Health Insurance Information
Datasets
US Core 6.1.0 maps each USCDI element to FHIR.
| Dataset | US Core 6.1.0 target profile(s) |
|---|---|
coverage | US Core Coverage |
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 |
|---|---|---|---|
patient_identifier | Yes | patient key | MRN-4471903 |
status | Yes | active, cancelled, draft, entered-in-error fm-status | active |
member_id | Recommended | plan member id | HSX9930012 |
subscriber_id | Recommended | text | HSX9930012 |
relationship_code | Yes | self, spouse, child, other subscriber-relationship | self |
coverage_type_code | Recommended | Source of Payment Typology Payer Type | 1 Medicare |
payer_org_npi | Yes | 10 digits, or your payer id | 1234567893 |
group_number | If available | text | GRP-4410 |
plan_number | If available | text | H6776-001 |
period_start | Recommended | date | 2026-01-01 |
period_end | Recommended | date | 2026-12-31 |
These resources are served by Patient Access, Provider Access, Payer-to-Payer, and Prior Auth.