 4.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/CDA-ccda/ and changes regularly. See the Directory of published versions

• Narrative Content

Example Binary: Coverage Activity Example

<act xmlns="urn:hl7-org:v3" moodCode="EVN" classCode="ACT">
  <templateId root="2.16.840.1.113883.10.20.22.4.60" extension="2024-05-01"/>
  <id root="1fe2cdd0-7aad-11db-9fe1-0800200c9a66"/>
  <code displayName="Payment sources" codeSystemName="LOINC"
        codeSystem="2.16.840.1.113883.6.1" code="52556-8"/>
  <text/>
  <statusCode code="completed"/>
  <effectiveTime value="20230501"/>
  <entryRelationship typeCode="COMP">
    <sequenceNumber value="2"/>
    <act moodCode="EVN" classCode="ACT">
      <!--  Policy Activity  -->
      <templateId root="2.16.840.1.113883.10.20.22.4.61"
                  extension="2024-05-01"/>
      <id root="1fe2cdd0-7aad-11db-9fe1-0800200c9a66"/>
      <code displayName="MEDICARE" codeSystemName="SOP"
            codeSystem="2.16.840.1.113883.3.221.5" code="1"/>
      <statusCode code="completed"/>
      <performer typeCode="PRF">
        <templateId root="2.16.840.1.113883.10.20.22.4.87"/>
        <assignedEntity>
          <id root="2.16.840.1.113883.19"/>
          <code codeSystemName="HL7 RoleCode"
                codeSystem="2.16.840.1.113883.5.110" code="PAYOR"/>
          <!--  US is "United States" from ISO 3166-1 Country Codes: 1.0.3166.1  -->
          <addr use="WP">
            <streetAddressLine>123 Insurance Road</streetAddressLine>
            <city>Blue Bell</city>
            <state>MA</state>
            <postalCode>02368</postalCode>
            <country>US</country>
          </addr>
          <telecom value="tel:+(555)555-1515" use="WP"/>
          <representedOrganization>
            <name>Good Health Insurance</name>
            <telecom value="tel:+(555)555-1515" use="WP"/>
            <addr use="WP">
              <streetAddressLine>123 Insurance Road</streetAddressLine>
              <city>Blue Bell</city>
              <state>MA</state>
              <postalCode>02368</postalCode>
              <country>US</country>
            </addr>
          </representedOrganization>
        </assignedEntity>
      </performer>
      <participant typeCode="COV">
        <!--  Coverage Target  -->
        <templateId root="2.16.840.1.113883.10.20.22.4.89"/>
        <participantRole>
          <id root="1fe2cdd0-7aad-11db-9fe1-0800200c9a66"/>
          <code displayName="self" codeSystemName="RoleCode"
                codeSystem="2.16.840.1.113883.5.111" code="SELF"/>
          <addr use="HP">
            <streetAddressLine>17 Daws Rd.</streetAddressLine>
            <city>Blue Bell</city>
            <state>MA</state>
            <postalCode>02368</postalCode>
            <country>US</country>
          </addr>
          <playingEntity>
            <name>
              <!--  Name is needed if different than name on health plan.  -->
              <prefix>Mr.</prefix>
              <given>Frank</given>
              <given>A.</given>
              <family>Everyman</family>
            </name>
            <sdtc:sdtcBirthTime xmlns:sdtc="urn:hl7-org:sdtc"
                                value="19620206"/>
          </playingEntity>
        </participantRole>
      </participant>
    </act>
  </entryRelationship>
</act>