CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®)
1.2.0 - STU 2 Ballot

This page is part of the CARIN Blue Button Implementation Guide (v1.2.0: STU 2 Ballot 1) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

Example Patient: Patient Example 1

Generated Narrative

Resource "ExamplePatient1" Updated "2020-10-30T13:48:01.851Z" (Language "en-US")

Information Source: Organization/PayerOrganizationExample1!

Profile: C4BB Patient (version 1.2.0)

identifier: An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier.: 88800933501

active: true

name: Member 01 Test

telecom: ph: 5555555551, ph: 5555555552, ph: 5555555553, ph: 5555555554, ph: 5555555555(HOME), ph: 5555555556(WORK), GXXX@XXXX.com, fax: 5555555557

gender: male

birthDate: 1943-01-01

address:

  • 123 Main Street PITTSBURGH PA 15239
  • 456 Murray Avenue PITTSBURGH PA 15217

maritalStatus: unknown (NullFlavor#UNK)

Communications

-LanguagePreferred
*English (Tags for the Identification of Languages#en)true

managingOrganization: Organization/PayerOrganizationExample1: UPMC Health Plan "UPMC Health Plan"

Notes:

FieldValue
resourceType "Patient"
id "ExamplePatient1"
meta.lastUpdated "2020-10-30T09:48:01.8512764-04:00"
meta.source "Organization/PayerOrganizationExample1"
meta.profile[0]"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Patient"
language "en-US"
identifier[0].type.coding[0].system "http://terminology.hl7.org/CodeSystem/v2-0203"
identifier[0].type.coding[0].code #MB
identifier[0].type.coding[0].display "Member Number"
identifier[0].type.text "An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier."
identifier[0].system "https://www.upmchealthplan.com/fhir/memberidentifier"
identifier[0].value 88800933501
identifier[0].assigner.reference "Organization/PayerOrganizationExample1"
identifier[0].assigner.display "UPMC Health Plan"
active "true"
name[0].family "Test"
name[0].given[0]"Member 01"
telecom[0].system "phone"
telecom[0].value 5555555551
telecom[0].rank "1"
telecom[1].system "phone"
telecom[1].value 5555555552
telecom[1].rank "2"
telecom[2].system "phone"
telecom[2].value 5555555553
telecom[2].rank "3"
telecom[3].system "phone"
telecom[3].value 5555555554
telecom[3].rank "4"
telecom[4].system "phone"
telecom[4].value 5555555555
telecom[4].use "home"
telecom[4].rank "5"
telecom[5].system "phone"
telecom[5].value 5555555556
telecom[5].use "work"
telecom[5].rank "6"
telecom[6].system "email"
telecom[6].value GXXX@XXXX.com
telecom[6].rank "7"
telecom[7].system "fax"
telecom[7].value 5555555557
telecom[7].rank "8"
gender "male"
birthDate "1943-01-01"
address[0].type "physical"
address[0].line[0]"123 Main Street"
address[0].city "PITTSBURGH"
address[0].state "PA"
address[0].postalCode "15239"
address[1].type "physical"
address[1].line[0]"456 Murray Avenue"
address[1].city "PITTSBURGH"
address[1].state "PA"
address[1].postalCode "15217"
maritalStatus.coding[0].system "http://terminology.hl7.org/CodeSystem/v3-NullFlavor"
maritalStatus.coding[0].code #UNK
maritalStatus.text "unknown"
communication[0].language.coding[0].system "urn:ietf:bcp:47"
communication[0].language.coding[0].code #en
communication[0].language.text "English"
communication[0].preferred "true"
managingOrganization.reference "Organization/PayerOrganizationExample1"
managingOrganization.display "UPMC Health Plan"