Health Insurance Information

Datasets

US Core 6.1.0 maps each USCDI data element onto a FHIR element.

Dataset	US Core 6.1.0 target profile(s)
`coverage`	US Core Coverage

One row per coverage. A member with more than one plan, or a plan year that changed mid-year, produces more than one row.

Column	Required	Format / values	Example
`record_id`	Yes	your stable key for this coverage	`COV-0001`
`patient_identifier`	Yes	patient key	`MBR0000012`
`status`	Yes	`active`, `cancelled`, `draft`, `entered-in-error` fm-status	`active`
`member_id`	Yes, unless `subscriber_id` is sent	plan member id	`MBR0000012`
`subscriber_id`	Yes, unless `member_id` is sent	text	`MBR0000012`
`relationship_code`	Yes	`self`, `spouse`, `child`, `other` subscriber-relationship	`self`
`coverage_type_code`	Recommended	Source of Payment Typology Payer Type	`1` Medicare
`payer_org_identifier`	Yes	the payer; key from `organizations`	`99999`
`group_number`	If available	text	`GRP-4410`
`group_name`	If available	text	`Acme Manufacturing`
`plan_number`	If available	text	`H6776-001`
`plan_name`	If available	text	`Gold PPO`
`network_id`	If available	text	`NET-GOLD-NY`
`period_start`	Recommended	date	`2026-01-01`
`period_end`	Recommended	date	`2026-12-31`
`is_deleted`	If retracting	`true` retracts this row	`true`

Send at least one of member_id and subscriber_id. US Core requires a member id or a subscriber id on every Coverage, so a row with neither cannot become one.
A group or plan name travels with its number: send group_number with group_name, and plan_number with plan_name.
network_id is the provider network this coverage is under, published to Coverage.network. It is a linking key, not a name: send the same identifier you use for that network in your provider directory delivery, so a member’s coverage and that network’s providers can be joined. It is stored as sent — we do not resolve it against any registry.