Electronic Long-Term Services and Supports (eLTSS) Release 1 - US Realm
2.0.0 - STU2
Electronic Long-Term Services and Supports (eLTSS) Release 1 - US Realm
2.0.0 - STU2
This page is part of the electronic Long-Term Services and Supports Implementation Guide (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
{
"resourceType" : "Bundle",
"id" : "2039212f3fa5406bb4ffd4a",
"type" : "collection",
"link" : [
{
"relation" : "self",
"url" : "https://example.com/base/CarePlan/253/$all-eltss-careplan"
}
],
"entry" : [
{
"fullUrl" : "https://hl7.org/fhir/Patient/patientBSJ1",
"resource" : {
"resourceType" : "Patient",
"id" : "patientBSJ1",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Patient-eltss"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_patientBSJ1\"> </a><p><b>Generated Narrative: Patient </b><a name=\"patientBSJ1\"> </a><a name=\"hcpatientBSJ1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourcePatient "patientBSJ1" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Patient-eltss.html\">Patient_eltss</a></p></div><blockquote><p><b>US Core Race Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: White (Details: CDC Race and Ethnicity code 2106-3 = ' White ', stated as ' White ')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: White</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: Not Hispanic or Latino (Details: CDC Race and Ethnicity code 2186-5 = ' Not Hispanic or Latino ', stated as ' Not Hispanic or Latino ')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>identifier</b>: Medical Record Number/10A3D58WH1600\u00a0(use:\u00a0usual)</p><p><b>active</b>: true</p><p><b>name</b>: Betsy Smith-Johnson</p><p><b>telecom</b>: ph: 210-222-1111(MOBILE)</p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1950-11-01</p><p><b>address</b>: 111 Maple Ct, San Antonio, TX 78212</p><p><b>maritalStatus</b>: Not married <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-MaritalStatus.html\">MaritalStatus</a>#U "unmarried")</span></p><blockquote><p><b>contact</b></p><p><b>relationship</b>: Son <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-RoleCode.html\">RoleCode</a>#SONC)</span>, Emergency Contact <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v2-0131.html\">contactRole2</a>#C)</span>, Guardian <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-RoleCode.html\">RoleCode</a>#GUARD)</span></p><p><b>name</b>: Charles Johnson</p><p><b>telecom</b>: ph: (210) 222-3333</p><p><b>address</b>: 100 Montana St., San Antonio, TX 78203</p></blockquote><blockquote><p><b>contact</b></p><p><b>relationship</b>: Daughter <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-RoleCode.html\">RoleCode</a>#DAUC)</span></p><p><b>name</b>: Debra Johnson</p><p><b>telecom</b>: ph: (410) 444-5555</p><p><b>address</b>: 333 W. Camden St., Baltimore, MD 21201</p></blockquote><h3>Communications</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Language</b></td><td><b>Preferred</b></td></tr><tr><td style=\"display: none\">*</td><td>US <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ietf3066.html\">Tags for the Identification of Languages</a>#en "English")</span></td><td>true</td></tr></table></div>"
},
"extension" : [
{
"extension" : [
{
"url" : "ombCategory",
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.113883.6.238",
"code" : "2106-3",
"display" : "White"
}
},
{
"url" : "text",
"valueString" : "White"
}
],
"url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
},
{
"extension" : [
{
"url" : "ombCategory",
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.113883.6.238",
"code" : "2186-5",
"display" : "Not Hispanic or Latino"
}
},
{
"url" : "text",
"valueString" : "Not Hispanic or Latino"
}
],
"url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
}
],
"identifier" : [
{
"use" : "usual",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "MR",
"display" : "Medical Record Number"
}
]
},
"system" : "http://hl7.org/fhir/sid/us-medicare",
"value" : "10A3D58WH1600"
}
],
"active" : true,
"name" : [
{
"text" : "Betsy Smith-Johnson",
"family" : "Smith-Johnson",
"given" : [
"Betsy"
]
}
],
"telecom" : [
{
"system" : "phone",
"value" : "210-222-1111",
"use" : "mobile"
}
],
"gender" : "female",
"birthDate" : "1950-11-01",
"address" : [
{
"text" : "111 Maple Ct, San Antonio, TX 78212",
"line" : [
"111 Maple Ct"
],
"city" : "San Antonio",
"district" : "Bexar",
"state" : "TX",
"postalCode" : "78212"
}
],
"maritalStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
"code" : "U",
"display" : "unmarried"
}
],
"text" : "Not married"
},
"contact" : [
{
"relationship" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code" : "SONC",
"display" : "Son"
}
]
},
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0131",
"code" : "C",
"display" : "Emergency Contact"
}
]
},
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code" : "GUARD",
"display" : "Guardian"
}
]
}
],
"name" : {
"text" : "Charles Johnson",
"family" : "Johnson",
"given" : [
"Charles"
]
},
"telecom" : [
{
"system" : "phone",
"value" : "(210) 222-3333"
}
],
"address" : {
"text" : "100 Montana St., San Antonio, TX 78203"
}
},
{
"relationship" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code" : "DAUC",
"display" : "Daughter"
}
]
}
],
"name" : {
"text" : "Debra Johnson",
"family" : "Johnson",
"given" : [
"Debra"
]
},
"telecom" : [
{
"system" : "phone",
"value" : "(410) 444-5555"
}
],
"address" : {
"text" : "333 W. Camden St., Baltimore, MD 21201"
}
}
],
"communication" : [
{
"language" : {
"coding" : [
{
"system" : "urn:ietf:bcp:47",
"code" : "en",
"display" : "English"
}
],
"text" : "US"
},
"preferred" : true
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/CarePlan/careplan1",
"resource" : {
"resourceType" : "CarePlan",
