BSeR: Bidirectional Services_eReferral

This page is part of the Bidirectional Services eReferrals (BSeR) (v1.0.0: STU 1) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

bundle-bser-referral-feedback-document-bundle-eve-everywoman - JSON Representation

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{
  "resourceType" : "Bundle",
  "id" : "bundle-bser-referral-feedback-document-bundle-eve-everywoman",
  "meta" : {
    "profile" : [
      "http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralFeedbackDocumentBundle"
    ]
  },
  "identifier" : {
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:uuid:2be4b4e4-6df1-4cb2-a947-c70fa0eda54e"
  },
  "type" : "document",
  "timestamp" : "2020-01-07T09:25:00Z",
  "entry" : [
    {
      "fullUrl" : "Composition/composition-bser-referral-feedback",
      "resource" : {
        "resourceType" : "Composition",
        "id" : "composition-bser-referral-feedback",
        "meta" : {
          "versionId" : "5",
          "lastUpdated" : "2020-01-06T00:48:15.000-05:00",
          "profile" : [
            "http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralFeedbackComposition"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n            <table>\n              <tr>\n                <td style=\"font-weight: bold\">id</td>\n                <td>\n                  <div title=\"id\">composition-bser-referral-feedback</div>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">meta</td>\n                <td>\n                  <table>\n                    <tr>\n                      <td style=\"font-weight: bold\">versionId</td>\n                      <td>\n                        <div title=\"versionId\">3</div>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">lastUpdated</td>\n                      <td>\n                        <div title=\"lastUpdated\">2020-01-22T00:31:00.000-05:00</div>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">profile</td>\n                      <td>\n                        <div title=\"profile\">http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralFeedbackComposition</div>\n                      </td>\n                    </tr>\n                  </table>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">status</td>\n                <td>\n                  <div title=\"status\">final</div>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">type</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li>\n                          <div title=\"display\">Referral note</div> (\n                                       <div title=\"code\">57133-1</div> ) \n                                    </li>\n                        <li>\n                          <div title=\"system\">\n                            <a href=\"http://loinc.org\">http://loinc.org</a>\n                          </div>\n                        </li>\n                      </ul>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">subject</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li/>\n                    <li>\n                      <a href=\"Patient-patient-us-core-patient-eve-everywoman.html\">Eve Everywoman</a>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">date</td>\n                <td>\n                  <div title=\"date\">2020-01-03T11:15:23Z</div>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">author</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li/>\n                    <li>\n                      <a href=\"PractitionerRole-practitionerrole-bser-referral-recipient.html\">Hailey Eight, MD</a>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">title</td>\n                <td>\n                  <div title=\"title\">Referral feedback</div>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">section</td>\n                <td>\n                  <table>\n                    <tr>\n                      <td style=\"font-weight: bold\">title</td>\n                      <td>\n                        <div title=\"title\">Arthritis referral request feedback summary</div>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">code</td>\n                      <td>\n                        <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                          <li>\n                            <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                              <li>\n                                <div title=\"display\">CompositionSectionReferralServiceRequestFeedbackSummary</div> (\n                                                <div title=\"code\">RSRFS</div> ) \n                                             </li>\n                              <li>\n                                <div title=\"system\">\n                                  <a href=\"http://hl7.org/fhir/us/bser/CodeSystem/bser\">http://hl7.org/fhir/us/bser/CodeSystem/bser</a>\n                                </div>\n                              </li>\n                            </ul>\n                          </li>\n                        </ul>\n                      </td>\n                    </tr>\n                  </table>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">section</td>\n                <td>\n                  <table>\n                    <tr>\n                      <td style=\"font-weight: bold\">title</td>\n                      <td>\n                        <div title=\"title\">Arthritis referral feedback supporting information</div>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">code</td>\n                      <td>\n                        <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                          <li>\n                            <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                              <li>\n                                <div title=\"display\">CompositionSectionReferralServiceRequestFeedbackSupportingInformation</div> (\n                                                <div title=\"code\">RSRFSI</div> ) \n                                             </li>\n                              <li>\n                                <div title=\"system\">\n                                  <a href=\"http://hl7.org/fhir/us/bser/CodeSystem/bser\">http://hl7.org/fhir/us/bser/CodeSystem/bser</a>\n                                </div>\n                              </li>\n                            </ul>\n                          </li>\n                        </ul>\n                      </td>\n                    </tr>\n                  </table>\n                </td>\n              </tr>\n            </table>\n          </div>"
        },
        "status" : "final",
        "type" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "57133-1",
              "display" : "Referral note"
            }
          ]
        },
        "subject" : {
          "reference" : "Patient/patient-us-core-patient-eve-everywoman",
          "display" : "Eve Everywoman"
        },
        "date" : "2020-01-03T11:15:23Z",
        "author" : [
          {
            "reference" : "PractitionerRole/practitionerrole-bser-referral-recipient",
            "display" : "Hailey Eight, MD"
          }
        ],
        "title" : "Referral feedback",
        "section" : [
          {
            "title" : "Arthritis referral request feedback summary",
            "code" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/us/bser/CodeSystem/bser",
                  "code" : "RSRFS",
                  "display" : "CompositionSectionReferralServiceRequestFeedbackSummary"
                }
              ]
            },
            "focus" : {
              "reference" : "ServiceRequest/servicerequest-BSeR-ReferralServiceRequest"
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n              <table>\n                <tr>\n                  <td style=\"font-weight: bold\">id</td>\n                  <td>\n                    <div title=\"id\">composition-bser-referral-feedback</div>\n                  </td>\n                </tr>\n                <tr>\n                  <td style=\"font-weight: bold\">meta</td>\n                  <td>\n                    <table>\n                      <tr>\n                        <td style=\"font-weight: bold\">versionId</td>\n                        <td>\n                          <div title=\"versionId\">3</div>\n                        </td>\n                      </tr>\n                      <tr>\n                        <td style=\"font-weight: bold\">lastUpdated</td>\n                        <td>\n                          <div title=\"lastUpdated\">2020-01-22T00:31:00.000-05:00</div>\n                        </td>\n                      </tr>\n                      <tr>\n                        <td style=\"font-weight: bold\">profile</td>\n                        <td>\n                          <div title=\"profile\">http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralFeedbackComposition</div>\n                        </td>\n                      </tr>\n                    </table>\n                  </td>\n                </tr>\n                <tr>\n                  <td style=\"font-weight: bold\">status</td>\n                  <td>\n                    <div title=\"status\">final</div>\n                  </td>\n                </tr>\n                <tr>\n                  <td style=\"font-weight: bold\">type</td>\n                  <td>\n                    <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                      <li>\n                        <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                          <li>\n                            <div title=\"display\">Referral note</div> (\n                                          <div title=\"code\">57133-1</div> ) \n                                       </li>\n                          <li>\n                            <div title=\"system\">\n                              <a href=\"http://loinc.org\">http://loinc.org</a>\n                            </div>\n                          </li>\n                        </ul>\n                      </li>\n                    </ul>\n                  </td>\n                </tr>\n                <tr>\n                  <td style=\"font-weight: bold\">subject</td>\n                  <td>\n                    <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                      <li/>\n                      <li>\n                        <a href=\"Patient-patient-us-core-patient-eve-everywoman.html\">Eve Everywoman</a>\n                      </li>\n                    </ul>\n                  </td>\n                </tr>\n                <tr>\n                  <td style=\"font-weight: bold\">date</td>\n                  <td>\n                    <div title=\"date\">2020-01-03T11:15:23Z</div>\n                  </td>\n                </tr>\n                <tr>\n                  <td style=\"font-weight: bold\">author</td>\n                  <td>\n                    <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                      <li/>\n                      <li>\n                        <a href=\"PractitionerRole-practitionerrole-bser-referral-recipient.html\">Hailey Eight, MD</a>\n                      </li>\n                    </ul>\n                  </td>\n                </tr>\n                <tr>\n                  <td style=\"font-weight: bold\">title</td>\n                  <td>\n                    <div title=\"title\">Referral feedback</div>\n                  </td>\n                </tr>\n                <tr>\n                  <td style=\"font-weight: bold\">section</td>\n                  <td>\n                    <table>\n                      <tr>\n                        <td style=\"font-weight: bold\">title</td>\n                        <td>\n                          <div title=\"title\">Arthritis referral request feedback summary</div>\n                        </td>\n                      </tr>\n                      <tr>\n                        <td style=\"font-weight: bold\">code</td>\n                        <td>\n                          <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                            <li>\n                              <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                                <li>\n                                  <div title=\"display\">CompositionSectionReferralServiceRequestFeedbackSummary</div> (\n                                                   <div title=\"code\">RSRFS</div> ) \n                                                </li>\n                                <li>\n                                  <div title=\"system\">\n                                    <a href=\"http://hl7.org/fhir/us/bser/CodeSystem/bser\">http://hl7.org/fhir/us/bser/CodeSystem/bser</a>\n                                  </div>\n                                </li>\n                              </ul>\n                            </li>\n                          </ul>\n                        </td>\n                      </tr>\n                    </table>\n                  </td>\n                </tr>\n                <tr>\n                  <td style=\"font-weight: bold\">section</td>\n                  <td>\n                    <table>\n                      <tr>\n                        <td style=\"font-weight: bold\">title</td>\n                        <td>\n                          <div title=\"title\">Arthritis referral feedback supporting information</div>\n                        </td>\n                      </tr>\n                      <tr>\n                        <td style=\"font-weight: bold\">code</td>\n                        <td>\n                          <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                            <li>\n                              <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                                <li>\n                                  <div title=\"display\">CompositionSectionReferralServiceRequestFeedbackSupportingInformation</div> (\n                                                   <div title=\"code\">RSRFSI</div> ) \n                                                </li>\n                                <li>\n                                  <div title=\"system\">\n                                    <a href=\"http://hl7.org/fhir/us/bser/CodeSystem/bser\">http://hl7.org/fhir/us/bser/CodeSystem/bser</a>\n                                  </div>\n                                </li>\n                              </ul>\n                            </li>\n                          </ul>\n                        </td>\n                      </tr>\n                    </table>\n                  </td>\n                </tr>\n              </table>\n            </div>"
            },
            "entry" : [
              {
                "reference" : "Observation/observation-BSeR-ReferralActivityStatus-eve-everywoman"
              }
            ]
          },
          {
            "title" : "Arthritis referral feedback supporting information",
            "code" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/us/bser/CodeSystem/bser",
                  "code" : "RSRFSI",
                  "display" : "CompositionSectionReferralServiceRequestFeedbackSupportingInformation"
                }
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n              <table>\n                <tr>\n                  <td style=\"font-weight: bold\">id</td>\n                  <td>\n                    <div title=\"id\">composition-bser-referral-feedback</div>\n                  </td>\n                </tr>\n                <tr>\n                  <td style=\"font-weight: bold\">meta</td>\n                  <td>\n                    <table>\n                      <tr>\n                        <td style=\"font-weight: bold\">versionId</td>\n                        <td>\n                          <div title=\"versionId\">3</div>\n                        </td>\n                      </tr>\n                      <tr>\n                        <td style=\"font-weight: bold\">lastUpdated</td>\n                        <td>\n                          <div title=\"lastUpdated\">2020-01-22T00:31:00.000-05:00</div>\n                        </td>\n                      </tr>\n                      <tr>\n                        <td style=\"font-weight: bold\">profile</td>\n                        <td>\n                          <div title=\"profile\">http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralFeedbackComposition</div>\n                        </td>\n                      </tr>\n                    </table>\n                  </td>\n                </tr>\n                <tr>\n                  <td style=\"font-weight: bold\">status</td>\n                  <td>\n                    <div title=\"status\">final</div>\n                  </td>\n                </tr>\n                <tr>\n                  <td style=\"font-weight: bold\">type</td>\n                  <td>\n                    <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                      <li>\n                        <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                          <li>\n                            <div title=\"display\">Referral note</div> (\n                                          <div title=\"code\">57133-1</div> ) \n                                       </li>\n                          <li>\n                            <div title=\"system\">\n                              <a href=\"http://loinc.org\">http://loinc.org</a>\n                            </div>\n                          </li>\n                        </ul>\n                      </li>\n                    </ul>\n                  </td>\n                </tr>\n                <tr>\n                  <td style=\"font-weight: bold\">subject</td>\n                  <td>\n                    <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                      <li/>\n                      <li>\n                        <a href=\"Patient-patient-us-core-patient-eve-everywoman.html\">Eve Everywoman</a>\n                      </li>\n                    </ul>\n                  </td>\n                </tr>\n                <tr>\n                  <td style=\"font-weight: bold\">date</td>\n                  <td>\n                    <div title=\"date\">2020-01-03T11:15:23Z</div>\n                  </td>\n                </tr>\n                <tr>\n                  <td style=\"font-weight: bold\">author</td>\n                  <td>\n                    <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                      <li/>\n                      <li>\n                        <a href=\"PractitionerRole-practitionerrole-bser-referral-recipient.html\">Hailey Eight, MD</a>\n                      </li>\n                    </ul>\n                  </td>\n                </tr>\n                <tr>\n                  <td style=\"font-weight: bold\">title</td>\n                  <td>\n                    <div title=\"title\">Referral feedback</div>\n                  </td>\n                </tr>\n                <tr>\n                  <td style=\"font-weight: bold\">section</td>\n                  <td>\n                    <table>\n                      <tr>\n                        <td style=\"font-weight: bold\">title</td>\n                        <td>\n                          <div title=\"title\">Arthritis referral request feedback summary</div>\n                        </td>\n                      </tr>\n                      <tr>\n                        <td style=\"font-weight: