Da Vinci - Coverage Requirements Discovery
2.0.1 - STU 2 United States of America flag

This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v2.0.1: STU 2.0) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: Patient example - XML Representation

Page standards status: Informative

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<Patient xmlns="http://hl7.org/fhir">
  <id value="example"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;"><b>Amy V. Shaw </b> female, DoB: 1987-02-20 ( Medical Record Number: 1032702 (use: USUAL))</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Record is active">Active:</td><td colspan="3">true</td></tr><tr><td style="background-color: #f3f5da" title="Alternate names (see the one above)">Alt. Name:</td><td colspan="3">Amy V. Baxter </td></tr><tr><td style="background-color: #f3f5da" title="Ways to contact the Patient">Contact Details:</td><td colspan="3"><ul><li>ph: 555-555-5555(HOME)</li><li><a href="mailto:amy.shaw@example.com">amy.shaw@example.com</a></li><li>49 Meadow St Mounds OK 74047 US </li><li>183 Mountain View St Mounds OK 74048 US </li></ul></td></tr><tr><td style="background-color: #f3f5da" title="Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.">US Core Ethnicity Extension:</td><td colspan="3"><ul><li>ombCategory: <a href="http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-cdcrec.html#cdcrec-2135-2">Race &amp; Ethnicity - CDC</a> 2135-2: Hispanic or Latino</li><li>detailed: <a href="http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-cdcrec.html#cdcrec-2148-5">Race &amp; Ethnicity - CDC</a> 2148-5: Mexican</li><li>text: Hispanic or Latino</li></ul></td></tr><tr><td style="background-color: #f3f5da" title="A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc). This extension aligns with the C-CDA Birth Sex Observation (LOINC 76689-9)."><a href="http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-birthsex.html">US Core Birth Sex Extension:</a></td><td colspan="3"><ul><li>F</li></ul></td></tr><tr><td style="background-color: #f3f5da" title="Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories:

 - American Indian or Alaska Native
 - Asian
 - Black or African American
 - Native Hawaiian or Other Pacific Islander
 - White.">US Core Race Extension:</td><td colspan="3"><ul><li>ombCategory: <a href="http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-cdcrec.html#cdcrec-2028-9">Race &amp; Ethnicity - CDC</a> 2028-9: Asian</li><li>detailed: <a href="http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-cdcrec.html#cdcrec-2036-2">Race &amp; Ethnicity - CDC</a> 2036-2: Filipino</li><li>text: Mixed</li></ul></td></tr></table></div>
  </text>
  <extension
             url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race">
    <extension url="ombCategory">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2028-9"/>
        <display value="Asian"/>
      </valueCoding>
    </extension>
    <extension url="detailed">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2036-2"/>
        <display value="Filipino"/>
      </valueCoding>
    </extension>
    <extension url="text">
      <valueString value="Mixed"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity">
    <extension url="ombCategory">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2135-2"/>
        <display value="Hispanic or Latino"/>
      </valueCoding>
    </extension>
    <extension url="detailed">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2148-5"/>
        <display value="Mexican"/>
      </valueCoding>
    </extension>
    <extension url="text">
      <valueString value="Hispanic or Latino"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex">
    <valueCode value="F"/>
  </extension>
  <identifier>
    <use value="usual"/>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="MR"/>
      </coding>
      <text value="Medical Record Number"/>
    </type>
    <system value="http://hospital.smarthealthit.org"/>
    <value value="1032702"/>
  </identifier>
  <active value="true"/>
  <name>
    <family value="Shaw"/>
    <given value="Amy"/>
    <given value="V."/>
    <period>
      <start value="2016-12-06"/>
      <end value="2020-07-22"/>
    </period>
  </name>
  <name>
    <family value="Baxter"/>
    <given value="Amy"/>
    <given value="V."/>
    <suffix value="PharmD"/>
    <period>
      <start value="2020-07-22"/>
    </period>
  </name>
  <telecom>
    <system value="phone"/>
    <value value="555-555-5555"/>
    <use value="home"/>
  </telecom>
  <telecom>
    <system value="email"/>
    <value value="amy.shaw@example.com"/>
  </telecom>
  <gender value="female"/>
  <birthDate value="1987-02-20"/>
  <address>
    <line value="49 Meadow St"/>
    <city value="Mounds"/>
    <state value="OK"/>
    <postalCode value="74047"/>
    <country value="US"/>
    <period>
      <start value="2016-12-06"/>
      <end value="2020-07-22"/>
    </period>
  </address>
  <address>
    <line value="183 Mountain View St"/>
    <city value="Mounds"/>
    <state value="OK"/>
    <postalCode value="74048"/>
    <country value="US"/>
    <period>
      <start value="2020-07-22"/>
    </period>
  </address>
</Patient>