"id" : "careplan1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/CarePlan-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"CarePlan_careplan1\"> </a><p><b>Generated Narrative: CarePlan </b><a name=\"careplan1\"> </a><a name=\"hccareplan1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceCarePlan "careplan1" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-CarePlan-eltss.html\">CarePlan_eltss</a></p></div><p><b>status</b>: active</p><p><b>intent</b>: plan</p><p><b>category</b>: Assessment and Plan of Treatment <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/us/core/STU6.1/CodeSystem-careplan-category.html\">US Core CarePlan Category Extension Codes</a>#assess-plan)</span></p><p><b>title</b>: Betsy Smith Johnson's Services and Supports Plan</p><p><b>description</b>: A service and support plan that outlines Betsy's assessed needs, goals, strengths, preferences, and services/providers to meet those needs and goals.</p><p><b>subject</b>: See on this page: Patient/patientBSJ1</p><p><b>period</b>: 2020-05-01 --> 2020-12-31</p><p><b>author</b>: See on this page: Practitioner/planner1</p><p><b>addresses</b>: </p><ul><li>See on this page: Condition/need1</li><li>See on this page: Condition/need2</li><li>See on this page: Condition/need3</li><li>See on this page: Condition/need4</li></ul><p><b>supportingInfo</b>: </p><ul><li>See on this page: Observation/strength1</li><li>See on this page: Observation/strength2</li><li>See on this page: Observation/pref1</li><li>See on this page: QuestionnaireResponse/questionnaireresponse1</li><li>See on this page: Contract/contract1</li><li>See on this page: RiskAssessment/risk1</li></ul><p><b>goal</b>: </p><ul><li>See on this page: Goal/goal1</li><li>See on this page: Goal/goal2</li></ul><blockquote><p><b>activity</b></p><p><b>reference</b>: See on this page: ServiceRequest/service1: Service 1</p></blockquote><blockquote><p><b>activity</b></p><p><b>reference</b>: See on this page: ServiceRequest/service2: Service 2</p></blockquote><blockquote><p><b>activity</b></p><p><b>reference</b>: See on this page: ServiceRequest/service3: Service 3</p></blockquote><blockquote><p><b>activity</b></p><p><b>reference</b>: See on this page: ServiceRequest/service4: Service 4</p></blockquote><blockquote><p><b>activity</b></p><p><b>progress</b>: Betsy will start doing balance exercises ( @2020-05-10)</p><p><b>reference</b>: See on this page: Task/Task1: Task1</p></blockquote><blockquote><p><b>activity</b></p><p><b>progress</b>: Betsy working on mobility to dance at son's upcoming wedding ( @2020-05-10)</p><p><b>reference</b>: See on this page: Task/Task2: Task2</p></blockquote></div>"
},
"status" : "active",
"intent" : "plan",
"category" : [
{
"coding" : [
{
"system" : "http://hl7.org/fhir/us/core/CodeSystem/careplan-category",
"code" : "assess-plan"
}
]
}
],
"title" : "Betsy Smith Johnson's Services and Supports Plan",
"description" : "A service and support plan that outlines Betsy's assessed needs, goals, strengths, preferences, and services/providers to meet those needs and goals.",
"subject" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"period" : {
"start" : "2020-05-01",
"end" : "2020-12-31"
},
"author" : {
🔗 "reference" : "Practitioner/planner1"
},
"addresses" : [
{
🔗 "reference" : "Condition/need1"
},
{
🔗 "reference" : "Condition/need2"
},
{
🔗 "reference" : "Condition/need3"
},
{
🔗 "reference" : "Condition/need4"
}
],
"supportingInfo" : [
{
🔗 "reference" : "Observation/strength1"
},
{
🔗 "reference" : "Observation/strength2"
},
{
🔗 "reference" : "Observation/pref1"
},
{
🔗 "reference" : "QuestionnaireResponse/questionnaireresponse1"
},
{
🔗 "reference" : "Contract/contract1"
},
{
🔗 "reference" : "RiskAssessment/risk1"
}
],
"goal" : [
{
🔗 "reference" : "Goal/goal1"
},
{
🔗 "reference" : "Goal/goal2"
}
],
"activity" : [
{
"reference" : {
🔗 "reference" : "ServiceRequest/service1",
"display" : "Service 1"
}
},
{
"reference" : {
🔗 "reference" : "ServiceRequest/service2",
"display" : "Service 2"
}
},
{
"reference" : {
🔗 "reference" : "ServiceRequest/service3",
"display" : "Service 3"
}
},
{
"reference" : {
🔗 "reference" : "ServiceRequest/service4",
"display" : "Service 4"
}
},
{
"progress" : [
{
"time" : "2020-05-10",
"text" : "Betsy will start doing balance exercises"
}
],
"reference" : {
🔗 "reference" : "Task/Task1",
"display" : "Task1"
}
},
{
"progress" : [
{
"time" : "2020-05-10",
"text" : "Betsy working on mobility to dance at son's upcoming wedding"
}
],
"reference" : {
🔗 "reference" : "Task/Task2",
"display" : "Task2"
}
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/Task/Task1",
"resource" : {
"resourceType" : "Task",
"id" : "Task1",
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Task_Task1\"> </a><p><b>Generated Narrative: Task </b><a name=\"Task1\"> </a><a name=\"hcTask1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceTask "Task1" </p></div><p><b>ServiceRequest Pertains To Goal</b>: See on this page: Goal/goal1</p><p><b>status</b>: ready</p><p><b>intent</b>: order</p><p><b>priority</b>: routine</p><p><b>code</b>: Fulfill the focal request <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-task-code.html\">Task Codes</a>#fulfill)</span></p><p><b>description</b>: Perform exercises to improve balance skills.</p><p><b>for</b>: See on this page: Patient/patientBSJ1: Betsy</p><p><b>requester</b>: See on this page: Practitioner/planner1: Mark Planner</p><p><b>owner</b>: See on this page: Patient/patientBSJ1: Betsy</p></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal",
"valueReference" : {
🔗 "reference" : "Goal/goal1"
}
}
],
"status" : "ready",
"intent" : "order",
"priority" : "routine",
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/CodeSystem/task-code",
"code" : "fulfill",
"display" : "Fulfill the focal request"
}
]
},
"description" : "Perform exercises to improve balance skills.",
"for" : {
🔗 "reference" : "Patient/patientBSJ1",
"display" : "Betsy"
},
"requester" : {
🔗 "reference" : "Practitioner/planner1",
"display" : "Mark Planner"
},
"owner" : {
🔗 "reference" : "Patient/patientBSJ1",
"display" : "Betsy"
}
}
},
{
"fullUrl" : "https://hl7.org/fhir/Task/Task2",
"resource" : {
"resourceType" : "Task",
"id" : "Task2",
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Task_Task2\"> </a><p><b>Generated Narrative: Task </b><a name=\"Task2\"> </a><a name=\"hcTask2\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceTask "Task2" </p></div><p><b>ServiceRequest Pertains To Goal</b>: See on this page: Goal/goal2</p><p><b>status</b>: ready</p><p><b>intent</b>: order</p><p><b>priority</b>: routine</p><p><b>code</b>: Fulfill the focal request <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-task-code.html\">Task Codes</a>#fulfill)</span></p><p><b>description</b>: Son working with Besty to work on mobility to dance at son's upcoming wedding.</p><p><b>for</b>: See on this page: Patient/patientBSJ1: Betsy</p><p><b>requester</b>: See on this page: Practitioner/planner1: Mark Planner</p><p><b>owner</b>: See on this page: RelatedPerson/son1: Charles - Betsy's son</p></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal",
