HRSA 2023 Uniform Data System (UDS) Patient Level Submission (PLS) (UDS+) FHIR IG
1.1.0 - STU1 Release 1.1 - Standard for Trial-Use International flag

This page is part of the HRSA Uniform Data System (UDS) Patient Level Submission (PLS) (UDS+ or uds-plus) FHIR IG (v1.1.0: STU1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: Uds Plus Coverage Example - JSON Representation

Page standards status: Informative

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{
  "resourceType" : "Coverage",
  "id" : "de-identified-example",
  "meta" : {
    "profile" : [
      🔗 "http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-coverage"
    ]
  },
  "extension" : [
    {
      "url" : "http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-capitated-member-months-extension",
      "valueQuantity" : {
        "value" : 36,
        "unit" : "yr",
        "system" : "http://unitsofmeasure.org",
        "code" : "a"
      }
    },
    {
      "url" : "http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-feeforservice-member-months-extension",
      "valueQuantity" : {
        "value" : 36,
        "unit" : "yr",
        "system" : "http://unitsofmeasure.org",
        "code" : "a"
      }
    }
  ],
  "status" : "active",
  "type" : {
    "coding" : [
      {
        "system" : "http://fhir.org/guides/hrsa/uds-plus/CodeSystem/uds-plus-insurance-codes",
        "code" : "private-insurance",
        "display" : "Private Insurance"
      }
    ]
  },
  "beneficiary" : {
    🔗 "reference" : "Patient/de-identified-example"
  },
  "period" : {
    "start" : "2019",
    "end" : "2023"
  },
  "payor" : [
    {
      🔗 "reference" : "Organization/acme-payer"
    }
  ]
}