Release 5 FHIR CI-Build

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See the Directory of published versions . Page versions: R5 R4B R4

Example CoverageEligibilityResponse/E2501 (Turtle)

Maturity Level : N/A
Responsible Owner: Financial Management Work Group Standards Status : Informative Compartments : Patient , Practitioner

Raw Turtle (+ also see Turtle/RDF Format Specification )

General Person Primary Coverage with Benefit Details 

@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .

@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

[a fhir:CoverageEligibilityResponse ;

<http://hl7.org/fhir/CoverageEligibilityResponse/E2501> a fhir:CoverageEligibilityResponse ;

  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "E2501"] ; # 
  fhir:text [
     fhir:status [ fhir:v "generated" ] ;
     fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the CoverageEligibilityResponse.</div>"

     fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the CoverageEligibilityResponse.</div>"^^rdf:XMLLiteral ]

  ] ; # 
  fhir:identifier ( [
     fhir:system [ fhir:v "http://www.BenefitsInc.com/fhir/coverageeligibilityresponse"^^xsd:anyURI ] ;

     fhir:system [
       fhir:v "http://www.BenefitsInc.com/fhir/coverageeligibilityresponse"^^xsd:anyURI ;
       fhir:l <http://www.BenefitsInc.com/fhir/coverageeligibilityresponse>
     ] ;

     fhir:value [ fhir:v "881234" ]
  ] ) ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:purpose ( [ fhir:v "validation"] [ fhir:v "benefits"] ) ; # 
  fhir:patient [
     fhir:l <http://hl7.org/fhir/Patient/pat1> ;

     fhir:reference [ fhir:v "Patient/pat1" ]
  ] ; # 
  fhir:serviced [ fhir:v "2014-09-17"^^xsd:date] ; # 

  fhir:serviced [
     a fhir:Date ;
     fhir:v "2014-09-17"^^xsd:date
  ] ; # 

  fhir:created [ fhir:v "2014-08-16"^^xsd:date] ; #   Anticipated service date  
  fhir:request [
     fhir:link <http://www.BenefitsInc.com/fhir/coverageeligibilityresponse/225476332402> ;

     fhir:l <http://www.BenefitsInc.com/fhir/coverageeligibilityresponse/225476332402> ;

     fhir:reference [ fhir:v "http://www.BenefitsInc.com/fhir/coverageeligibilityresponse/225476332402" ]
  ] ; # 
  fhir:outcome [ fhir:v "complete"] ; # 
  fhir:disposition [ fhir:v "Policy is currently in-force."] ; # 
  fhir:insurer [
     fhir:l <http://hl7.org/fhir/Organization/2> ;

     fhir:reference [ fhir:v "Organization/2" ]
  ] ; # 
  fhir:insurance ( [
     fhir:coverage [
       fhir:l <http://hl7.org/fhir/Coverage/9876B1> ;

       fhir:reference [ fhir:v "Coverage/9876B1" ]
     ] ;
     fhir:inforce [ fhir:v "true"^^xsd:boolean ] ;

     fhir:inforce [ fhir:v true ] ;

     fhir:item ( [
       fhir:category [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/ex-benefitcategory>
           ] ;

           fhir:code [ fhir:v "30" ] ;
           fhir:display [ fhir:v "Health Benefit Plan Coverage" ]
         ] )
       ] ;
       fhir:network [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-network>
           ] ;

           fhir:code [ fhir:v "in" ]
         ] )
       ] ;
       fhir:unit [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-unit>
           ] ;

           fhir:code [ fhir:v "individual" ]
         ] )
       ] ;
       fhir:term [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-term>
           ] ;

           fhir:code [ fhir:v "annual" ]
         ] )
       ] ;
       fhir:benefit ( [
         fhir:type [
           fhir:coding ( [
             fhir:code [ fhir:v "benefit" ]
           ] )
         ] ;
         fhir:allowed [
           a fhir:Money ;
           fhir:value [ fhir:v "500000"^^xsd:decimal ] ;
           fhir:currency [ fhir:v "SAR" ]
         ]
       ] [
         fhir:type [
           fhir:coding ( [
             fhir:code [ fhir:v "copay-maximum" ]
           ] )
         ] ;
         fhir:allowed [
           a fhir:Money ;
           fhir:value [ fhir:v "100"^^xsd:decimal ] ;
           fhir:currency [ fhir:v "SAR" ]
         ]
       ] [
         fhir:type [
           fhir:coding ( [
             fhir:code [ fhir:v "copay-percent" ]
           ] )
         ] ;
         fhir:allowed [ fhir:v "20"^^xsd:nonNegativeInteger ]

         fhir:allowed [
           a fhir:UnsignedInt ;
           fhir:v "20"^^xsd:nonNegativeInteger
         ]

