BSeR: Bidirectional Services_eReferral - Local Development build (v2.0.0-connectathon). See the Directory of published versions
Resource Coverage "coverage-BSeR-Coverage-eve-everywoman" Version "3" Updated "2023-03-31 04:46:33+0000"
Information Source: #inkCoxzgZSNurkBt!
Profile: BSeR Coverage
identifier: id: 12345
status: active
type: extended healthcare (ActCode#EHCPOL)
subscriber: RelatedPerson/relatedperson-self-eve-everywoman: Eve Everywoman " EVERYWOMAN"
beneficiary: Patient/patient-us-core-patient-eve-everywoman: Eve Everywoman " EVERYWOMAN"
relationship: self (RoleCode#ONESELF)
period: 2019-05-23 --> 2020-05-23
payor: Organization/organization-bser-organization-saint-luke "Saint Luke's Hospital of Kansas City"
class
type: Group (Coverage Class Codes#group)
value: CB135
name: Corporate Baker's Inc. Local #35
class
type: SubGroup (Coverage Class Codes#subgroup)
value: 123
name: Trainee Part-time Benefits
class
type: Plan (Coverage Class Codes#plan)
value: B37FC
name: Full Coverage: Medical, Dental, Pharmacy, Vision, EHC
class
type: SubPlan (Coverage Class Codes#subplan)
value: P7
name: Includes afterlife benefits
class
type: Class (Coverage Class Codes#class)
value: SILVER
name: Silver: Family Plan spouse only
class
type: SubClass (Coverage Class Codes#subclass)
value: Tier2
name: Low deductable, max $20 copay
class
type: Sequence (Coverage Class Codes#sequence)
value: 9
class
type: RX Id (Coverage Class Codes#rxid)
value: MDF12345
class
type: RX BIN (Coverage Class Codes#rxbin)
value: 987654
class
type: RX Group (Coverage Class Codes#rxgroup)
value: M35PT
class
type: RX PCN (Coverage Class Codes#rxpcn)
value: 234516
class
type: Sequence (Coverage Class Codes#sequence)
value: 9