bold\">code</td>\n                        <td>\n                          <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                            <li>\n                              <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                                <li>\n                                  <div title=\"display\">CompositionSectionReferralServiceRequestFeedbackSummary</div> (\n                                                   <div title=\"code\">RSRFS</div> ) \n                                                </li>\n                                <li>\n                                  <div title=\"system\">\n                                    <a href=\"http://hl7.org/fhir/us/bser/CodeSystem/bser\">http://hl7.org/fhir/us/bser/CodeSystem/bser</a>\n                                  </div>\n                                </li>\n                              </ul>\n                            </li>\n                          </ul>\n                        </td>\n                      </tr>\n                    </table>\n                  </td>\n                </tr>\n                <tr>\n                  <td style=\"font-weight: bold\">section</td>\n                  <td>\n                    <table>\n                      <tr>\n                        <td style=\"font-weight: bold\">title</td>\n                        <td>\n                          <div title=\"title\">Arthritis referral feedback supporting information</div>\n                        </td>\n                      </tr>\n                      <tr>\n                        <td style=\"font-weight: bold\">code</td>\n                        <td>\n                          <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                            <li>\n                              <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                                <li>\n                                  <div title=\"display\">CompositionSectionReferralServiceRequestFeedbackSupportingInformation</div> (\n                                                   <div title=\"code\">RSRFSI</div> ) \n                                                </li>\n                                <li>\n                                  <div title=\"system\">\n                                    <a href=\"http://hl7.org/fhir/us/bser/CodeSystem/bser\">http://hl7.org/fhir/us/bser/CodeSystem/bser</a>\n                                  </div>\n                                </li>\n                              </ul>\n                            </li>\n                          </ul>\n                        </td>\n                      </tr>\n                    </table>\n                  </td>\n                </tr>\n              </table>\n            </div>"
            },
            "entry" : [
              {
                "reference" : "Bundle/bundle-bser-arthritis-referral-feedback-eve-everywoman"
              }
            ]
          }
        ]
      }
    },
    {
      "fullUrl" : "Observation/observation-BSeR-ReferralActivityStatus-eve-everywoman",
      "resource" : {
        "resourceType" : "Observation",
        "id" : "observation-BSeR-ReferralActivityStatus-eve-everywoman",
        "meta" : {
          "versionId" : "2",
          "lastUpdated" : "2020-01-20T18:21:50.000-05:00",
          "profile" : [
            "http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralActivityStatus"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n            <table>\n              <tr>\n                <td style=\"font-weight: bold\">id</td>\n                <td>\n                  <div title=\"id\">observation-BSeR_ReferralActivityStatus-eve-everywoman</div>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">meta</td>\n                <td>\n                  <table>\n                    <tr>\n                      <td style=\"font-weight: bold\">profile</td>\n                      <td>\n                        <div title=\"profile\">http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralActivityStatus</div>\n                      </td>\n                    </tr>\n                  </table>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">status</td>\n                <td>\n                  <div title=\"status\">final</div>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">code</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li>\n                          <div title=\"display\">Action status</div> (\n                                       <div title=\"code\">385641008</div> ) \n                                    </li>\n                        <li>\n                          <div title=\"system\">\n                            <a href=\"http://snomed.info/sct\">http://snomed.info/sct</a>\n                          </div>\n                        </li>\n                      </ul>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">subject</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li/>\n                    <li>\n                      <a href=\"Patient-patient-us-core-patient-eve-everywoman.html\">Eve Everywoman</a>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">effectiveDateTime</td>\n                <td>\n                  <div title=\"effectiveDateTime\">2019-01-17</div>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">performer</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <a href=\"PractitionerRole-practitionerrole-bser-referral-recipient.html\">PractitionerRole/practitionerrole-bser-referral-recipient</a>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">valueString</td>\n                <td>\n                  <div title=\"valueString\">Referral accepted</div>\n                </td>\n              </tr>\n            </table>\n          </div>"
        },
        "status" : "final",
        "code" : {
          "coding" : [
            {
              "system" : "http://snomed.info/sct",
              "code" : "385641008",
              "display" : "Action status"
            }
          ]
        },
        "subject" : {
          "reference" : "Patient/patient-us-core-patient-eve-everywoman",
          "display" : "Eve Everywoman"
        },
        "effectiveDateTime" : "2019-01-17",
        "performer" : [
          {
            "reference" : "PractitionerRole/practitionerrole-bser-referral-recipient"
          }
        ],
        "valueString" : "Referral accepted"
      }
    },
    {
      "fullUrl" : "Bundle/bundle-bser-arthritis-referral-feedback-eve-everywoman",
      "resource" : {
        "resourceType" : "Bundle",
        "id" : "bundle-bser-arthritis-referral-feedback-eve-everywoman",
        "meta" : {
          "versionId" : "10",
          "lastUpdated" : "2020-01-13T20:41:48.000-05:00",
          "profile" : [
            "http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ArthritisReferralFeedbackSupportingInformation"
          ]
        },
        "type" : "collection",
        "entry" : [
          {
            "fullUrl" : "Observation/observation-BSeR-ArthritisFeedbackObservation-1-eve-everywoman",
            "resource" : {
              "resourceType" : "Observation",
              "id" : "observation-BSeR-ArthritisFeedbackObservation-1-eve-everywoman",
              "meta" : {
                "profile" : [
                  "http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ArthritisFeedbackObservation"
                ]
              },
              "text" : {
                "status" : "generated",
                "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n                  <table>\n                    <tr>\n                      <td style=\"font-weight: bold\">id</td>\n                      <td>\n                        <div title=\"id\">observation-BSeR-ArthritisFeedbackObservation-1-eve-everywoman</div>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">meta</td>\n                      <td>\n                        <table>\n                          <tr>\n                            <td style=\"font-weight: bold\">versionId</td>\n                            <td>\n                              <div title=\"versionId\">3</div>\n                            </td>\n                          </tr>\n                          <tr>\n                            <td style=\"font-weight: bold\">lastUpdated</td>\n                            <td>\n                              <div title=\"lastUpdated\">2019-12-10T21:56:18.000-05:00</div>\n                            </td>\n                          </tr>\n                          <tr>\n                            <td style=\"font-weight: bold\">profile</td>\n                            <td>\n                              <div title=\"profile\">http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ArthritisFeedbackObservation</div>\n                            </td>\n                          </tr>\n                        </table>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">status</td>\n                      <td>\n                        <div title=\"status\">final</div>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">code</td>\n                      <td>\n                        <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                          <li>\n                            <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                              <li>\n                                <div title=\"display\">Endurance (observable entity)</div> ( \n                                                <div title=\"code\">406203001</div> ) \n                                             </li>\n                              <li>\n                                <div title=\"system\">\n                                  <a href=\"http://snomed.info/sct\">http://snomed.info/sct</a>\n                                </div>\n                              </li>\n                            </ul>\n                          </li>\n                        </ul>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">subject</td>\n                      <td>\n                        <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                          <li/>\n                          <li>\n                            <a href=\"Patient-patient-us-core-patient-eve-everywoman.html\">Eve Everywoman</a>\n                          </li>\n                        </ul>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">effectiveDateTime</td>\n                      <td>\n                        <div title=\"effectiveDateTime\">2019-01-18T22:33:22Z</div>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">performer</td>\n                      <td>\n                        <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                          <li>\n                            <a href=\"PractitionerRole-practitionerrole-bser-referral-recipient.html\">PractitionerRole/practitionerrole-bser-referral-recipient</a>\n                          </li>\n                        </ul>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">valueCodeableConcept</td>\n                      <td>\n                        <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                          <li>\n                            <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                              <li>\n                                <div title=\"display\">Patient's condition improved (finding)</div> ( \n                                                <div title=\"code\">268910001</div> ) \n                                             </li>\n                              <li>\n                                <div title=\"system\">\n                                  <a href=\"http://snomed.info/sct\">http://snomed.info/sct</a>\n                                </div>\n                              </li>\n                            </ul>\n                          </li>\n                        </ul>\n                      </td>\n                    </tr>\n                  </table>\n                </div>"
              },
              "status" : "final",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://snomed.info/sct",
                    "code" : "406203001",
                    "display" : "Endurance (observable entity)"
                  }
                ]
              },
              "subject" : {
                "reference" : "Patient/patient-us-core-patient-eve-everywoman",
                "display" : "Eve Everywoman"
              },
              "effectiveDateTime" : "2019-01-18T22:33:22Z",
              "performer" : [
                {
                  "reference" : "PractitionerRole/practitionerrole-bser-referral-recipient"
                }
              ],
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://snomed.info/sct",
                    "code" : "268910001",
                    "display" : "Patient's condition improved (finding)"
                  }
                ]
              }
            }
          }
        ]
      }
    },
    {
      "fullUrl" : "Patient/patient-us-core-patient-eve-everywoman",
      "resource" : {
        "resourceType" : "Patient",
        "id" : "patient-us-core-patient-eve-everywoman",
        "meta" : {
          "versionId" : "3",
          "lastUpdated" : "2019-12-19T21:35:47.000-05:00",
          "profile" : [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n            <table>\n              <tr>\n                <td style=\"font-weight: bold\">id</td>\n                <td>\n                  <span title=\"id\">patient-us-core-patient-eve-everywoman</span>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">meta</td>\n                <td>\n                  <table>\n                    <tr>\n                      <td style=\"font-weight: bold\">profile</td>\n                      <td>\n                        <span title=\"profile\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient</span>\n                      </td>\n                    </tr>\n                  </table>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">us-core-race</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <span title=\"display\">White</span>\n                    </li>\n                    <li>\n                      <span title=\"system\">urn:oid:2.16.840.1.113883.6.238</span>\n                    </li>\n                    <li>\n                      <span title=\"code\">2106-3</span>\n                    </li>\n                    <li>\n                      <span title=\"valueString\">White</span>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">us-core-ethnicity</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <span title=\"display\">Not Hispanic or Latino</span>\n                    </li>\n                    <li>\n                      <span title=\"system\">urn:oid:2.16.840.1.113883.6.238</span>\n                    </li>\n                    <li>\n                      <span title=\"code\">2186-5</span>\n                    </li>\n                    <li>\n                      <span title=\"valueString\">Not Hispanic or Latino</span>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">us-core-birthsex</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <span title=\"valueCode\">F</span>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">identifier</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <span title=\"use\">usual</span>\n                    </li>\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li>\n                          <span title=\"display\">Medical Record Number</span> ( \n                                       <span title=\"code\">MR</span> ) \n                                    </li>\n                        <li>\n                          <span title=\"system\">\n                            <a href=\"http://terminology.hl7.org/CodeSystem/v2-0203\">http://terminology.hl7.org/CodeSystem/v2-0203</a>\n                          </span>\n                        </li>\n                      </ul>\n                    </li>\n                    <li>\n                      <span title=\"system\">\n                        <a href=\"http://hospital.smarthealthit.org\">http://hospital.smarthealthit.org</a>\n                      </span>\n                    </li>\n                    <li>\n                      <span title=\"value\">1032702</span>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">active</td>\n                <td>\n                  <span title=\"active\">true</span>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">name</td>\n                <td>\n                  <table>\n                    <tr>\n                      <td style=\"font-weight: bold\">family</td>\n                      <td>\n                        <span title=\"family\">Everywoman</span>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">given</td>\n                      <td>\n                        <span title=\"given\">Eve</span>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">given</td>\n                      <td>\n                        <span title=\"given\">L</span>\n                      </td>\n                    </tr>\n                  </table>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">telecom</td>\n                <td>\n                  <table>\n                    <tr>\n                      <td style=\"font-weight: bold\">system</td>\n                      <td>\n                        <span title=\"system\">phone</span>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">value</td>\n                      <td>\n                        <span title=\"value\">1-(404)555-1212</span>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">use</td>\n                      <td>\n                        <span title=\"use\">home</span>\n                      </td>\n                    </tr>\n                  </table>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">telecom</td>\n                <td>\n                  <table>\n                    <tr>\n                      <td style=\"font-weight: bold\">system</td>\n                      <td>\n                        <span title=\"system\">email</span>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">value</td>\n                      <td>\n                        <span title=\"value\">eve.everywoman@example.com</span>\n                      </td>\n                    </tr>\n                  </table>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">gender</td>\n                <td>\n                  <span title=\"gender\">female</span>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">birthDate</td>\n                <td>\n                  <span title=\"birthDate\">1974-11-24</span>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">address</td>\n                <td>\n                  <table>\n                    <tr>\n                      <td style=\"font-weight: bold\">line</td>\n                      <td>\n                        <span title=\"line\">5101 Peachtree St NE</span>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">city</td>\n                      <td>\n                        <span title=\"city\">Atlanta</span>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">state</td>\n                      <td>\n                        <span title=\"state\">GA</span>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">postalCode</td>\n                      <td>\n                        <span title=\"postalCode\">30302</span>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">country</td>\n                      <td>\n                        <span title=\"country\">US</span>\n                      </td>\n                    </tr>\n                  </table>\n                </td>\n              </tr>\n            </table>\n          </div>"