"valueReference" : {
🔗 "reference" : "Goal/goal2"
}
}
],
"status" : "ready",
"intent" : "order",
"priority" : "routine",
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/CodeSystem/task-code",
"code" : "fulfill",
"display" : "Fulfill the focal request"
}
]
},
"description" : "Son working with Besty to work on mobility to dance at son's upcoming wedding.",
"for" : {
🔗 "reference" : "Patient/patientBSJ1",
"display" : "Betsy"
},
"requester" : {
🔗 "reference" : "Practitioner/planner1",
"display" : "Mark Planner"
},
"owner" : {
🔗 "reference" : "RelatedPerson/son1",
"display" : "Charles - Betsy's son"
}
}
},
{
"fullUrl" : "https://hl7.org/fhir/Goal/goal2",
"resource" : {
"resourceType" : "Goal",
"id" : "goal2",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Goal-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Goal_goal2\"> </a><p><b>Generated Narrative: Goal </b><a name=\"goal2\"> </a><a name=\"hcgoal2\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceGoal "goal2" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Goal-eltss.html\">Goal_eltss</a></p></div><p><b>lifecycleStatus</b>: accepted</p><p><b>description</b>: Dance at son's upcoming wedding <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>subject</b>: See on this page: Patient/patientBSJ1</p></div>"
},
"lifecycleStatus" : "accepted",
"description" : {
"text" : "Dance at son's upcoming wedding"
},
"subject" : {
🔗 "reference" : "Patient/patientBSJ1"
}
}
},
{
"fullUrl" : "https://hl7.org/fhir/Goal/goal1",
"resource" : {
"resourceType" : "Goal",
"id" : "goal1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Goal-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Goal_goal1\"> </a><p><b>Generated Narrative: Goal </b><a name=\"goal1\"> </a><a name=\"hcgoal1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceGoal "goal1" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Goal-eltss.html\">Goal_eltss</a></p></div><p><b>lifecycleStatus</b>: accepted</p><p><b>description</b>: Improve balance skills <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>subject</b>: See on this page: Patient/patientBSJ1</p></div>"
},
"lifecycleStatus" : "accepted",
"description" : {
"text" : "Improve balance skills"
},
"subject" : {
🔗 "reference" : "Patient/patientBSJ1"
}
}
},
{
"fullUrl" : "https://hl7.org/fhir/Practitioner/planner1",
"resource" : {
"resourceType" : "Practitioner",
"id" : "planner1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_planner1\"> </a><p><b>Generated Narrative: Practitioner </b><a name=\"planner1\"> </a><a name=\"hcplanner1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourcePractitioner "planner1" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Practitioner-eltss.html\">Practitioner_eltss</a></p></div><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.5.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/9941339100, <code>http://www.acme.org/practitioners</code>/25456</p><p><b>name</b>: Mark Planner</p><p><b>telecom</b>: ph: (210) 555 1221</p></div>"
},
"identifier" : [
{
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "9941339100"
},
{
"system" : "http://www.acme.org/practitioners",
"value" : "25456"
}
],
"name" : [
{
"text" : "Mark Planner",
"family" : "Planner",
"given" : [
"Mark"
]
}
],
"telecom" : [
{
"system" : "phone",
"value" : "(210) 555 1221"
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/ServiceRequest/service2",
"resource" : {
"resourceType" : "ServiceRequest",
"id" : "service2",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/ServiceRequest-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ServiceRequest_service2\"> </a><p><b>Generated Narrative: ServiceRequest </b><a name=\"service2\"> </a><a name=\"hcservice2\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceServiceRequest "service2" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ServiceRequest-eltss.html\">ServiceRequest_eltss</a></p></div><p><b>status</b>: active</p><p><b>intent</b>: plan</p><p><b>code</b>: Non-emergency transportation; encounter/trip <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-hcpcs-Level-II.html\">Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes</a>#T2003)</span></p><p><b>quantity</b>: 2 trips<span style=\"background: LightGoldenRodYellow\"> (Details: NCI Thesaurus codeC141286 = 'Transportation')</span>/1 month<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM codemo = 'mo')</span></p><p><b>subject</b>: See on this page: Patient/patientBSJ1</p><p><b>occurrence</b>: 2020-07-01 --> 2020-12-31</p><p><b>performer</b>: See on this page: Organization/provider2a</p><p><b>reasonReference</b>: See on this page: Condition/need1</p><p><b>insurance</b>: See on this page: Coverage/coverage1</p><p><b>supportingInfo</b>: See on this page: Claim/claim1</p><p><b>note</b>: Service provider will provide a reminder the business day before the trip, and will call when on the way.</p></div>"
},
"status" : "active",
"intent" : "plan",
"code" : {
"coding" : [
{
"system" : "http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets",
"code" : "T2003"
}
],
"text" : "Non-emergency transportation; encounter/trip"
},
"quantityRatio" : {
"numerator" : {
"value" : 2,
"unit" : "trips",
"system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
"code" : "C141286"
},
"denominator" : {
"value" : 1,
"unit" : "month",
"system" : "http://unitsofmeasure.org",
"code" : "mo"
}
},
"subject" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"occurrencePeriod" : {
"start" : "2020-07-01",
"end" : "2020-12-31"
},
"performer" : [
{
🔗 "reference" : "Organization/provider2a"
}
],
"reasonReference" : [
{
🔗 "reference" : "Condition/need1"
}
],
"insurance" : [
{
🔗 "reference" : "Coverage/coverage1"
}
],
"supportingInfo" : [
{
🔗 "reference" : "Claim/claim1"
}
],
"note" : [
{
"text" : "Service provider will provide a reminder the business day before the trip, and will call when on the way."
