LinuxForHealth FHIR Implementation Guide
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: CDM Insurance Plan Example - JSON Representation

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{
  "resourceType" : "InsurancePlan",
  "id" : "InsurancePlanExample",
  "meta" : {
    "source" : "http://acme-health.com/WellnessInsuranceCompany",
    "profile" : [
      "http://linuxforhealth.org/fhir/cdm/StructureDefinition/cdm-insurance-plan"
    ]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: InsurancePlan</b><a name=\"InsurancePlanExample\"> </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 InsurancePlan \"InsurancePlanExample\" </p><p style=\"margin-bottom: 0px\">Information Source: http://acme-health.com/WellnessInsuranceCompany!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-cdm-insurance-plan.html\">CDM Insurance Plan</a></p></div><p><b>Payer Medical Coverage Indicator</b>: Y</p><p><b>Payer Dental Coverage Indicator</b>: Y</p><p><b>Payer Drug Coverage Indicator</b>: Y</p><p><b>Payer Hearing Coverage Indicator</b>: Y</p><p><b>Payer Vision Coverage Indicator</b>: Y</p><p><b>Payer Psychiatric Coverage Indicator</b>: N</p><p><b>Payer Shortterm Care Coverage Indicator</b>: Y</p><p><b>Payer Longterm Care Coverage Indicator</b>: Y</p><p><b>Payer Substance Abuse Ambulatory Coverage Indicator</b>: N</p><p><b>Payer Substance Abuse Day-Night Coverage Indicator</b>: N</p><p><b>Payer Substance Abuse Inpatient Coverage Indicator</b>: N</p><p><b>Payer Mental Health Ambulatory Coverage Indicator</b>: N</p><p><b>Payer Mental Health Day Night Coverage Indicator</b>: N</p><p><b>Payer Mental Health Inpatient Coverage Indicator</b>: N</p><p><b>Dental Fully Insured Indicator</b>: Y</p><p><b>Drug Fully Insured Indicator</b>: Y</p><p><b>Enrollment Type</b>: LocalEnrollType <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-enrollment-type#LocalEnrollType)</span></p><p><b>Exchange Plan Indicator</b>: N</p><p><b>Industry Classification</b>: 621112 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-naics.html\">North American Industry Classification System</a>#621112)</span></p><p><b>Medical Fully Insured Indicator</b>: Y</p><p><b>Vision Fully Insured Indicator</b>: Y</p><p><b>Payer Managed Care Plan Type</b>: LocalManagedCarePlan <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-managed-care-plan-type#LocalManagedCarePlan)</span></p><p><b>identifier</b>: Source System Row Identifier: plan_code_1234(use: OFFICIAL), Source System Row Identifier: account_id_1234(use: SECONDARY), Source System Row Identifier: dental-plan_code_5555(use: OFFICIAL), Source System Row Identifier: vision-plan_code_2345(use: OFFICIAL)</p><p><b>type</b>: Medical <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#medical)</span>, Dental <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#dental)</span>, Drug <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#Drug)</span>, Hearing <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#hearing)</span>, Vision <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#vision)</span>, Mental Health <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#mental)</span>, Substance Abuse <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#subst-ab)</span>, Short Term <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#short-term)</span>, Long Term Care <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#long-term)</span>, Substance Abuse Ambulatory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#substance-abuse-ambulatory)</span>, Substance Abuse Day Night <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#substance-abuse-day-night)</span>, Substance Abuse Inpatient <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#substance-abuse-inpatient)</span>, Mental Health Ambulatory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#mental-health-ambulatory)</span>, Mental Health Day Night <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#mental-health-day-night)</span>, Mental Health Inpatient <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#mental-health-inpatient)</span></p><p><b>ownedBy</b>: <a href=\"Organization-GeneralHospital.html\">Organization/GeneralHospital</a> \"General Hospital\"</p><blockquote><p><b>coverage</b></p><p><b>type</b>: Medical <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#medical)</span></p><p><b>network</b>: <a href=\"Organization-GeneralHospital.html\">Organization/GeneralHospital</a> \"General Hospital\"</p><h3>Benefits</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td></tr><tr><td>*</td><td>Medical <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#medical)</span></td></tr></table></blockquote><blockquote><p><b>coverage</b></p><p><b>type</b>: Dental <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#dental)</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td></tr><tr><td>*</td><td>Dental <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#dental)</span></td></tr></table></blockquote><blockquote><p><b>coverage</b></p><p><b>type</b>: Drug <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#Drug)</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td></tr><tr><td>*</td><td>Drug <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#Drug)</span></td></tr></table></blockquote><blockquote><p><b>coverage</b></p><p><b>type</b>: Hearing <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#hearing)</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td></tr><tr><td>*</td><td>Hearing <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#hearing)</span></td></tr></table></blockquote><blockquote><p><b>coverage</b></p><p><b>type</b>: Vision <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#vision)</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td></tr><tr><td>*</td><td>Vision <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#vision)</span></td></tr></table></blockquote><blockquote><p><b>coverage</b></p><p><b>type</b>: Mental Health <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#mental)</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td></tr><tr><td>*</td><td>Mental Health <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#mental)</span></td></tr></table></blockquote><blockquote><p><b>coverage</b></p><p><b>type</b>: Substance Abuse <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#subst-ab)</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td></tr><tr><td>*</td><td>Substance Abuse <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#subst-ab)</span></td></tr></table></blockquote><blockquote><p><b>coverage</b></p><p><b>type</b>: Short Term <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#short-term)</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td></tr><tr><td>*</td><td>Short Term <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#short-term)</span></td></tr></table></blockquote><blockquote><p><b>coverage</b></p><p><b>type</b>: Long Term Care <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#long-term)</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td></tr><tr><td>*</td><td>Long Term Care <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#long-term)</span></td></tr></table></blockquote><blockquote><p><b>coverage</b></p><p><b>type</b>: Substance Abuse Ambulatory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#substance-abuse-ambulatory)</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td></tr><tr><td>*</td><td>Substance Abuse Ambulatory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#substance-abuse-ambulatory)</span></td></tr></table></blockquote><blockquote><p><b>coverage</b></p><p><b>type</b>: Substance Abuse Day Night <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#substance-abuse-day-night)</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td></tr><tr><td>*</td><td>Substance Abuse Day Night <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#substance-abuse-day-night)</span></td></tr></table></blockquote><blockquote><p><b>coverage</b></p><p><b>type</b>: Substance Abuse Inpatient <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#substance-abuse-inpatient)</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td></tr><tr><td>*</td><td>Substance Abuse Inpatient <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#substance-abuse-inpatient)</span></td></tr></table></blockquote><blockquote><p><b>coverage</b></p><p><b>type</b>: Mental Health Ambulatory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#mental-health-ambulatory)</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td></tr><tr><td>*</td><td>Mental Health Ambulatory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#mental-health-ambulatory)</span></td></tr></table></blockquote><blockquote><p><b>coverage</b></p><p><b>type</b>: Mental Health Day Night <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#mental-health-day-night)</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td></tr><tr><td>*</td><td>Mental Health Day Night <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#mental-health-day-night)</span></td></tr></table></blockquote><blockquote><p><b>coverage</b></p><p><b>type</b>: Mental Health Inpatient <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#mental-health-inpatient)</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td></tr><tr><td>*</td><td>Mental Health Inpatient <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-type.html\">Insurance Plan Type Codes</a>#mental-health-inpatient)</span></td></tr></table></blockquote><blockquote><p><b>plan</b></p><p><b>ACA Health Insurance Oversight System Plan</b>: LocalACAPlanCd <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-aca-health-insurance-oversight-system-plan#LocalACAPlanCd)</span></p><p><b>ACA Health Insurance Oversight System Product</b>: LocalACAProductCd <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-aca-health-insurance-oversight-system-product#LocalACAProductCd)</span></p><p><b>ACA Market Type</b>: LocalACAMarketTypeCd <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-aca-market-type#LocalACAMarketTypeCd)</span></p><p><b>ACA Metal Tier</b>: LocalACAMetalTierCd <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-aca-metal-tier#LocalACAMetalTierCd)</span></p><p><b>Capitation Arrangement</b>: LocalCapArrangement <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-capitation-arrangement#LocalCapArrangement)</span></p><p><b>Carve Out</b>: LocalCarveOutCode <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-carve-out#LocalCarveOutCode)</span></p><p><b>Cost Sharing Reduction Variant</b>: LocalCostSharingCd <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-cost-sharing-reduction-variant#LocalCostSharingCd)</span></p><p><b>Funding Arrangement</b>: LocalFundArrangement <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-funding-arrangement#LocalFundArrangement)</span></p><p><b>Level Of Care</b>: LocalLevelOfCare <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-level-of-care#LocalLevelOfCare)</span></p><p><b>Longterm Care Duration</b>: 36</p><p><b>Longterm Care Waiting Period</b>: 90</p><p><b>Rating Area</b>: LocalRatingArea <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-rating-area#LocalRatingArea)</span></p><p><b>Shortterm Care Duration</b>: 16</p><p><b>Shortterm Care Waiting Period</b>: 