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 - XML Representation

Page standards status: Informative

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<Coverage xmlns="http://hl7.org/fhir">
  <id value="de-identified-example"/>
  <meta>
    <profile
             value="http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-coverage"/>
  </meta>
  <extension
             url="http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-capitated-member-months-extension">
    <valueQuantity>
      <value value="36"/>
      <unit value="yr"/>
      <system value="http://unitsofmeasure.org"/>
      <code value="a"/>
    </valueQuantity>
  </extension>
  <extension
             url="http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-feeforservice-member-months-extension">
    <valueQuantity>
      <value value="36"/>
      <unit value="yr"/>
      <system value="http://unitsofmeasure.org"/>
      <code value="a"/>
    </valueQuantity>
  </extension>
  <status value="active"/>
  <type>
    <coding>
      <system
              value="http://fhir.org/guides/hrsa/uds-plus/CodeSystem/uds-plus-insurance-codes"/>
      <code value="private-insurance"/>
      <display value="Private Insurance"/>
    </coding>
  </type>
  <beneficiary>🔗 
    <reference value="Patient/de-identified-example"/>
  </beneficiary>
  <period>
    <start value="2019"/>
    <end value="2023"/>
  </period>
  <payor>🔗 
    <reference value="Organization/acme-payer"/>
  </payor>
</Coverage>