Da Vinci - Coverage Requirements Discovery
2.1.0-preview - STU 2
Da Vinci - Coverage Requirements Discovery
2.1.0-preview - STU 2
This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v2.1.0-preview: STU 2.1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.0.1. For a full list of available versions, see the Directory of published versions
<Bundle xmlns="http://hl7.org/fhir">
<id value="search-response"/>
<type value="batch-response"/>
<entry>
<fullUrl value="http://example.org/someEHR/fhir/Patient/123"/>
<resource>
<Patient>
<id value="123"/>
<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. Baxter </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. Shaw (OLD)</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 (OLD)</li><li>183 MOUNTAIN VIEW ST MOUNDS OK 74048 US </li></ul></td></tr></table></div>
</text>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex">
<valueCode value="F"/>
</extension>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex">
<valueCode value="248152002"/>
</extension>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-genderIdentity">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-NullFlavor"/>
<code value="UNK"/>
<display value="Unknown"/>
</coding>
<text value="Unknown"/>
</valueCodeableConcept>
</extension>
<identifier>
<use value="usual"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MR"/>
<display value="Medical Record Number"/>
</coding>
<text value="Medical Record Number"/>
</type>
<system value="http://hospital.smarthealthit.org"/>
<value value="1032702"/>
</identifier>
<active value="true"/>
<name>
<use value="old"/>
<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>
<use value="old"/>
<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>
</resource>
<response>
<status value="200"/>
<lastModified value="2019-03-15T15:38:13.028Z"/>
</response>
</entry>
<entry>
<fullUrl value="urn:uuid:f95e9abf-1c8f-4873-ad15-f6f016334568"/>
<resource>
<Bundle>
<id value="f95e9abf-1c8f-4873-ad15-f6f016334568"/>
<type value="searchset"/>
<total value="1"/>
<link>
<relation value="self"/>
<url
value="Encounter?_id=987&_include=Encounter:service-provider&_include=Encounter:practitioner&_include=Encounter:location"/>
</link>
<entry>
<fullUrl value="http://example.org/someEHR/fhir/Encounter/987"/>
<resource>
<Encounter>
<id value="987"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>status</b>: finished</p><p><b>class</b>: ambulatory</p><p><b>type</b>: Office Visit</p><p><b>subject</b>: <a href="Patient-example.html">Patient/example</a> " SHAW"</p><p><b>period</b>: 2015-11-01 17:00:14-0500 --> 2015-11-01 18:00:14-0500</p><h3>Locations</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Location</b></td></tr><tr><td style="display: none">*</td><td>Holy Family Hospital</td></tr></table></div>
</text>
<status value="finished"/>
<class>
<system
value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="AMB"/>
<display value="ambulatory"/>
</class>
<type>
<coding>
<system value="http://www.ama-assn.org/go/cpt"/>
<code value="99211"/>
</coding>
<text value="Office Visit"/>
</type>
<subject>
<reference
value="http://example.org/someEHR/fhir/Patient/123"/>
</subject>
<period>
<start value="2015-11-01T17:00:14-05:00"/>
<end value="2015-11-01T18:00:14-05:00"/>
</period>
<location>
<location>
<reference
value="http://example.org/someEHR/fhir/Location/hospital"/>
<display value="Holy Family Hospital"/>
</location>
</location>
</Encounter>
</resource>
<search>
<mode value="match"/>
</search>
</entry>
<entry>
<fullUrl value="http://example.org/someEHR/fhir/Location/hospital"/>
<resource>
<Location>
<id value="hospital"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>name</b>: Acme Clinic</p><p></p><p><b>address</b>: 3300 WASHTENAW AVE STE 227 AMHERST MA 01002 USA </p></div>
</text>
<name value="Acme Clinic"/>
<address>
<line value="3300 WASHTENAW AVE STE 227"/>
<city value="AMHERST"/>
<state value="MA"/>
<postalCode value="01002"/>
<country value="USA"/>
</address>
<managingOrganization>
<reference
value="http://example.org/someEHR/fhir/Organization/GHI"/>
</managingOrganization>
</Location>
</resource>
<search>
<mode value="include"/>
</search>
</entry>
</Bundle>
</resource>
<response>
<status value="200"/>
<lastModified value="2019-03-15T15:38:13.028Z"/>
