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="prophylaxis-example"/>
<meta>
<versionId value="2"/>
<lastUpdated value="2021-08-25T15:09:04.425+00:00"/>
<source value="#3GuJaGTJjbgyJVdj"/>
<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>status</b>: active</p><p><b>intent</b>: plan</p><p><b>code</b>: <span title="Codes: {http://ada.org/cdt D1352}">Preventive resin restoration in a moderate to high caries risk patient-permanent tooth</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-D.html">Generated Summary: id: 1234560000; John D ; Phone: 720-555-6443; gender: male; birthDate: 1990-06-09</a></p><p><b>bodySite</b>: <span title="Codes: {http://www.ada.org/snodent 161941D}, {http://snomed.info/sct 245574002}">Entire maxillary right lateral incisor tooth</span></p></div>
</text>
<status value="active"/>
<intent value="plan"/>
<code>
<coding>
<system value="http://ada.org/cdt"/>
<code value="D1352"/>
<display
value="Preventive resin restoration in a moderate to high caries risk patient-permanent tooth"/>
</coding>
<text
value="Preventive resin restoration in a moderate to high caries risk patient-permanent tooth"/>
</code>
<subject>
<reference value="Patient/example-dental"/>
</subject>
<requester>
<reference value="Practitioner/practitioner-D"/>
</requester>
<bodySite>
<coding>
<system value="http://www.ada.org/snodent"/>
<code value="161941D"/>
<display value="Permanent upper right lateral incisor tooth"/>
</coding>
<coding>
<system value="http://snomed.info/sct"/>
<code value="245574002"/>
<display value="Entire maxillary right lateral incisor tooth"/>
</coding>
<text value="Entire maxillary right lateral incisor tooth"/>
</bodySite>
</ServiceRequest>