Coverage.class
FHIR attribute (r4)
In the Coverage resource for FHIR r4 , the class attribute identifies the Additional coverage classifications
class (Coverage) description
Resource Type: Coverage
Attribute Name: class
Description: Additional coverage classifications
FHIR Version: r4
Attribute Type :
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Coverage.class Example
"class": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "group"
}
]
},
"value": "CB135",
"name": "Corporate Baker's Inc. Local #35"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "subgroup"
}
]
},
"value": "123",
"name": "Trainee Part-time Benefits"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "plan"
}
]
},
"value": "B37FC",
"name": "Full Coverage: Medical, Dental, Pharmacy, Vision, EHC"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "subplan"
}
]
},
"value": "P7",
"name": "Includes afterlife benefits"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "class"
}
]
},
"value": "SILVER",
"name": "Silver: Family Plan spouse only"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "subclass"
}
]
},
"value": "Tier2",
"name": "Low deductable, max $20 copay"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "sequence"
}
]
},
"value": "9"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "rxid"
}
]
},
"value": "MDF12345"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "rxbin"
}
]
},
"value": "987654"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "rxgroup"
}
]
},
"value": "M35PT"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "rxpcn"
}
]
},
"value": "234516"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "sequence"
}
]
},
"value": "9"
}
]Coverage attributes
AttributeField is listTypeDescription
Description: Business Identifier for the coverage
FHIR Version: r4
Attribute Type : Identifier
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"identifier": [
{
"system": "http://benefitsinc.com/certificate",
"value": "12345"
}
]Learn more about the (Coverage) identifier FHIR attribute
Description: active | cancelled | draft | entered-in-error
FHIR Version: r4
Attribute Type : code
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"status": "active"Learn more about the (Coverage) status FHIR attribute
Description: Coverage category such as medical or accident
FHIR Version: r4
Attribute Type : CodeableConcept
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "EHCPOL",
"display": "extended healthcare"
}
]
}Learn more about the (Coverage) type FHIR attribute
Description: Owner of the policy
FHIR Version: r4
Attribute Type : Reference
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"policyHolder": {
"reference": "http://benefitsinc.com/FHIR/Organization/CBI35"
}Learn more about the (Coverage) policyHolder FHIR attribute
Description: Subscriber to the policy
FHIR Version: r4
Attribute Type : Reference
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"subscriber": {
"reference": "Patient/4"
}Learn more about the (Coverage) subscriber FHIR attribute
Description: ID assigned to the subscriber
FHIR Version: r4
Attribute Type : string
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"subscriberId": Learn more about the (Coverage) subscriberId FHIR attribute
Description: Plan beneficiary
FHIR Version: r4
Attribute Type : Reference
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"beneficiary": {
"reference": "Patient/4"
}Learn more about the (Coverage) beneficiary FHIR attribute
Description: Dependent number
FHIR Version: r4
Attribute Type : string
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"dependent": "0"Learn more about the (Coverage) dependent FHIR attribute
Description: Beneficiary relationship to the subscriber
FHIR Version: r4
Attribute Type : CodeableConcept
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"relationship": {
"coding": [
{
"code": "self"
}
]
}Learn more about the (Coverage) relationship FHIR attribute
Description: Coverage start and end dates
FHIR Version: r4
Attribute Type : Period
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"period": {
"start": "2011-05-23",
"end": "2012-05-23"
}Learn more about the (Coverage) period FHIR attribute
Description: Issuer of the policy
FHIR Version: r4
Attribute Type : Reference
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"payor": [
{
"reference": "Organization/2"
}
]Learn more about the (Coverage) payor FHIR attribute
Description: Additional coverage classifications
FHIR Version: r4
Attribute Type : Data Type
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"class": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "group"
}
]
},
"value": "CB135",
"name": "Corporate Baker's Inc. Local #35"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "subgroup"
}
]
},
"value": "123",
"name": "Trainee Part-time Benefits"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "plan"
}
]
},
"value": "B37FC",
"name": "Full Coverage: Medical, Dental, Pharmacy, Vision, EHC"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "subplan"
}
]
},
"value": "P7",
"name": "Includes afterlife benefits"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "class"
}
]
},
"value": "SILVER",
"name": "Silver: Family Plan spouse only"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "subclass"
}
]
},
"value": "Tier2",
"name": "Low deductable, max $20 copay"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "sequence"
}
]
},
"value": "9"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "rxid"
}
]
},
"value": "MDF12345"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "rxbin"
}
]
},
"value": "987654"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "rxgroup"
}
]
},
"value": "M35PT"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "rxpcn"
}
]
},
"value": "234516"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "sequence"
}
]
},
"value": "9"
}
]Learn more about the (Coverage) class FHIR attribute
Description: Relative order of the coverage
FHIR Version: r4
Attribute Type : positiveInt
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"order": Learn more about the (Coverage) order FHIR attribute
Description: Insurer network
FHIR Version: r4
Attribute Type : string
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"network": Learn more about the (Coverage) network FHIR attribute
Description: Patient payments for services/products
FHIR Version: r4
Attribute Type : Data Type
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"costToBeneficiary": Learn more about the (Coverage) costToBeneficiary FHIR attribute
Description: Reimbursement to insurer
FHIR Version: r4
Attribute Type : boolean
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"subrogation": Learn more about the (Coverage) subrogation FHIR attribute
Description: Contract details
FHIR Version: r4
Attribute Type : Reference
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"contract": Learn more about the (Coverage) contract FHIR attribute
