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: Coverage - ACH Daily Condition Example Negative PCR - XML Representation

Page standards status: Informative

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<Coverage xmlns="http://hl7.org/fhir">
  <id value="coverage-example-ach-daily-negativepcr"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Coverage coverage-example-ach-daily-negativepcr</b></p><a name="coverage-example-ach-daily-negativepcr"> </a><a name="hccoverage-example-ach-daily-negativepcr"> </a><p><b>identifier</b>: Member Number/88800933501</p><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode SUBSIDIZ}">MEDICAID</span></p><p><b>subscriberId</b>: 123456789</p><p><b>beneficiary</b>: <a href="Patient-patient-example-ach-daily-negativepcr.html">ACHDaily NegativePCR(official) Other, DoB: 2005-02-01 ( MRN:?1000009001?(use:?usual,?))</a></p><p><b>relationship</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}">Self</span></p><p><b>period</b>: 2023-01-01 --&gt; (ongoing)</p><p><b>payor</b>: Medicaid Coverage</p><h3>Classes</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Value</b></td><td><b>Name</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/coverage-class group}">Medicaid</span></td><td>Medicaid</td><td>Medicaid</td></tr></table></div>
  </text>
  <identifier>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="MB"/>
        <display value="Member Number"/>
      </coding>
    </type>
    <system value="http://example.org/fhir/memberidentifier"/>
    <value value="88800933501"/>
  </identifier>
  <status value="active"/>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
      <version value="9.0.0"/>
      <code value="SUBSIDIZ"/>
      <display value="subsidized health program"/>
    </coding>
    <text value="MEDICAID"/>
  </type>
  <subscriberId value="123456789"/>
  <beneficiary>🔗 
    <reference value="Patient/patient-example-ach-daily-negativepcr"/>
  </beneficiary>
  <relationship>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
      <code value="self"/>
    </coding>
    <text value="Self"/>
  </relationship>
  <period>
    <start value="2023-01-01"/>
  </period>
  <payor>
    <display value="Medicaid Coverage"/>
  </payor>
  <class>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
        <code value="group"/>
        <display value="Group"/>
      </coding>
      <text value="Medicaid"/>
    </type>
    <value value="Medicaid"/>
    <name value="Medicaid"/>
  </class>
</Coverage>