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/ServiceRequest/service3",
"resource" : {
"resourceType" : "ServiceRequest",
"id" : "service3",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/ServiceRequest-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ServiceRequest_service3\"> </a><p><b>Generated Narrative: ServiceRequest </b><a name=\"service3\"> </a><a name=\"hcservice3\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceServiceRequest "service3" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ServiceRequest-eltss.html\">ServiceRequest_eltss</a></p></div><p><b>status</b>: active</p><p><b>intent</b>: plan</p><p><b>code</b>: Diabetes outpatient self-management training services, individual, per 30 minutes <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-hcpcs-Level-II.html\">Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes</a>#G0108)</span></p><p><b>quantity</b>: 1 visit<span style=\"background: LightGoldenRodYellow\"> (Details: NCI Thesaurus codeC25716 = 'Visit')</span>/1 week<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM codewk = 'wk')</span></p><p><b>subject</b>: See on this page: Patient/patientBSJ1</p><p><b>occurrence</b>: 2020-05-01 --> 2020-08-01</p><p><b>performer</b>: See on this page: Practitioner/provider3</p><p><b>reasonReference</b>: See on this page: Condition/need2</p><p><b>supportingInfo</b>: See on this page: Claim/claim2</p></div>"
},
"status" : "active",
"intent" : "plan",
"code" : {
"coding" : [
{
"system" : "http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets",
"code" : "G0108"
}
],
"text" : "Diabetes outpatient self-management training services, individual, per 30 minutes"
},
"quantityRatio" : {
"numerator" : {
"value" : 1,
"unit" : "visit",
"system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
"code" : "C25716"
},
"denominator" : {
"value" : 1,
"unit" : "week",
"system" : "http://unitsofmeasure.org",
"code" : "wk"
}
},
"subject" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"occurrencePeriod" : {
"start" : "2020-05-01",
"end" : "2020-08-01"
},
"performer" : [
{
🔗 "reference" : "Practitioner/provider3"
}
],
"reasonReference" : [
{
🔗 "reference" : "Condition/need2"
}
],
"supportingInfo" : [
{
🔗 "reference" : "Claim/claim2"
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/ServiceRequest/service4",
"resource" : {
"resourceType" : "ServiceRequest",
"id" : "service4",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/ServiceRequest-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ServiceRequest_service4\"> </a><p><b>Generated Narrative: ServiceRequest </b><a name=\"service4\"> </a><a name=\"hcservice4\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceServiceRequest "service4" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ServiceRequest-eltss.html\">ServiceRequest_eltss</a></p></div><p><b>status</b>: active</p><p><b>intent</b>: plan</p><p><b>code</b>: therapeutic exercises to improve balance skills <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-hcpcs-Level-II.html\">Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes</a>#97110)</span></p><p><b>quantity</b>: 1 visit<span style=\"background: LightGoldenRodYellow\"> (Details: NCI Thesaurus codeC25716 = 'Visit')</span>/1 week<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM codewk = 'wk')</span></p><p><b>subject</b>: See on this page: Patient/patientBSJ1</p><p><b>occurrence</b>: 2020-05-01 --> 2020-08-01</p><p><b>performer</b>: See on this page: Practitioner/provider4</p><p><b>reasonReference</b>: See on this page: Condition/need1</p><p><b>supportingInfo</b>: </p><ul><li>See on this page: Goal/goal1</li><li>See on this page: Goal/goal2</li><li>See on this page: Claim/claim3</li></ul></div>"
},
"status" : "active",
"intent" : "plan",
"code" : {
"coding" : [
{
"system" : "http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets",
"code" : "97110"
}
],
"text" : "therapeutic exercises to improve balance skills"
},
"quantityRatio" : {
"numerator" : {
"value" : 1,
"unit" : "visit",
"system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
"code" : "C25716"
},
"denominator" : {
"value" : 1,
"unit" : "week",
"system" : "http://unitsofmeasure.org",
"code" : "wk"
}
},
"subject" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"occurrencePeriod" : {
"start" : "2020-05-01",
"end" : "2020-08-01"
},
"performer" : [
{
🔗 "reference" : "Practitioner/provider4"
}
],
"reasonReference" : [
{
🔗 "reference" : "Condition/need1"
}
],
"supportingInfo" : [
{
🔗 "reference" : "Goal/goal1"
},
{
🔗 "reference" : "Goal/goal2"
},
{
🔗 "reference" : "Claim/claim3"
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/RelatedPerson/son1",
"resource" : {
"resourceType" : "RelatedPerson",
"id" : "son1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/RelatedPerson-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"RelatedPerson_son1\"> </a><p><b>Generated Narrative: RelatedPerson </b><a name=\"son1\"> </a><a name=\"hcson1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceRelatedPerson "son1" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-RelatedPerson-eltss.html\">eLTSS RelatedPerson Profile</a></p></div><p><b>active</b>: true</p><p><b>patient</b>: See on this page: Patient/patientBSJ1</p><p><b>relationship</b>: son <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-RoleCode.html\">RoleCode</a>#SONC)</span></p><p><b>name</b>: Charles Johnson</p></div>"
},
"active" : true,
"patient" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"relationship" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code" : "SONC"
}
]
}
],
"name" : [
{
"text" : "Charles Johnson",
"family" : "Charles",
"given" : [
"Johnson"
]
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/Observation/strength1",
"resource" : {
"resourceType" : "Observation",
"id" : "strength1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Observation-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_strength1\"> </a><p><b>Generated Narrative: Observation </b><a name=\"strength1\"> </a><a name=\"hcstrength1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceObservation "strength1" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Observation-eltss.html\">Observation_eltss</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Social History <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#social-history)</span></p><p><b>code</b>: Strength <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-eltss-observation-codes-temporary.html\">eLTSS Observation Codes</a>#strength)</span></p><p><b>subject</b>: See on this page: Patient/patientBSJ1</p><p><b>effective</b>: 2013-04-02 10:30:10+0100</p><p><b>issued</b>: Apr 3, 2013, 2:30:10 PM</p><p><b>performer</b>: See on this page: Practitioner/caremgr1: Care Manager</p><p><b>value</b>: Able to manage her bills.</p></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "social-history",
"display" : "Social History"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/eltss/CodeSystem/eltss-observation-codes-temporary",
"code" : "strength",
"display" : "Strength"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"effectiveDateTime" : "2013-04-02T10:30:10+01:00",
"issued" : "2013-04-03T15:30:10+01:00",
"performer" : [
{
🔗 "reference" : "Practitioner/caremgr1",
"display" : "Care Manager"
}
],
"valueString" : "Able to manage her bills."
}
},
{
"fullUrl" : "https://hl7.org/fhir/Observation/strength2",
"resource" : {
"resourceType" : "Observation",
"id" : "strength2",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Observation-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_strength2\"> </a><p><b>Generated Narrative: Observation </b><a name=\"strength2\"> </a><a name=\"hcstrength2\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceObservation "strength2" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Observation-eltss.html\">Observation_eltss</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Social History <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#social-history)</span></p><p><b>code</b>: Strength <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-eltss-observation-codes-temporary.html\">eLTSS Observation Codes</a>#strength)</span></p><p><b>subject</b>: See on this page: Patient/patientBSJ1</p><p><b>effective</b>: 2013-04-02 10:30:10+0100</p><p><b>issued</b>: Apr 3, 2013, 2:30:10 PM</p><p><b>performer</b>: See on this page: Practitioner/caremgr1: Care Manager</p><p><b>value</b>: Independent walking with cane.</p></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "social-history",
"display" : "Social History"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/eltss/CodeSystem/eltss-observation-codes-temporary",
"code" : "strength",
"display" : "Strength"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"effectiveDateTime" : "2013-04-02T10:30:10+01:00",
"issued" : "2013-04-03T15:30:10+01:00",
"performer" : [
{
🔗 "reference" : "Practitioner/caremgr1",
"display" : "Care Manager"
}
],
"valueString" : "Independent walking with cane."
