FHIR © HL7.org  |  FHIRsmith 4.0.1  |  Server Home  |  XIG Home  |  XIG Stats  | 

FHIR IG analytics

Packagehl7.fhir.us.quality-core
Resource TypeCoverage
IdCoverage-example.json
FHIR VersionR4

Resources that use this resource

No resources found

Resources that this resource uses

No resources found

Narrative

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

Generated Narrative: Coverage example

identifier: Member ID/MB123456789

status: Active

type: Preferred Provider Organization (PPO)

policyHolder: Example Patient Male, DoB: 1974-12-25 ( Medical record number (use: usual, period: 2001-05-06 --> (ongoing)))

subscriber: Example Patient Male, DoB: 1974-12-25 ( Medical record number (use: usual, period: 2001-05-06 --> (ongoing)))

subscriberId: SUB987654321

beneficiary: Example Patient Male, DoB: 1974-12-25 ( Medical record number (use: usual, period: 2001-05-06 --> (ongoing)))

dependent: 0

relationship: Self

period: 2026-01-01 --> 2026-12-31

payor: Organization Example Organization

class

type: Group

value: GRP-99482

name: Example Employer Health Plan

class

type: Plan

value: PLN-GOLD-2026

name: Example PPO Option

Source1

{
  "resourceType": "Coverage",
  "id": "example",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/us/quality-core/StructureDefinition/us-quality-core-coverage"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "identifier": [
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code": "MB",
            "display": "Member Number"
          }
        ],
        "text": "Member ID"
      },
      "system": "http://example.org/payer/member-ids",
      "value": "MB123456789"
    }
  ],
  "status": "active",
  "type": {
    "text": "Preferred Provider Organization (PPO)"
  },
  "policyHolder": {
    "reference": "Patient/example"
  },
  "subscriber": {
    "reference": "Patient/example"
  },
  "subscriberId": "SUB987654321",
  "beneficiary": {
    "reference": "Patient/example"
  },
  "dependent": "0",
  "relationship": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
        "code": "self",
        "display": "Self"
      }
    ]
  },
  "period": {
    "start": "2026-01-01",
    "end": "2026-12-31"
  },
  "payor": [
    {
      "reference": "Organization/example"
    }
  ],
  "class": [
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code": "group",
            "display": "Group"
          }
        ]
      },
      "value": "GRP-99482",
      "name": "Example Employer Health Plan"
    },
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code": "plan",
            "display": "Plan"
          }
        ]
      },
      "value": "PLN-GOLD-2026",
      "name": "Example PPO Option"
    }
  ]
}