Patient Cost Transparency Implementation Guide
2.0.1 - STU 2

Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

## : coverage1001 - JSON Representation

Page standards status: Informative

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    {
      "resourceType" : "Coverage",
      "id" : "coverage1001",
      "meta" : {
        "profile" : [
          🔗 "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage"
        ]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Coverage coverage1001</b></p><a name=\"coverage1001\"> </a><a name=\"hccoverage1001\"> </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=\"StructureDefinition-davinci-pct-coverage.html\">PCT Coverage</a></p></div><p><b>Extension Definition for Coverage.kind for Version 5.0</b>: insurance</p><p><b>status</b>: Active</p><p><b>subscriberId</b>: PFP123450000</p><p><b>beneficiary</b>: <a href=\"Patient-patient1001.html\">Eve Betterhalf Female, DoB: 1955-07-23 ( http://example.com/identifiers/patient#1001)</a></p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}\">Self</span></p><p><b>period</b>: 2021-01-01 --&gt; 2022-01-01</p><p><b>payor</b>: <a href=\"Organization-org1001.html\">Organization Umbrella 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><h3>CostToBeneficiaries</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-copay-type copaypct}\">Copay Percentage</span></td><td>20</td></tr></table></div>"
      },
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Coverage.kind",
          "valueCode" : "insurance"
        }
      ],
      "status" : "active",
      "subscriberId" : "PFP123450000",
      "beneficiary" : {
        🔗 "reference" : "Patient/patient1001"
      },
      "relationship" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
            "code" : "self",
            "display" : "Self"
          }
        ]
      },
      "period" : {
        "start" : "2021-01-01",
        "end" : "2022-01-01"
      },
      "payor" : [
        {
          🔗 "reference" : "Organization/org1001"
        }
      ],
      "class" : [
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                "code" : "plan",
                "display" : "Plan"
              }
            ]
          },
          "value" : "Premim Family Plus",
          "name" : "Premim Family Plus Plan"
        }
      ],
      "costToBeneficiary" : [
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/coverage-copay-type",
                "code" : "copaypct",
                "display" : "Copay Percentage"
              }
            ]
          },
          "valueQuantity" : {
            "value" : 20
          }
        }
      ]
    }