Da Vinci Payer Data Exchange
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This page is part of the Da Vinci Payer Data Exchange (v2.0.0: STU2) 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

: Patient100 - JSON Representation

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{
  "resourceType" : "Patient",
  "id" : "100",
  "meta" : {
    "lastUpdated" : "2020-07-07T13:26:22.0314215+00:00",
    "profile" : [
      🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
    ]
  },
  "language" : "en-US",
  "text" : {
    "status" : "generated",
    "div" : "<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>Johnny Appleseed </b> male, DoB: 1986-01-01 ( Member Number:\u00a0https://www.xxxhealthplan.com/fhir/memberidentifier#1234-234-1243-12345678901)</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=\"Other Ids (see the one above)\">Other Ids:</td><td colspan=\"3\"><ul><li>Medical record number:\u00a01234-234-1243-12345678901m</li><li>Health Plan Identifier:\u00a01234-234-1243-12345678901u</li><li>Patient external identifier:\u00a01234-234-1243-12345678901a</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Details:</td><td colspan=\"3\"><ul><li>ph: (443)555-1212</li><li>ph: (410)678-2323</li><li>123 Main Street Pittsburgh PA 12519 </li></ul></td></tr></table></div>"
  },
  "identifier" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "MB"
          }
        ]
      },
      "system" : "https://www.xxxhealthplan.com/fhir/memberidentifier",
      "value" : "https://www.xxxhealthplan.com/fhir/memberidentifier#1234-234-1243-12345678901"
    },
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "MR"
          }
        ]
      },
      "system" : "https://www.xxxhealthplan.com/fhir/medicalrecordnumber",
      "value" : "1234-234-1243-12345678901m"
    },
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "XV"
          }
        ]
      },
      "system" : "https://www.xxxhealthplan.com/fhir/uniquememberidentifier",
      "value" : "1234-234-1243-12345678901u"
    },
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "PT"
          }
        ]
      },
      "system" : "https://www.xxxhealthplan.com/fhir/patacctnum",
      "value" : "1234-234-1243-12345678901a"
    }
  ],
  "active" : true,
  "name" : [
    {
      "family" : "Appleseed",
      "given" : [
        "Johnny"
      ]
    }
  ],
  "telecom" : [
    {
      "system" : "phone",
      "value" : "(443)555-1212",
      "rank" : 1
    },
    {
      "system" : "phone",
      "value" : "(410)678-2323",
      "rank" : 2
    }
  ],
  "gender" : "male",
  "birthDate" : "1986-01-01",
  "address" : [
    {
      "type" : "physical",
      "line" : [
        "123 Main Street"
      ],
      "city" : "Pittsburgh",
      "state" : "PA",
      "postalCode" : "12519"
    }
  ],
  "maritalStatus" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
        "code" : "UNK"
      }
    ]
  }
}