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: General Coverage Example - JSON Representation

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{
  "resourceType" : "Coverage",
  "id" : "Example1",
  "meta" : {
    "lastUpdated" : "2024-12-20T10:40:07.000+00:00",
    "profile" : [
      🔗 "https://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-coverage-profile"
    ],
    "security" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-Confidentiality",
        "code" : "N",
        "display" : "Normal"
      }
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Coverage Example1</b></p><a name=\"Example1\"> </a><a name=\"hcExample1\"> </a><a name=\"Example1-en-US\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Last updated: 2024-12-20 10:40:07+0000</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-athena-coverage-profile.html\">ATHENACoverage</a></p><p style=\"margin-bottom: 0px\">Security Label: Normal (Details: Confidentiality code N  = ' normal ', stated as ' Normal ')</p></div><p><b>identifier</b>: Member Number/89438</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{https://docs.mydata.athenahealth.com/fhir-r4/athenaFlex/namingsystem/InsuranceCarrierType/BLRT-345 1}\">MEDICARE</span></p><p><b>policyHolder</b>: <a href=\"Patient-Example1.html\">Robert S Benson (official) Male, DoB: 1974-05-21 ( Medical record number)</a></p><p><b>subscriber</b>: <a href=\"Patient-Example1.html\">Robert S Benson (official) Male, DoB: 1974-05-21 ( Medical record number)</a></p><p><b>subscriberId</b>: 89438</p><p><b>beneficiary</b>: <a href=\"Patient-Example1.html\">Robert S Benson (official) Male, DoB: 1974-05-21 ( Medical record number)</a></p><p><b>relationship</b>: <span title=\"Codes:{https://hl7.org/fhir/R4/valueset-subscriber-relationship common}\">Common Law Spouse</span></p><p><b>period</b>: 2024-12-11 00:00:00+0000 --&gt; 2024-12-26 00:00:00+0000</p><p><b>payor</b>: <a href=\"Organization-Example1.html\">(D000)</a></p><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class group}\">coverage-class group</span></p><p><b>value</b>: 3433</p><p><b>name</b>: Star Group</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class plan}\">plan</span></p><p><b>value</b>: 1532879610244880</p><p><b>name</b>: Test Plan</p></blockquote></div>"
  },
  "extension" : [
    {
      "url" : "https://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-coverage-extension-coverage-type",
      "valueString" : "Primary"
    },
    {
      "url" : "https://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-coverage-extension-subscriber-name",
      "valueHumanName" : {
        "family" : "Abbey",
        "given" : [
          "Jeff"
        ]
      }
    }
  ],
  "identifier" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "MB",
            "display" : "Member Number"
          }
        ],
        "text" : "Member Number"
      },
      "value" : "89438"
    }
  ],
  "status" : "active",
  "type" : {
    "coding" : [
      {
        "system" : "https://docs.mydata.athenahealth.com/fhir-r4/athenaFlex/namingsystem/InsuranceCarrierType/BLRT-345",
        "code" : "1",
        "display" : "MEDICARE"
      }
    ],
    "text" : "MEDICARE"
  },
  "policyHolder" : {
    🔗 "reference" : "Patient/Example1"
  },
  "subscriber" : {
    🔗 "reference" : "Patient/Example1"
  },
  "subscriberId" : "89438",
  "beneficiary" : {
    🔗 "reference" : "Patient/Example1"
  },
  "relationship" : {
    "coding" : [
      {
        "system" : "https://hl7.org/fhir/R4/valueset-subscriber-relationship",
        "code" : "common",
        "display" : "Common Law Spouse"
      }
    ],
    "text" : "Common Law Spouse"
  },
  "period" : {
    "start" : "2024-12-11T00:00:00+00:00",
    "end" : "2024-12-26T00:00:00+00:00"
  },
  "payor" : [
    {
      🔗 "reference" : "Organization/Example1",
      "display" : "(D000)"
    }
  ],
  "class" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "group"
          }
        ],
        "text" : "coverage-class group"
      },
      "value" : "3433",
      "name" : "Star Group"
    },
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "plan",
            "display" : "plan"
          }
        ],
        "text" : "plan"
      },
      "value" : "1532879610244880",
      "name" : "Test Plan"
    }
  ]
}