CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue ButtonĀ®)
2.0.0 - STU 2 US

This page is part of the CARIN Blue Button Implementation Guide (v2.0.0: STU 2) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: Patient Example 2 - XML Representation

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<Patient xmlns="http://hl7.org/fhir">
  <id value="Patient2"/>
  <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|2.0.0"/>
  </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 style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;"><b>Member 01 Test </b> 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.:Ā 88800933501)</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Record is active">Active:</td><td>true</td><td style="background-color: #f3f5da" title="Known Marital status of Patient">Marital Status:</td><td colspan="3"><span title="Codes: {http://terminology.hl7.org/CodeSystem/v3-NullFlavor UNK}">unknown</span></td></tr><tr><td style="background-color: #f3f5da" title="Ways to contact the Patient">Contact Details:</td><td colspan="3"><ul><li>ph: 5555555551</li><li>ph: 5555555552</li><li>ph: 5555555553</li><li>ph: 5555555554</li><li>ph: 5555555555(HOME)</li><li>ph: 5555555556(WORK)</li><li><a href="mailto:GXXX@XXXX.com">GXXX@XXXX.com</a></li><li>fax: 5555555557</li><li>123 Main Street PITTSBURGH PA 15239 </li><li>456 Murray Avenue PITTSBURGH PA 15217 </li></ul></td></tr><tr><td style="background-color: #f3f5da" title="Languages spoken">Language:</td><td colspan="3"><span title="Codes: {urn:ietf:bcp:47 en}">English</span> (preferred)</td></tr><tr><td style="background-color: #f3f5da" title="Patient Links">Links:</td><td colspan="3"><ul><li>Managing Organization: <a href="Organization-Payer2.html">Organization/Payer2: UPMC Health Plan</a> &quot;UPMC Health Plan&quot;</li></ul></td></tr></table></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/Payer2"/>
      <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/Payer2"/>
    <display value="UPMC Health Plan"/>
  </managingOrganization>
</Patient>