        },
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race",
            "extension" : [
              {
                "url" : "ombCategory",
                "valueCoding" : {
                  "system" : "urn:oid:2.16.840.1.113883.6.238",
                  "code" : "2106-3",
                  "display" : "White"
                }
              },
              {
                "url" : "text",
                "valueString" : "White"
              }
            ]
          },
          {
            "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity",
            "extension" : [
              {
                "url" : "ombCategory",
                "valueCoding" : {
                  "system" : "urn:oid:2.16.840.1.113883.6.238",
                  "code" : "2186-5",
                  "display" : "Not Hispanic or Latino"
                }
              },
              {
                "url" : "text",
                "valueString" : "Not Hispanic or Latino"
              }
            ]
          },
          {
            "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
            "valueCode" : "F"
          }
        ],
        "identifier" : [
          {
            "use" : "usual",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "MR",
                  "display" : "Medical Record Number"
                }
              ]
            },
            "system" : "http://hospital.smarthealthit.org",
            "value" : "1032702"
          }
        ],
        "active" : true,
        "name" : [
          {
            "family" : "Everywoman",
            "given" : [
              "Eve",
              "L"
            ]
          }
        ],
        "telecom" : [
          {
            "system" : "phone",
            "value" : "1-(404)555-1212",
            "use" : "home"
          },
          {
            "system" : "email",
            "value" : "eve.everywoman@example.com"
          }
        ],
        "gender" : "female",
        "birthDate" : "1974-11-24",
        "address" : [
          {
            "line" : [
              "5101 Peachtree St NE"
            ],
            "city" : "Atlanta",
            "state" : "GA",
            "postalCode" : "30302",
            "country" : "US"
          }
        ]
      }
    },
    {
      "fullUrl" : "PractitionerRole/practitionerrole-bser-referral-recipient",
      "resource" : {
        "resourceType" : "PractitionerRole",
        "id" : "practitionerrole-bser-referral-recipient",
        "meta" : {
          "versionId" : "7",
          "lastUpdated" : "2020-01-21T21:27:01.000-05:00",
          "profile" : [
            "http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralRecipientPractitionerRole"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n            <table>\n              <tr>\n                <td style=\"font-weight: bold\">id</td>\n                <td>\n                  <div title=\"id\">practitionerrole-bser-referral-recipient</div>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">meta</td>\n                <td>\n                  <table>\n                    <tr>\n                      <td style=\"font-weight: bold\">profile</td>\n                      <td>\n                        <div title=\"profile\">http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralInitiatorPractitionerRole</div>\n                      </td>\n                    </tr>\n                  </table>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">identifier</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <div title=\"system\">\n                        <a href=\"http://hl7.org/fhir/sid/us-npi\">http://hl7.org/fhir/sid/us-npi</a>\n                      </div>\n                    </li>\n                    <li>\n                      <div title=\"value\">2222222222</div>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">practitioner</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li/>\n                    <li>\n                      <a href=\"Practitioner-practitioner-bser-hailey-eight.html\">Hailey Eight, MD</a>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">organization</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">code</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li>\n                          <div title=\"display\">Primary Care</div> ( \n                                       <div title=\"code\">261QP2300X</div> ) \n                                    </li>\n                        <li>\n                          <div title=\"system\">\n                            <a href=\"http://nucc.org/provider-taxonomy\">http://nucc.org/provider-taxonomy</a>\n                          </div>\n                        </li>\n                      </ul>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">specialty</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li>\n                          <div title=\"display\">Family Practice</div> ( \n                                       <div title=\"code\">419772000</div> ) \n                                    </li>\n                        <li>\n                          <div title=\"system\">\n                            <a href=\"http://snomed.info/sct\">http://snomed.info/sct</a>\n                          </div>\n                        </li>\n                      </ul>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">telecom</td>\n                <td>\n                  <table>\n                    <tr>\n                      <td style=\"font-weight: bold\">system</td>\n                      <td>\n                        <div title=\"system\">email</div>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">value</td>\n                      <td>\n                        <div title=\"value\">hailey.eight@example.com</div>\n                      </td>\n                    </tr>\n                  </table>\n                </td>\n              </tr>\n            </table>\n          </div>"
        },
        "identifier" : [
          {
            "system" : "http://hl7.org/fhir/sid/us-npi",
            "value" : "2222222222"
          }
        ],
        "practitioner" : {
          "reference" : "Practitioner/practitioner-bser-hailey-eight",
          "display" : "Hailey Eight, MD"
        },
        "organization" : {
          "reference" : "Organization/organization-bser-organization-saint-luke"
        },
        "code" : [
          {
            "coding" : [
              {
                "system" : "http://nucc.org/provider-taxonomy",
                "code" : "261QP2300X",
                "display" : "Primary Care"
              }
            ]
          }
        ],
        "specialty" : [
          {
            "coding" : [
              {
                "system" : "http://snomed.info/sct",
                "code" : "419772000",
                "display" : "Family Practice"
              }
            ]
          }
        ],
        "telecom" : [
          {
            "system" : "email",
            "value" : "hailey.eight@example.com"
          }
        ]
      }
    },
    {
      "fullUrl" : "Practitioner/practitioner-bser-hailey-eight",
      "resource" : {
        "resourceType" : "Practitioner",
        "id" : "practitioner-bser-hailey-eight",
        "meta" : {
          "versionId" : "2",
          "lastUpdated" : "2020-01-17T23:52:09.000-05:00",
          "profile" : [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n            <table>\n              <tr>\n                <td style=\"font-wEight: bold\">id</td>\n                <td>\n                  <span title=\"id\">practitioner-bser-hailey-eight</span>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-wEight: bold\">meta</td>\n                <td>\n                  <table>\n                    <tr>\n                      <td style=\"font-wEight: bold\">versionId</td>\n                      <td>\n                        <span title=\"versionId\">6</span>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-wEight: bold\">lastUpdated</td>\n                      <td>\n                        <span title=\"lastUpdated\">2019-10-05T02:50:13.000-04:00</span>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-wEight: bold\">profile</td>\n                      <td>\n                        <span title=\"profile\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner</span>\n                      </td>\n                    </tr>\n                  </table>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-wEight: bold\">identifier</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <span title=\"system\">\n                        <a href=\"http://hl7.org/fhir/sid/us-npi\">http://hl7.org/fhir/sid/us-npi</a>\n                      </span>\n                    </li>\n                    <li>\n                      <span title=\"value\">9941339888</span>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-wEight: bold\">name</td>\n                <td>\n                  <table>\n                    <tr>\n                      <td style=\"font-wEight: bold\">family</td>\n                      <td>\n                        <span title=\"family\">Hailey</span>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-wEight: bold\">given</td>\n                      <td>\n                        <span title=\"given\">Eight</span>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-wEight: bold\">suffix</td>\n                      <td>\n                        <span title=\"suffix\">M.D.