       ] )
     ] [
       fhir:category [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/ex-benefitcategory>
           ] ;

           fhir:code [ fhir:v "69" ] ;
           fhir:display [ fhir:v "Maternity" ]
         ] )
       ] ;
       fhir:network [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-network>
           ] ;

           fhir:code [ fhir:v "in" ]
         ] )
       ] ;
       fhir:unit [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-unit>
           ] ;

           fhir:code [ fhir:v "individual" ]
         ] )
       ] ;
       fhir:term [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-term>
           ] ;

           fhir:code [ fhir:v "annual" ]
         ] )
       ] ;
       fhir:benefit ( [
         fhir:type [
           fhir:coding ( [
             fhir:code [ fhir:v "benefit" ]
           ] )
         ] ;
         fhir:allowed [
           a fhir:Money ;
           fhir:value [ fhir:v "15000"^^xsd:decimal ] ;
           fhir:currency [ fhir:v "SAR" ]
         ]
       ] )
     ] [
       fhir:category [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/ex-benefitcategory>
           ] ;

           fhir:code [ fhir:v "F3" ] ;
           fhir:display [ fhir:v "Dental Coverage" ]
         ] )
       ] ;
       fhir:network [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-network>
           ] ;

           fhir:code [ fhir:v "in" ]
         ] )
       ] ;
       fhir:unit [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-unit>
           ] ;

           fhir:code [ fhir:v "individual" ]
         ] )
       ] ;
       fhir:term [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-term>
           ] ;

           fhir:code [ fhir:v "annual" ]
         ] )
       ] ;
       fhir:benefit ( [
         fhir:type [
           fhir:coding ( [
             fhir:code [ fhir:v "benefit" ]
           ] )
         ] ;
         fhir:allowed [
           a fhir:Money ;
           fhir:value [ fhir:v "2000"^^xsd:decimal ] ;
           fhir:currency [ fhir:v "SAR" ]
         ]
       ] )
     ] [
       fhir:category [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/ex-benefitcategory>
           ] ;

           fhir:code [ fhir:v "F6" ] ;
           fhir:display [ fhir:v "Vision Coverage" ]
         ] )
       ] ;
       fhir:network [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-network>
           ] ;

           fhir:code [ fhir:v "in" ]
         ] )
       ] ;
       fhir:unit [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-unit>
           ] ;

           fhir:code [ fhir:v "individual" ]
         ] )
       ] ;
       fhir:term [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-term>
           ] ;

           fhir:code [ fhir:v "annual" ]
         ] )
       ] ;
       fhir:benefit ( [
         fhir:type [
           fhir:coding ( [
             fhir:code [ fhir:v "benefit" ]
           ] )
         ] ;
         fhir:allowed [
           a fhir:Money ;
           fhir:value [ fhir:v "400"^^xsd:decimal ] ;
           fhir:currency [ fhir:v "SAR" ]
         ]
       ] )
     ] [
       fhir:category [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/ex-benefitcategory>
           ] ;

           fhir:code [ fhir:v "49" ] ;
           fhir:display [ fhir:v "Hospital Room and Board" ]
         ] )
       ] ;
       fhir:network [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-network>
           ] ;

           fhir:code [ fhir:v "in" ]
         ] )
       ] ;
       fhir:unit [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-unit>
           ] ;

           fhir:code [ fhir:v "individual" ]
         ] )
       ] ;
       fhir:term [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-term>
           ] ;

           fhir:code [ fhir:v "day" ]
         ] )
       ] ;
       fhir:benefit ( [
         fhir:type [
           fhir:coding ( [
             fhir:code [ fhir:v "room" ]
           ] )
         ] ;
         fhir:allowed [ fhir:v "shared" ]

         fhir:allowed [
           a fhir:String ;
           fhir:v "shared"
         ]

       ] [
         fhir:type [
           fhir:coding ( [
             fhir:code [ fhir:v "benefit" ]
           ] )
         ] ;
         fhir:allowed [
           a fhir:Money ;
           fhir:value [ fhir:v "600"^^xsd:decimal ] ;
           fhir:currency [ fhir:v "SAR" ]
         ]
       ] )
     ] )
  ] )] . # 

  ] ) . # 

<http://hl7.org/fhir/Patient/pat1> a fhir:Patient .

<http://hl7.org/fhir/Organization/2> a fhir:Organization .

<http://hl7.org/fhir/Coverage/9876B1> a fhir:Coverage .


# -------------------------------------------------------------------------------------

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.