This page is part of the Dental Data Exchange (v1.0.0: STU1) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions
<Bundle xmlns="http://hl7.org/fhir">
<id value="Complete-Dental-Referral-Note-Document-Bundle-Example"/>
<meta>
<versionId value="15"/>
<lastUpdated value="2021-08-27T15:26:44.763+00:00"/>
<source value="#CQB8fiR496ieQq0G"/>
<profile
value="http://hl7.org/fhir/us/dental-data-exchange/StructureDefinition/dental-bundle"/>
</meta>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:b417cad7-57b3-47a6-bab8-33fdae616839"/>
</identifier>
<type value="document"/>
<timestamp value="2021-04-11T10:30:00.000-08:00"/>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Composition/Med-2-Dental-Referral"/>
<resource>
<Composition>
<id value="Med-2-Dental-Referral"/>
<language value="en-US"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en-US" lang="en-US"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: http://any.org/1</p><p><b>status</b>: final</p><p><b>type</b>: <span title="Codes: {http://loinc.org 57134-9}">Dentistry Referral note</span></p><p><b>encounter</b>: <a href="#Encounter_Med-visit-1">PCP visit. Generated Summary: status: finished; <span title="{http://terminology.hl7.org/CodeSystem/v3-ActCode AMB}">ambulatory</span>; <span title="Codes: {http://www.ama-assn.org/go/cpt 99201}">Office Visit</span>; <span title="Codes: {http://terminology.hl7.org/CodeSystem/v3-ActPriority R}">routine</span>; period: Feb 14, 2020 8:00:14 PM --> Feb 14, 2020 8:30:14 PM</a></p><p><b>date</b>: Jan 14, 2020 3:10:14 AM</p><p><b>author</b>: <a href="#Practitioner_practitioner-M">Dr. John M, MD. Generated Summary: id: 1234569999; John M ; Phone: 303-303-6443; gender: male; birthDate: 1975-06-09</a></p><p><b>title</b>: Referral Note</p><h3>Attesters</h3><table class="grid"><tr><td>-</td><td><b>Mode</b></td><td><b>Time</b></td><td><b>Party</b></td></tr><tr><td>*</td><td>legal</td><td>Mar 14, 2020 9:10:14 AM</td><td><a href="#PractitionerRole_PractitionerRole-M">Dr. John M, MD. Generated Summary: <span title="Codes: {http://snomed.info/sct 394814009}">General practice (specialty)</span>; Phone: 5555557777</a></td></tr></table><p><b>custodian</b>: <a href="#Organization_GHC-organization">Good Health Clinic. Generated Summary: id: 1316452725; active: true; <span title="Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}">Healthcare Provider</span>; name: Good Health Clinic; Phone: (+1) 555-677-7777, customer-service@GHclinic.org</a></p></div>
</text>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="http://any.org/1"/>
</identifier>
<status value="final"/>
<type>
<coding>
<system value="http://loinc.org"/>
<code value="57134-9"/>
<display value="Dentistry Referral note"/>
</coding>
</type>
<subject>
<reference value="Patient/example-dental"/>
<display value="Patient A"/>
</subject>
<encounter>
<reference value="Encounter/Med-visit-1"/>
<display value="PCP visit"/>
</encounter>
<date value="2020-01-14T03:10:14Z"/>
<author>
<reference value="Practitioner/practitioner-M"/>
<display value="Dr. John M, MD"/>
</author>
<title value="Referral Note"/>
<attester>
<mode value="legal"/>
<time value="2020-03-14T09:10:14Z"/>
<party>
<reference value="PractitionerRole/PractitionerRole-M"/>
<display value="Dr. John M, MD"/>
</party>
</attester>
<custodian>
<reference value="Organization/GHC-organization"/>
<display value="Good Health Clinic"/>
</custodian>
<section>
<title value="Allergies and Intolerances Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="48765-2"/>
<display value="Allergies and adverse reactions Document"/>
</coding>
</code>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table>
<tr>
<td>
<b>Allergen</b>
</td>
<td>
<b>Code</b>
</td>
<td>
<b>Manifestation</b>
</td>
<td>
<b>Severity</b>
</td>
</tr>
<tr>
<td>Penicillin G</td>
<td>7908</td>
<td>Skin rash</td>
<td>mild</td>
</tr>
</table>
</div>
</text>
<entry>
<reference value="AllergyIntolerance/Allergy-example-dental"/>
</entry>
</section>
<section>
<title value="Medication Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="10160-0"/>
<display value="History of Medication use Narrative"/>
</coding>
</code>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table>
<tr>
<td>
<b>Medication</b>
</td>
<td>
<b>Directions</b>
</td>
<td>
<b>Start Date</b>
</td>
<td>
<b>Status</b>
</td>
<td>
<b>Indications</b>
</td>
<td>
<b>Fill Instructions</b>
</td>
</tr>
<tr>
<td>Lisinopril 10 mg tab</td>
<td>1 tab once/day</td>
<td/>
<td>Active</td>
<td/>
<td>Generic substitution allowed</td>
</tr>
</table>
</div>
</text>
<entry>
<reference value="MedicationRequest/Lisinopril-medreq"/>
</entry>
</section>
<section>
<title value="Problem Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="11450-4"/>
<display value="Problem list - Reported"/>
</coding>
</code>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<p> Mild, Hypertension</p>
<p> Type 1 diabetes</p>
<p> Teeth covered in plague</p>
<p> Toothache</p>
<p> Swollen Gums</p>
<p> Bleeding Gums</p>
<p> At high risk for dental carries</p>
</div>
</text>
<entry>
<reference value="Condition/HTN-example"/>
</entry>
<entry>
<reference value="Condition/DM1-example"/>
</entry>
<entry>
<reference value="Condition/Dental-plaque-example"/>
</entry>
<entry>
<reference value="Condition/toothache-example"/>
</entry>
<entry>
<reference value="Condition/Swollen-gums-example"/>
</entry>
<entry>
<reference value="Condition/Bleeding-gums-example"/>
</entry>
<entry>
<reference value="Condition/Caries-risk"/>
</entry>
</section>
<section>
<title value="Reason for Referral Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="42349-1"/>
<display value="Reason for referral (narrative)"/>
</coding>
</code>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<p>Toothache</p>
<p>Left lower quadrant pain</p>
<p>Bleeding gums</p>
</div>
</text>
<entry>
<reference value="ServiceRequest/example-dental-referral-1"/>
</entry>
</section>
<section>
<title value="Plan of Treatment Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="18776-5"/>
<display value="Plan of care note"/>
</coding>
</code>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<p>D0150 - Comprehensive Oral Evaluation</p>
</div>
</text>
<entry>
<reference value="Encounter/Comp-oral-eval"/>
</entry>
</section>
<section>
<title value="Assessment Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="51848-0"/>
<display value="Evaluation note"/>
</coding>
</code>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<p>Patient has pain in his lower left jaw and occassional bleeding from his gums - referring for dental evaluation.</p>
</div>
</text>
</section>
<section>
<title value="History of Present Illness Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="10164-2"/>
<display value="History of Present illness Narrative"/>
</coding>
</code>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<p>The patient has not visited a dentist or received flouride treatments in the past 4 years while away at college</p>
</div>
</text>
</section>
<section>
<title value="Immunizations Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="11369-6"/>
<display value="History of Immunization Narrative"/>
</coding>
</code>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table border="1" width="100%">
<thead>
<tr>