</response>
</entry>
<entry>
<fullUrl value="urn:uuid:c81d99b6-caf9-4e01-8eda-0550a837def3"/>
<resource>
<Bundle>
<id value="c81d99b6-caf9-4e01-8eda-0550a837def3"/>
<type value="searchset"/>
<total value="1"/>
<link>
<relation value="self"/>
<url
value="http://example.org/someEHR/fhir/r4/Coverage?patient=123&status=active"/>
</link>
<entry>
<fullUrl value="http://example.org/someEHR/fhir/Coverage/COV1"/>
<resource>
<Coverage>
<id value="COV1"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>identifier</b>: Member Number: 88800933501</p><p><b>status</b>: active</p><p><b>type</b>: PPO</p><p><b>subscriberId</b>: 888009335</p><p><b>beneficiary</b>: <a href="Patient-example.html">Patient/example</a> " SHAW"</p><p><b>relationship</b>: Self</p><p><b>period</b>: 2020-01-01 --> (ongoing)</p><p><b>payor</b>: Acme Health Plan</p><blockquote><p><b>class</b></p><p><b>type</b>: An employee group</p><p><b>value</b>: xyz</p><p><b>name</b>: XYZ employee Group Plan</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: A specific suite of benefits.</p><p><b>value</b>: gold</p><p><b>name</b>: Acme Gold Plan</p></blockquote></div>
</text>
<identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MB"/>
<display value="Member Number"/>
</coding>
</type>
<system value="http://example.org/fhir/memberidentifier"/>
<value value="88800933501"/>
</identifier>
<status value="active"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="PPO"/>
<display value="preferred provider organization policy"/>
</coding>
<text value="PPO"/>
</type>
<subscriberId value="888009335"/>
<beneficiary>
<reference
value="http://example.org/someEHR/fhir/Patient/123"/>
</beneficiary>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
<code value="self"/>
</coding>
<text value="Self"/>
</relationship>
<period>
<start value="2020-01-01"/>
</period>
<payor>
<reference
value="http://example.org/someEHR/fhir/Organization/acme-payer"/>
<display value="Acme Health Plan"/>
</payor>
<class>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="group"/>
<display value="Group"/>
</coding>
<text value="An employee group"/>
</type>
<value value="xyz"/>
<name value="XYZ employee Group Plan"/>
</class>
<class>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="plan"/>
<display value="Plan"/>
</coding>
<text value="A specific suite of benefits."/>
</type>
<value value="gold"/>
<name value="Acme Gold Plan"/>
</class>
</Coverage>
</resource>
<search>
<mode value="match"/>
</search>
</entry>
</Bundle>
</resource>
<response>
<status value="200"/>
<lastModified value="2019-03-15T15:38:13.028Z"/>
</response>
</entry>
<entry>
<fullUrl value="urn:uuid:dc616366-2f3f-4cca-b02c-0f80981770db"/>
<resource>
<Bundle>
<id value="dc616366-2f3f-4cca-b02c-0f80981770db"/>
<type value="searchset"/>
<total value="2"/>
<link>
<relation value="self"/>
<url
value="http://example.org/someEHR/fhir/r4/Medication?_id=MED1,MED2&_sort=_id"/>
</link>
<entry>
<fullUrl value="http://example.org/someEHR/fhir/Mediation/MED1"/>
<resource>
<Medication>
<id value="MED1"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">diclofenac potassium 50 MG Oral Tablet</div>
</text>
<code>
<coding>
<system
value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="855942"/>
<display value="diclofenac potassium 50 MG Oral Tablet"/>
</coding>
<text value="diclofenac potassium 50 MG Oral Tablet"/>
</code>
</Medication>
</resource>
<search>
<mode value="match"/>
</search>
</entry>
<entry>
<fullUrl value="http://example.org/someEHR/fhir/Mediation/MED2"/>
<resource>
<Medication>
<id value="MED2"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">Abuse-Deterrent 12 HR oxycodone hydrochloride 10 MG Extended Release Oral Tablet [Oxycontin]</div>
</text>
<code>
<coding>
<system
value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="1049504"/>
<display
value="Abuse-Deterrent 12 HR oxycodone hydrochloride 10 MG Extended Release Oral Tablet [Oxycontin]"/>
</coding>
<text
value="Abuse-Deterrent 12 HR oxycodone hydrochloride 10 MG Extended Release Oral Tablet [Oxycontin]"/>
</code>
</Medication>
</resource>
<search>
<mode value="match"/>
</search>
</entry>
</Bundle>
</resource>
<response>
<status value="200"/>
<lastModified value="2019-03-15T15:38:13.037Z"/>
</response>