}
},
{
"fullUrl" : "https://hl7.org/fhir/Practitioner/caremgr1",
"resource" : {
"resourceType" : "Practitioner",
"id" : "caremgr1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_caremgr1\"> </a><p><b>Generated Narrative: Practitioner </b><a name=\"caremgr1\"> </a><a name=\"hccaremgr1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourcePractitioner "caremgr1" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Practitioner-eltss.html\">Practitioner_eltss</a></p></div><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.5.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/1144221847, <code>http://www.acme.org/practitioners</code>/25457</p><p><b>name</b>: Sam Monitor</p><p><b>telecom</b>: ph: (210) 224 1599</p></div>"
},
"identifier" : [
{
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "1144221847"
},
{
"system" : "http://www.acme.org/practitioners",
"value" : "25457"
}
],
"name" : [
{
"text" : "Sam Monitor",
"family" : "Monitor",
"given" : [
"Sam"
]
}
],
"telecom" : [
{
"system" : "phone",
"value" : "(210) 224 1599"
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/CarePlan/careplan2",
"resource" : {
"resourceType" : "CarePlan",
"id" : "careplan2",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/CarePlan-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"CarePlan_careplan2\"> </a><p><b>Generated Narrative: CarePlan </b><a name=\"careplan2\"> </a><a name=\"hccareplan2\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceCarePlan "careplan2" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-CarePlan-eltss.html\">CarePlan_eltss</a></p></div><p><b>partOf</b>: See on this page: CarePlan/careplan1</p><p><b>status</b>: active</p><p><b>intent</b>: plan</p><p><b>category</b>: Assessment and Plan of Treatment <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/us/core/STU6.1/CodeSystem-careplan-category.html\">US Core CarePlan Category Extension Codes</a>#assess-plan)</span></p><p><b>description</b>: Weather Emergency: A shelf-stable meal is delivered to Meals On Wheels clients. It is to be eaten in the unlikely event of cancellation. Weather meals are donated by the Sheboygan Service Club.</p><p><b>subject</b>: See on this page: Patient/patientBSJ1</p></div>"
},
"partOf" : [
{
🔗 "reference" : "CarePlan/careplan1"
}
],
"status" : "active",
"intent" : "plan",
"category" : [
{
"coding" : [
{
"system" : "http://hl7.org/fhir/us/core/CodeSystem/careplan-category",
"code" : "assess-plan"
}
]
}
],
"description" : "Weather Emergency: A shelf-stable meal is delivered to Meals On Wheels clients. It is to be eaten in the unlikely event of cancellation. Weather meals are donated by the Sheboygan Service Club.",
"subject" : {
🔗 "reference" : "Patient/patientBSJ1"
}
}
},
{
"fullUrl" : "https://hl7.org/fhir/Claim/claim1",
"resource" : {
"resourceType" : "Claim",
"id" : "claim1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Claim-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_claim1\"> </a><p><b>Generated Narrative: Claim </b><a name=\"claim1\"> </a><a name=\"hcclaim1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceClaim "claim1" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Claim-eltss.html\">Claim_eltss</a></p></div><p><b>status</b>: active</p><p><b>type</b>: Professional <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-claim-type.html\">Claim Type Codes</a>#professional)</span></p><p><b>use</b>: claim</p><p><b>patient</b>: See on this page: Patient/patientBSJ1</p><p><b>created</b>: 2020-05-01</p><p><b>provider</b>: See on this page: Organization/funding1</p><p><b>priority</b>: Normal <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-processpriority.html\">Process Priority Codes</a>#normal)</span></p><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td>See on this page: Coverage/coverage1</td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: T2003 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-hcpcs-Level-II.html\">Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes</a>#T2003)</span></p><h3>UnitPrices</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>60</td><td>USD</td></tr></table><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>600</td><td>USD</td></tr></table></blockquote></div>"
},
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claim-type",
"code" : "professional"
}
]
},
"use" : "claim",
"patient" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"created" : "2020-05-01",
"provider" : {
🔗 "reference" : "Organization/funding1"
},
"priority" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/processpriority",
"code" : "normal"
}
]
},
"insurance" : [
{
"sequence" : 1,
"focal" : true,
"coverage" : {
🔗 "reference" : "Coverage/coverage1"
}
}
],
"item" : [
{
"sequence" : 1,
"productOrService" : {
"coding" : [
{
"system" : "http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets",
"code" : "T2003"
}
]
},
"unitPrice" : {
"value" : 60,
"currency" : "USD"
},
"net" : {
"value" : 600,
"currency" : "USD"
}
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/Claim/claim2",
"resource" : {
"resourceType" : "Claim",
"id" : "claim2",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Claim-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_claim2\"> </a><p><b>Generated Narrative: Claim </b><a name=\"claim2\"> </a><a name=\"hcclaim2\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceClaim "claim2" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Claim-eltss.html\">Claim_eltss</a></p></div><p><b>status</b>: active</p><p><b>type</b>: Professional <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-claim-type.html\">Claim Type Codes</a>#professional)</span></p><p><b>use</b>: claim</p><p><b>patient</b>: See on this page: Patient/patientBSJ1</p><p><b>created</b>: 2020-05-01</p><p><b>provider</b>: See on this page: Organization/funding1</p><p><b>priority</b>: Normal <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-processpriority.html\">Process Priority Codes</a>#normal)</span></p><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td>See on this page: Coverage/coverage1</td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: G0108 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-hcpcs-Level-II.html\">Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes</a>#G0108)</span></p><h3>UnitPrices</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>55</td><td>USD</td></tr></table><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>660</td><td>USD</td></tr></table></blockquote></div>"
},
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claim-type",
"code" : "professional"
}
]
},
"use" : "claim",
"patient" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"created" : "2020-05-01",
"provider" : {
🔗 "reference" : "Organization/funding1"
},
"priority" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/processpriority",
"code" : "normal"
}
]
},
"insurance" : [
{
"sequence" : 1,
"focal" : true,
"coverage" : {
🔗 "reference" : "Coverage/coverage1"
}
}
],
"item" : [
{
"sequence" : 1,
"productOrService" : {
"coding" : [
{
"system" : "http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets",
"code" : "G0108"
}
]
},
"unitPrice" : {
"value" : 55,
"currency" : "USD"
},
"net" : {
"value" : 660,
"currency" : "USD"
}
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/Claim/claim3",
"resource" : {
"resourceType" : "Claim",
