FHIR IG analytics| Package | ntt.healthgenig |
| Resource Type | Coverage |
| Id | Coverage11-Example.json |
| FHIR Version | R4 |
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Note: links and images are rebased to the (stated) source
Resource Coverage "Coverage1" Updated "2020-10-30 09:48:01-0400" (Language "en-US")
Profile: C4BB Coverage (version 2.0.0)
identifier: An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier.: 88800933501
status: active
policyHolder: Patient/Patient1 " EXAMPLE1"
subscriber: Patient/Patient1 " EXAMPLE1"
subscriberId: 888009335
beneficiary: Patient/Patient1 " EXAMPLE1"
dependent: 01
relationship: Self (SubscriberPolicyholder Relationship Codes#self)
period: 2020-01-01 --> (ongoing)
payor: Organization/Payer2: UPMC Health Plan "UPMC Health Plan"
class
type: An employee group (Coverage Class Codes#group "Group")
value: MCHMO1
name: MEDICARE HMO PLAN
class
type: A specific suite of benefits. (Coverage Class Codes#plan "Plan")
value: GR5
name: GR5-HMO DEDUCTIBLE
network: GR5-HMO DEDUCTIBLE
{
"resourceType": "Coverage",
"id": "Coverage1",
"meta": {
"lastUpdated": "2020-10-30T09:48:01.8462752-04:00",
"profile": [
"https://dxp.com/fhir/StructureDefinition/DXPCoverage"
]
},
"language": "en-US",
"text": {
"status": "generated",
"div": "<!-- snip (see above) -->"
},
"identifier": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "MB",
"display": "Member Number"
}
],
"text": "An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier."
},
"system": "https://www.upmchealthplan.com/fhir/memberidentifier",
"value": "88800933501",
"assigner": {
"reference": "Organization/Payer2",
"display": "UPMC Health Plan"
}
}
],
"status": "active",
"policyHolder": {
"reference": "Patient/Patient1"
},
"subscriber": {
"reference": "Patient/Patient1"
},
"subscriberId": "888009335",
"beneficiary": {
"reference": "Patient/Patient1"
},
"dependent": "01",
"relationship": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
"code": "self"
}
],
"text": "Self"
},
"period": {
"start": "2020-01-01"
},
"payor": [
{
"reference": "Organization/Payer2",
"display": "UPMC Health Plan"
}
],
"class": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "group",
"display": "Group"
}
],
"text": "An employee group"
},
"value": "MCHMO1",
"name": "MEDICARE HMO PLAN"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "plan",
"display": "Plan"
}
],
"text": "A specific suite of benefits."
},
"value": "GR5",
"name": "GR5-HMO DEDUCTIBLE"
}
],
"network": "GR5-HMO DEDUCTIBLE"
}