HRSA 2023 Uniform Data System (UDS) Patient Level Submission (PLS) (UDS+) FHIR IG
1.0.0 - STU1 Release 1 - Standard for Trial-Use International flag

HRSA 2023 Uniform Data System (UDS) Patient Level Submission (PLS) (UDS+) FHIR IG - Local Development build (v1.0.0). See the Directory of published versions

: Uds Plus Coverage Example - XML Representation

Page standards status: Informative

Raw xml | Download



<Coverage xmlns="http://hl7.org/fhir">
  <id value="de-identified-example"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-coverage"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Coverage</b><a name="de-identified-example"> </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 &quot;de-identified-example&quot; </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uds-plus-coverage.html">DeIdentified UDS Plus Coverage</a></p></div><p><b>UDS Plus Capitated Member Months Extension</b>: 36 yr<span style="background: LightGoldenRodYellow"> (Details: UCUM code a = 'a')</span></p><p><b>UDS Plus FeeForService Member Months Extension</b>: 36 yr<span style="background: LightGoldenRodYellow"> (Details: UCUM code a = 'a')</span></p><p><b>status</b>: active</p><p><b>type</b>: Private Insurance <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-uds-plus-insurance-codes.html">UDS Plus Insurance Codes</a>#private-insurance)</span></p><p><b>beneficiary</b>: <a href="Patient-de-identified-example.html">Patient/de-identified-example</a></p><p><b>period</b>: 2019-03-17 --&gt; 2023-03-17</p><p><b>payor</b>: <a href="Organization-acme-payer.html">Organization/acme-payer</a> &quot;Acme Health Plan&quot;</p></div>
  </text>
  <extension
             url="http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-capitated-member-months-extension">
    <valueQuantity>
      <value value="36"/>
      <unit value="yr"/>
      <system value="http://unitsofmeasure.org"/>
      <code value="a"/>
    </valueQuantity>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-feeforservice-member-months-extension">
    <valueQuantity>
      <value value="36"/>
      <unit value="yr"/>
      <system value="http://unitsofmeasure.org"/>
      <code value="a"/>
    </valueQuantity>
  </extension>
  <status value="active"/>
  <type>
    <coding>
      <system
              value="http://hl7.org/fhir/us/uds-plus/CodeSystem/uds-plus-insurance-codes"/>
      <code value="private-insurance"/>
      <display value="Private Insurance"/>
    </coding>
  </type>
  <beneficiary>
    <reference value="Patient/de-identified-example"/>
  </beneficiary>
  <period>
    <start value="2019-03-17"/>
    <end value="2023-03-17"/>
  </period>
  <payor>
    <reference value="Organization/acme-payer"/>
  </payor>
</Coverage>