haau3 FHIR Implementation Guide (HFIG) - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

• Narrative Content
• XML
• JSON
• TTL

: Plan Benefits No Network Data Reason - JSON Representation

Active as of 2026-10-14

Raw json | Download

{
  "resourceType" : "CodeSystem",
  "id" : "plan-benefits-no-network-data-reason",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem plan-benefits-no-network-data-reason</b></p><a name=\"plan-benefits-no-network-data-reason\"> </a><a name=\"hcplan-benefits-no-network-data-reason\"> </a><p>This case-sensitive code system <code>https://haau3.com/fhir/CodeSystem/plan-benefits-no-network-data-reason</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">marketplace<a name=\"plan-benefits-no-network-data-reason-marketplace\"> </a></td><td>Marketplace plan</td><td>An ACA Marketplace plan. Its insurer publishes its provider directory itself, outside the CMS National Provider Directory, which holds no network data for Marketplace plans.</td></tr><tr><td style=\"white-space:nowrap\">plan-not-in-directory<a name=\"plan-benefits-no-network-data-reason-plan-not-in-directory\"> </a></td><td>Plan not in the directory</td><td>The directory holds no plan with this plan's CMS plan id, or holds it for the plan's year without naming a network.</td></tr><tr><td style=\"white-space:nowrap\">other-plan-year<a name=\"plan-benefits-no-network-data-reason-other-plan-year\"> </a></td><td>Another plan year</td><td>The directory holds a plan with this plan's CMS plan id only for another plan year. A plan's network can change between years, so another year's listings are not used.</td></tr></table></div>"
  },
  "url" : "https://haau3.com/fhir/CodeSystem/plan-benefits-no-network-data-reason",
  "version" : "1.0.0",
  "name" : "PlanBenefitsNoNetworkDataReasonCS",
  "title" : "Plan Benefits No Network Data Reason",
  "status" : "active",
  "experimental" : false,
  "date" : "2026-10-14T18:01:46+00:00",
  "publisher" : "haau3",
  "contact" : [
    {
      "name" : "haau3",
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://haau3.com"
        },
        {
          "system" : "email",
          "value" : "hello@haau3.com"
        }
      ]
    }
  ],
  "description" : "Why the CMS National Provider Directory holds no network data for a plan in the plan's year: the reason codes of the $in-network operation on InsurancePlan.",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "caseSensitive" : true,
  "content" : "complete",
  "count" : 3,
  "concept" : [
    {
      "code" : "marketplace",
      "display" : "Marketplace plan",
      "definition" : "An ACA Marketplace plan. Its insurer publishes its provider directory itself, outside the CMS National Provider Directory, which holds no network data for Marketplace plans."
    },
    {
      "code" : "plan-not-in-directory",
      "display" : "Plan not in the directory",
      "definition" : "The directory holds no plan with this plan's CMS plan id, or holds it for the plan's year without naming a network."
    },
    {
      "code" : "other-plan-year",
      "display" : "Another plan year",
      "definition" : "The directory holds a plan with this plan's CMS plan id only for another plan year. A plan's network can change between years, so another year's listings are not used."
    }
  ]
}