"id" : "claim3",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Claim-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_claim3\"> </a><p><b>Generated Narrative: Claim </b><a name=\"claim3\"> </a><a name=\"hcclaim3\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceClaim "claim3" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Claim-eltss.html\">Claim_eltss</a></p></div><p><b>status</b>: active</p><p><b>type</b>: Professional <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-claim-type.html\">Claim Type Codes</a>#professional)</span></p><p><b>use</b>: claim</p><p><b>patient</b>: See on this page: Patient/patientBSJ1</p><p><b>created</b>: 2020-05-01</p><p><b>provider</b>: See on this page: Organization/funding1</p><p><b>priority</b>: Normal <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-processpriority.html\">Process Priority Codes</a>#normal)</span></p><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td>See on this page: Coverage/coverage1</td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-CPT.html\">Current Procedural Terminology (CPT®)</a>#97110)</span></p><h3>UnitPrices</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>65</td><td>USD</td></tr></table><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>780</td><td>USD</td></tr></table></blockquote></div>"
},
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claim-type",
"code" : "professional"
}
]
},
"use" : "claim",
"patient" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"created" : "2020-05-01",
"provider" : {
🔗 "reference" : "Organization/funding1"
},
"priority" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/processpriority",
"code" : "normal"
}
]
},
"insurance" : [
{
"sequence" : 1,
"focal" : true,
"coverage" : {
🔗 "reference" : "Coverage/coverage1"
}
}
],
"item" : [
{
"sequence" : 1,
"productOrService" : {
"coding" : [
{
"system" : "http://www.ama-assn.org/go/cpt",
"code" : "97110"
}
]
},
"unitPrice" : {
"value" : 65,
"currency" : "USD"
},
"net" : {
"value" : 780,
"currency" : "USD"
}
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/Contract/contract1",
"resource" : {
"resourceType" : "Contract",
"id" : "contract1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Contract-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Contract_contract1\"> </a><p><b>Generated Narrative: Contract </b><a name=\"contract1\"> </a><a name=\"hccontract1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceContract "contract1" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Contract-eltss.html\">Contract_eltss</a></p></div><blockquote><p><b>signer</b></p><p><b>type</b>: Patient (Details: Contract Signer Type Codes code PAT = ' Patient ', stated as ' null ')</p><p><b>party</b>: See on this page: Patient/patientBSJ1</p><h3>Signatures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>When</b></td><td><b>Who</b></td><td><b>Data</b></td></tr><tr><td style=\"display: none\">*</td><td>Consent Signature (Details: Signature Type Codes code 1.2.840.10065.1.12.1.7 = ' Consent Signature ', stated as ' null ')</td><td>Apr 2, 2020, 3:00:00 AM</td><td>See on this page: Patient/patientBSJ1</td><td>(base64 data - 187 bytes)</td></tr></table></blockquote><blockquote><p><b>signer</b></p><p><b>type</b>: Guardian (Details: Contract Signer Type Codes code GUARD = ' Guardian ', stated as ' null ')</p><p><b>party</b>: See on this page: RelatedPerson/guardian1</p><h3>Signatures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>When</b></td><td><b>Who</b></td><td><b>Data</b></td></tr><tr><td style=\"display: none\">*</td><td>Consent Signature (Details: Signature Type Codes code 1.2.840.10065.1.12.1.7 = ' Consent Signature ', stated as ' null ')</td><td>Apr 2, 2020, 3:00:00 AM</td><td>See on this page: RelatedPerson/guardian1</td><td>(base64 data - 187 bytes)</td></tr></table></blockquote><blockquote><p><b>signer</b></p><p><b>type</b>: Author (Details: Contract Signer Type Codes code AUT = ' Author ', stated as ' null ')</p><p><b>party</b>: See on this page: Practitioner/planner1</p><h3>Signatures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>When</b></td><td><b>Who</b></td><td><b>Data</b></td></tr><tr><td style=\"display: none\">*</td><td>Author's Signature (Details: Signature Type Codes code 1.2.840.10065.1.12.1.1 = ' Author's Signature ', stated as ' null ')</td><td>Apr 2, 2020, 3:00:00 AM</td><td>See on this page: Practitioner/planner1</td><td>(base64 data - 187 bytes)</td></tr></table></blockquote><blockquote><p><b>signer</b></p><p><b>type</b>: Co-Author (Details: Contract Signer Type Codes code COAUTH = ' Co-Author ', stated as ' null ')</p><p><b>party</b>: See on this page: Practitioner/caremgr1</p><h3>Signatures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>When</b></td><td><b>Who</b></td><td><b>Data</b></td></tr><tr><td style=\"display: none\">*</td><td>Author's Signature (Details: Signature Type Codes code 1.2.840.10065.1.12.1.1 = ' Author's Signature ', stated as ' null ')</td><td>Apr 2, 2020, 3:00:00 AM</td><td>See on this page: Practitioner/caremgr1</td><td>(base64 data - 187 bytes)</td></tr></table></blockquote><blockquote><p><b>signer</b></p><p><b>type</b>: Healthcare Provider (Details: Contract Signer Type Codes code HPROV = ' Healthcare Provider ', stated as ' null ')</p><p><b>party</b>: See on this page: Practitioner/provider3</p><h3>Signatures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>When</b></td><td><b>Who</b></td><td><b>Data</b></td></tr><tr><td style=\"display: none\">*</td><td>Consent Signature (Details: Signature Type Codes code 1.2.840.10065.1.12.1.7 = ' Consent Signature ', stated as ' null ')</td><td>Apr 2, 2020, 3:00:00 AM</td><td>See on this page: Practitioner/provider3</td><td>(base64 data - 187 bytes)</td></tr></table></blockquote><blockquote><p><b>signer</b></p><p><b>type</b>: Healthcare Provider (Details: Contract Signer Type Codes code HPROV = ' Healthcare Provider ', stated as ' null ')</p><p><b>party</b>: See on this page: Practitioner/provider2b</p><h3>Signatures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>When</b></td><td><b>Who</b></td><td><b>Data</b></td></tr><tr><td style=\"display: none\">*</td><td>Consent Signature (Details: Signature Type Codes code 1.2.840.10065.1.12.1.7 = ' Consent Signature ', stated as ' null ')</td><td>Apr 2, 2020, 3:00:00 AM</td><td>See on this page: Practitioner/provider2b</td><td>(base64 data - 187 bytes)</td></tr></table></blockquote><blockquote><p><b>signer</b></p><p><b>type</b>: Healthcare Provider (Details: Contract Signer Type Codes code HPROV = ' Healthcare Provider ', stated as ' null ')</p><p><b>party</b>: See on this page: RelatedPerson/son1</p><h3>Signatures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>When</b></td><td><b>Who</b></td><td><b>Data</b></td></tr><tr><td style=\"display: none\">*</td><td>Consent Signature (Details: Signature Type Codes code 1.2.840.10065.1.12.1.7 = ' Consent Signature ', stated as ' null ')</td><td>Apr 2, 2020, 3:00:00 AM</td><td>See on this page: RelatedPerson/son1</td><td>(base64 data - 187 bytes)</td></tr></table></blockquote><blockquote><p><b>signer</b></p><p><b>type</b>: Healthcare Provider (Details: Contract Signer Type Codes code HPROV = ' Healthcare Provider ', stated as ' null ')</p><p><b>party</b>: See on this page: Practitioner/provider4</p><h3>Signatures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>When</b></td><td><b>Who</b></td><td><b>Data</b></td></tr><tr><td style=\"display: none\">*</td><td>Consent Signature (Details: Signature Type Codes code 1.2.840.10065.1.12.1.7 = ' Consent Signature ', stated as ' null ')</td><td>Apr 2, 2020, 3:00:00 AM</td><td>See on this page: Practitioner/provider4</td><td>(base64 data - 187 bytes)</td></tr></table></blockquote></div>"
},
"signer" : [
{
"type" : {