<th>Vaccine</th>
<th>Date</th>
<th>Status</th>
</tr>
</thead>
<tbody>
<tr>
<td>
Hepatitis B vaccine
</td>
<td>January 4, 2020</td>
<td>Completed</td>
</tr>
</tbody>
</table>
</div>
</text>
<entry>
<reference value="Immunization/imm-1"/>
</entry>
</section>
<section>
<title value="Medical Equipment Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="46264-8"/>
<display value="History of medical device use"/>
</coding>
</code>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table border="1" width="100%">
<thead>
<tr>
<th>Device Type</th>
<th>Procedure</th>
<th>Implant Date</th>
</tr>
</thead>
<tbody>
<tr>
<td>Insulin Pump</td>
<td>Insertion of insulin pump (procedure)</td>
<td>November 3, 2013</td>
</tr>
</tbody>
</table>
</div>
</text>
<entry>
<reference value="Procedure/Insulin-pump-insertion"/>
</entry>
</section>
<section>
<title value="Procedures Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="47519-4"/>
<display value="History of Procedures Document"/>
</coding>
</code>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<p>No Procedures performed</p>
</div>
</text>
</section>
<section>
<title value="Social History Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="29762-2"/>
<display value="Social history Narrative"/>
</coding>
</code>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table>
<tr>
<td>
<b>Social History Element</b>
</td>
<td>
<b>Description</b>
</td>
<td>
<b>Effective Dates</b>
</td>
</tr>
<tr>
<td>Smoking Status</td>
<td>NA</td>
<td>2005/05/01 - 2020/03/28</td>
</tr>
<tr>
<td>Highest Education Received</td>
<td>Collect Education</td>
<td>2010/05/01 - 2014/03/28</td>
</tr>
<tr>
<td>Employment</td>
<td>Full-time accountant</td>
<td>2015/05/01 - current</td>
</tr>
</table>
</div>
</text>
<entry>
<reference value="Observation/Smoker-obs-example-dental"/>
</entry>
<entry>
<reference value="Observation/Education-level-example-dental"/>
</entry>
<entry>
<reference value="Observation/Present-job-example-dental"/>
</entry>
</section>
<section>
<title value="Vital Signs Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="8716-3"/>
<display value="Vital signs"/>
</coding>
</code>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table>
<tr>
<td>
<b>Vital Sign</b>
</td>
<td>
<b>Date</b>
</td>
<td>
<b>Value</b>
</td>
</tr>
<tr>
<td>Temperature</td>
<td>2020/04/15</td>
<td>98.5</td>
</tr>
<tr>
<td>Heart Rate</td>
<td>2020/04/15</td>
<td>78</td>
</tr>
<tr>
<td>Respiration Rate</td>
<td>2020/04/15</td>
<td>20</td>
</tr>
<tr>
<td>Blood Pressure</td>
<td>2020/04/15</td>
<td>120/80</td>
</tr>
</table>
</div>
</text>
<entry>
<reference value="Observation/vitals-panel"/>
</entry>
</section>
<section>
<title value="Goals Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="61146-7"/>
<display value="Goals"/>
</coding>
</code>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<p>No soda/sugary drinks/energy drinks</p>
<p>Use fluoride toothpaste</p>
</div>
</text>
</section>
<section>
<title value="Health Concerns Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="75310-3"/>
<display value="Health concerns Document"/>
</coding>
</code>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<p>Neuropathy due to diabetes mellitus</p>
</div>
</text>
</section>
<section>
<title value="Instructions Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="69730-0"/>
<display value="Instructions"/>
</coding>
</code>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<p>Pt. Education. Advised to see dentist regularly, brush 2x/day w/ fluoride
toothpaste, floss</p>
</div>
</text>
<entry>
<reference value="Communication/dental-education"/>
</entry>
</section>
<section>
<title value="Payers Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="48768-6"/>
<display value="Payment sources Document"/>
</coding>
</code>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<p>Aetna Comprehensive Medical /Dental Insurance</p>
</div>
</text>
<entry>
<reference value="Coverage/Dental-Aetna"/>
</entry>
</section>
<section>
<title value="Dental Findings Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="8704-9"/>
<display value="Physical findings of Mouth and Throat and Teeth"/>
</coding>
</code>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<p>No Information</p>
</div>
</text>
</section>
</Composition>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Patient/example-dental"/>
<resource>
<Patient>
<id value="example-dental"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<div class="hapiHeaderText">Patient
<b>A </b>
</div>
<table class="hapiPropertyTable">
<tbody>
<tr>
<td>Identifier</td>
<td>5152020</td>
</tr>
<tr>
<td>Address</td>
<td>
<span>123 Test Dr. </span>
<br/>
<span>Denver </span>
<span>CO </span>
<span>US </span>
</td>
</tr>
<tr>
<td>Date of birth</td>
<td>
<span>01 January 1990</span>
</td>
</tr>
</tbody>
</table>
</div>
</text>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race">
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2106-3"/>
<display value="White"/>
</valueCoding>
</extension>
<extension url="detailed">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="1516-4"/>
<display value="Zuni"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="Mixed"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity">
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2135-2"/>
<display value="Hispanic or Latino"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="Hispanic or Latino"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex">
<valueCode value="M"/>
</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://clinic.goodhealth.org"/>
<value value="5152020"/>
</identifier>
<active value="true"/>
<name>
<family value="A"/>
<given value="Patient"/>
</name>
<telecom>
<system value="phone"/>
<value value="123-456-7890"/>
<use value="home"/>
</telecom>
<telecom>
<system value="email"/>
<value value="testA@email.com"/>
</telecom>
<gender value="male"/>
<birthDate value="1990-01-01"/>
<address>
<line value="123 Test Dr."/>
<city value="Denver"/>
<state value="CO"/>
<postalCode value="80204"/>
<country value="US"/>
</address>
</Patient>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Encounter/Med-visit-1"/>
<resource>
<Encounter>
<id value="Med-visit-1"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>status</b>: finished</p><p><b>class</b>: <span title="{http://terminology.hl7.org/CodeSystem/v3-ActCode AMB}">ambulatory</span></p><p><b>type</b>: <span title="Codes: {http://www.ama-assn.org/go/cpt 99201}">Office Visit</span></p><p><b>priority</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/v3-ActPriority R}">routine</span></p><p><b>subject</b>: <a href="#Patient_example-dental">See above (Patient/example-dental)</a></p><p><b>period</b>: Feb 14, 2020 8:00:14 PM --> Feb 14, 2020 8:30:14 PM</p></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="99201"/>
<display value="Level 1 New Patient Office Visit"/>
</coding>
<text value="Office Visit"/>
</type>
<priority>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActPriority"/>
<code value="R"/>
<display value="routine"/>
</coding>
</priority>
<subject>
<reference value="Patient/example-dental"/>
</subject>
<period>
<start value="2020-02-14T15:00:14-05:00"/>
<end value="2020-02-14T15:30:14-05:00"/>
</period>
