Bundle CoverageEligibilityRequestBundle-auth-requirement-example-01 of type collection

Entry 1 - fullUrl = CoverageEligibilityRequest/CoverageEligibilityRequest-auth-requirement-example-01

Resource CoverageEligibilityRequest:

Generated Narrative: CoverageEligibilityRequest

Resource CoverageEligibilityRequest "CoverageEligibilityRequest-auth-requirement-example-01" (Language "en")

Profile: CoverageEligibilityRequest

identifier: id: 7612345

status: ACTIVE

priority: Normal (Process Priority Codes#normal)

purpose: AUTHREQUIREMENTS

patient: See above (Patient/Patient-example-01)

created: 2023-09-07 11:01:00+0500

enterer: See above (Practitioner/Practitioner-example-01)

provider: See above (Practitioner/Practitioner-example-01)

insurer: See above (Organization/Organization-example-01)

facility: See above (Location/Location-example-01)

Insurances

-	Focal	Coverage
*	true	See above (Coverage/Coverage-example-01)

item

productOrService: Consultant (SNOMED CT#768839008)

Diagnoses

-	Diagnosis[x]
*	Type 2 diabetes mellitus : Without complications (ICD-10#E11.9)

item

productOrService: Metformin hydrochloride 500 mg prolonged-release oral tablet (SNOMED CT#765507008)

Diagnoses

-	Diagnosis[x]
*	Type 2 diabetes mellitus : Without complications (ICD-10#E11.9)

Entry 2 - fullUrl = Patient/Patient-example-01

Resource Patient:

Adarsh Agrawal Male, DoB: 1981-01-12 ( Adhaar number: 7225-4829-5255)

Entry 3 - fullUrl = Practitioner/Practitioner-example-01

Resource Practitioner:

Generated Narrative: Practitioner

Resource Practitioner "Practitioner-example-01" Version "1" Updated "2023-09-07 14:58:58+0530"

Profile: Practitioner

identifier: Medical License number: 21-1521-3828-3227

name: Dr. Aayush Agrawal

Entry 4 - fullUrl = Organization/Organization-example-01

Resource Organization:

Generated Narrative: Organization

Resource Organization "Organization-example-01"

Profile: Organization

identifier: Provider number: 4567878

type: Insurance Company (Organization type#ins)

name: XYZ Insurance Co. Ltd.

Contacts

-	Telecom
*	+91 243 2634 1234, contact@xyz.org

Entry 5 - fullUrl = Location/Location-example-01

Resource Location:

Generated Narrative: Location

Resource Location "Location-example-01"

identifier: id: B1-S.F2

status: ACTIVE

name: South Wing, second floor

alias: IndiaFirst Life Insurance Co. Ltd., South Wing, second floor

description: Second floor of the Old South Wing, formerly in use by Psychiatry

mode: INSTANCE

address: 91, Building A Pune 451855 IND (WORK)

Positions

-	Longitude	Latitude	Altitude
*	-83.6945691	42.25475478	0

managingOrganization: See above (Organization/Organization-example-01)

Entry 6 - fullUrl = Coverage/Coverage-example-01

Resource Coverage:

Generated Narrative: Coverage

Resource Coverage "Coverage-example-01"

Profile: Coverage

identifier: id: 235037120

status: ACTIVE

type: PAY (Coverage SelfPay Codes#pay)

subscriber: See above (Patient/Patient-example-01)

subscriberId: id: ABC123456BI007

beneficiary: See above (Patient/Patient-example-01)

relationship: Self (SubscriberPolicyholder Relationship Codes#self)

period: ?? --> 2026-03-17