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 in it's permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

servicerequest-BSeR-ReferralServiceRequest - XML Representation

(back to description)

Raw xml

Source view

<ServiceRequest xmlns="http://hl7.org/fhir">
  <id value="servicerequest-BSeR-ReferralServiceRequest"/>
  <meta>
    <versionId value="4"/>
    <lastUpdated value="2020-01-21T23:02:38.000-05:00"/>
    <profile
             value="http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralServiceRequest"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
            <table xmlns:xsl="http://www.w3.org/1999/XSL/Transform">
                <tr>
                    <td style="font-weight: bold">id</td>
                    <td>
                        <div title="id">servicerequest-BSeR-ReferralServiceRequest</div>
                    </td>
                </tr>
                <tr>
                    <td style="font-weight: bold">identifier</td>
                    <td>
                        <ul style="list-style:none; padding-left:0; margin:0 0;">
                            <li>
                                <ul style="list-style:none; padding-left:0; margin:0 0;">
                                    <li> (
                                        
                                        <div title="code">PLAC</div> )
            
                                    
                                    </li>
                                    <li>
                                        <div title="system">
                                            <a href="http://terminology.hl7.org/CodeSystem/v2-0203">http://terminology.hl7.org/CodeSystem/v2-0203</a>
                                        </div>
                                    </li>
                                </ul>
                            </li>
                            <li>
                                <div title="value">88888888</div>
                            </li>
                            <li>
                                <a href="Organization-organization-bser-organization-saint-luke.html">Organization/organization-bser-organization-saint-luke</a>
                            </li>
                        </ul>
                    </td>
                </tr>
                <tr>
                    <td style="font-weight: bold">identifier</td>
                    <td>
                        <ul style="list-style:none; padding-left:0; margin:0 0;">
                            <li>
                                <ul style="list-style:none; padding-left:0; margin:0 0;">
                                    <li> (
                                        
                                        <div title="code">FILL</div> )
            
                                    
                                    </li>
                                    <li>
                                        <div title="system">
                                            <a href="http://terminology.hl7.org/CodeSystem/v2-0203">http://terminology.hl7.org/CodeSystem/v2-0203</a>
                                        </div>
                                    </li>
                                </ul>
                            </li>
                            <li>
                                <div title="value">99999999</div>
                            </li>
                            <li>
                                <a href="Organization-organization-bser-organization-saint-luke.html">Organization/organization-bser-organization-saint-luke</a>
                            </li>
                        </ul>
                    </td>
                </tr>
                <tr>
                    <td style="font-weight: bold">status</td>
                    <td>
                        <div title="status">active</div>
                    </td>
                </tr>
                <tr>
                    <td style="font-weight: bold">intent</td>
                    <td>
                        <div title="intent">order</div>
                    </td>
                </tr>
                <tr>
                    <td style="font-weight: bold">code</td>
                    <td>
                        <ul style="list-style:none; padding-left:0; margin:0 0;">
                            <li>
                                <ul style="list-style:none; padding-left:0; margin:0 0;">
                                    <li>
                                        <div title="display">Patient referral</div>  (
                                        
                                        <div title="code">3457005</div> )
          
                                    
                                    </li>
                                    <li>
                                        <div title="system">
                                            <a href="http://snomed.info/sct">http://snomed.info/sct</a>
                                        </div>
                                    </li>
                                </ul>
                            </li>
                        </ul>
                    </td>
                </tr>
                <tr>
                    <td style="font-weight: bold">subject</td>
                    <td>
                        <ul style="list-style:none; padding-left:0; margin:0 0;">
                            <li/>
                            <li>
                                <a href="Patient-patient-us-core-patient-eve-everywoman.html">Eve Everywoman</a>
                            </li>
                        </ul>
                    </td>
                </tr>
                <tr>
                    <td style="font-weight: bold">occurrenceDateTime</td>
                    <td>
                        <div title="occurrenceDateTime">2020-01-09</div>
                    </td>
                </tr>
                <tr>
                    <td style="font-weight: bold">authoredOn</td>
                    <td>
                        <div title="authoredOn">2020-02-14</div>
                    </td>
                </tr>
                <tr>
                    <td style="font-weight: bold">requester</td>
                    <td>
                        <ul style="list-style:none; padding-left:0; margin:0 0;">
                            <li/>
                            <li>
                                <a href="PractitionerRole-practitionerrole-bser-referral-initiator.html">Henry Seven, MD</a>
                            </li>
                        </ul>
                    </td>
                </tr>
                <tr>
                    <td style="font-weight: bold">performer</td>
                    <td>
                        <ul style="list-style:none; padding-left:0; margin:0 0;">
                            <li/>
                            <li>
                                <a href="PractitionerRole-practitionerrole-bser-referral-recipient.html">Hailey Eight, MD</a>
                            </li>
                        </ul>
                    </td>
                </tr>
                <tr>
                    <td style="font-weight: bold">reasonCode</td>
                    <td>
                        <ul style="list-style:none; padding-left:0; margin:0 0;">
                            <li>
                                <ul style="list-style:none; padding-left:0; margin:0 0;">
                                    <li>
                                        <div title="display">Arthritis (disorder)</div>  (
                                        
                                        <div title="code">3723001</div> )
          
                                    
                                    </li>
                                    <li>
                                        <div title="system">
                                            <a href="http://snomed.info/sct">http://snomed.info/sct</a>
                                        </div>
                                    </li>
                                </ul>
                            </li>
                        </ul>
                    </td>
                </tr>
            </table>
        </div>
  </text>
  <identifier>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="PLAC"/>
      </coding>
    </type>
    <value value="88888888"/>
    <assigner>
      <reference value="Organization/organization-bser-organization-saint-luke"/>
    </assigner>
  </identifier>
  <identifier>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="FILL"/>
      </coding>
    </type>
    <value value="99999999"/>
    <assigner>
      <reference value="Organization/organization-bser-organization-saint-luke"/>
    </assigner>
  </identifier>
  <status value="active"/>
  <intent value="order"/>
  <code>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="3457005"/>
      <display value="Patient referral"/>
    </coding>
  </code>
  <subject>
    <reference value="Patient/patient-us-core-patient-eve-everywoman"/>
    <display value="Eve Everywoman"/>
  </subject>
  <occurrenceDateTime value="2020-01-09"/>
  <authoredOn value="2020-02-14"/>
  <requester>
    <reference value="PractitionerRole/practitionerrole-bser-referral-initiator"/>
    <display value="Henry Seven, MD"/>
  </requester>
  <performer>
    <reference value="PractitionerRole/practitionerrole-bser-referral-recipient"/>
    <display value="Hailey Eight, MD"/>
  </performer>
  <reasonCode>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="3723001"/>
      <display value="Arthritis (disorder)"/>
    </coding>
  </reasonCode>
  <insurance>
    <reference value="Coverage/coverage-BSeR-Coverage-eve-everywoman"/>
  </insurance>
  <supportingInfo>
    <reference
               value="Bundle/bundle-bser-referral-request-document-bundle-eve-everywoman"/>
  </supportingInfo>
</ServiceRequest>