</Encounter>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/PractitionerRole/PractitionerRole-M"/>
<resource>
<PractitionerRole>
<id value="PractitionerRole-M"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>practitioner</b>: <a href="#Practitioner_practitioner-M">Dr. John M. Generated Summary: id: 1234569999; John M ; Phone: 303-303-6443; gender: male; birthDate: 1975-06-09</a></p><p><b>organization</b>: <a href="#Organization_GHC-organization">Good Health Clinic. Generated Summary: id: 1316452725; active: true; <span title="Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}">Healthcare Provider</span>; name: Good Health Clinic; Phone: (+1) 555-677-7777, customer-service@GHclinic.org</a></p><p><b>specialty</b>: <span title="Codes: {http://snomed.info/sct 394814009}">General practice (specialty)</span></p><p><b>telecom</b>: ph: 5555557777</p></div>
</text>
<practitioner>
<reference value="Practitioner/practitioner-M"/>
<display value="Dr. John M"/>
</practitioner>
<organization>
<reference value="Organization/GHC-organization"/>
<display value="Good Health Clinic"/>
</organization>
<specialty>
<coding>
<system value="http://snomed.info/sct"/>
<code value="394814009"/>
<display value="General practice (specialty)"/>
</coding>
</specialty>
<telecom>
<system value="phone"/>
<value value="5555557777"/>
</telecom>
</PractitionerRole>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Practitioner/practitioner-M"/>
<resource>
<Practitioner>
<id value="practitioner-M"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 1234569999</p><p><b>name</b>: John M </p><p><b>telecom</b>: ph: 303-303-6443(WORK)</p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1975-06-09</p></div>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="1234569999"/>
</identifier>
<name>
<family value="M"/>
<given value="John"/>
<prefix value="Dr"/>
</name>
<telecom>
<system value="phone"/>
<value value="303-303-6443"/>
<use value="work"/>
</telecom>
<gender value="male"/>
<birthDate value="1975-06-09"/>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Organization/GHC-organization"/>
<resource>
<Organization>
<id value="GHC-organization"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 1316452725</p><p><b>active</b>: true</p><p><b>type</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}">Healthcare Provider</span></p><p><b>name</b>: Good Health Clinic</p><p><b>telecom</b>: ph: (+1) 555-677-7777, <a href="mailto:customer-service@GHclinic.org">customer-service@GHclinic.org</a></p><p><b>address</b>: 7551 W Alameda Ave Lakewood CO 80226 USA </p></div>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="1316452725"/>
</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="Good Health Clinic"/>
<telecom>
<system value="phone"/>
<value value="(+1) 555-677-7777"/>
</telecom>
<telecom>
<system value="email"/>
<value value="customer-service@GHclinic.org"/>
</telecom>
<address>
<line value="7551 W Alameda Ave"/>
<city value="Lakewood"/>
<state value="CO"/>
<postalCode value="80226"/>
<country value="USA"/>
</address>
</Organization>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/AllergyIntolerance/Allergy-example-dental"/>
<resource>
<AllergyIntolerance>
<id value="Allergy-example-dental"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>clinicalStatus</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical active}">Active</span></p><p><b>verificationStatus</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/allergyintolerance-verification confirmed}">Confirmed</span></p><p><b>category</b>: medication</p><p><b>criticality</b>: high</p><p><b>code</b>: <span title="Codes: {http://www.nlm.nih.gov/research/umls/rxnorm 7980}">Penicillin G (Ingredient)</span></p><p><b>patient</b>: <a href="#Patient_example-dental">Patient A. Generated Summary: Medical Record Number: 5152020 (USUAL); active: true; Patient A ; Phone: 123-456-7890, testA@email.com; gender: male; birthDate: 1990-01-01</a></p><p><b>onset</b>: 1998-05-01</p></div>
</text>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical"/>
<code value="active"/>
</coding>
</clinicalStatus>
<verificationStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/allergyintolerance-verification"/>
<code value="confirmed"/>
</coding>
</verificationStatus>
<category value="medication"/>
<criticality value="high"/>
<code>
<coding>
<system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="7980"/>
<display value="Penicillin G"/>
</coding>
<text value="Penicillin G (Ingredient)"/>
</code>
<patient>
<reference value="Patient/example-dental"/>
<display value="Patient A"/>
</patient>
<onsetDateTime value="1998-05-01"/>
</AllergyIntolerance>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/MedicationRequest/Lisinopril-medreq"/>
<resource>
<MedicationRequest>
<id value="Lisinopril-medreq"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>status</b>: active</p><p><b>intent</b>: plan</p><p><b>medication</b>: <a href="#Medication_Lisinopril-med-example">See above (Medication/Lisinopril-med-example)</a></p><p><b>subject</b>: <a href="#Patient_example-dental">Patient A. Generated Summary: Medical Record Number: 5152020 (USUAL); active: true; Patient A ; Phone: 123-456-7890, testA@email.com; gender: male; birthDate: 1990-01-01</a></p><p><b>authoredOn</b>: 2020-02-14</p><p><b>requester</b>: <a href="#Practitioner_practitioner-M">Dr. John M, MD. Generated Summary: id: 1234569999; John M ; Phone: 303-303-6443; gender: male; birthDate: 1975-06-09</a></p><p><b>reasonReference</b>: <a href="#Condition_HTN-example">See above (Condition/HTN-example)</a></p></div>
</text>
<status value="active"/>
<intent value="plan"/>
<medicationReference>
<reference value="Medication/Lisinopril-med-example"/>
</medicationReference>
<subject>
<reference value="Patient/example-dental"/>
<display value="Patient A"/>
</subject>
<authoredOn value="2020-02-14"/>
<requester>
<reference value="Practitioner/practitioner-M"/>
<display value="Dr. John M, MD"/>
</requester>
<reasonReference>
<reference value="Condition/HTN-example"/>
</reasonReference>
<dosageInstruction>
<text value="Take 1 tab once a day"/>
<timing>
<repeat>
<boundsPeriod>
<start value="2020-01-03"/>
</boundsPeriod>
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct"/>
<code value="26643006"/>
<display value="Oral use"/>
</coding>
</route>
</dosageInstruction>
</MedicationRequest>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Medication/Lisinopril-med-example"/>
<resource>
<Medication>
<id value="Lisinopril-med-example"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<div class="hapiHeaderText">Lisinopril 10 mg tab</div>
</div>
</text>
<code>
<coding>
<system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="314076"/>
<display value="Lisinopril 10 mg Oral Tablet"/>
</coding>
<text value="Lisinopril 10 mg Oral Tablet"/>
</code>
</Medication>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Condition/HTN-example"/>
<resource>
<Condition>
