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-ballot 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
This content is an example of the Policy Activity Logical Model and is not a FHIR Resource
<act classCode="ACT" moodCode="EVN" xmlns="urn:hl7-org:v3" xmlns:sdtc="urn:hl7-org:sdtc">
<templateId root="2.16.840.1.113883.10.20.22.4.61" extension="2024-05-01" />
<id root="3e676a50-7aac-11db-9fe1-0800200c9a66" />
<code code="12" displayName="Medicare Secondary Working Aged Beneficiary or Spouse with Employer Group Health Plan"
codeSystemName="Insurance Type Code (x12N-1336)"
codeSystem="2.16.840.1.113883.6.255.1336">
<translation code="2" displayName="Medicare"
codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="Source of Payment Typology (PHDSC)"></translation>
</code>
<statusCode code="completed" />
<!-- Insurance company information -->
<performer typeCode="PRF">
<templateId root="2.16.840.1.113883.10.20.22.4.87" />
<time>
<low nullFlavor="UNK" />
<high nullFlavor="UNK" />
</time>
<assignedEntity>
<id root="2.16.840.1.113883.19" />
<code code="PAYOR" codeSystem="2.16.840.1.113883.5.110" codeSystemName="HL7 RoleCode" />
<addr use="WP">
<streetAddressLine>123 Insurance Road</streetAddressLine>
<city>Blue Bell</city>
<state>MA</state>
<postalCode>02368</postalCode>
<country>US</country>
<!-- US is "United States" from ISO 3166-1 Country Codes: 1.0.3166.1 -->
</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>
<!-- Guarantor information (the person responsible for the final bill) -->
<performer typeCode="PRF">
<templateId root="2.16.840.1.113883.10.20.22.4.88" />
<time>
<low nullFlavor="UNK" />
<high nullFlavor="UNK" />
</time>
<assignedEntity>
<id root="329fcdf0-7ab3-11db-9fe1-0800200c9a66" />
<code code="GUAR" codeSystem="2.16.840.1.113883.5.110" codeSystemName="HL7 RoleCode" />
<addr use="HP">
<streetAddressLine>17 Daws Rd.</streetAddressLine>
<city>Blue Bell</city>
<state>MA</state>
<postalCode>02368</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+(781)555-1212" use="HP" />
<assignedPerson>
<name>
<prefix>Mr.</prefix>
<given>Adam</given>
<given>Frankie</given>
<family>Everyman</family>
</name>
</assignedPerson>
</assignedEntity>
</performer>
<!-- Covered party -->
<participant typeCode="COV">
<templateId root="2.16.840.1.113883.10.20.22.4.89" />
<time>
<low nullFlavor="UNK" />
<high nullFlavor="UNK" />
</time>
<participantRole classCode="PAT">
<!-- Health plan ID for patient. -->
<id root="1.1.1.1.1.1.1.1.14" extension="1138345" />
<code code="FAMDEP" codeSystem="2.16.840.1.113883.5.111" />
<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:birthTime value="19620206" />
</playingEntity>
</participantRole>
</participant>
<!-- Policy holder / Subscriber - not allowed if the COV participant's code is SELF -->
<participant typeCode="HLD">
<templateId root="2.16.840.1.113883.10.20.22.4.90" />
<participantRole>
<id extension="1138345" root="2.16.840.1.113883.19" />
<addr use="HP">
<streetAddressLine>17 Daws Rd.</streetAddressLine>
<city>Blue Bell</city>
<state>MA</state>
<postalCode>02368</postalCode>
<country>US</country>
</addr>
</participantRole>
</participant>
<!-- Coverange Plan
<entryRelationship typeCode="REFR">
<act classCode="ACT" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.1.19" />
. . .
</act>
</entryRelationship> -->
</act>