"system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code" : "PAT"
},
"party" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"signature" : [
{
"type" : [
{
"system" : "urn:iso-astm:E1762-95:2013",
"code" : "1.2.840.10065.1.12.1.7"
}
],
"when" : "2020-04-02T03:00:00Z",
"who" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="
}
]
},
{
"type" : {
"system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code" : "GUARD"
},
"party" : {
🔗 "reference" : "RelatedPerson/guardian1"
},
"signature" : [
{
"type" : [
{
"system" : "urn:iso-astm:E1762-95:2013",
"code" : "1.2.840.10065.1.12.1.7"
}
],
"when" : "2020-04-02T03:00:00Z",
"who" : {
🔗 "reference" : "RelatedPerson/guardian1"
},
"data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="
}
]
},
{
"type" : {
"system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code" : "AUT"
},
"party" : {
🔗 "reference" : "Practitioner/planner1"
},
"signature" : [
{
"type" : [
{
"system" : "urn:iso-astm:E1762-95:2013",
"code" : "1.2.840.10065.1.12.1.1"
}
],
"when" : "2020-04-02T03:00:00Z",
"who" : {
🔗 "reference" : "Practitioner/planner1"
},
"data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="
}
]
},
{
"type" : {
"system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code" : "COAUTH"
},
"party" : {
🔗 "reference" : "Practitioner/caremgr1"
},
"signature" : [
{
"type" : [
{
"system" : "urn:iso-astm:E1762-95:2013",
"code" : "1.2.840.10065.1.12.1.1"
}
],
"when" : "2020-04-02T03:00:00Z",
"who" : {
🔗 "reference" : "Practitioner/caremgr1"
},
"data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="
}
]
},
{
"type" : {
"system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code" : "HPROV"
},
"party" : {
🔗 "reference" : "Practitioner/provider3"
},
"signature" : [
{
"type" : [
{
"system" : "urn:iso-astm:E1762-95:2013",
"code" : "1.2.840.10065.1.12.1.7"
}
],
"when" : "2020-04-02T03:00:00Z",
"who" : {
🔗 "reference" : "Practitioner/provider3"
},
"data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="
}
]
},
{
"type" : {
"system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code" : "HPROV"
},
"party" : {
🔗 "reference" : "Practitioner/provider2b"
},
"signature" : [
{
"type" : [
{
"system" : "urn:iso-astm:E1762-95:2013",
"code" : "1.2.840.10065.1.12.1.7"
}
],
"when" : "2020-04-02T03:00:00Z",
"who" : {
🔗 "reference" : "Practitioner/provider2b"
},
"data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="
}
]
},
{
"type" : {
"system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code" : "HPROV"
},
"party" : {
🔗 "reference" : "RelatedPerson/son1"
},
"signature" : [
{
"type" : [
{
"system" : "urn:iso-astm:E1762-95:2013",
"code" : "1.2.840.10065.1.12.1.7"
}
],
"when" : "2020-04-02T03:00:00Z",
"who" : {
🔗 "reference" : "RelatedPerson/son1"
},
"data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="
}
]
},
{
"type" : {
"system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code" : "HPROV"
},
"party" : {
🔗 "reference" : "Practitioner/provider4"
},
"signature" : [
{
"type" : [
{
"system" : "urn:iso-astm:E1762-95:2013",
"code" : "1.2.840.10065.1.12.1.7"
}
],
"when" : "2020-04-02T03:00:00Z",
"who" : {
🔗 "reference" : "Practitioner/provider4"
},
"data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="
}
]
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/Coverage/coverage1",
"resource" : {
"resourceType" : "Coverage",
"id" : "coverage1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif"
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Coverage_coverage1\"> </a><p><b>Generated Narrative: Coverage </b><a name=\"coverage1\"> </a><a name=\"hccoverage1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceCoverage "coverage1" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p></div><p><b>status</b>: active</p><p><b>beneficiary</b>: See on this page: Patient/patientBSJ1</p><p><b>payor</b>: See on this page: Organization/funding1</p></div>"
},
"status" : "active",
"beneficiary" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"payor" : [
{
🔗 "reference" : "Organization/funding1"
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/EpisodeOfCare/episode1",
"resource" : {
"resourceType" : "EpisodeOfCare",
"id" : "episode1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/EpisodeOfCare-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"EpisodeOfCare_episode1\"> </a><p><b>Generated Narrative: EpisodeOfCare </b><a name=\"episode1\"> </a><a name=\"hcepisode1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceEpisodeOfCare "episode1" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-EpisodeOfCare-eltss.html\">EpisodeOfCare_eltss</a></p></div><p><b>status</b>: active</p><p><b>patient</b>: See on this page: Patient/patientBSJ1</p><p><b>careManager</b>: See on this page: Practitioner/caremgr1</p></div>"
},
"status" : "active",
"patient" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"careManager" : {
🔗 "reference" : "Practitioner/caremgr1"
}
}
},
{
"fullUrl" : "https://hl7.org/fhir/Organization/funding1",
"resource" : {
"resourceType" : "Organization",
"id" : "funding1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_funding1\"> </a><p><b>Generated Narrative: Organization </b><a name=\"funding1\"> </a><a name=\"hcfunding1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceOrganization "funding1" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-organization.html\">US Core Organization Profile</a></p></div><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.5.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/1144221847, <a href=\"http://terminology.hl7.org/5.5.0/NamingSystem-CLIA.html\" title=\""The Centers for Medicare & Medicaid Services (CMS) regulates all laboratory testing (except research) performed on humans in the U.S. through the Clinical Laboratory Improvement Amendments (CLIA). In total, CLIA covers approximately 330,000 laboratory entities. The Division of Clinical Laboratory Improvement & Quality, within the Quality, Safety & Oversight Group, under the Center for Clinical Standards and Quality (CCSQ) has the responsibility for implementing the CLIA Program.\r\n\r\nThe objective of the CLIA program is to ensure quality laboratory testing. Although all clinical laboratories must be properly certified to receive Medicare or Medicaid payments, CLIA has no direct Medicare or Medicaid program responsibilities."\r\n\r\nCMS CLIA certified laboratories will be assigned a10-digit alphanumeric CLIA identification number, with the "D" in the third position identifying the provider/supplier as a laboratory certified under CLIA."\r\n\r\nCLIA is maintained by CMS. It is in the public domain and free to use without restriction.\r\n\r\nSee http://cms.gov/regulations-and-guidance/legislation/clia.\">Clinical Laboratory Improvement Amendments</a>/12D4567890</p><p><b>active</b>: true</p><p><b>name</b>: Texas Department of Community Health</p><p><b>address</b>: 7430 Louis Pasteur Dr, San Antonio, TX 78229</p></div>"
},
"identifier" : [
{
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "1144221847"
},
{
"system" : "urn:oid:2.16.840.1.113883.4.7",
"value" : "12D4567890"
}
],
"active" : true,
"name" : "Texas Department of Community Health",
"address" : [
{
"text" : "7430 Louis Pasteur Dr, San Antonio, TX 78229"
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/RelatedPerson/guardian1",
"resource" : {
"resourceType" : "RelatedPerson",