<id value="HTN-example"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>clinicalStatus</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-clinical active}">Active</span></p><p><b>verificationStatus</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-ver-status confirmed}">Confirmed</span></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-category problem-list-item}">Problem</span></p><p><b>code</b>: <span title="Codes: {http://snomed.info/sct 38341003}, {http://www.ada.org/snodent 175027D}">Hypertensive disorder (disorder)</span></p><p><b>subject</b>: <a href="#Patient_example-dental">Patient A. Generated Summary: Medical Record Number: 5152020 (USUAL); active: true; Patient A ; Phone: 123-456-7890, testA@email.com; gender: male; birthDate: 1990-01-01</a></p><p><b>onset</b>: 2013-07-06</p><p><b>asserter</b>: <a href="#Practitioner_practitioner-UNK">See above (Practitioner/practitioner-UNK)</a></p></div>
</text>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
<display value="Active"/>
</coding>
<text value="Active"/>
</clinicalStatus>
<verificationStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="confirmed"/>
<display value="Confirmed"/>
</coding>
<text value="Confirmed"/>
</verificationStatus>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-category"/>
<code value="problem-list-item"/>
<display value="Problem List Item"/>
</coding>
<text value="Problem"/>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="38341003"/>
<display value="High blood pressure"/>
</coding>
<coding>
<system value="http://www.ada.org/snodent"/>
<code value="175027D"/>
<display value="High blood pressure"/>
</coding>
<text value="Hypertensive disorder (disorder)"/>
</code>
<subject>
<reference value="Patient/example-dental"/>
<display value="Patient A"/>
</subject>
<onsetDateTime value="2013-07-06"/>
<asserter>
<reference value="Practitioner/practitioner-UNK"/>
</asserter>
</Condition>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Condition/DM1-example"/>
<resource>
<Condition>
<id value="DM1-example"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>clinicalStatus</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-clinical active}">Active</span></p><p><b>verificationStatus</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-ver-status confirmed}">Confirmed</span></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-category problem-list-item}">Problem</span></p><p><b>code</b>: <span title="Codes: {http://snomed.info/sct 46635009}, {http://www.ada.org/snodent 175321D}">Diabetes mellitus type I</span></p><p><b>subject</b>: <a href="#Patient_example-dental">Patient A. Generated Summary: Medical Record Number: 5152020 (USUAL); active: true; Patient A ; Phone: 123-456-7890, testA@email.com; gender: male; birthDate: 1990-01-01</a></p><p><b>onset</b>: 2013-07-06</p><p><b>asserter</b>: <a href="#Practitioner_practitioner-UNK">See above (Practitioner/practitioner-UNK)</a></p></div>
</text>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
<display value="Active"/>
</coding>
<text value="Active"/>
</clinicalStatus>
<verificationStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="confirmed"/>
<display value="Confirmed"/>
</coding>
<text value="Confirmed"/>
</verificationStatus>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-category"/>
<code value="problem-list-item"/>
<display value="Problem List Item"/>
</coding>
<text value="Problem"/>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="46635009"/>
<display value="Diabetes mellitus type I"/>
</coding>
<coding>
<system value="http://www.ada.org/snodent"/>
<code value="175321D"/>
<display value="Diabetes mellitus type I"/>
</coding>
<text value="Diabetes mellitus type I"/>
</code>
<subject>
<reference value="Patient/example-dental"/>
<display value="Patient A"/>
</subject>
<onsetDateTime value="2013-07-06"/>
<asserter>
<reference value="Practitioner/practitioner-UNK"/>
</asserter>
</Condition>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Condition/Dental-plaque-example"/>
<resource>
<Condition>
<id value="Dental-plaque-example"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>clinicalStatus</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-clinical active}">Active</span></p><p><b>verificationStatus</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-ver-status confirmed}">Confirmed</span></p><p><b>category</b>: <span title="Codes: {http://hl7.org/fhir/us/core/CodeSystem/condition-category health-concern}">Health Concern</span></p><p><b>code</b>: <span title="Codes: {http://snomed.info/sct 276453000}, {http://www.ada.org/snodent 108723D}">Teeth covered in plaque (finding)</span></p><p><b>subject</b>: <a href="#Patient_example-dental">Patient A. Generated Summary: Medical Record Number: 5152020 (USUAL); active: true; Patient A ; Phone: 123-456-7890, testA@email.com; gender: male; birthDate: 1990-01-01</a></p><p><b>onset</b>: 2013-07-06</p><p><b>asserter</b>: <a href="#Practitioner_practitioner-UNK">See above (Practitioner/practitioner-UNK)</a></p></div>
</text>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
<display value="Active"/>
</coding>
<text value="Active"/>
</clinicalStatus>
<verificationStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="confirmed"/>
<display value="Confirmed"/>
</coding>
<text value="Confirmed"/>
</verificationStatus>
<category>
<coding>
<system
value="http://hl7.org/fhir/us/core/CodeSystem/condition-category"/>
<code value="health-concern"/>
<display value="Health Concern"/>
</coding>
<text value="Health Concern"/>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="276453000"/>
<display value="Teeth covered in plaque (finding)"/>
</coding>
<coding>
<system value="http://www.ada.org/snodent"/>
<code value="108723D"/>
<display value="Teeth covered in plaque (finding)"/>
</coding>
<text value="Teeth covered in plaque (finding)"/>
</code>
<subject>
<reference value="Patient/example-dental"/>
<display value="Patient A"/>
</subject>
<onsetDateTime value="2013-07-06"/>
<asserter>
<reference value="Practitioner/practitioner-UNK"/>
</asserter>
</Condition>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Practitioner/practitioner-UNK"/>
<resource>
<Practitioner>
<id value="practitioner-UNK"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 555555555</p><p><b>name</b>: UNK </p></div>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="555555555"/>
</identifier>
<name>
<family value="UNK">
<extension
url="http://hl7.org/fhir/StructureDefinition/data-absent-reason">
<valueCode value="unknown"/>
</extension>
</family>
</name>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Condition/toothache-example"/>
<resource>
<Condition>
<id value="toothache-example"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>clinicalStatus</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-clinical active}">Active</span></p><p><b>verificationStatus</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-ver-status confirmed}">Confirmed</span></p><p><b>category</b>: <span title="Codes: {http://hl7.org/fhir/us/core/CodeSystem/condition-category health-concern}">Health Concern</span></p><p><b>code</b>: <span title="Codes: {http://snomed.info/sct 27355003}, {http://www.ada.org/snodent 131687D}">Toothache (finding)</span></p><p><b>subject</b>: <a href="#Patient_example-dental">Patient A. Generated Summary: Medical Record Number: 5152020 (USUAL); active: true; Patient A ; Phone: 123-456-7890, testA@email.com; gender: male; birthDate: 1990-01-01</a></p><p><b>onset</b>: 2020-02-14</p></div>
</text>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
<display value="Active"/>
