CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue ButtonĀ®)
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

: Patient Example 1 - XML Representation

Raw xml | Download



<Patient xmlns="http://hl7.org/fhir">
  <id value="ExamplePatient1"/>
  <meta>
    <lastUpdated value="2020-10-30T09:48:01.8512764-04:00"/>
    <source value="Organization/PayerOrganizationExample1"/>
    <profile
             value="http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Patient|1.2.0"/>
  </meta>
  <language value="en-US"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en-US" lang="en-US"><p><b>Generated Narrative</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource "ExamplePatient1" Updated "2020-10-30T13:48:01.851Z"  (Language "en-US") </p><p style="margin-bottom: 0px">Information Source: Organization/PayerOrganizationExample1!</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-C4BB-Patient.html">C4BB Patient (version 1.2.0)</a></p></div><p><b>identifier</b>: An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier.: 88800933501</p><p><b>active</b>: true</p><p><b>name</b>: Member 01 Test </p><p><b>telecom</b>: ph: 5555555551, ph: 5555555552, ph: 5555555553, ph: 5555555554, ph: 5555555555(HOME), ph: 5555555556(WORK), <a href="mailto:GXXX@XXXX.com">GXXX@XXXX.com</a>, fax: 5555555557</p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1943-01-01</p><p><b>address</b>: </p><ul><li>123 Main Street PITTSBURGH PA 15239 </li><li>456 Murray Avenue PITTSBURGH PA 15217 </li></ul><p><b>maritalStatus</b>: unknown <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/3.0.0/CodeSystem-v3-NullFlavor.html">NullFlavor</a>#UNK)</span></p><h3>Communications</h3><table class="grid"><tr><td>-</td><td><b>Language</b></td><td><b>Preferred</b></td></tr><tr><td>*</td><td>English <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/3.0.0/CodeSystem-v3-ietf3066.html">Tags for the Identification of Languages</a>#en)</span></td><td>true</td></tr></table><p><b>managingOrganization</b>: <a href="Organization-PayerOrganizationExample1.html">Organization/PayerOrganizationExample1: UPMC Health Plan</a> "UPMC Health Plan"</p></div>
  </text>
  <identifier>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="MB"/>
        <display value="Member Number"/>
      </coding>
      <text
            value="An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier."/>
    </type>
    <system value="https://www.upmchealthplan.com/fhir/memberidentifier"/>
    <value value="88800933501"/>
    <assigner>
      <reference value="Organization/PayerOrganizationExample1"/>
      <display value="UPMC Health Plan"/>
    </assigner>
  </identifier>
  <active value="true"/>
  <name>
    <family value="Test"/>
    <given value="Member 01"/>
  </name>
  <telecom>
    <system value="phone"/>
    <value value="5555555551"/>
    <rank value="1"/>
  </telecom>
  <telecom>
    <system value="phone"/>
    <value value="5555555552"/>
    <rank value="2"/>
  </telecom>
  <telecom>
    <system value="phone"/>
    <value value="5555555553"/>
    <rank value="3"/>
  </telecom>
  <telecom>
    <system value="phone"/>
    <value value="5555555554"/>
    <rank value="4"/>
  </telecom>
  <telecom>
    <system value="phone"/>
    <value value="5555555555"/>
    <use value="home"/>
    <rank value="5"/>
  </telecom>
  <telecom>
    <system value="phone"/>
    <value value="5555555556"/>
    <use value="work"/>
    <rank value="6"/>
  </telecom>
  <telecom>
    <system value="email"/>
    <value value="GXXX@XXXX.com"/>
    <rank value="7"/>
  </telecom>
  <telecom>
    <system value="fax"/>
    <value value="5555555557"/>
    <rank value="8"/>
  </telecom>
  <gender value="male"/>
  <birthDate value="1943-01-01"/>
  <address>
    <type value="physical"/>
    <line value="123 Main Street"/>
    <city value="PITTSBURGH"/>
    <state value="PA"/>
    <postalCode value="15239"/>
  </address>
  <address>
    <type value="physical"/>
    <line value="456 Murray Avenue"/>
    <city value="PITTSBURGH"/>
    <state value="PA"/>
    <postalCode value="15217"/>
  </address>
  <maritalStatus>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/v3-NullFlavor"/>
      <code value="UNK"/>
    </coding>
    <text value="unknown"/>
  </maritalStatus>
  <communication>
    <language>
      <coding>
        <system value="urn:ietf:bcp:47"/>
        <code value="en"/>
      </coding>
      <text value="English"/>
    </language>
    <preferred value="true"/>
  </communication>
  <managingOrganization>
    <reference value="Organization/PayerOrganizationExample1"/>
    <display value="UPMC Health Plan"/>
  </managingOrganization>
</Patient>