LinuxForHealth FHIR Implementation Guide - Local Development build (v8.0.0). See the Directory of published versions

• Narrative Content
• XML
• JSON
• TTL

: CDM Claim - Drug Coverage Example - JSON Representation

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{
  "resourceType" : "Coverage",
  "id" : "CoverageDrugExample",
  "meta" : {
    "source" : "http://acme-health.com/WellnessCenterPharmacy",
    "profile" : [
      "http://linuxforhealth.org/fhir/cdm/StructureDefinition/cdm-coverage"
    ]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Coverage</b><a name=\"CoverageDrugExample\"> </a></p><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\">Resource Coverage \"CoverageDrugExample\" </p><p style=\"margin-bottom: 0px\">Information Source: http://acme-health.com/WellnessCenterPharmacy!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-cdm-coverage.html\">CDM Coverage</a></p></div><p><b>Age and Gender Groups</b>: Males 20-24 yr <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-age-gender-group.html\">Age and Gender Group Codes</a>#7)</span></p><p><b>Snapshot Age In Years</b>: 21</p><p><b>Claim Group Identifier</b>: claim group id</p><p><b>Coverage Month</b>: 2017-06-01</p><p><b>Employee Count</b>: 1</p><p><b>Employee Status</b>: Active Full Time <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-payer-employee-status-code.html\">payer Employee Status Codes</a>#1)</span></p><p><b>Employee Hire Date</b>: 2017-01-30</p><p><b>identifier</b>: Source System Row Identifier: encryp-id1234</p><p><b>status</b>: active</p><p><b>subscriber</b>: <a href=\"Patient-CDMPatientInstance.html\">Patient/CDMPatientInstance</a> \" MCLASTNAME\"</p><p><b>beneficiary</b>: <span></span></p><p><b>relationship</b>: Self <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-subscriber-relationship.html\">SubscriberPolicyholder Relationship Codes</a>#self)</span></p><p><b>period</b>: 2017-06-01 --&gt; 2017-06-30</p><p><b>payor</b>: <span></span></p></div>"
  },
  "extension" : [
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/age-gender-group",
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://linuxforhealth.org/fhir/cdm/CodeSystem/age-gender-group",
            "code" : "7"
          }
        ]
      }
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/snapshot-age-in-years",
      "valueUnsignedInt" : 21
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/claim-group-identifier",
      "valueString" : "claim group id"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/coverage-month",
      "valueDate" : "2017-06-01"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/employee-count",
      "valueUnsignedInt" : 1
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/employee-status",
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://linuxforhealth.org/fhir/cdm/CodeSystem/payer-employee-status-code",
            "code" : "1"
          }
        ]
      }
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/employee-hire-date",
      "valueDate" : "2017-01-30"
    }
  ],
  "identifier" : [
    {
      "extension" : [
        {
          "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/encrypted-state",
          "valueBoolean" : true
        }
      ],
      "type" : {
        "coding" : [
          {
            "system" : "http://linuxforhealth.org/fhir/cdm/CodeSystem/identifier-type",
            "code" : "SSRI"
          }
        ]
      },
      "system" : "http://acme-health.com/emr1/WellnessCenterPharmacy",
      "value" : "encryp-id1234"
    }
  ],
  "status" : "active",
  "subscriber" : {
    "reference" : "Patient/CDMPatientInstance"
  },
  "beneficiary" : {
    "type" : "Person",
    "identifier" : {
      "system" : "http://acme-health.com/emr1/person",
      "value" : "Payer1"
    }
  },
  "relationship" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
        "code" : "self"
      }
    ]
  },
  "period" : {
    "start" : "2017-06-01",
    "end" : "2017-06-30"
  },
  "payor" : [
    {
      "type" : "Organiation",
      "identifier" : {
        "system" : "http://acme-health.com/payer1/payer",
        "value" : "encryp-id1234"
      }
    }
  ]
}