Da Vinci - Documentation Templates and Rules
2.0.1 - STU 2 United States of America flag

This page is part of the Documentation Templates and Rules (v2.0.1: STU 2.0) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Example Parameters: QuestionnairePackageInputParamsExample

Parameters

coverage

Coverage/CoverageExample

Generated Narrative: Coverage

Resource Coverage "CoverageExample"

Profile: CRD Coverage

status: active

subscriber: Patient/examplepatient

subscriberId: PFP123450000

beneficiary: Patient/examplepatient

relationship: Self (SubscriberPolicyholder Relationship Codes#self)

period: 2022-01-01 --> 2023-01-01

payor:

active: true

type: Payer (Organization type#pay)

name: Insurance Company

telecom: ph: 860-547-5001(WORK)

address: 680 Asylum Street Hartford CT 06155 US

Classes

-TypeValueName
*Plan (Coverage Class Codes#plan)Premim Family PlusPremim Family Plus Plan

Generated Narrative: Organization #OrgExample

active: true

type: Payer (Organization type#pay)

name: Insurance Company

telecom: ph: 860-547-5001(WORK)

address: 680 Asylum Street Hartford CT 06155 US

order

ServiceRequest/ServiceRequestExample

Generated Narrative: ServiceRequest

Resource ServiceRequest "ServiceRequestExample"

Profile: CRD Service Request

status: draft

intent: original-order

code: Gas panel - Blood (LOINC#24338-6)

subject: Patient/examplepatient

occurrence: 2019-05-08 09:33:27+0700

authoredOn: 2019-09-18 07:53:21+0700

requester: Practitioner/PractitionerExample " DOE"

reasonCode: Decreased oxygen affinity (SNOMED CT#4565000)