</span>\n                      </td>\n                    </tr>\n                  </table>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-wEight: bold\">telecom</td>\n                <td>\n                  <table>\n                    <tr>\n                      <td style=\"font-wEight: bold\">system</td>\n                      <td>\n                        <span title=\"system\">email</span>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-wEight: bold\">value</td>\n                      <td>\n                        <span title=\"value\">hailey.eight@example.com</span>\n                      </td>\n                    </tr>\n                  </table>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-wEight: bold\">address</td>\n                <td>\n                  <table>\n                    <tr>\n                      <td style=\"font-wEight: bold\">line</td>\n                      <td>\n                        <span title=\"line\">BMass Doctors</span>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-wEight: bold\">line</td>\n                      <td>\n                        <span title=\"line\">2100 North Ave</span>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-wEight: bold\">city</td>\n                      <td>\n                        <span title=\"city\">Burlington</span>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-wEight: bold\">state</td>\n                      <td>\n                        <span title=\"state\">MA</span>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-wEight: bold\">postalCode</td>\n                      <td>\n                        <span title=\"postalCode\">02368</span>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-wEight: bold\">country</td>\n                      <td>\n                        <span title=\"country\">US</span>\n                      </td>\n                    </tr>\n                  </table>\n                </td>\n              </tr>\n            </table>\n          </div>"
        },
        "identifier" : [
          {
            "system" : "http://hl7.org/fhir/sid/us-npi",
            "value" : "9941339888"
          }
        ],
        "name" : [
          {
            "family" : "Hailey",
            "given" : [
              "Eight"
            ],
            "suffix" : [
              "M.D."
            ]
          }
        ],
        "telecom" : [
          {
            "system" : "email",
            "value" : "hailey.eight@example.com"
          }
        ],
        "address" : [
          {
            "line" : [
              "BMass Doctors",
              "2100 North Ave"
            ],
            "city" : "Burlington",
            "state" : "MA",
            "postalCode" : "02368",
            "country" : "US"
          }
        ]
      }
    },
    {
      "fullUrl" : "Organization/organization-bser-organization-saint-luke",
      "resource" : {
        "resourceType" : "Organization",
        "id" : "organization-bser-organization-saint-luke",
        "meta" : {
          "versionId" : "6",
          "lastUpdated" : "2020-01-20T17:34:47.000-05:00",
          "profile" : [
            "http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-Organization"
          ]
        },
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padding-left:0; margin:0 0;\">\n                    <li>\n                      <div title=\"system\">\n                        <a href=\"http://hl7.org/fhir/sid/us-npi\">http://hl7.org/fhir/sid/us-npi</a>\n                      </div>\n                    </li>\n                    <li>\n                      <div title=\"value\">1063494177</div>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">active</td>\n                <td>\n                  <div title=\"active\">true</div>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">type</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li>\n                          <div title=\"display\">Healthcare Provider</div> (\n                                       <div title=\"code\">prov</div> ) \n                                    </li>\n                        <li>\n                          <div title=\"system\">\n                            <a href=\"http://terminology.hl7.org/CodeSystem/organization-type\">http://terminology.hl7.org/CodeSystem/organization-type</a>\n                          </div>\n                        </li>\n                      </ul>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">name</td>\n                <td>\n                  <div title=\"name\">Saint Luke's Hospital of Kansas City</div>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">telecom</td>\n                <td>\n                  <table>\n                    <tr>\n                      <td style=\"font-weight: bold\">system</td>\n                      <td>\n                        <div title=\"system\">phone</div>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">value</td>\n                      <td>\n                        <div title=\"value\">(816)932-2000</div>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">use</td>\n                      <td>\n                        <div title=\"use\">work</div>\n                      </td>\n                    </tr>\n                  </table>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">telecom</td>\n                <td>\n                  <table>\n                    <tr>\n                      <td style=\"font-weight: bold\">system</td>\n                      <td>\n                        <div title=\"system\">other</div>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">value</td>\n                      <td>\n                        <div title=\"value\">http://www.saintlukeshealthsystem.org/locations/saint-lukes-hospital-kansas-city</div>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">use</td>\n                      <td>\n                        <div title=\"use\">work</div>\n                      </td>\n                    </tr>\n                  </table>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">address</td>\n                <td>\n                  <table>\n                    <tr>\n                      <td style=\"font-weight: bold\">line</td>\n                      <td>\n                        <div title=\"line\">4401 Wornall Rd,</div>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">city</td>\n                      <td>\n                        <div title=\"city\">Amherst</div>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">state</td>\n                      <td>\n                        <div title=\"state\">MA</div>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">postalCode</td>\n                      <td>\n                        <div title=\"postalCode\">64111</div>\n                      </td>\n                    </tr>\n                  </table>\n                </td>\n              </tr>\n            </table>\n          </div>"
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        "type" : [
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            "coding" : [
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                "system" : "http://terminology.hl7.org/CodeSystem/organization-type",
                "code" : "prov",
                "display" : "Healthcare Provider"
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        "name" : "Saint Luke's Hospital of Kansas City",
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            "system" : "phone",
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            "system" : "other",
            "value" : "http://www.saintlukeshealthsystem.org/locations/saint-lukes-hospital-kansas-city",
            "use" : "work"
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            "city" : "Amherst",
            "state" : "MA",
            "postalCode" : "64111"
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      "fullUrl" : "ServiceRequest/servicerequest-BSeR-ReferralServiceRequest",
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        "resourceType" : "ServiceRequest",
        "id" : "servicerequest-BSeR-ReferralServiceRequest",
        "meta" : {
          "versionId" : "4",
          "lastUpdated" : "2020-01-21T23:02:38.000-05:00",
          "profile" : [
            "http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralServiceRequest"
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        },
        "text" : {
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padding-left:0; margin:0 0;\">\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li>\n                          <div title=\"display\">Patient referral</div>  (\n                          \n                          <div title=\"code\">3457005</div> )\n                          \n                          \n                        </li>\n                        <li>\n                          <div title=\"system\">\n                            <a href=\"http://snomed.info/sct\">http://snomed.info/sct</a>\n                          </div>\n                        </li>\n                      </ul>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">subject</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li/>\n                    <li>\n                      <a href=\"Patient-patient-us-core-patient-eve-everywoman.html\">Eve Everywoman</a>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">occurrenceDateTime</td>\n                <td>\n                  <div title=\"occurrenceDateTime\">2020-01-09</div>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">authoredOn</td>\n                <td>\n                  <div title=\"authoredOn\">2020-02-14</div>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">requester</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li/>\n                    <li>\n                      <a href=\"PractitionerRole-practitionerrole-bser-referral-initiator.html\">Henry Seven, MD</a>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">performer</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li/>\n                    <li>\n                      <a href=\"PractitionerRole-practitionerrole-bser-referral-recipient.html\">Hailey Eight, MD</a>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">reasonCode</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li>\n                          <div title=\"display\">Arthritis (disorder)</div>  (\n                          \n                          <div title=\"code\">3723001</div> )\n                          \n                          \n                        </li>\n                        <li>\n                          <div title=\"system\">\n                            <a href=\"http://snomed.info/sct\">http://snomed.info/sct</a>\n                          </div>\n                        </li>\n                      </ul>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n            </table>\n          </div>"
