Universal API Implementation Guide
1.1.20 - ci-build

Universal API Implementation Guide - Local Development build (v1.1.20) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: External - UAPI Copay Explanation of Benefit in copay enrollment response - XML Representation

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<ExplanationOfBenefit xmlns="http://hl7.org/fhir">
  <id value="d9acfd1d-addc-4e0d-b7a6-ff921bde9236"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ExplanationOfBenefit d9acfd1d-addc-4e0d-b7a6-ff921bde9236</b></p><a name="d9acfd1d-addc-4e0d-b7a6-ff921bde9236"> </a><a name="hcd9acfd1d-addc-4e0d-b7a6-ff921bde9236"> </a><p><b>identifier</b>: <code>http://connectiverx.com/enrollmentId</code>/ad44f19a-42b6-ed11-827c-9e11af077484 (use: usual, )</p><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:">institutional</span></p><p><b>use</b>: Predetermination</p><p><b>patient</b>: <a href="Bundle-uapi-copay-request-response-with-error.html#urn-uuid-2c5aa62c-b6cd-49d2-ad9f-3128a69a32a9">Bundle: identifier = http://connectiverx.com/requestId#86a42a99-663b-48b8-8fd9-c1afdbca5b98 (use: usual, ); type = message; timestamp = 2023-01-11 08:10:17-0500</a></p><p><b>created</b>: 2023-02-26 21:01:11+0000</p><p><b>insurer</b>: <a href="Bundle-uapi-copay-request-response-enrollment.html#urn-uuid-d02db104-a75c-433f-8764-9778c2e20626">Bundle: identifier = http://risrx.com/requestId#42c481a9-7e7e-4d14-ab37-f648e376802d (use: usual, ); type = message; timestamp = 2024-04-19 08:10:17-0500</a></p><p><b>provider</b>: <a href="Bundle-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-695d0991-5e03-46df-934a-85a28acd95c1">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 08:10:13-0500</a></p><p><b>outcome</b>: Complete</p><h3>Insurances</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style="display: none">*</td><td>true</td><td><a href="Bundle-uapi-copay-request-response-enrollment.html#urn-uuid-5c2e19ac-8227-4de5-a893-069dec07448e">Bundle: identifier = http://risrx.com/requestId#42c481a9-7e7e-4d14-ab37-f648e376802d (use: usual, ); type = message; timestamp = 2024-04-19 08:10:17-0500</a></td></tr></table></div>
  </text>
  <identifier>
    <use value="usual"/>
    <system value="http://connectiverx.com/enrollmentId"/>
    <value value="ad44f19a-42b6-ed11-827c-9e11af077484"/>
  </identifier>
  <status value="active"/>
  <type>
    <coding>
      <code value="institutional"/>
    </coding>
  </type>
  <use value="predetermination"/>
  <patient>
    <reference value="urn:uuid:2c5aa62c-b6cd-49d2-ad9f-3128a69a32a9"/>
  </patient>
  <created value="2023-02-26T21:01:11.230Z"/>
  <insurer>
    <reference value="urn:uuid:d02db104-a75c-433f-8764-9778c2e20626"/>
  </insurer>
  <provider>
    <reference value="urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1"/>
  </provider>
  <outcome value="complete"/>
  <insurance>
    <focal value="true"/>
    <coverage>
      <reference value="urn:uuid:5c2e19ac-8227-4de5-a893-069dec07448e"/>
    </coverage>
  </insurance>
</ExplanationOfBenefit>