| Name | Flags | Card. | Type |
Description & Constraints
|
|---|---|---|---|---|
Coverage
|
C | Coverage | us-core-15: Member Id in Coverage.identifier or Coverage.subscriberId SHALL be present | |
Slices for identifier
|
S |
(USCDI) Member ID and other identifiers
Slice: Unordered, Open by pattern:type |
||
identifier:memberid
|
S C | 0..1 | (USCDI) Member ID | |
type
|
S | 1.. |
(USCDI) Member Number identifier type Required Pattern: At least the following |
|
coding
|
1..* | Coding |
Code defined by a terminology system Fixed Value: (complex) |
|
|
system
|
1..1 | uri |
Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203 |
|
|
code
|
1..1 | code |
Symbol in syntax defined by the system Fixed Value: MB |
|
|
status
|
S | (USCDI) active | cancelled | draft | entered-in-error | ||
|
type
|
S |
(USCDI) Coverage category such as medical or accident Binding: Payer Type ( extensible ): US Public Health Data Consortium Source of Payment Codes |
||
|
subscriberId
|
S C | (USCDI) ID assigned to the subscriber | ||
beneficiary
|
S | Reference (US Core Patient Profile) | (USCDI) Plan beneficiary | |
|
relationship
|
S | 1.. |
(USCDI) Beneficiary relationship to the subscriber Binding: SubscriberPolicyholder Relationship Codes ( extensible ) |
|
|
period
|
S | (USCDI) Coverage start and end dates | ||
|
payor
|
S | ..1 | Reference (US Core Organization Profile S | US Core Patient Profile | US Core RelatedPerson Profile) | (USCDI) Issuer of the policy |
|
Slices for class
|
S |
(USCDI) Additional coverage classifications
Slice: Unordered, Open by pattern:type |
||
class:group
|
S | 0..1 | (USCDI) Group | |
type
|
Required Pattern: At least the following | |||
coding
|
1..* | Coding |
Code defined by a terminology system Fixed Value: (complex) |
|
|
system
|
1..1 | uri |
Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class |
|
|
code
|
1..1 | code |
Symbol in syntax defined by the system Fixed Value: group |
|
|
value
|
S | (USCDI) Group Number | ||
|
name
|
S | (USCDI) Group Name | ||
|
class:plan
|
S | 0..1 | (USCDI) Plan | |
|
type
|
Required Pattern: At least the following | |||
|
coding
|
1..* | Coding |
Code defined by a terminology system Fixed Value: (complex) |
|
|
system
|
1..1 | uri |
Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class |
|
|
code
|
1..1 | code |
Symbol in syntax defined by the system Fixed Value: plan |
|
|
value
|
S | (USCDI) Plan Number | ||
|
name
|
S | (USCDI) Plan Name | ||
|
Documentation for this format
|
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