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
<ServiceRequest xmlns="http://hl7.org/fhir">
<id value="example-dental-referral-1"/>
<meta>
<versionId value="9"/>
<lastUpdated value="2021-08-17T18:21:18.760+00:00"/>
<source value="#SNBbxDLfpSgMOlLL"/>
<profile
value="http://hl7.org/fhir/us/dental-data-exchange/dental-servicerequest"/>
</meta>
<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.html">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>requester</b>: <a href="Practitioner-practitioner-M.html">Generated Summary: id: 1234569999; John M ; Phone: 303-303-6443; gender: male; birthDate: 1975-06-09</a></p><p><b>reasonReference</b>: </p><ul><li><a href="Condition-toothache-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/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>; <span title="Codes: {http://snomed.info/sct 27355003}, {http://www.ada.org/snodent 131687D}">Toothache (finding)</span>; onset: 2020-02-14</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.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/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>; <span title="Codes: {http://www.ada.org/snodent 148393D}, {http://snomed.info/sct 86276007}">Bleeding gums</span>; onset: 2020-02-14</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>