FHIR IG analytics| Package | hl7.fhir.us.dme-orders |
| Resource Type | Coverage |
| Id | Coverage-example.json |
| FHIR Version | R4 |
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Note: links and images are rebased to the (stated) source
Resource Coverage "example" Version "8" Updated "2020-08-10 03:27:39+0000"
Profile: PAO Coverage
identifier: id: 12345
status: active
type: extended healthcare (ActCode#EHCPOL)
subscriber: Patient/example1 " SHAW"
beneficiary: Patient/example1 " SHAW"
dependent: 0
relationship: Self (SubscriberPolicyholder Relationship Codes#self)
period: 2011-05-23 --> 2012-05-23
payor: Organization/Inpatient "St. Michael's Hospital"
class
type: Group (Coverage Class Codes#group)
value: CB135
name: Corporate Baker's Inc. Local #35
class
type: SubGroup (Coverage Class Codes#subgroup)
value: 123
name: Trainee Part-time Benefits
class
type: Plan (Coverage Class Codes#plan)
value: B37FC
name: Full Coverage: Medical, Dental, Pharmacy, Vision, EHC
class
type: SubPlan (Coverage Class Codes#subplan)
value: P7
name: Includes afterlife benefits
class
type: Class (Coverage Class Codes#class)
value: SILVER
name: Silver: Family Plan spouse only
class
type: SubClass (Coverage Class Codes#subclass)
value: Tier2
name: Low deductable, max $20 copay
class
type: Sequence (Coverage Class Codes#sequence)
value: 9
class
type: RX Id (Coverage Class Codes#rxid)
value: MDF12345
class
type: RX BIN (Coverage Class Codes#rxbin)
value: 987654
class
type: RX Group (Coverage Class Codes#rxgroup)
value: M35PT
class
type: RX PCN (Coverage Class Codes#rxpcn)
value: 234516
class
type: Sequence (Coverage Class Codes#sequence)
value: 9
FHIR
FHIRsmith{
"resourceType": "Coverage",
"id": "example",
"meta": {
"versionId": "8",
"lastUpdated": "2020-08-10T03:27:39.427Z",
"profile": [
"http://hl7.org/fhir/us/dme-orders/StructureDefinition/PAOX-coverage"
]
},
"text": {
"status": "generated",
"div": "<!-- snip (see above) -->"
},
"identifier": [
{
"system": "http://benefitsinc.com/certificate",
"value": "12345"
}
],
"status": "active",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "EHCPOL",
"display": "extended healthcare"
}
]
},
"subscriber": {
"reference": "Patient/example1"
},
"beneficiary": {
"reference": "Patient/example1"
},
"dependent": "0",
"relationship": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
"code": "self"
}
]
},
"period": {
"start": "2011-05-23",
"end": "2012-05-23"
},
"payor": [
{
"reference": "Organization/Inpatient"
}
],
"class": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "group"
}
]
},
"value": "CB135",
"name": "Corporate Baker's Inc. Local #35"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "subgroup"
}
]
},
"value": "123",
"name": "Trainee Part-time Benefits"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "plan"
}
]
},
"value": "B37FC",
"name": "Full Coverage: Medical, Dental, Pharmacy, Vision, EHC"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "subplan"
}
]
},
"value": "P7",
"name": "Includes afterlife benefits"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "class"
}
]
},
"value": "SILVER",
"name": "Silver: Family Plan spouse only"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "subclass"
}
]
},
"value": "Tier2",
"name": "Low deductable, max $20 copay"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "sequence"
}
]
},
"value": "9"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "rxid"
}
]
},
"value": "MDF12345"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "rxbin"
}
]
},
"value": "987654"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "rxgroup"
}
]
},
"value": "M35PT"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "rxpcn"
}
]
},
"value": "234516"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "sequence"
}
]
},
"value": "9"
}
]
}