https://docs.mydata.athenahealth.com/fhir-r4/Coverage/8
type: Coverage
node role: treeRoot
id:
  v: 8
meta:
  last updated:
    v: 2026-01-07T01:21:11.866-06:00
  profile:
    v: https://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-pas-coverage-profile
    link: https://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-pas-coverage-profile
text:
  status:
    v: extensions
  div: Generated Narrative: Coverage 8 Last updated: 2026-01-07 01:21:11-0600 Profile: PAS Coverage org/fhir/us/davinci-pas/StructureDefinition/extension-coverageKind: health insurance plan policy identifier: Member Number/665993433, National Insurance Payor Identifier (Payor)/Unknown, National Insurance Payor Identifier (Payor)/12345678, National Insurance Payor Identifier (Payor)/1101 status: Active policyHolder: Patient/1442678380400620 subscriber: Patient/1442678380400620 subscriberId: 665993433 beneficiary: Patient/1442678380400620 relationship: other period: 2007-01-31 00:00:00-0600 --> 2008-01-30 00:00:00-0600 payor: Organization/IC-5
extension:
  url:
    v: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-coverageKind
  value: CodeableConcept
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v3-ActCode
      code:
        v: HIP
      display:
        v: health insurance plan policy
identifier:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: MB
      display:
        v: Member Number
    text:
      v: Member Number
  value:
    v: 665993433
identifier:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: NIIP
      display:
        v: National Insurance Payor Identifier (Payor)
    text:
      v: National Insurance Payor Identifier (Payor)
  value:
    v: Unknown
identifier:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: NIIP
      display:
        v: National Insurance Payor Identifier (Payor)
    text:
      v: National Insurance Payor Identifier (Payor)
  value:
    v: 12345678
identifier:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: NIIP
      display:
        v: National Insurance Payor Identifier (Payor)
    text:
      v: National Insurance Payor Identifier (Payor)
  value:
    v: 1101
status:
  v: active
policy holder:
  link: https://docs.mydata.athenahealth.com/fhir-r4/Patient/1442678380400620
  reference:
    v: Patient/1442678380400620
subscriber:
  link: https://docs.mydata.athenahealth.com/fhir-r4/Patient/1442678380400620
  reference:
    v: Patient/1442678380400620
subscriber id:
  v: 665993433
beneficiary:
  link: https://docs.mydata.athenahealth.com/fhir-r4/Patient/1442678380400620
  reference:
    v: Patient/1442678380400620
relationship:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/subscriber-relationship
    code:
      v: other
    display:
      v: other
  coding:
    system:
      v: https://valueset.x12.org/x217/005010/request/2000D/INS/1/02/00/1069
    code:
      v: G8
    display:
      v: Other Relationship
  text:
    v: other
period:
  start:
    v: 2007-01-31T00:00:00-06:00
  end:
    v: 2008-01-30T00:00:00-06:00
payor:
  link: https://docs.mydata.athenahealth.com/fhir-r4/Organization/IC-5
  reference:
    v: Organization/IC-5