Universal API Implementation Guide - Local Development build (v1.1.19). See the Directory of published versions
: External - UAPI Copay Explanation of Benefit in copay enrollment response - JSON Representation
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{
"resourceType" : "ExplanationOfBenefit",
"id" : "0d8ed4d1-26e8-4715-bf3d-34f368fe9585",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: ExplanationOfBenefit</b><a name=\"0d8ed4d1-26e8-4715-bf3d-34f368fe9585\"> </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 ExplanationOfBenefit \"0d8ed4d1-26e8-4715-bf3d-34f368fe9585\" </p></div><p><b>identifier</b>: id: 2747b8b5-97a7-ed11-827b-8ee762650010(use: USUAL)</p><p><b>status</b>: active</p><p><b>type</b>: pharmacy <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ([not stated]#pharmacy)</span></p><p><b>use</b>: predetermination</p><p><b>patient</b>: <a href=\"Bundle-uapi-copay-response-rejected-1.html#urn-uuid-2c5aa62c-b6cd-49d2-ad9f-3128a69a32a9\">urn:uuid:2c5aa62c-b6cd-49d2-ad9f-3128a69a32a9</a></p><p><b>created</b>: 2023-02-08 05:02:36+0000</p><p><b>insurer</b>: <a href=\"Bundle-18faf9d2-4553-4b8c-ac81-c9c845a72be6.html#urn-uuid-d02db104-a75c-433f-8764-9778c2e20626\">urn:uuid:d02db104-a75c-433f-8764-9778c2e20626</a></p><p><b>provider</b>: <a href=\"Bundle-caf568e0-21b6-40e4-b0b8-1fdddef30fd2.html#urn-uuid-695d0991-5e03-46df-934a-85a28acd95c1\">urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1</a></p><p><b>outcome</b>: complete</p><h3>Insurances</h3><table class=\"grid\"><tr><td>-</td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td>*</td><td>true</td><td><a href=\"Bundle-18faf9d2-4553-4b8c-ac81-c9c845a72be6.html#urn-uuid-597540c9-6248-466e-81e0-58e78f15454e\">urn:uuid:597540c9-6248-466e-81e0-58e78f15454e</a></td></tr></table></div>"
},
"identifier" : [
{
"use" : "usual",
"system" : "http://connectiverx.com/enrollmentId",
"value" : "2747b8b5-97a7-ed11-827b-8ee762650010"
}
],
"status" : "active",
"type" : {
"coding" : [
{
"code" : "pharmacy"
}
]
},
"use" : "predetermination",
"patient" : {
"reference" : "urn:uuid:2c5aa62c-b6cd-49d2-ad9f-3128a69a32a9"
},
"created" : "2023-02-08T05:02:36.070Z",
"insurer" : {
"reference" : "urn:uuid:d02db104-a75c-433f-8764-9778c2e20626"
},
"provider" : {
"reference" : "urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1"
},
"outcome" : "complete",
"insurance" : [
{
"focal" : true,
"coverage" : {
"reference" : "urn:uuid:597540c9-6248-466e-81e0-58e78f15454e"
}
}
]
}