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hl7 samples json Contract Contract-INS-101.json
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samples/json/Contract/Contract-INS-101.json

{"resourceType":"Contract","id":"INS-101","text":{"status":"generated","div":"\u003cdiv xmlns\u003d\"http://www.w3.org/1999/xhtml\"\u003e\n \u003cp\u003ePlan: Your Choice Split Copay (Non-Grandfathered)\u003c/p\u003e\n \u003cp\u003eCertificate Form Number: YCSCWLN (01-2017)\u003c/p\u003e\n \u003c/div\u003e"},"identifier":[{"system":"http://xyz-insurance.com/forms","value":"YCSCWLN(01-2017)"}],"applies":{"start":"2017-01-01"},"subject":[{"reference":"Patient/1"}],"type":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/contract-type","code":"healthinsurance","display":"Health Insurance"}]},"term":[{"offer":{"text":"The benefits, limitations, exclusions and other coverage provisions in this booklet are subject to the terms of our contract with the Group. This booklet is a part of that contract, which is on file in the Group\u0027s office."},"asset":[{"type":[{"coding":[{"system":"urn:ietf:rfc:3986","code":"urn:uuid:3a48c68c-318d-4c68-8471-4a3c10fcb41b","display":"RicardianContract"}]}],"subtype":[{"text":"sample"}],"period":[{"start":"2017-06-01"}],"valuedItem":[{"entityCodeableConcept":{"text":"Ford Bobcat"},"identifier":{"system":"http://somewhere.motor-vehicle.com/vin","value":"XXSVT34-7665t952236"},"effectiveTime":"1995","quantity":{"value":1},"unitPrice":{"value":200.00,"currency":"CAD"},"factor":1.0,"points":1.0,"net":{"value":200.00,"currency":"CAD"}}]}],"group":[{"offer":{"text":"Eligible Providers"}},{"offer":{"text":"Responsibility for Payment"}},{"offer":{"text":"List of Benefits"},"group":[{"offer":{"text":"Copays"},"group":[{"offer":{"text":"Emergency Room Copay"}},{"offer":{"text":"Professional Visit Copay"}}]},{"offer":{"text":"Calendar Year Deductible"}},{"offer":{"text":"Out-Of-Pocket Maximum"}},{"offer":{"text":"Medical Services"},"group":[{"offer":{"text":"Ambulance Services"}},{"offer":{"text":"Dental Services"}},{"offer":{"text":"Diagnostic Services"}},{"offer":{"text":"Emergency Room Services"}},{"offer":{"text":"Hospital Inpatient Care"}}]}]}]}],"meta":{"tag":[{"system":"http://terminology.hl7.org/CodeSystem/v3-ActReason","code":"HTEST","display":"test health data"}]}}