</entry>
<entry>
<fullUrl value="urn:uuid:ee0d8bb2-f7a1-4b53-bfff-902dd4513b07"/>
<resource>
<Bundle>
<id value="ee0d8bb2-f7a1-4b53-bfff-902dd4513b07"/>
<type value="searchset"/>
<total value="1"/>
<link>
<relation value="self"/>
<url
value="http://example.org/someEHR/fhir/r4/PractitionerRole?_id=123&_include=PractitionerRole:organization&_include=PractitionerRole:practitioner&_sort=_id"/>
</link>
<entry>
<fullUrl
value="http://example.org/someEHR/fhir/PractitionerRole/ABC"/>
<resource>
<PractitionerRole>
<id value="ABC"/>
<meta>
<lastUpdated value="2016-02-29T23:52:32.387Z"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">Dr. Ronald Bone, primary care physician at Acme Clinic</div>
</text>
<practitioner>
<reference
value="http://example.org/someEHR/fhir/Practitioner/DEF"/>
<display value="Dr. Ronald Bone"/>
</practitioner>
<organization>
<reference
value="http://example.org/someEHR/fhir/Organization/GHI"/>
<display value="Acme Clinic"/>
</organization>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-ParticipationFunction"/>
<code value="PCP"/>
<display value="primary care physician"/>
</coding>
<coding>
<system value="http://nucc.org/provider-taxonomy"/>
<code value="261QP2300X"/>
<display value="Primary Care Clinic/Center"/>
</coding>
</code>
</PractitionerRole>
</resource>
<search>
<mode value="match"/>
</search>
</entry>
<entry>
<fullUrl value="http://example.org/someEHR/fhir/Practitioner/DEF"/>
<resource>
<Practitioner>
<id value="DEF"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>identifier</b>: <a href="https://terminology.hl7.org/NamingSystem-npi.html">United States National Provider Identifier (NPI)</a> 9941339100, id: 25456</p><p><b>name</b>: Ronald Bone </p><p><b>address</b>: 1003 HEALTHCARE DR AMHERST MA 01002 (WORK)</p></div>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="9941339100"/>
</identifier>
<identifier>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-jurisdiction">
<valueCodeableConcept>
<coding>
<system value="https://www.usps.com/"/>
<code value="MA"/>
</coding>
<text value="Massachusetts"/>
</valueCodeableConcept>
</extension>
<system value="http://www.acme.org/practitioners"/>
<value value="25456"/>
</identifier>
<name>
<family value="Bone"/>
<given value="Ronald"/>
<prefix value="Dr"/>
</name>
<address>
<use value="work"/>
<line value="1003 HEALTHCARE DR"/>
<city value="AMHERST"/>
<state value="MA"/>
<postalCode value="01002"/>
</address>
</Practitioner>
</resource>
<search>
<mode value="include"/>
</search>
</entry>
<entry>
<fullUrl value="http://example.org/someEHR/fhir/Organization/GHI"/>
<resource>
<Organization>
<id value="GHI"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>identifier</b>: <a href="https://terminology.hl7.org/NamingSystem-npi.html">United States National Provider Identifier (NPI)</a> 1407071236, id: 121111111</p><p><b>active</b>: true</p><p><b>type</b>: Healthcare Provider</p><p><b>name</b>: Acme Clinic</p><p><b>telecom</b>: ph: (+1) 734-677-7777, <a href="mailto:customer-service@acme-clinic.org">customer-service@acme-clinic.org</a></p><p><b>address</b>: 3300 WASHTENAW AVE STE 227 AMHERST MA 01002 USA </p></div>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="1407071236"/>
</identifier>
<identifier>
<system value="http://example.org/fhir/sid/us-tin"/>
<value value="121111111"/>
</identifier>
<active value="true"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/organization-type"/>
<code value="prov"/>
<display value="Healthcare Provider"/>
</coding>
</type>
<name value="Acme Clinic"/>
<telecom>
<system value="phone"/>
<value value="(+1) 734-677-7777"/>
</telecom>
<telecom>
<system value="email"/>
<value value="customer-service@acme-clinic.org"/>
</telecom>
<address>
<line value="3300 WASHTENAW AVE STE 227"/>
<city value="AMHERST"/>
<state value="MA"/>
<postalCode value="01002"/>
<country value="USA"/>
</address>
</Organization>
</resource>
<search>
<mode value="include"/>
</search>
</entry>
</Bundle>
</resource>
<response>
<status value="200"/>
<lastModified value="2019-03-15T15:38:13.011Z"/>
</response>
</entry>
</Bundle>
IG © 2019+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-crd#2.1.0-preview based on FHIR 4.0.1. Generated 2024-09-26
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