</coding>
<text value="Active"/>
</clinicalStatus>
<verificationStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="confirmed"/>
<display value="Confirmed"/>
</coding>
<text value="Confirmed"/>
</verificationStatus>
<category>
<coding>
<system
value="http://hl7.org/fhir/us/core/CodeSystem/condition-category"/>
<code value="health-concern"/>
<display value="Health Concern"/>
</coding>
<text value="Health Concern"/>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="27355003"/>
<display value="Toothache (finding)"/>
</coding>
<coding>
<system value="http://www.ada.org/snodent"/>
<code value="131687D"/>
<display value="Toothache (finding)"/>
</coding>
<text value="Toothache (finding)"/>
</code>
<subject>
<reference value="Patient/example-dental"/>
<display value="Patient A"/>
</subject>
<onsetDateTime value="2020-02-14"/>
</Condition>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Condition/Swollen-gums-example"/>
<resource>
<Condition>
<id value="Swollen-gums-example"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>clinicalStatus</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-clinical active}">Active</span></p><p><b>verificationStatus</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-ver-status confirmed}">Confirmed</span></p><p><b>category</b>: <span title="Codes: {http://hl7.org/fhir/us/core/CodeSystem/condition-category health-concern}">Health Concern</span>, <span title="Codes: {http://hl7.org/fhir/us/dental-data-exchange/CodeSystem/dental-category dental}">Dental</span></p><p><b>code</b>: <span title="Codes: {http://www.ada.org/snodent 148393D}, {http://snomed.info/sct 309685001}">Swollen gums (finding)</span></p><p><b>subject</b>: <a href="#Patient_example-dental">Patient A. Generated Summary: Medical Record Number: 5152020 (USUAL); active: true; Patient A ; Phone: 123-456-7890, testA@email.com; gender: male; birthDate: 1990-01-01</a></p><p><b>onset</b>: 2020-02-14</p></div>
</text>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
<display value="Active"/>
</coding>
<text value="Active"/>
</clinicalStatus>
<verificationStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="confirmed"/>
<display value="Confirmed"/>
</coding>
<text value="Confirmed"/>
</verificationStatus>
<category>
<coding>
<system
value="http://hl7.org/fhir/us/core/CodeSystem/condition-category"/>
<code value="health-concern"/>
<display value="Health Concern"/>
</coding>
<text value="Health Concern"/>
</category>
<category>
<coding>
<system
value="http://hl7.org/fhir/us/dental-data-exchange/CodeSystem/dental-category"/>
<code value="dental"/>
<display value="Dental"/>
</coding>
</category>
<code>
<coding>
<system value="http://www.ada.org/snodent"/>
<code value="148393D"/>
<display value="Swollen gums (finding)"/>
</coding>
<coding>
<system value="http://snomed.info/sct"/>
<code value="309685001"/>
<display value="Swollen gums (finding)"/>
</coding>
<text value="Swollen gums (finding)"/>
</code>
<subject>
<reference value="Patient/example-dental"/>
<display value="Patient A"/>
</subject>
<onsetDateTime value="2020-02-14"/>
</Condition>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Condition/Bleeding-gums-example"/>
<resource>
<Condition>
<id value="Bleeding-gums-example"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>clinicalStatus</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-clinical active}">Active</span></p><p><b>verificationStatus</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-ver-status confirmed}">Confirmed</span></p><p><b>category</b>: <span title="Codes: {http://hl7.org/fhir/us/core/CodeSystem/condition-category health-concern}">Health Concern</span>, <span title="Codes: {http://hl7.org/fhir/us/dental-data-exchange/CodeSystem/dental-category dental}">Dental</span></p><p><b>code</b>: <span title="Codes: {http://www.ada.org/snodent 148393D}, {http://snomed.info/sct 86276007}">Bleeding gums</span></p><p><b>subject</b>: <a href="#Patient_example-dental">Patient A. Generated Summary: Medical Record Number: 5152020 (USUAL); active: true; Patient A ; Phone: 123-456-7890, testA@email.com; gender: male; birthDate: 1990-01-01</a></p><p><b>onset</b>: 2020-02-14</p></div>
</text>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
<display value="Active"/>
</coding>
<text value="Active"/>
</clinicalStatus>
<verificationStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="confirmed"/>
<display value="Confirmed"/>
</coding>
<text value="Confirmed"/>
</verificationStatus>
<category>
<coding>
<system
value="http://hl7.org/fhir/us/core/CodeSystem/condition-category"/>
<code value="health-concern"/>
<display value="Health Concern"/>
</coding>
<text value="Health Concern"/>
</category>
<category>
<coding>
<system
value="http://hl7.org/fhir/us/dental-data-exchange/CodeSystem/dental-category"/>
<code value="dental"/>
<display value="Dental"/>
</coding>
</category>
<code>
<coding>
<system value="http://www.ada.org/snodent"/>
<code value="148393D"/>
<display value="Bleeding gums"/>
</coding>
<coding>
<system value="http://snomed.info/sct"/>
<code value="86276007"/>
<display value="Bleeding gums"/>
</coding>
<text value="Bleeding gums"/>
</code>
<subject>
<reference value="Patient/example-dental"/>
<display value="Patient A"/>
</subject>
<onsetDateTime value="2020-02-14"/>
</Condition>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Condition/Caries-risk"/>
<resource>
<Condition>
<id value="Caries-risk"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>clinicalStatus</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-clinical active}">Active</span></p><p><b>verificationStatus</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-ver-status confirmed}">Confirmed</span></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-category problem-list-item}">Problem</span>, <span title="Codes: {http://hl7.org/fhir/us/dental-data-exchange/CodeSystem/dental-category dental}">Dental</span></p><p><b>code</b>: <span title="Codes: {http://www.ada.org/snodent 179051D}, {http://snomed.info/sct 609402003}">At high risk for dental caries (finding)</span></p><p><b>subject</b>: <a href="#Patient_example-dental">Patient A. Generated Summary: Medical Record Number: 5152020 (USUAL); active: true; Patient A ; Phone: 123-456-7890, testA@email.com; gender: male; birthDate: 1990-01-01</a></p><p><b>onset</b>: 2020-02-14</p></div>
</text>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
<display value="Active"/>
</coding>
<text value="Active"/>
</clinicalStatus>
<verificationStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="confirmed"/>
<display value="Confirmed"/>
</coding>
<text value="Confirmed"/>
</verificationStatus>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-category"/>
<code value="problem-list-item"/>
<display value="Problem List Item"/>
</coding>
<text value="Problem"/>
</category>
<category>
<coding>
<system
value="http://hl7.org/fhir/us/dental-data-exchange/CodeSystem/dental-category"/>
<code value="dental"/>
<display value="Dental"/>
</coding>
</category>
<code>
<coding>
<system value="http://www.ada.org/snodent"/>
<code value="179051D"/>
<display value="At high risk for dental caries (finding)"/>
</coding>
<coding>
<system value="http://snomed.info/sct"/>
<code value="609402003"/>
