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Packagehl7.fhir.us.davinci-dtr.r4
Resource TypeCoverage
IdCoverage-CoverageExample.json
FHIR VersionR4

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Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: Coverage CoverageExample

status: Active

subscriber: Anonymous Patient Male, DoB: 1996-12-23

subscriberId: PFP123450000

beneficiary: Anonymous Patient Male, DoB: 1996-12-23

relationship: Self

period: 2022-01-01 --> 2023-01-01

payor: Organization Insurance Company

Classes

-TypeValueName
*PlanPremim Family PlusPremim Family Plus Plan

Generated Narrative: Organization #OrgExample

identifier: Clinical Laboratory Improvement Amendments/10D0202020

active: true

type: Payer

name: Insurance Company

telecom: ph: 860-547-5001(Work)

address: 680 Asylum Street Hartford CT 06155 US


Source1

{
  "resourceType": "Coverage",
  "id": "CoverageExample",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-coverage|2.1.0"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "contained": [
    {
      "resourceType": "Organization",
      "id": "OrgExample",
      "meta": {
        "profile": [
          "http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-organization|2.1.0"
        ]
      },
      "identifier": [
        {
          "system": "urn:oid:2.16.840.1.113883.4.7",
          "value": "10D0202020"
        }
      ],
      "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"
    }
  ]
}