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

• Narrative Content
• XML
• JSON
• TTL

: Coverage to Match Example 2 - JSON Representation

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{
  "resourceType" : "Coverage",
  "id" : "CoverageMatchExample2",
  "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 CoverageMatchExample2</b></p><a name=\"CoverageMatchExample2\"> </a><a name=\"hcCoverageMatchExample2\"> </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-002\">Patient/patient-prov-002</a></p><p><b>subscriberId</b>: 87654321</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-002\">Patient/patient-prov-002</a></p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}\">Self</span></p><p><b>period</b>: 2023-06-01 --&gt; 2024-05-31</p><p><b>payor</b>: Another Health Plan (Identifier: <a href=\"http://terminology.hl7.org/3.1.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">NPI</a>/1111111111)</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-67890</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>: HMO-BASIC</p></blockquote></div>"
  },
  "status" : "draft",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code" : "EHPLANS"
      }
    ]
  },
  "subscriber" : {
    "reference" : "Patient/patient-prov-002"
  },
  "subscriberId" : "87654321",
  "beneficiary" : {
    "reference" : "Patient/patient-prov-002"
  },
  "relationship" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
        "code" : "self"
      }
    ]
  },
  "period" : {
    "start" : "2023-06-01",
    "end" : "2024-05-31"
  },
  "payor" : [
    {
      "identifier" : {
        "system" : "http://hl7.org/fhir/sid/us-npi",
        "value" : "1111111111"
      },
      "display" : "Another Health Plan"
    }
  ],
  "class" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "group"
          }
        ]
      },
      "value" : "EMPLOY-67890"
    },
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "plan"
          }
        ]
      },
      "value" : "HMO-BASIC"
    }
  ]
}