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: General Coverage Example - XML Representation

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<Coverage xmlns="http://hl7.org/fhir">
  <id value="Example1"/>
  <meta>
    <lastUpdated value="2024-12-20T10:40:07.000+00:00"/>
    <profile
             value="https://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-coverage-profile"/>
    <security>
      <system
              value="http://terminology.hl7.org/CodeSystem/v3-Confidentiality"/>
      <code value="N"/>
      <display value="Normal"/>
    </security>
  </meta>
  <text>
    <status value="generated"/>
    <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>
  </text>
  <extension
             url="https://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-coverage-extension-coverage-type">
    <valueString value="Primary"/>
  </extension>
  <extension
             url="https://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-coverage-extension-subscriber-name">
    <valueHumanName>
      <family value="Abbey"/>
      <given value="Jeff"/>
    </valueHumanName>
  </extension>
  <identifier>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="MB"/>
        <display value="Member Number"/>
      </coding>
      <text value="Member Number"/>
    </type>
    <value value="89438"/>
  </identifier>
  <status value="active"/>
  <type>
    <coding>
      <system
              value="https://docs.mydata.athenahealth.com/fhir-r4/athenaFlex/namingsystem/InsuranceCarrierType/BLRT-345"/>
      <code value="1"/>
      <display value="MEDICARE"/>
    </coding>
    <text value="MEDICARE"/>
  </type>
  <policyHolder>🔗 
    <reference value="Patient/Example1"/>
  </policyHolder>
  <subscriber>🔗 
    <reference value="Patient/Example1"/>
  </subscriber>
  <subscriberId value="89438"/>
  <beneficiary>🔗 
    <reference value="Patient/Example1"/>
  </beneficiary>
  <relationship>
    <coding>
      <system
              value="https://hl7.org/fhir/R4/valueset-subscriber-relationship"/>
      <code value="common"/>
      <display value="Common Law Spouse"/>
    </coding>
    <text value="Common Law Spouse"/>
  </relationship>
  <period>
    <start value="2024-12-11T00:00:00+00:00"/>
    <end value="2024-12-26T00:00:00+00:00"/>
  </period>
  <payor>🔗 
    <reference value="Organization/Example1"/>
    <display value="(D000)"/>
  </payor>
  <class>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
        <code value="group"/>
      </coding>
      <text value="coverage-class group"/>
    </type>
    <value value="3433"/>
    <name value="Star Group"/>
  </class>
  <class>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
        <code value="plan"/>
        <display value="plan"/>
      </coding>
      <text value="plan"/>
    </type>
    <value value="1532879610244880"/>
    <name value="Test Plan"/>
  </class>
</Coverage>