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

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: $in-network: a Medicare Advantage plan with network data - JSON Representation

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{
  "resourceType" : "Parameters",
  "id" : "in-network-h2406-013-000",
  "parameter" : [
    {
      "name" : "plan",
      "valueReference" : {
        🔗 "reference" : "InsurancePlan/H2406-013-000"
      }
    },
    {
      "name" : "data-date",
      "valueDate" : "2026-10-07"
    },
    {
      "name" : "network",
      "part" : [
        {
          "name" : "network",
          "valueReference" : {
            "reference" : "Organization/Organization-example-network",
            "display" : "Example Medicare Advantage Network"
          }
        },
        {
          "name" : "organizations-listed",
          "valueInteger" : 2618
        }
      ]
    },
    {
      "name" : "provider",
      "part" : [
        {
          "name" : "npi",
          "valueIdentifier" : {
            "system" : "http://hl7.org/fhir/sid/us-npi",
            "value" : "1992700001"
          }
        },
        {
          "name" : "status",
          "valueCoding" : {
            "system" : "https://haau3.com/fhir/CodeSystem/plan-benefits-network-status",
            "code" : "in-network",
            "display" : "In network"
          }
        },
        {
          "name" : "evidence",
          "valueReference" : {
            "reference" : "PractitionerRole/PractitionerRole-example-role"
          }
        }
      ]
    },
    {
      "name" : "provider",
      "part" : [
        {
          "name" : "npi",
          "valueIdentifier" : {
            "system" : "http://hl7.org/fhir/sid/us-npi",
            "value" : "1992700002"
          }
        },
        {
          "name" : "status",
          "valueCoding" : {
            "system" : "https://haau3.com/fhir/CodeSystem/plan-benefits-network-status",
            "code" : "not-found",
            "display" : "Not found in the network's listings"
          }
        }
      ]
    },
    {
      "name" : "provider",
      "part" : [
        {
          "name" : "npi",
          "valueIdentifier" : {
            "system" : "http://hl7.org/fhir/sid/us-npi",
            "value" : "1992700003"
          }
        },
        {
          "name" : "status",
          "valueCoding" : {
            "system" : "https://haau3.com/fhir/CodeSystem/plan-benefits-network-status",
            "code" : "not-in-directory",
            "display" : "Not in the directory"
          }
        }
      ]
    },
    {
      "name" : "source",
      "valueString" : "CMS National Provider Directory: https://directory.cms.gov/fhir"
    }
  ]
}