HL7 Terminology (THO)
5.4.0 - Publication International flag

This page is part of the HL7 Terminology (v5.4.0: Release) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: Coverage Class Codes - XML Representation

Draft as of 2023-11-17 Maturity Level: 2

Raw xml | Download



<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="coverage-class"/>
  <meta>
    <lastUpdated value="2020-04-09T21:10:28.568+00:00"/>
    <profile
             value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p>This case-sensitive code system <code>http://terminology.hl7.org/CodeSystem/coverage-class</code> defines the following codes:</p><table class="codes"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style="white-space:nowrap">group<a name="coverage-class-group"> </a></td><td>Group</td><td>An employee group</td></tr><tr><td style="white-space:nowrap">subgroup<a name="coverage-class-subgroup"> </a></td><td>SubGroup</td><td>A sub-group of an employee group</td></tr><tr><td style="white-space:nowrap">plan<a name="coverage-class-plan"> </a></td><td>Plan</td><td>A specific suite of benefits.</td></tr><tr><td style="white-space:nowrap">subplan<a name="coverage-class-subplan"> </a></td><td>SubPlan</td><td>A subset of a specific suite of benefits.</td></tr><tr><td style="white-space:nowrap">class<a name="coverage-class-class"> </a></td><td>Class</td><td>A class of benefits.</td></tr><tr><td style="white-space:nowrap">subclass<a name="coverage-class-subclass"> </a></td><td>SubClass</td><td>A subset of a class of benefits.</td></tr><tr><td style="white-space:nowrap">sequence<a name="coverage-class-sequence"> </a></td><td>Sequence</td><td>A sequence number associated with a short-term continuance of the coverage.</td></tr><tr><td style="white-space:nowrap">rxbin<a name="coverage-class-rxbin"> </a></td><td>RX BIN</td><td>Pharmacy benefit manager's Business Identification Number.</td></tr><tr><td style="white-space:nowrap">rxpcn<a name="coverage-class-rxpcn"> </a></td><td>RX PCN</td><td>A Pharmacy Benefit Manager specified Processor Control Number.</td></tr><tr><td style="white-space:nowrap">rxid<a name="coverage-class-rxid"> </a></td><td>RX Id</td><td>A Pharmacy Benefit Manager specified Member ID.</td></tr><tr><td style="white-space:nowrap">rxgroup<a name="coverage-class-rxgroup"> </a></td><td>RX Group</td><td>A Pharmacy Benefit Manager specified Group number.</td></tr></table></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="fm"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="2"/>
  </extension>
  <url value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:2.16.840.1.113883.4.642.1.1147"/>
  </identifier>
  <version value="1.0.0"/>
  <name value="CoverageClassCodes"/>
  <title value="Coverage Class Codes"/>
  <status value="draft"/>
  <experimental value="false"/>
  <date value="2023-11-17T03:23:21-07:00"/>
  <publisher value="Health Level Seven International"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://hl7.org"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="hq@HL7.org"/>
    </telecom>
  </contact>
  <description value="This value set includes Coverage Class codes."/>
  <copyright
             value="This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license"/>
  <caseSensitive value="true"/>
  <valueSet value="http://terminology.hl7.org/ValueSet/coverage-class"/>
  <content value="complete"/>
  <concept>
    <code value="group"/>
    <display value="Group"/>
    <definition value="An employee group"/>
  </concept>
  <concept>
    <code value="subgroup"/>
    <display value="SubGroup"/>
    <definition value="A sub-group of an employee group"/>
  </concept>
  <concept>
    <code value="plan"/>
    <display value="Plan"/>
    <definition value="A specific suite of benefits."/>
  </concept>
  <concept>
    <code value="subplan"/>
    <display value="SubPlan"/>
    <definition value="A subset of a specific suite of benefits."/>
  </concept>
  <concept>
    <code value="class"/>
    <display value="Class"/>
    <definition value="A class of benefits."/>
  </concept>
  <concept>
    <code value="subclass"/>
    <display value="SubClass"/>
    <definition value="A subset of a class of benefits."/>
  </concept>
  <concept>
    <code value="sequence"/>
    <display value="Sequence"/>
    <definition
                value="A sequence number associated with a short-term continuance of the coverage."/>
  </concept>
  <concept>
    <code value="rxbin"/>
    <display value="RX BIN"/>
    <definition
                value="Pharmacy benefit manager's Business Identification Number."/>
  </concept>
  <concept>
    <code value="rxpcn"/>
    <display value="RX PCN"/>
    <definition
                value="A Pharmacy Benefit Manager specified Processor Control Number."/>
  </concept>
  <concept>
    <code value="rxid"/>
    <display value="RX Id"/>
    <definition value="A Pharmacy Benefit Manager specified Member ID."/>
  </concept>
  <concept>
    <code value="rxgroup"/>
    <display value="RX Group"/>
    <definition value="A Pharmacy Benefit Manager specified Group number."/>
  </concept>
</CodeSystem>