HL7 Terminology (THO)
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This page is part of the HL7 Terminology (v6.0.0: Release) based on FHIR (HL7® FHIR® Standard) v5.0.0. 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 - JSON Representation

Active as of 2024-07-14 Maturity Level: 2

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{
  "resourceType" : "CodeSystem",
  "id" : "coverage-class",
  "meta" : {
    "lastUpdated" : "2024-04-24T00:00:00+00:00",
    "profile" : [
      🔗 "http://hl7.org/fhir/StructureDefinition/shareablecodesystem"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem coverage-class</b></p><a name=\"coverage-class\"> </a><a name=\"hccoverage-class\"> </a><a name=\"coverage-class-en-US\"> </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\">Last updated: 2024-04-24 00:00:00+0000</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/R5/shareablecodesystem.html\">Shareable CodeSystem</a></p></div><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>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "fm"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger" : 2
    }
  ],
  "url" : "http://terminology.hl7.org/CodeSystem/coverage-class",
  "identifier" : [
    {
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:oid:2.16.840.1.113883.4.642.1.1147"
    }
  ],
  "version" : "1.0.1",
  "name" : "CoverageClassCodes",
  "title" : "Coverage Class Codes",
  "status" : "active",
  "experimental" : false,
  "date" : "2024-07-14T15:19:17-06:00",
  "publisher" : "Health Level Seven International",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://hl7.org"
        },
        {
          "system" : "email",
          "value" : "hq@HL7.org"
        }
      ]
    }
  ],
  "description" : "This value set includes Coverage Class codes.",
  "copyright" : "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" : true,
  "valueSet" : "http://terminology.hl7.org/ValueSet/coverage-class",
  "content" : "complete",
  "concept" : [
    {
      "code" : "group",
      "display" : "Group",
      "definition" : "An employee group"
    },
    {
      "code" : "subgroup",
      "display" : "SubGroup",
      "definition" : "A sub-group of an employee group"
    },
    {
      "code" : "plan",
      "display" : "Plan",
      "definition" : "A specific suite of benefits."
    },
    {
      "code" : "subplan",
      "display" : "SubPlan",
      "definition" : "A subset of a specific suite of benefits."
    },
    {
      "code" : "class",
      "display" : "Class",
      "definition" : "A class of benefits."
    },
    {
      "code" : "subclass",
      "display" : "SubClass",
      "definition" : "A subset of a class of benefits."
    },
    {
      "code" : "sequence",
      "display" : "Sequence",
      "definition" : "A sequence number associated with a short-term continuance of the coverage."
    },
    {
      "code" : "rxbin",
      "display" : "RX BIN",
      "definition" : "Pharmacy benefit manager's Business Identification Number."
    },
    {
      "code" : "rxpcn",
      "display" : "RX PCN",
      "definition" : "A Pharmacy Benefit Manager specified Processor Control Number."
    },
    {
      "code" : "rxid",
      "display" : "RX Id",
      "definition" : "A Pharmacy Benefit Manager specified Member ID."
    },
    {
      "code" : "rxgroup",
      "display" : "RX Group",
      "definition" : "A Pharmacy Benefit Manager specified Group number."
    }
  ]
}