example
type: Coverage
node role: treeRoot
id:
  v: example
meta:
  profile:
    v: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-coverage
    l: us-quality-core-coverage
language:
  v: en
text:
  status:
    v: generated
  div:
    v: Generated Narrative: Coverage example Profile: US Quality Core Coverage identifier: Member Number/?ngen-9? status: Active type: Other Private Insurance policyHolder: Jim Chalmers Male, DoB: 1974-12-25 ( Social Security number (use: usual, period: 2001-05-06 --> (ongoing))) subscriber: Jim Chalmers Male, DoB: 1974-12-25 ( Social Security number (use: usual, period: 2001-05-06 --> (ongoing))) subscriberId: 12191 beneficiary: Jim Chalmers Male, DoB: 1974-12-25 ( Social Security number (use: usual, period: 2001-05-06 --> (ongoing))) dependent: 0 relationship: Self period: 2011-05-23 --> 2012-05-23 payor: Organization Health Level Seven International class type: Group value: CBI35 name: Corporate Baker's Inc. Local #35 class type: Plan value: B37FC name: Full Coverage: Medical, Dental, Pharmacy, Vision, EHC order: 9
identifier:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
        l: v2-0203
      code:
        v: MB
status:
  v: active
type:
  coding:
    system:
      v: https://nahdo.org/sopt
      l: sopt
    code:
      v: 59
    display:
      v: Other Private Insurance
policy holder:
  l: example
  reference:
    v: Patient/example
subscriber:
  l: example
  reference:
    v: Patient/example
subscriber id:
  v: 12191
beneficiary:
  l: example
  reference:
    v: Patient/example
dependent:
  v: 0
relationship:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/subscriber-relationship
      l: subscriber-relationship
    code:
      v: self
period:
  start:
    v: 2011-05-23
  end:
    v: 2012-05-23
payor:
  l: example
  reference:
    v: Organization/example
class:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/coverage-class
        l: coverage-class
      code:
        v: group
      display:
        v: Group
  value:
    v: CBI35
  name:
    v: Corporate Baker's Inc. Local #35
class:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/coverage-class
        l: coverage-class
      code:
        v: plan
      display:
        v: Plan
  value:
    v: B37FC
  name:
    v: Full Coverage: Medical, Dental, Pharmacy, Vision, EHC
order:
  v: 9