{
  "resourceType" : "DocumentReference",
  "id" : "provider-attestation-doc-1",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: DocumentReference provider-attestation-doc-1</b></p><a name=\"provider-attestation-doc-1\"> </a><a name=\"hcprovider-attestation-doc-1\"> </a><p><b>status</b>: Current</p><p><b>docStatus</b>: Final</p><p><b>type</b>: <span title=\"Codes:{http://loinc.org 64292-6}\">Release of information consent</span></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode IDSCL}\">Information Disclosure</span></p><p><b>subject</b>: <a href=\"Patient-1.html\">Patricia Ann Person</a></p><p><b>date</b>: 2024-11-14 10:30:00+0000</p><p><b>author</b>: <a href=\"Practitioner-4.html\">Dr. Susan Smith</a></p><p><b>authenticator</b>: <a href=\"Organization-ProviderOrg1.html\">Provider 1</a></p><p><b>custodian</b>: <a href=\"Organization-ProviderOrg1.html\">Provider 1</a></p><blockquote><p><b>content</b></p><h3>Attachments</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ContentType</b></td><td><b>Url</b></td><td><b>Title</b></td><td><b>Creation</b></td></tr><tr><td style=\"display: none\">*</td><td>application/pdf</td><td><a href=\"https://simplifier.net/resolve?scope=hl7.fhir.us.davinci-atr@2.1.0&amp;canonical=https://example.org/provider1/attestations/2024/attestation-001.pdf\">https://example.org/provider1/attestations/2024/attestation-001.pdf</a></td><td>Provider Treatment Relationship Attestation Form</td><td>2024-11-14 10:30:00+0000</td></tr></table><p><b>format</b>: IHE.FormatCode.codesystem: urn:ihe:iti:xds:2017:mimeTypeSufficient (urn:ihe:iti:xds:2017:mimeTypeSufficient)</p></blockquote><h3>Contexts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Period</b></td><td><b>Related</b></td></tr><tr><td style=\"display: none\">*</td><td>2024-01-15 --&gt; (ongoing)</td><td><a href=\"Encounter-6.html\">Encounter: status = finished; class = Ambulatory (ActCode#AMB); type = Consultation</a></td></tr></table></div>"
  },
  "status" : "current",
  "docStatus" : "final",
  "type" : {
    "coding" : [{
      "system" : "http://loinc.org",
      "code" : "64292-6",
      "display" : "Release of information consent"
    }]
  },
  "category" : [{
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
      "code" : "IDSCL",
      "display" : "Information Disclosure"
    }]
  }],
  "subject" : {
    "reference" : "Patient/1",
    "display" : "Patricia Ann Person"
  },
  "date" : "2024-11-14T10:30:00Z",
  "author" : [{
    "reference" : "Practitioner/4",
    "display" : "Dr. Susan Smith"
  }],
  "authenticator" : {
    "reference" : "Organization/ProviderOrg1",
    "display" : "Provider 1"
  },
  "custodian" : {
    "reference" : "Organization/ProviderOrg1",
    "display" : "Provider 1"
  },
  "content" : [{
    "attachment" : {
      "contentType" : "application/pdf",
      "url" : "https://example.org/provider1/attestations/2024/attestation-001.pdf",
      "title" : "Provider Treatment Relationship Attestation Form",
      "creation" : "2024-11-14T10:30:00Z"
    },
    "format" : {
      "system" : "http://ihe.net/fhir/ValueSet/IHE.FormatCode.codesystem",
      "code" : "urn:ihe:iti:xds:2017:mimeTypeSufficient"
    }
  }],
  "context" : {
    "period" : {
      "start" : "2024-01-15"
    },
    "related" : [{
      "reference" : "Encounter/6"
    }]
  }
}