<display value="At high risk for dental caries (finding)"/>
</coding>
<text value="At high risk for dental caries (finding)"/>
</code>
<subject>
<reference value="Patient/example-dental"/>
<display value="Patient A"/>
</subject>
<onsetDateTime value="2020-02-14"/>
</Condition>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/ServiceRequest/example-dental-referral-1"/>
<resource>
<ServiceRequest>
<id value="example-dental-referral-1"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: urn:uid:0c2aacfc-ce7d-4652-b9ea-7280ea21dec4</p><p><b>status</b>: active</p><p><b>intent</b>: plan</p><p><b>category</b>: <span title="Codes: {http://snomed.info/sct 14736009}">Evaluation and management of patient (procedure)</span></p><p><b>priority</b>: asap</p><p><b>code</b>: <span title="Codes: {http://snomed.info/sct 103697008}">Patient referral for dental care (procedure)</span></p><p><b>subject</b>: <a href="#Patient_example-dental">See above (Patient/example-dental)</a></p><p><b>requester</b>: <a href="#Practitioner_practitioner-M">See above (Practitioner/practitioner-M)</a></p><p><b>reasonReference</b>: </p><ul><li><a href="#Condition_toothache-example">See above (Condition/toothache-example)</a></li><li><a href="Condition-LLQP-example.html">Generated Summary: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-clinical active}">Active</span>; <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-ver-status confirmed}">Confirmed</span>; <span title="Codes: {http://hl7.org/fhir/us/dental-data-exchange/CodeSystem/dental-category dental}">Dental</span>, <span title="Codes: {http://hl7.org/fhir/us/core/CodeSystem/condition-category health-concern}">Health Concern problem</span>; <span title="Codes: {http://snomed.info/sct 301716002}">Left lower quadrant pain</span></a></li><li><a href="#Condition_Bleeding-gums-example">See above (Condition/Bleeding-gums-example)</a></li></ul></div>
</text>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uid:0c2aacfc-ce7d-4652-b9ea-7280ea21dec4"/>
</identifier>
<status value="active"/>
<intent value="plan"/>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="14736009"/>
<display
value="History and physical examination with evaluation and management of patient (procedure)"/>
</coding>
<text value="Evaluation and management of patient (procedure)"/>
</category>
<priority value="asap"/>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="103697008"/>
<display value="Patient referral for dental care (procedure)"/>
</coding>
<text value="Patient referral for dental care (procedure)"/>
</code>
<subject>
<reference value="Patient/example-dental"/>
</subject>
<requester>
<reference value="Practitioner/practitioner-M"/>
</requester>
<reasonReference>
<reference value="Condition/toothache-example"/>
</reasonReference>
<reasonReference>
<reference value="Condition/LLQP-example"/>
</reasonReference>
<reasonReference>
<reference value="Condition/Bleeding-gums-example"/>
</reasonReference>
</ServiceRequest>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Encounter/Comp-oral-eval"/>
<resource>
<Encounter>
<id value="Comp-oral-eval"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>status</b>: planned</p><p><b>class</b>: <span title="{http://terminology.hl7.org/CodeSystem/v3-ActCode AMB}">ambulatory</span></p><p><b>type</b>: <span title="Codes: {http://ada.org/cdt D0150}">Comprehensive Oral Evaluation</span></p><p><b>priority</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/v3-ActPriority R}">routine</span></p><p><b>subject</b>: <a href="#Patient_example-dental">See above (Patient/example-dental)</a></p><p><b>period</b>: Mar 10, 2020 8:00:14 PM --> Mar 10, 2020 8:30:14 PM</p></div>
</text>
<status value="planned"/>
<class>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="AMB"/>
<display value="ambulatory"/>
</class>
<type>
<coding>
<system value="http://ada.org/cdt"/>
<code value="D0150"/>
</coding>
<text value="Comprehensive Oral Evaluation"/>
</type>
<priority>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActPriority"/>
<code value="R"/>
<display value="routine"/>
</coding>
</priority>
<subject>
<reference value="Patient/example-dental"/>
</subject>
<period>
<start value="2020-03-10T15:00:14-05:00"/>
<end value="2020-03-10T15:30:14-05:00"/>
</period>
</Encounter>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Immunization/imm-1"/>
<resource>
<Immunization>
<id value="imm-1"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>status</b>: completed</p><p><b>vaccineCode</b>: <span title="Codes: {http://hl7.org/fhir/sid/cvx 08}">hepatitis B vaccine, pediatric or pediatric/adolescent dosage</span></p><p><b>patient</b>: <a href="#Patient_example-dental">Patient A. Generated Summary: Medical Record Number: 5152020 (USUAL); active: true; Patient A ; Phone: 123-456-7890, testA@email.com; gender: male; birthDate: 1990-01-01</a></p><p><b>occurrence</b>: 2020-01-04</p><p><b>primarySource</b>: false</p></div>
</text>
<status value="completed"/>
<vaccineCode>
<coding>
<system value="http://hl7.org/fhir/sid/cvx"/>
<code value="08"/>
<display
value="hepatitis B vaccine, pediatric or pediatric/adolescent dosage"/>
</coding>
</vaccineCode>
<patient>
<reference value="Patient/example-dental"/>
<display value="Patient A"/>
</patient>
<occurrenceDateTime value="2020-01-04"/>
<primarySource value="false"/>
</Immunization>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Procedure/Insulin-pump-insertion"/>
<resource>
<Procedure>
<id value="Insulin-pump-insertion"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: urn:uuid:b2a737f2-2fdb-49c1-b097-dac173d07aff</p><p><b>status</b>: completed</p><p><b>code</b>: <span title="Codes: {http://snomed.info/sct 443263006}">Insertion of insulin pump (procedure)</span></p><p><b>subject</b>: <a href="#Patient_example-dental">See above (Patient/example-dental)</a></p><p><b>performed</b>: 2013-11-03</p></div>
</text>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:b2a737f2-2fdb-49c1-b097-dac173d07aff"/>
</identifier>
<status value="completed"/>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="443263006"/>
</coding>
<text value="Insertion of insulin pump (procedure)"/>
</code>
<subject>
<reference value="Patient/example-dental"/>
</subject>
<performedDateTime value="2013-11-03"/>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Observation/Smoker-obs-example-dental"/>
<resource>
<Observation>
<id value="Smoker-obs-example-dental"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category social-history}">Social History</span></p><p><b>code</b>: <span title="Codes: {http://loinc.org 72166-2}">Tobacco smoking status</span></p><p><b>subject</b>: <a href="#Patient_example-dental">Patient A. Generated Summary: Medical Record Number: 5152020 (USUAL); active: true; Patient A ; Phone: 123-456-7890, testA@email.com; gender: male; birthDate: 1990-01-01</a></p><p><b>issued</b>: Jan 15, 2020 5:27:04 AM</p><p><b>value</b>: <span title="Codes: {http://snomed.info/sct 266919005}">Never smoked tobacco (finding)</span></p></div>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="social-history"/>
<display value="Social History"/>
</coding>
<text value="Social History"/>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="72166-2"/>
<display value="Tobacco smoking status"/>
</coding>
