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 - XML Representation
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<ExplanationOfBenefit xmlns="http://hl7.org/fhir">
<id value="4822ddcc-2ce7-4b43-b6af-4f3435ce5a6d"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: ExplanationOfBenefit</b><a name="4822ddcc-2ce7-4b43-b6af-4f3435ce5a6d"> </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 "4822ddcc-2ce7-4b43-b6af-4f3435ce5a6d" </p></div><p><b>identifier</b>: id: 45d1b98c-587c-ed11-8279-d6b6a2da4722(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>: 2023-02-07 08:10:13-0500</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>
</text>
<identifier>
<use value="usual"/>
<system value="http://connectiverx.com/enrollmentId"/>
<value value="45d1b98c-587c-ed11-8279-d6b6a2da4722"/>
</identifier>
<status value="active"/>
<type>
<coding>
<code value="pharmacy"/>
</coding>
</type>
<use value="predetermination"/>
<patient>
<reference value="urn:uuid:2c5aa62c-b6cd-49d2-ad9f-3128a69a32a9"/>
</patient>
<created value="2023-02-07T08:10:13-05:00"/>
<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:597540c9-6248-466e-81e0-58e78f15454e"/>
</coverage>
</insurance>
</ExplanationOfBenefit>