1</p><blockquote><p><b>specificCost</b></p><p><b>category</b>: Drug <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-cost-category.html\">Insurance Plan Cost Category Codes</a>#drug)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: Administrative Fee <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#administrative-fee)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td>*</td><td>Administrative Fee <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#administrative-fee)</span></td><td>3</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: Medical <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-cost-category.html\">Insurance Plan Cost Category Codes</a>#medical)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: Administrative Fee <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#administrative-fee)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td>*</td><td>Administrative Fee <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#administrative-fee)</span></td><td>75</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: Drug <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-cost-category.html\">Insurance Plan Cost Category Codes</a>#drug)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: Employee Contribution <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#employee-contribution)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td>*</td><td>Employee Contribution <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#employee-contribution)</span></td><td>15</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: Medical <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-cost-category.html\">Insurance Plan Cost Category Codes</a>#medical)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: Employee Contribution <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#employee-contribution)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td>*</td><td>Employee Contribution <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#employee-contribution)</span></td><td>125</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: Drug <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-cost-category.html\">Insurance Plan Cost Category Codes</a>#drug)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: Monthly Premium Paid <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#monthly-premium-paid)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td>*</td><td>Monthly Premium Paid <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#monthly-premium-paid)</span></td><td>25</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: Medical <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-cost-category.html\">Insurance Plan Cost Category Codes</a>#medical)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: Monthly Premium Paid <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#monthly-premium-paid)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td>*</td><td>Monthly Premium Paid <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#monthly-premium-paid)</span></td><td>55</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: Other <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-cost-category.html\">Insurance Plan Cost Category Codes</a>#other)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: Non Claim Payment <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#non-claim-payment)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td>*</td><td>Non Claim Payment <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#non-claim-payment)</span></td><td>5</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: Dental <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-cost-category.html\">Insurance Plan Cost Category Codes</a>#dental)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: Administrative Fee <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#administrative-fee)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td>*</td><td>Administrative Fee <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#administrative-fee)</span></td><td>2</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: Vision <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-cost-category.html\">Insurance Plan Cost Category Codes</a>#vision)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: Administrative Fee <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#administrative-fee)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td>*</td><td>Administrative Fee <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#administrative-fee)</span></td><td>3</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: Dental <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-cost-category.html\">Insurance Plan Cost Category Codes</a>#dental)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: Employee Contribution <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#employee-contribution)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td>*</td><td>Employee Contribution <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#employee-contribution)</span></td><td>0</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: Vision <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-cost-category.html\">Insurance Plan Cost Category Codes</a>#vision)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: Employee Contribution <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#employee-contribution)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td>*</td><td>Employee Contribution <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#employee-contribution)</span></td><td>0</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: Other <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-cost-category.html\">Insurance Plan Cost Category Codes</a>#other)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: Capitation Amount <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#capitation-amount)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td>*</td><td>Capitation Amount <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#capitation-amount)</span></td><td>0</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: Other <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-cost-category.html\">Insurance Plan Cost Category Codes</a>#other)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: Monthly Premium Billed <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#monthly-premium-billed)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td>*</td><td>Monthly Premium Billed <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#monthly-premium-billed)</span></td><td>10</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: Dental <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-cost-category.html\">Insurance Plan Cost Category Codes</a>#dental)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: Monthly Premium Paid <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#monthly-premium-paid)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td>*</td><td>Monthly Premium Paid <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#monthly-premium-paid)</span></td><td>5</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: Vision <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-cost-category.html\">Insurance Plan Cost Category Codes</a>#vision)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: Monthly Premium Paid <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#monthly-premium-paid)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td>*</td><td>Monthly Premium Paid <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#monthly-premium-paid)</span></td><td>2</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: Other <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-cost-category.html\">Insurance Plan Cost Category Codes</a>#other)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: Administrative Fee <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#administrative-fee)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td>*</td><td>Administrative Fee <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#administrative-fee)</span></td><td>2</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: Other <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-cost-category.html\">Insurance Plan Cost Category Codes</a>#other)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: Employee Contribution <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#employee-contribution)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td>*</td><td>Employee Contribution <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#employee-contribution)</span></td><td>6</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: Other <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-cost-category.html\">Insurance Plan Cost Category Codes</a>#other)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: Monthly Premium Paid <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#monthly-premium-paid)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td>*</td><td>Monthly Premium Paid <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-benefit-type.html\">Insurance Plan Benefit Type Codes</a>#monthly-premium-paid)</span></td><td>6</td></tr></table></blockquote></blockquote></blockquote></div>"
  },
  "extension" : [
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/payer-medical-coverage-indicator",
      "valueString" : "Y"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/payer-dental-coverage-indicator",
      "valueString" : "Y"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/payer-drug-coverage-indicator",
      "valueString" : "Y"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/payer-hearing-coverage-indicator",
      "valueString" : "Y"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/payer-vision-coverage-indicator",
      "valueString" : "Y"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/payer-psych-coverage-indicator",
      "valueString" : "N"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/payer-short-term-care-coverage-indicator",
      "valueString" : "Y"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/payer-long-term-care-coverage-indicator",
      "valueString" : "Y"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/payer-substance-abuse-ambulatory-coverage-indicator",
      "valueString" : "N"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/payer-substance-abuse-day-night-coverage-indicator",
      "valueString" : "N"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/payer-substance-abuse-inpatient-coverage-indicator",
      "valueString" : "N"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/payer-mental-health-ambulatory-coverage-indicator",
      "valueString" : "N"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/payer-mental-health-day-night-coverage-indicator",
      "valueString" : "N"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/payer-mental-health-inpatient-coverage-indicator",
      "valueString" : "N"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/dental-fully-insured-indicator",
      "valueString" : "Y"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/drug-fully-insured-indicator",