<text value="Tobacco smoking status"/>
</code>
<subject>
<reference value="Patient/example-dental"/>
<display value="Patient A"/>
</subject>
<issued value="2020-01-15T05:27:04Z"/>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="266919005"/>
<display value="Never smoked tobacco (finding)"/>
</coding>
<text value="Never smoked tobacco (finding)"/>
</valueCodeableConcept>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Observation/Education-level-example-dental"/>
<resource>
<Observation>
<id value="Education-level-example-dental"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>code</b>: <span title="Codes: {http://loinc.org 82589-3}">Highest Level of Education</span></p><p><b>subject</b>: <a href="#Patient_example-dental">Patient A. Generated Summary: Medical Record Number: 5152020 (USUAL); active: true; Patient A ; Phone: 123-456-7890, testA@email.com; gender: male; birthDate: 1990-01-01</a></p><p><b>effective</b>: 2012-01-01 --> 2016-01-01</p><p><b>value</b>: <span title="Codes: {http://snomed.info/sct 224302000}">Received higher education college education (finding)</span></p></div>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="82589-3"/>
<display value="Highest Level of Education"/>
</coding>
</code>
<subject>
<reference value="Patient/example-dental"/>
<display value="Patient A"/>
</subject>
<effectivePeriod>
<start value="2012-01-01"/>
<end value="2016-01-01"/>
</effectivePeriod>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="224302000"/>
<display
value="Received higher education college education (finding)"/>
</coding>
</valueCodeableConcept>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Observation/Present-job-example-dental"/>
<resource>
<Observation>
<id value="Present-job-example-dental"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>code</b>: <span title="Codes: {http://loinc.org 11341-5}">History of Occupation</span></p><p><b>subject</b>: <a href="#Patient_example-dental">Patient A. Generated Summary: Medical Record Number: 5152020 (USUAL); active: true; Patient A ; Phone: 123-456-7890, testA@email.com; gender: male; birthDate: 1990-01-01</a></p><p><b>effective</b>: 2015-01-01 --> (ongoing)</p><p><b>value</b>: <span title="Codes: {urn:oid:2.16.840.1.114222.4.11.7186 0800}">Accountants and Auditors</span></p></div>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="11341-5"/>
<display value="History of Occupation"/>
</coding>
</code>
<subject>
<reference value="Patient/example-dental"/>
<display value="Patient A"/>
</subject>
<effectivePeriod>
<start value="2015-01-01"/>
</effectivePeriod>
<valueCodeableConcept>
<coding>
<system value="urn:oid:2.16.840.1.114222.4.11.7186"/>
<code value="0800"/>
<display value="Accountants and Auditors"/>
</coding>
</valueCodeableConcept>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Observation/vitals-panel"/>
<resource>
<Observation>
<id value="vitals-panel"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category vital-signs}">Vital Signs</span></p><p><b>code</b>: <span title="Codes: {http://loinc.org 85353-1}">Vital signs Panel</span></p><p><b>subject</b>: <a href="#Patient_example-dental">See above (Patient/example-dental)</a></p><p><b>effective</b>: 2020-02-14</p><p><b>hasMember</b>: </p><ul><li><a href="#Observation_respiratory-rate">Respiratory Rate. Generated Summary: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category vital-signs}">Vital Signs</span>; <span title="Codes: {http://loinc.org 9279-1}">Respiratory rate</span>; effective: 2020-02-14; 20 breaths/minute</a></li><li><a href="#Observation_heart-rate">Heart Rate. Generated Summary: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category vital-signs}">Vital Signs</span>; <span title="Codes: {http://loinc.org 8867-4}">Heart rate</span>; effective: 1999-07-02; 78 beats/minute</a></li><li><a href="#Observation_blood-pressure">Blood Pressure. Generated Summary: id: urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281; <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category vital-signs}">Vital Signs</span>; <span title="Codes: {http://loinc.org 85354-9}">Blood pressure systolic & diastolic</span>; effective: 2020-02-14</a></li><li><a href="#Observation_body-temperature">Body Temperature. Generated Summary: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category vital-signs}">Vital Signs</span>; <span title="Codes: {http://loinc.org 8310-5}">Body temperature</span>; effective: 2020-02-14; 36.9 C</a></li></ul></div>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="vital-signs"/>
<display value="Vital Signs"/>
</coding>
<text value="Vital Signs"/>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="85353-1"/>
<display
value="Vital signs, weight, height, head circumference, oxygen saturation and BMI panel"/>
</coding>
<text value="Vital signs Panel"/>
</code>
<subject>
<reference value="Patient/example-dental"/>
</subject>
<effectiveDateTime value="2020-02-14"/>
<hasMember>
<reference value="Observation/respiratory-rate"/>
<display value="Respiratory Rate"/>
</hasMember>
<hasMember>
<reference value="Observation/heart-rate"/>
<display value="Heart Rate"/>
</hasMember>
<hasMember>
<reference value="Observation/blood-pressure"/>
<display value="Blood Pressure"/>
</hasMember>
<hasMember>
<reference value="Observation/body-temperature"/>
<display value="Body Temperature"/>
</hasMember>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Communication/dental-education"/>
<resource>
<Communication>
<id value="dental-education"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>status</b>: completed</p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/communication-category instruction}">Instruction</span></p><p><b>subject</b>: <a href="#Patient_example-dental">See above (Patient/example-dental)</a></p><p><b>encounter</b>: <a href="#Encounter_Med-visit-1">See above (Encounter/Med-visit-1)</a></p><p><b>recipient</b>: <a href="#Patient_example-dental">See above (Patient/example-dental)</a></p><p><b>sender</b>: <a href="#Practitioner_practitioner-M">See above (Practitioner/practitioner-M)</a></p><h3>Payloads</h3><table class="grid"><tr><td>-</td><td><b>Content[x]</b></td></tr><tr><td>*</td><td>Pt. Education. Advised to see dentist regularly, brush 2x/day w/ fluoride toothpaste, floss</td></tr></table></div>
</text>
<status value="completed"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/communication-category"/>
<code value="instruction"/>
<display value="Instruction"/>
</coding>
</category>
<subject>
<reference value="Patient/example-dental"/>
</subject>
<encounter>
<reference value="Encounter/Med-visit-1"/>
</encounter>
<recipient>
<reference value="Patient/example-dental"/>
</recipient>
<sender>
<reference value="Practitioner/practitioner-M"/>
</sender>
<payload>
<contentString
value="Pt. Education. Advised to see dentist regularly, brush 2x/day w/ fluoride toothpaste, floss"/>
</payload>
</Communication>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Observation/respiratory-rate"/>
<resource>
<Observation>
<id value="respiratory-rate"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category vital-signs}">Vital Signs</span></p><p><b>code</b>: <span title="Codes: {http://loinc.org 9279-1}">Respiratory rate</span></p><p><b>subject</b>: <a href="#Patient_example-dental">See above (Patient/example-dental)</a></p><p><b>effective</b>: 2020-02-14</p><p><b>value</b>: 20 breaths/minute</p></div>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="vital-signs"/>
