CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®)
2.1.0-snapshot1 - STU 2.1 prepublication draft United States of America flag

This page is part of the CARIN Blue Button Implementation Guide (v2.1.0-snapshot1: STU 2) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

Example Patient: Patient Example 2

Page standards status: Informative

Generated Narrative: Patient Patient2

Last updated: 2020-10-30 09:48:01-0400; Language: en-US;

Information Source: Organization/PayerOrganizationExample1

Profile: C4BB Patientversion: {0}2.1.0-snapshot1)

Member 01 Test Male, DoB: 1943-01-01 ( An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier.: 88800933501)

Active:trueMarital Status:unknown
Contact Detail
  • ph: 5555555551
  • ph: 5555555552
  • ph: 5555555553
  • ph: 5555555554
  • ph: 5555555555(Home)
  • ph: 5555555556(Work)
  • GXXX@XXXX.com
  • fax: 5555555557
  • 123 Main Street PITTSBURGH PA 15239
  • 456 Murray Avenue PITTSBURGH PA 15217
Language:English (preferred)
Links:

Notes:

Instance: Patient2
InstanceOf: http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Patient|2.1.0-snapshot1
Title: "Patient Example 2"
Description: "Patient Example 2"
Usage: #example
* meta
  * lastUpdated = "2020-10-30T09:48:01.8512764-04:00"
  * source = "Organization/PayerOrganizationExample1"
* language = #en-US
* identifier
  * type = http://terminology.hl7.org/CodeSystem/v2-0203#MB "Member Number"
    * text = "An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier."
  * system = "https://www.upmchealthplan.com/fhir/memberidentifier"
  * value = "88800933501"
  * assigner = Reference(Payer2) "UPMC Health Plan"
* active = true
* name
  * family = "Test"
  * given = "Member 01"
* telecom[0]
  * system = #phone
  * value = "5555555551"
  * rank = 1
* telecom[+]
  * system = #phone
  * value = "5555555552"
  * rank = 2
* telecom[+]
  * system = #phone
  * value = "5555555553"
  * rank = 3
* telecom[+]
  * system = #phone
  * value = "5555555554"
  * rank = 4
* telecom[+]
  * system = #phone
  * value = "5555555555"
  * use = #home
  * rank = 5
* telecom[+]
  * system = #phone
  * value = "5555555556"
  * use = #work
  * rank = 6
* telecom[+]
  * system = #email
  * value = "GXXX@XXXX.com"
  * rank = 7
* telecom[+]
  * system = #fax
  * value = "5555555557"
  * rank = 8
* gender = #male
* birthDate = "1943-01-01"
* address[0]
  * type = #physical
  * line = "123 Main Street"
  * city = "PITTSBURGH"
  * state = "PA"
  * postalCode = "15239"
* address[+]
  * type = #physical
  * line = "456 Murray Avenue"
  * city = "PITTSBURGH"
  * state = "PA"
  * postalCode = "15217"
* maritalStatus = http://terminology.hl7.org/CodeSystem/v3-NullFlavor#UNK
  * text = "unknown"
* communication
  * language = urn:ietf:bcp:47#en
    * text = "English"
  * preferred = true
* managingOrganization = Reference(Payer2) "UPMC Health Plan"