      "valueString" : "Y"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/enrollment-type",
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://acme-health.com/CodeSystem/local-enrollment-type",
            "code" : "LocalEnrollType"
          }
        ]
      }
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/exchange-plan-indicator",
      "valueString" : "N"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/industry-classification",
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/naics",
            "code" : "621112"
          }
        ]
      }
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/medical-fully-insured-indicator",
      "valueString" : "Y"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/vision-fully-insured-indicator",
      "valueString" : "Y"
    },
    {
      "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/payer-managed-care-plan-type",
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://acme-health.com/CodeSystem/local-managed-care-plan-type",
            "code" : "LocalManagedCarePlan"
          }
        ]
      }
    }
  ],
  "identifier" : [
    {
      "use" : "official",
      "type" : {
        "coding" : [
          {
            "system" : "http://linuxforhealth.org/fhir/cdm/CodeSystem/identifier-type",
            "code" : "SSRI"
          }
        ]
      },
      "system" : "http://acme-health.com/plan/insuranceplan1",
      "value" : "plan_code_1234",
      "assigner" : {
        "display" : "Acme Health - Insurance Plan"
      }
    },
    {
      "use" : "secondary",
      "type" : {
        "coding" : [
          {
            "system" : "http://linuxforhealth.org/fhir/cdm/CodeSystem/identifier-type",
            "code" : "SSRI"
          }
        ]
      },
      "system" : "http://acme-health.com/plan/insuranceplan1",
      "value" : "account_id_1234",
      "assigner" : {
        "display" : "Acme Health - Insurance Plan Account ID"
      }
    },
    {
      "use" : "official",
      "type" : {
        "coding" : [
          {
            "system" : "http://linuxforhealth.org/fhir/cdm/CodeSystem/identifier-type",
            "code" : "SSRI"
          }
        ]
      },
      "system" : "http://acme-health.com/plan/DentalInsurancePlan",
      "value" : "dental-plan_code_5555",
      "assigner" : {
        "display" : "Acme Health - Dental Insurance Plan"
      }
    },
    {
      "use" : "official",
      "type" : {
        "coding" : [
          {
            "system" : "http://linuxforhealth.org/fhir/cdm/CodeSystem/identifier-type",
            "code" : "SSRI"
          }
        ]
      },
      "system" : "http://acme-health.com/plan/VisionInsurancePlan",
      "value" : "vision-plan_code_2345",
      "assigner" : {
        "display" : "Acme Health - Vision Insurance Plan"
      }
    }
  ],
  "type" : [
    {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/insurance-plan-type",
          "code" : "medical"
        }
      ]
    },
    {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/insurance-plan-type",
          "code" : "dental"
        }
      ]
    },
    {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/insurance-plan-type",
          "code" : "Drug"
        }
      ]
    },
    {
      "coding" : [
        {
          "system" : "http://linuxforhealth.org/fhir/cdm/CodeSystem/insurance-plan-type",
          "code" : "hearing"
        }
      ]
    },
    {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/insurance-plan-type",
          "code" : "vision"
        }
      ]
    },
    {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/insurance-plan-type",
          "code" : "mental"
        }
      ]
    },
    {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/insurance-plan-type",
          "code" : "subst-ab"
        }
      ]
    },
    {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/insurance-plan-type",
          "code" : "short-term"
        }
      ]
    },
    {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/insurance-plan-type",
          "code" : "long-term"
        }
      ]
    },
    {
      "coding" : [
        {
          "system" : "http://linuxforhealth.org/fhir/cdm/CodeSystem/insurance-plan-type",
          "code" : "substance-abuse-ambulatory"
        }
      ]
    },
    {
      "coding" : [
        {
          "system" : "http://linuxforhealth.org/fhir/cdm/CodeSystem/insurance-plan-type",
          "code" : "substance-abuse-day-night"
        }
      ]
    },
    {
      "coding" : [
        {
          "system" : "http://linuxforhealth.org/fhir/cdm/CodeSystem/insurance-plan-type",
          "code" : "substance-abuse-inpatient"
        }
      ]
    },
    {
      "coding" : [
        {
          "system" : "http://linuxforhealth.org/fhir/cdm/CodeSystem/insurance-plan-type",
          "code" : "mental-health-ambulatory"
        }
      ]
    },
    {
      "coding" : [
        {
          "system" : "http://linuxforhealth.org/fhir/cdm/CodeSystem/insurance-plan-type",
          "code" : "mental-health-day-night"
        }
      ]
    },
    {
      "coding" : [
        {
          "system" : "http://linuxforhealth.org/fhir/cdm/CodeSystem/insurance-plan-type",
          "code" : "mental-health-inpatient"
        }
      ]
    }
  ],
  "ownedBy" : {
    "reference" : "Organization/GeneralHospital"
  },
  "coverage" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/insurance-plan-type",
            "code" : "medical"
          }
        ]
      },
      "network" : [
        {
          "reference" : "Organization/GeneralHospital"
        }
      ],
      "benefit" : [
        {
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