Da Vinci Payer Data Exchange
2.1.1 - STU 2.1

Da Vinci Payer Data Exchange, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-epdx/ and changes regularly. See the Directory of published versions

## : Coverage to Match Example 1 - JSON Representation

Page standards status: Informative

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    {
      "resourceType" : "Coverage",
      "id" : "CoverageMatchExample1",
      "meta" : {
        "profile" : [
          🔗 "http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-coverage"
        ]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Coverage CoverageMatchExample1</b></p><a name=\"CoverageMatchExample1\"> </a><a name=\"hcCoverageMatchExample1\"> </a><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\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/davinci-hrex/STU1.1/StructureDefinition-hrex-coverage.html\">HRex Member Match Coverage Profile</a></p></div><p><b>status</b>: Draft</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode EHPLANS}\">EHPLANS</span></p><p><b>subscriber</b>: <a href=\"https://simplifier.net/resolve?scope=hl7.fhir.us.core.3.1.1@3.1.1&amp;canonical=http://hl7.org/fhir/us/core/Patient/patient-prov-001\">Patient/patient-prov-001</a></p><p><b>subscriberId</b>: 12345678</p><p><b>beneficiary</b>: <a href=\"https://simplifier.net/resolve?scope=hl7.fhir.us.core.3.1.1@3.1.1&amp;canonical=http://hl7.org/fhir/us/core/Patient/patient-prov-001\">Patient/patient-prov-001</a></p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}\">Self</span></p><p><b>period</b>: 2023-01-01 --&gt; 2023-12-31</p><p><b>payor</b>: Previous Health Plan (Identifier: <a href=\"http://terminology.hl7.org/3.1.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">NPI</a>/9876543210)</p><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class group}\">Group</span></p><p><b>value</b>: EMPLOY-12345</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class plan}\">Plan</span></p><p><b>value</b>: PPO-GOLD</p></blockquote></div>"
      },
      "status" : "draft",
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
            "code" : "EHPLANS"
          }
        ]
      },
      "subscriber" : {
        "reference" : "Patient/patient-prov-001"
      },
      "subscriberId" : "12345678",
      "beneficiary" : {
        "reference" : "Patient/patient-prov-001"
      },
      "relationship" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
            "code" : "self"
          }
        ]
      },
      "period" : {
        "start" : "2023-01-01",
        "end" : "2023-12-31"
      },
      "payor" : [
        {
          "identifier" : {
            "system" : "http://hl7.org/fhir/sid/us-npi",
            "value" : "9876543210"
          },
          "display" : "Previous Health Plan"
        }
      ],
      "class" : [
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                "code" : "group"
              }
            ]
          },
          "value" : "EMPLOY-12345"
        },
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                "code" : "plan"
              }
            ]
          },
          "value" : "PPO-GOLD"
        }
      ]
    }