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        "authoredOn" : "2020-02-14",
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          "reference" : "PractitionerRole/practitionerrole-bser-referral-initiator",
          "display" : "Henry Seven, MD"
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        "performer" : [
          {
            "reference" : "PractitionerRole/practitionerrole-bser-referral-recipient",
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          {
            "reference" : "Coverage/coverage-BSeR-Coverage-eve-everywoman"
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        "supportingInfo" : [
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            "reference" : "Bundle/bundle-bser-referral-request-document-bundle-eve-everywoman"
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        "id" : "coverage-BSeR-Coverage-eve-everywoman",
        "meta" : {
          "versionId" : "3",
          "lastUpdated" : "2020-01-18T00:10:51.000-05:00",
          "profile" : [
            "http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-Coverage"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n            <table xmlns:xsl=\"http://www.w3.org/1999/XSL/Transform\">\n              <tr>\n                <td style=\"font-weight: bold\">id</td>\n                <td>\n                  <div title=\"id\">coverage-BSeR-Coverage-eve-everywoman</div>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">meta</td>\n                <td>\n                  <table>\n                    <tr>\n                      <td style=\"font-weight: bold\">profile</td>\n                      <td>\n                        <div title=\"profile\">http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-Coverage</div>\n                      </td>\n                    </tr>\n                  </table>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">identifier</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <div title=\"system\">\n                        <a href=\"http://benefitsinc.com/certificate\">http://benefitsinc.com/certificate</a>\n                      </div>\n                    </li>\n                    <li>\n                      <div title=\"value\">12345</div>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">status</td>\n                <td>\n                  <div title=\"status\">active</div>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">type</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li>\n                          <div title=\"display\">extended healthcare</div>  (\n                                        \n                                        \n                                        <div title=\"code\">EHCPOL</div> )\n          \n                                    \n                                    \n                                    </li>\n                        <li>\n                          <div title=\"system\">\n                            <a href=\"http://terminology.hl7.org/CodeSystem/v3-ActCode\">http://terminology.hl7.org/CodeSystem/v3-ActCode</a>\n                          </div>\n                        </li>\n                      </ul>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">subscriber</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li/>\n                    <li>\n                      <a href=\"RelatedPerson-relatedperson-self-eve-everywoman.html\">Eve Everywoman</a>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">beneficiary</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li/>\n                    <li>\n                      <a href=\"Patient-patient-us-core-patient-eve-everywoman.html\">Eve Everywoman</a>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">relationship</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li> (\n                                        \n                                        \n                                        <div title=\"code\">self</div> )\n            \n                                    \n                                    \n                                    </li>\n                      </ul>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">period</td>\n                <td>\n                  <table>\n                    <tr>\n                      <td style=\"font-weight: bold\">start</td>\n                      <td>\n                        <div title=\"start\">2019-05-23</div>\n                      </td>\n                    </tr>\n                    <tr>\n                      <td style=\"font-weight: bold\">end</td>\n                      <td>\n                        <div title=\"end\">2020-05-23</div>\n                      </td>\n                    </tr>\n                  </table>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">payor</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <a href=\"Organization-organization-bser-organization-saint-luke.html\">Organization/organization-bser-organization-saint-luke</a>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">class</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li> (\n                                        \n                                        \n                                        <div title=\"code\">group</div> )\n            \n                                    \n                                    \n                                    </li>\n                        <li>\n                          <div title=\"system\">\n                            <a href=\"http://terminology.hl7.org/CodeSystem/coverage-class\">http://terminology.hl7.org/CodeSystem/coverage-class</a>\n                          </div>\n                        </li>\n                      </ul>\n                    </li>\n                    <li>\n                      <div title=\"value\">CB135</div>\n                    </li>\n                    <li>\n                      <div title=\"name\">Corporate Baker's Inc. 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padding-left:0; margin:0 0;\">\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li> (\n                                        \n                                        \n                                        <div title=\"code\">plan</div> )\n            \n                                    \n                                    \n                                    </li>\n                        <li>\n                          <div title=\"system\">\n                            <a href=\"http://terminology.hl7.org/CodeSystem/coverage-class\">http://terminology.hl7.org/CodeSystem/coverage-class</a>\n                          </div>\n                        </li>\n                      </ul>\n                    </li>\n                    <li>\n                      <div title=\"value\">B37FC</div>\n                    </li>\n                    <li>\n                      <div title=\"name\">Full Coverage: Medical, Dental, Pharmacy, Vision, EHC</div>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">class</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li> (\n                                        \n                                        \n                                        <div title=\"code\">subplan</div> )\n            \n                                    \n                                    \n                                    </li>\n                        <li>\n                          <div title=\"system\">\n                            <a href=\"http://terminology.hl7.org/CodeSystem/coverage-class\">http://terminology.hl7.org/CodeSystem/coverage-class</a>\n                          </div>\n                        </li>\n                      </ul>\n                    </li>\n                    <li>\n                      <div title=\"value\">P7</div>\n                    </li>\n                    <li>\n                      <div title=\"name\">Includes afterlife benefits</div>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">class</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li> (\n                                        \n                                        \n                                        <div title=\"code\">class</div> )\n            \n                                    \n                                    \n                                    </li>\n                        <li>\n                          <div title=\"system\">\n                            <a href=\"http://terminology.hl7.org/CodeSystem/coverage-class\">http://terminology.hl7.org/CodeSystem/coverage-class</a>\n                          </div>\n                        </li>\n                      </ul>\n                    </li>\n                    <li>\n                      <div title=\"value\">SILVER</div>\n                    </li>\n                    <li>\n                      <div title=\"name\">Silver: Family Plan spouse only</div>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">class</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li> (\n                                        \n                                        \n                                        <div title=\"code\">subclass</div> )\n            \n                                    \n                                    \n                                    </li>\n                        <li>\n                          <div title=\"system\">\n                            <a href=\"http://terminology.hl7.org/CodeSystem/coverage-class\">http://terminology.hl7.org/CodeSystem/coverage-class</a>\n                          </div>\n                        </li>\n                      </ul>\n                    </li>\n                    <li>\n                      <div title=\"value\">Tier2</div>\n                    </li>\n                    <li>\n                      <div title=\"name\">Low deductable, max $20 copay</div>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">class</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li> (\n                                        \n                                        \n                                        <div title=\"code\">sequence</div> )\n            \n                                    \n                                    \n                                    </li>\n                        <li>\n                          <div title=\"system\">\n                            <a href=\"http://terminology.hl7.org/CodeSystem/coverage-class\">http://terminology.hl7.org/CodeSystem/coverage-class</a>\n                          </div>\n                        </li>\n                      </ul>\n                    </li>\n                    <li>\n                      <div title=\"value\">9</div>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">class</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li> (\n                                        \n                                        \n                                        <div title=\"code\">rxid</div> )\n            \n                                    \n                                    \n                                    </li>\n                        <li>\n                          <div title=\"system\">\n                            <a href=\"http://terminology.hl7.org/CodeSystem/coverage-class\">http://terminology.hl7.org/CodeSystem/coverage-class</a>\n                          </div>\n                        </li>\n                      </ul>\n                    </li>\n                    <li>\n                      <div title=\"value\">MDF12345</div>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">class</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li> (\n                                        \n                                        \n                                        <div title=\"code\">rxbin</div> )\n            \n                                    \n                                    \n                                    </li>\n                        <li>\n                          <div title=\"system\">\n                            <a href=\"http://terminology.hl7.org/CodeSystem/coverage-class\">http://terminology.hl7.org/CodeSystem/coverage-class</a>\n                          </div>\n                        </li>\n                      </ul>\n                    </li>\n                    <li>\n                      <div title=\"value\">987654</div>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">class</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li> (\n                                        \n                                        \n                                        <div title=\"code\">rxgroup</div> )\n            \n                                    \n                                    \n                                    </li>\n                        <li>\n                          <div title=\"system\">\n                            <a href=\"http://terminology.hl7.org/CodeSystem/coverage-class\">http://terminology.hl7.org/CodeSystem/coverage-class</a>\n                          </div>\n                        </li>\n                      </ul>\n                    </li>\n                    <li>\n                      <div title=\"value\">M35PT</div>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">class</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li> (\n                                        \n                                        \n                                        <div title=\"code\">rxpcn</div> )\n            \n                                    \n                                    \n                                    </li>\n                        <li>\n                          <div title=\"system\">\n                            <a href=\"http://terminology.hl7.org/CodeSystem/coverage-class\">http://terminology.hl7.org/CodeSystem/coverage-class</a>\n                          </div>\n                        </li>\n                      </ul>\n                    </li>\n                    <li>\n                      <div title=\"value\">234516</div>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n              <tr>\n                <td style=\"font-weight: bold\">class</td>\n                <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                    <li>\n                      <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li> (\n                                        \n                                        \n                                        <div title=\"code\">sequence</div> )\n            \n                                    \n                                    \n                                    </li>\n                        <li>\n                          <div title=\"system\">\n                            <a href=\"http://terminology.hl7.org/CodeSystem/coverage-class\">http://terminology.hl7.org/CodeSystem/coverage-class</a>\n                          </div>\n                        </li>\n                      </ul>\n                    </li>\n                    <li>\n                      <div title=\"value\">9</div>\n                    </li>\n                  </ul>\n                </td>\n              </tr>\n            </table>\n          </div>"
        },
        "identifier" : [
          {
            "system" : "http://benefitsinc.com/certificate",
            "value" : "12345"
          }
        ],
        "status" : "active",
        "type" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
              "code" : "EHCPOL",
              "display" : "extended healthcare"
            }
          ]
        },
        "subscriber" : {
          "reference" : "RelatedPerson/relatedperson-self-eve-everywoman",
          "display" : "Eve Everywoman"
        },
        "beneficiary" : {
          "reference" : "Patient/patient-us-core-patient-eve-everywoman",
          "display" : "Eve Everywoman"
        },
        "relationship" : {
          "coding" : [
            {
              "code" : "self"
            }
          ]
        },
        "period" : {
          "start" : "2019-05-23",
          "end" : "2020-05-23"
        },
        "payor" : [
          {
            "reference" : "Organization/organization-bser-organization-saint-luke"
          }
        ],
        "class" : [
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code" : "group"
                }
              ]
            },
            "value" : "CB135",
            "name" : "Corporate Baker's Inc. Local #35"
          },
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code" : "subgroup"
                }
              ]
            },
            "value" : "123",
            "name" : "Trainee Part-time Benefits"
          },
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code" : "plan"
                }
              ]
            },
            "value" : "B37FC",
            "name" : "Full Coverage: Medical, Dental, Pharmacy, Vision, EHC"
          },
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code" : "subplan"
                }
              ]
            },
            "value" : "P7",
            "name" : "Includes afterlife benefits"
          },
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code" : "class"
                }
              ]
            },
            "value" : "SILVER",
            "name" : "Silver: Family Plan spouse only"
          },
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code" : "subclass"
                }
              ]
            },
            "value" : "Tier2",
            "name" : "Low deductable, max $20 copay"
          },
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code" : "sequence"
                }
              ]
            },
            "value" : "9"
          },
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code" : "rxid"
                }
              ]
            },
            "value" : "MDF12345"
          },
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code" : "rxbin"
                }
              ]
            },
            "value" : "987654"
          },
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code" : "rxgroup"
                }
              ]
            },
            "value" : "M35PT"
          },
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code" : "rxpcn"
                }
              ]
            },
            "value" : "234516"
          },
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code" : "sequence"
                }
              ]
            },
            "value" : "9"
          }
        ]
      }
    }
  ]
}