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Packagehl7.fhir.us.nhsn-dqm
Resource TypeCoverage
IdCoverage-coverage-example-ach-pass1.json
FHIR VersionR4

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Narrative

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

Generated Narrative: Coverage coverage-example-ach-pass1

identifier: Member Number/084536836

status: Active

type: subsidized supplemental health program

policyHolder: Mom Parent

subscriberId: 98435938934

beneficiary: Pass1 ACH(official) Female, DoB: 2024-02-01 ( MRN: 1601191901010308 (use: usual, ))

relationship: Child

period: 2020-08-01 --> (ongoing)

payor: Medicaid

Source1

{
  "resourceType": "Coverage",
  "id": "coverage-example-ach-pass1",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage|6.0.0"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "identifier": [
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code": "MB",
            "display": "Member Number"
          }
        ]
      },
      "system": "http://example.org/fhir/memberidentifier",
      "value": "084536836"
    }
  ],
  "status": "active",
  "type": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "version": "9.0.0",
        "code": "SUBSUPP",
        "display": "subsidized supplemental health program"
      }
    ]
  },
  "policyHolder": {
    "display": "Mom Parent"
  },
  "subscriberId": "98435938934",
  "beneficiary": {
    "reference": "Patient/patient-example-ach-ach-pass1"
  },
  "relationship": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
        "code": "child",
        "display": "Child"
      }
    ],
    "text": "Child"
  },
  "period": {
    "start": "2020-08-01"
  },
  "payor": [
    {
      "display": "Medicaid"
    }
  ]
}