Da Vinci Payer Data Exchange
2.0.0 - STU2 United States of America flag

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 - XML Representation

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<Patient xmlns="http://hl7.org/fhir">
  <id value="100"/>
  <meta>
    <lastUpdated value="2020-07-07T13:26:22.0314215+00:00"/>
    <profile
             value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/>
  </meta>
  <language value="en-US"/>
  <text>
    <status value="generated"/>
    <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: https://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: 1234-234-1243-12345678901m</li><li>Health Plan Identifier: 1234-234-1243-12345678901u</li><li>Patient external identifier: 1234-234-1243-12345678901a</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>
  </text>
  <identifier>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="MB"/>
      </coding>
    </type>
    <system value="https://www.xxxhealthplan.com/fhir/memberidentifier"/>
    <value
           value="https://www.xxxhealthplan.com/fhir/memberidentifier#1234-234-1243-12345678901"/>
  </identifier>
  <identifier>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="MR"/>
      </coding>
    </type>
    <system value="https://www.xxxhealthplan.com/fhir/medicalrecordnumber"/>
    <value value="1234-234-1243-12345678901m"/>
  </identifier>
  <identifier>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="XV"/>
      </coding>
    </type>
    <system
            value="https://www.xxxhealthplan.com/fhir/uniquememberidentifier"/>
    <value value="1234-234-1243-12345678901u"/>
  </identifier>
  <identifier>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="PT"/>
      </coding>
    </type>
    <system value="https://www.xxxhealthplan.com/fhir/patacctnum"/>
    <value value="1234-234-1243-12345678901a"/>
  </identifier>
  <active value="true"/>
  <name>
    <family value="Appleseed"/>
    <given value="Johnny"/>
  </name>
  <telecom>
    <system value="phone"/>
    <value value="(443)555-1212"/>
    <rank value="1"/>
  </telecom>
  <telecom>
    <system value="phone"/>
    <value value="(410)678-2323"/>
    <rank value="2"/>
  </telecom>
  <gender value="male"/>
  <birthDate value="1986-01-01"/>
  <address>
    <type value="physical"/>
    <line value="123 Main Street"/>
    <city value="Pittsburgh"/>
    <state value="PA"/>
    <postalCode value="12519"/>
  </address>
  <maritalStatus>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/v3-NullFlavor"/>
      <code value="UNK"/>
    </coding>
  </maritalStatus>
</Patient>