<display value="Vital Signs"/>
</coding>
<text value="Vital Signs"/>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="9279-1"/>
<display value="Respiratory rate"/>
</coding>
<text value="Respiratory rate"/>
</code>
<subject>
<reference value="Patient/example-dental"/>
</subject>
<effectiveDateTime value="2020-02-14"/>
<valueQuantity>
<value value="20"/>
<unit value="breaths/minute"/>
<system value="http://unitsofmeasure.org"/>
<code value="/min"/>
</valueQuantity>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Observation/heart-rate"/>
<resource>
<Observation>
<id value="heart-rate"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category vital-signs}">Vital Signs</span></p><p><b>code</b>: <span title="Codes: {http://loinc.org 8867-4}">Heart rate</span></p><p><b>subject</b>: <a href="#Patient_example-dental">See above (Patient/example-dental)</a></p><p><b>effective</b>: 1999-07-02</p><p><b>value</b>: 78 beats/minute</p></div>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="vital-signs"/>
<display value="Vital Signs"/>
</coding>
<text value="Vital Signs"/>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="8867-4"/>
<display value="Heart rate"/>
</coding>
<text value="Heart rate"/>
</code>
<subject>
<reference value="Patient/example-dental"/>
</subject>
<effectiveDateTime value="1999-07-02"/>
<valueQuantity>
<value value="78"/>
<unit value="beats/minute"/>
<system value="http://unitsofmeasure.org"/>
<code value="/min"/>
</valueQuantity>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Observation/blood-pressure"/>
<resource>
<Observation>
<id value="blood-pressure"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281</p><p><b>basedOn</b>: <span></span></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category vital-signs}">Vital Signs</span></p><p><b>code</b>: <span title="Codes: {http://loinc.org 85354-9}">Blood pressure systolic & diastolic</span></p><p><b>subject</b>: <a href="#Patient_example-dental">See above (Patient/example-dental)</a></p><p><b>effective</b>: 2020-02-14</p><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://loinc.org 8480-6}, {http://snomed.info/sct 271649006}">Systolic blood pressure</span></p><p><b>value</b>: 120 mmHg</p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://loinc.org 8462-4}">Diastolic blood pressure</span></p><p><b>value</b>: 80 mmHg</p></blockquote></div>
</text>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:187e0c12-8dd2-67e2-99b2-bf273c878281"/>
</identifier>
<basedOn>
<identifier>
<system value="https://acme.org/identifiers"/>
<value value="1234"/>
</identifier>
</basedOn>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="vital-signs"/>
<display value="Vital Signs"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="85354-9"/>
<display value="Blood pressure panel with all children optional"/>
</coding>
<text value="Blood pressure systolic & diastolic"/>
</code>
<subject>
<reference value="Patient/example-dental"/>
</subject>
<effectiveDateTime value="2020-02-14"/>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="8480-6"/>
<display value="Systolic blood pressure"/>
</coding>
<coding>
<system value="http://snomed.info/sct"/>
<code value="271649006"/>
<display value="Systolic blood pressure"/>
</coding>
</code>
<valueQuantity>
<value value="120"/>
<unit value="mmHg"/>
<system value="http://unitsofmeasure.org"/>
<code value="mm[Hg]"/>
</valueQuantity>
</component>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="8462-4"/>
<display value="Diastolic blood pressure"/>
</coding>
</code>
<valueQuantity>
<value value="80"/>
<unit value="mmHg"/>
<system value="http://unitsofmeasure.org"/>
<code value="mm[Hg]"/>
</valueQuantity>
</component>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Observation/body-temperature"/>
<resource>
<Observation>
<id value="body-temperature"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category vital-signs}">Vital Signs</span></p><p><b>code</b>: <span title="Codes: {http://loinc.org 8310-5}">Body temperature</span></p><p><b>subject</b>: <a href="#Patient_example-dental">See above (Patient/example-dental)</a></p><p><b>effective</b>: 2020-02-14</p><p><b>value</b>: 36.9 C</p></div>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="vital-signs"/>
<display value="Vital Signs"/>
</coding>
<text value="Vital Signs"/>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="8310-5"/>
<display value="Body temperature"/>
</coding>
<text value="Body temperature"/>
</code>
<subject>
<reference value="Patient/example-dental"/>
</subject>
<effectiveDateTime value="2020-02-14"/>
<valueQuantity>
<value value="36.9"/>
<unit value="C"/>
<system value="http://unitsofmeasure.org"/>
<code value="Cel"/>
</valueQuantity>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/us/dental-data-exchange/Coverage/Dental-Aetna"/>
<resource>
<Coverage>
<id value="Dental-Aetna"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 12345</p><p><b>status</b>: active</p><p><b>type</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/v3-ActCode DENTAL}">dental care policy</span></p><p><b>subscriber</b>: <a href="#Patient_example-dental">See above (Patient/example-dental)</a></p><p><b>subscriberId</b>: 123456</p><p><b>beneficiary</b>: <a href="#Patient_example-dental">See above (Patient/example-dental)</a></p><p><b>dependent</b>: 0</p><p><b>relationship</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/subscriber-relationship self}">Self</span></p><p><b>period</b>: 2020-01-01 --> 2020-01-01</p><p><b>payor</b>: <a href="Organization-Aetna-organization.html">Generated Summary: id: 9316452725; active: true; <span title="Codes: {http://terminology.hl7.org/CodeSystem/organization-type pay}">Payer</span>; name: Aetna Insurance; Phone: (+1) 720-677-7777, customer2-service@Aetna.org</a></p><h3>Classes</h3><table class="grid"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td><td><b>Name</b></td></tr><tr><td>*</td><td><span title="Codes: {http://terminology.hl7.org/CodeSystem/coverage-class plan}">Plan</span></td><td>B37FC</td><td>Aetna Full Coverage: Medical, Dental, Pharmacy, Vision, EHC</td></tr></table></div>
</text>
<identifier>
<system value="http://benefitsAetna.com/certificate"/>
<value value="12345"/>
</identifier>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="DENTAL"/>
<display value="dental care policy"/>
</coding>
</type>
<subscriber>
<reference value="Patient/example-dental"/>
</subscriber>
<subscriberId value="123456"/>
<beneficiary>
<reference value="Patient/example-dental"/>
</beneficiary>
<dependent value="0"/>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
<code value="self"/>
<display value="Self"/>
</coding>
</relationship>
<period>
<start value="2020-01-01"/>
<end value="2020-01-01"/>
</period>
<payor>
<reference value="Organization/Aetna-organization"/>
</payor>
<class>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="plan"/>
</coding>
</type>
<value value="B37FC"/>
<name
value="Aetna Full Coverage: Medical, Dental, Pharmacy, Vision, EHC"/>
</class>
</Coverage>
</resource>
</entry>
</Bundle>