Generated Narrative: CoverageEligibilityResponse

identifier: id: urn:uuiad:581da6a9

status: active

purpose: discovery, benefits

patient:

serviced: 2021-12-22 --> 2021-12-25

created: 2021-12-22

requestor:

request:

outcome: complete

insurer:

insurance

coverage:

inforce: true

item

category: Health Benefit Plan Coverage (Benefit Category Codes#30)

network: In Network (Network Type Codes#in)

unit: Individual (Unit Type Codes#individual)

term: Annual (Benefit Term Codes#annual)

benefit

type: Benefit (Benefit Type Codes#benefit)

allowed: ₹500,000.00 (INR)

benefit

type: Copayment maximum per service (Benefit Type Codes#copay-maximum)

allowed: ₹100.00 (INR)

benefit

type: Copayment Percent per service (Benefit Type Codes#copay-percent)

allowed: 20

item

category: Maternity (Benefit Category Codes#69)

network: In Network (Network Type Codes#in)

unit: Individual (Unit Type Codes#individual)

term: Annual (Benefit Term Codes#annual)

Benefits

-	Type	Allowed[x]
*	Benefit (Benefit Type Codes#benefit)	₹15,000.00 (INR)

item

category: Dental Coverage (Benefit Category Codes#F3)

network: In Network (Network Type Codes#in)

unit: Individual (Unit Type Codes#individual)

term: Annual (Benefit Term Codes#annual)

Benefits

-	Type	Allowed[x]
*	Benefit (Benefit Type Codes#benefit)	₹2,000.00 (INR)

item

category: Vision Coverage (Benefit Category Codes#F6)

network: In Network (Network Type Codes#in)

unit: Individual (Unit Type Codes#individual)

term: Annual (Benefit Term Codes#annual)

Benefits

-	Type	Allowed[x]
*	Benefit (Benefit Type Codes#benefit)	₹400.00 (INR)

item

category: Hospital Room and Board (Benefit Category Codes#49)

network: In Network (Network Type Codes#in)

unit: Individual (Unit Type Codes#individual)

term: Day (Benefit Term Codes#day)

benefit

type: Room (Benefit Type Codes#room)

allowed: shared

benefit

type: Benefit (Benefit Type Codes#benefit)

allowed: ₹600.00 (INR)