CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®), published by HL7 Financial Management Working Group. This is not an authorized publication; it is the continuous build for version 2.0.0). This version is based on the current content of https://github.com/HL7/carin-bb/ and changes regularly. See the Directory of published versions
: Coverage Example 1 - TTL Representation
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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 "Coverage1"] ; #
fhir:meta [
fhir:lastUpdated [ fhir:v "2020-10-30T09:48:01.8462752-04:00"^^xsd:dateTime ] ;
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage|2.0.0"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage|2.0.0> ] )
] ; #
fhir:language [ fhir:v "en-US"] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en-US\" lang=\"en-US\"><p><b>Generated Narrative: Coverage</b><a name=\"Coverage1\"> </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 "Coverage1" Updated "2020-10-30 09:48:01-0400" (Language "en-US") </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-C4BB-Coverage.html\">C4BB Coverage (version 2.0.0)</a></p></div><p><b>identifier</b>: An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier.: 88800933501</p><p><b>status</b>: active</p><p><b>policyHolder</b>: <a href=\"Patient-Patient1.html\">Patient/Patient1</a> " EXAMPLE1"</p><p><b>subscriber</b>: <a href=\"Patient-Patient1.html\">Patient/Patient1</a> " EXAMPLE1"</p><p><b>subscriberId</b>: 888009335</p><p><b>beneficiary</b>: <a href=\"Patient-Patient1.html\">Patient/Patient1</a> " EXAMPLE1"</p><p><b>dependent</b>: 01</p><p><b>relationship</b>: Self <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-subscriber-relationship.html\">SubscriberPolicyholder Relationship Codes</a>#self)</span></p><p><b>period</b>: 2020-01-01 --> (ongoing)</p><p><b>payor</b>: <a href=\"Organization-Payer2.html\">Organization/Payer2: UPMC Health Plan</a> "UPMC Health Plan"</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/5.0.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#group "Group")</span></p><p><b>value</b>: MCHMO1</p><p><b>name</b>: MEDICARE HMO 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/5.0.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#plan "Plan")</span></p><p><b>value</b>: GR5</p><p><b>name</b>: GR5-HMO DEDUCTIBLE</p></blockquote><p><b>network</b>: GR5-HMO DEDUCTIBLE</p></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:text [ fhir:v "An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier." ] ] ;
fhir:system [ fhir:v "https://www.upmchealthplan.com/fhir/memberidentifier"^^xsd:anyURI ] ;
fhir:value [ fhir:v "88800933501" ] ;
fhir:assigner [
fhir:reference [ fhir:v "Organization/Payer2" ] ;
fhir:display [ fhir:v "UPMC Health Plan" ] ]
] ) ; #
fhir:status [ fhir:v "active"] ; #
fhir:policyHolder [
fhir:reference [ fhir:v "Patient/Patient1" ]
] ; #
fhir:subscriber [
fhir:reference [ fhir:v "Patient/Patient1" ]
] ; #
fhir:subscriberId [ fhir:v "888009335"] ; #
fhir:beneficiary [
fhir:reference [ fhir:v "Patient/Patient1" ]
] ; #
fhir:dependent [ fhir:v "01"] ; #
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/Payer2" ] ;
fhir:display [ fhir:v "UPMC 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 "MCHMO1" ] ;
fhir:name [ fhir:v "MEDICARE HMO 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 "GR5" ] ;
fhir:name [ fhir:v "GR5-HMO DEDUCTIBLE" ]
] ) ; #
fhir:network [ fhir:v "GR5-HMO DEDUCTIBLE"] . #
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