NextGen Healthcare · Schema

Coverage

HealthcareUnited StatesElectronic Health RecordsFHIRHL7InteroperabilitySMART on FHIRUSCDIBulk FHIRPatient Access21st Century Cures

Properties

Name	Type	Description
resourceType	string
id	string	ID of the resource
meta	object	Metadata about the resource
identifier	array	Business identifier for the coverage
status	string	Status of the coverage (e.g., active)
type	object	Type of coverage (e.g., PPO, HMO)
subscriberId	string	Identifier of the subscriber
beneficiary	object	Patient covered by the policy
relationship	object	Relationship of beneficiary to subscriber
payor	array	Payor responsible for the coverage
class	array	Plan or group classification
period	object	Coverage period

View JSON Schema on GitHub

JSON Schema

{
  "$schema": "https://json-schema.org/draft/2020-12/schema",
  "$id": "https://raw.githubusercontent.com/api-evangelist/nextgen-healthcare/main/json-schema/nextgen-healthcare-coverage-schema.json",
  "title": "Coverage",
  "x-generated": "2026-10-12",
  "x-method": "derived",
  "x-generator": "derive-json-schema.py",
  "x-source": "openapi/nextgen-healthcare-coverage-api-openapi.yml#/components/schemas/Coverage",
  "type": "object",
  "properties": {
    "resourceType": {
      "type": "string"
    },
    "id": {
      "type": "string",
      "minLength": 1,
      "description": "ID of the resource"
    },
    "meta": {
      "type": "object",
      "description": "Metadata about the resource",
      "properties": {
        "profile": {
          "type": "array",
          "items": {
            "type": "string"
          }
        }
      },
      "required": [
        "profile"
      ]
    },
    "identifier": {
      "type": "array",
      "description": "Business identifier for the coverage",
      "items": {
        "type": "object",
        "properties": {
          "type": {
            "type": "object",
            "properties": {
              "coding": {
                "type": "array",
                "items": {
                  "type": "object",
                  "properties": {
                    "system": {
                      "type": "string"
                    },
                    "code": {
                      "type": "string"
                    }
                  }
                }
              }
            }
          },
          "value": {
            "type": "string"
          }
        }
      }
    },
    "status": {
      "type": "string",
      "description": "Status of the coverage (e.g., active)"
    },
    "type": {
      "type": "object",
      "description": "Type of coverage (e.g., PPO, HMO)",
      "properties": {
        "coding": {
          "type": "array",
          "items": {
            "type": "object",
            "properties": {
              "system": {
                "type": "string"
              },
              "code": {
                "type": "string"
              },
              "display": {
                "type": "string"
              }
            }
          }
        },
        "text": {
          "type": "string"
        }
      }
    },
    "subscriberId": {
      "type": "string",
      "description": "Identifier of the subscriber"
    },
    "beneficiary": {
      "type": "object",
      "description": "Patient covered by the policy",
      "properties": {
        "reference": {
          "type": "string"
        }
      }
    },
    "relationship": {
      "type": "object",
      "description": "Relationship of beneficiary to subscriber",
      "properties": {
        "coding": {
          "type": "array",
          "items": {
            "type": "object",
            "properties": {
              "system": {
                "type": "string"
              },
              "code": {
                "type": "string"
              }
            }
          }
        },
        "text": {
          "type": "string"
        }
      }
    },
    "payor": {
      "type": "array",
      "description": "Payor responsible for the coverage",
      "items": {
        "type": "object",
        "properties": {
          "reference": {
            "type": "string"
          }
        }
      }
    },
    "class": {
      "type": "array",
      "description": "Plan or group classification",
      "items": {
        "type": "object",
        "properties": {
          "type": {
            "type": "object",
            "properties": {
              "coding": {
                "type": "array",
                "items": {
                  "type": "object",
                  "properties": {
                    "system": {
                      "type": "string"
                    },
                    "code": {
                      "type": "string"
                    }
                  }
                }
              }
            }
          },
          "value": {
            "type": "string"
          },
          "name": {
            "type": "string"
          }
        }
      }
    },
    "period": {
      "type": "object",
      "description": "Coverage period",
      "properties": {
        "start": {
          "type": "string"
        },
        "end": {
          "type": "string"
        }
      }
    }
  },
  "required": [
    "resourceType",
    "id",
    "meta",
    "beneficiary",
    "payor"
  ]
}

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