{
  "resourceType" : "CoverageEligibilityResponse",
  "id" : "benefits-example-01",
  "meta" : {
    "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponse"]
  },
  "language" : "en",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><p class=\"res-header-id\"><b>Generated Narrative: CoverageEligibilityResponse benefits-example-01</b></p><a name=\"benefits-example-01\"> </a><a name=\"hcbenefits-example-01\"> </a><a name=\"benefits-example-01-hi-IN\"> </a><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\">Language: en</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-CoverageEligibilityResponse.html\">CoverageEligibilityResponse</a></p></div><p><b>status</b>: Active</p><p><b>purpose</b>: Coverage benefits</p><p><b>patient</b>: <a href=\"Patient-example-01.html\">ABC Male, DoB: 1981-01-12 ( Medical record number: 22-7225-4829-5255)</a></p><p><b>created</b>: 2023-09-07</p><p><b>requestor</b>: <a href=\"Practitioner-example-01.html\">Practitioner Dr. DEF</a></p><p><b>request</b>: <a href=\"CoverageEligibilityRequest-benefits-example-01.html\">CoverageEligibilityRequest: identifier = 7612345; status = active; priority = Normal; purpose = benefits; created = 2023-09-07 11:01:00+0500</a></p><p><b>outcome</b>: Processing Complete</p><p><b>disposition</b>: Policy is currently in-force.</p><p><b>insurer</b>: <a href=\"Organization-example-02.html\">Organization XYZ Insurance Co. Ltd.</a></p><blockquote><p><b>insurance</b></p><p><b>coverage</b>: <a href=\"Coverage-example-01.html\">Coverage: identifier = https://xyzinsurance.in/policynumber/#235037120; status = active; type = PAY; subscriberId = ABC123456BI007; relationship = Self; period = (?) --&gt; 2026-03-17</a></p><p><b>inforce</b>: true</p><p><b>benefitPeriod</b>: 2023-09-07 --&gt; 2026-08-07</p><blockquote><p><b>item</b></p><p><b>productOrService</b>: <span title=\"Codes:{http://snomed.info/sct 768839008}\">Consultant</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Allowed[x]</b></td><td><b>Used[x]</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/benefit-type benefit}\">Benefit</span></td><td><span title=\"Indian Rupee\">₹50,000.00</span> (INR)</td><td><span title=\"Indian Rupee\">₹0.00</span> (INR)</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>productOrService</b>: <span title=\"Codes:{http://snomed.info/sct 765507008}\">Metformin hydrochloride 500 mg prolonged-release oral tablet</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Allowed[x]</b></td><td><b>Used[x]</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/benefit-type benefit}\">Benefit</span></td><td><span title=\"Indian Rupee\">₹50,000.00</span> (INR)</td><td><span title=\"Indian Rupee\">₹0.00</span> (INR)</td></tr></table></blockquote></blockquote></div>"
  },
  "status" : "active",
  "purpose" : ["benefits"],
  "patient" : {
    "reference" : "Patient/example-01"
  },
  "created" : "2023-09-07",
  "requestor" : {
    "reference" : "Practitioner/example-01"
  },
  "request" : {
    "reference" : "CoverageEligibilityRequest/benefits-example-01"
  },
  "outcome" : "complete",
  "disposition" : "Policy is currently in-force.",
  "insurer" : {
    "reference" : "Organization/example-02"
  },
  "insurance" : [{
    "coverage" : {
      "reference" : "Coverage/example-01"
    },
    "inforce" : true,
    "benefitPeriod" : {
      "start" : "2023-09-07",
      "end" : "2026-08-07"
    },
    "item" : [{
      "productOrService" : {
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "768839008",
          "display" : "Consultant"
        }]
      },
      "benefit" : [{
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/benefit-type",
            "code" : "benefit",
            "display" : "Benefit"
          }]
        },
        "allowedMoney" : {
          "value" : 50000,
          "currency" : "INR"
        },
        "usedMoney" : {
          "value" : 0,
          "currency" : "INR"
        }
      }]
    },
    {
      "productOrService" : {
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "765507008",
          "display" : "Metformin hydrochloride 500 mg prolonged-release oral tablet"
        }]
      },
      "benefit" : [{
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/benefit-type",
            "code" : "benefit",
            "display" : "Benefit"
          }]
        },
        "allowedMoney" : {
          "value" : 50000,
          "currency" : "INR"
        },
        "usedMoney" : {
          "value" : 0,
          "currency" : "INR"
        }
      }]
    }]
  }]
}