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

Raw json | Download

{
  "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>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/core/StructureDefinition/us-core-organization"
        ]
      },
      "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"
    }
  ]
}