"id" : "guardian1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/RelatedPerson-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"RelatedPerson_guardian1\"> </a><p><b>Generated Narrative: RelatedPerson </b><a name=\"guardian1\"> </a><a name=\"hcguardian1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceRelatedPerson "guardian1" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-RelatedPerson-eltss.html\">eLTSS RelatedPerson Profile</a></p></div><p><b>active</b>: true</p><p><b>patient</b>: See on this page: Patient/patientBSJ1</p><p><b>relationship</b>: guardian <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-RoleCode.html\">RoleCode</a>#GUARD)</span></p><p><b>name</b>: Charles Johnson</p></div>"
},
"active" : true,
"patient" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"relationship" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code" : "GUARD"
}
]
}
],
"name" : [
{
"text" : "Charles Johnson",
"family" : "Charles",
"given" : [
"Johnson"
]
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/Location/location1",
"resource" : {
"resourceType" : "Location",
"id" : "location1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Location-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Location_location1\"> </a><p><b>Generated Narrative: Location </b><a name=\"location1\"> </a><a name=\"hclocation1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceLocation "location1" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Location-eltss.html\">Location_eltss</a></p></div><p><b>name</b>: In Home</p><p><b>address</b>: 111 Maple Ct, San Antonio, TX 78212</p></div>"
},
"name" : "In Home",
"address" : {
"text" : "111 Maple Ct, San Antonio, TX 78212"
}
}
},
{
"fullUrl" : "https://hl7.org/fhir/Condition/need1",
"resource" : {
"resourceType" : "Condition",
"id" : "need1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Condition-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Condition_need1\"> </a><p><b>Generated Narrative: Condition </b><a name=\"need1\"> </a><a name=\"hcneed1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceCondition "need1" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Condition-eltss.html\">Condition_eltss</a></p></div><p><b>clinicalStatus</b>: Active <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html\">Condition Clinical Status Codes</a>#active)</span></p><p><b>verificationStatus</b>: Confirmed <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-ver-status.html\">ConditionVerificationStatus</a>#confirmed)</span></p><p><b>category</b>: Health Concern <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/us/core/STU6.1/CodeSystem-condition-category.html\">US Core Condition Category Extension Codes</a>#health-concern)</span>, Assessed Need <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-eltss-condition-category-code.html\">eLTSS Condition Category Codes</a>#assessed-need)</span>, SDOH <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/us/core/STU6.1/CodeSystem-us-core-category.html\">US Core Category</a>#sdoh)</span></p><p><b>code</b>: Needs transportation <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#713458007 "Lack of access to transportation (finding)")</span></p><p><b>subject</b>: See on this page: Patient/patientBSJ1</p></div>"
},
"clinicalStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "active"
}
]
},
"verificationStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code" : "confirmed"
}
]
},
"category" : [
{
"coding" : [
{
"system" : "http://hl7.org/fhir/us/core/CodeSystem/condition-category",
"code" : "health-concern",
"display" : "Health Concern"
}
]
},
{
"coding" : [
{
"system" : "http://hl7.org/fhir/us/eltss/CodeSystem/eltss-condition-category-code",
"code" : "assessed-need"
}
]
},
{
"coding" : [
{
"system" : "http://hl7.org/fhir/us/core/CodeSystem/us-core-category",
"code" : "sdoh"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "713458007",
"display" : "Lack of access to transportation (finding)"
}
],
"text" : "Needs transportation"
},
"subject" : {
🔗 "reference" : "Patient/patientBSJ1"
}
}
},
{
"fullUrl" : "https://hl7.org/fhir/Condition/need2",
"resource" : {
"resourceType" : "Condition",
"id" : "need2",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Condition-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Condition_need2\"> </a><p><b>Generated Narrative: Condition </b><a name=\"need2\"> </a><a name=\"hcneed2\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceCondition "need2" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Condition-eltss.html\">Condition_eltss</a></p></div><p><b>clinicalStatus</b>: Active <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html\">Condition Clinical Status Codes</a>#active)</span></p><p><b>verificationStatus</b>: Confirmed <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-ver-status.html\">ConditionVerificationStatus</a>#confirmed)</span></p><p><b>category</b>: Health Concern <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/us/core/STU6.1/CodeSystem-condition-category.html\">US Core Condition Category Extension Codes</a>#health-concern)</span>, Assessed Need <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-eltss-condition-category-code.html\">eLTSS Condition Category Codes</a>#assessed-need)</span></p><p><b>code</b>: Needs health / nutrition education for diabetes <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#734920002 "Diabetes mellitus education service")</span></p><p><b>subject</b>: See on this page: Patient/patientBSJ1</p></div>"
},
"clinicalStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "active"
}
]
},
"verificationStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code" : "confirmed"
}
]
},
"category" : [
{
"coding" : [
{
"system" : "http://hl7.org/fhir/us/core/CodeSystem/condition-category",
"code" : "health-concern",
"display" : "Health Concern"
}
]
},
{
"coding" : [
{
"system" : "http://hl7.org/fhir/us/eltss/CodeSystem/eltss-condition-category-code",
"code" : "assessed-need"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "734920002",
"display" : "Diabetes mellitus education service"
}
],
"text" : "Needs health / nutrition education for diabetes"
},
"subject" : {
🔗 "reference" : "Patient/patientBSJ1"
}
}
},
{
"fullUrl" : "https://hl7.org/fhir/Condition/need3",
"resource" : {
"resourceType" : "Condition",
"id" : "need3",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Condition-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Condition_need3\"> </a><p><b>Generated Narrative: Condition </b><a name=\"need3\"> </a><a name=\"hcneed3\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceCondition "need3" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Condition-eltss.html\">Condition_eltss</a></p></div><p><b>clinicalStatus</b>: Active <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html\">Condition Clinical Status Codes</a>#active)</span></p><p><b>verificationStatus</b>: Confirmed <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-ver-status.html\">ConditionVerificationStatus</a>#confirmed)</span></p><p><b>category</b>: Health Concern <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/us/core/STU6.1/CodeSystem-condition-category.html\">US Core Condition Category Extension Codes</a>#health-concern)</span>, Assessed Need <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-eltss-condition-category-code.html\">eLTSS Condition Category Codes</a>#assessed-need)</span>, Cognitive Status <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/us/core/STU6.1/CodeSystem-us-core-category.html\">US Core Category</a>#cognitive-status)</span></p><p><b>code</b>: Depression (on treatment) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#35489007 "Depressive disorder (disorder)")</span></p><p><b>subject</b>: See on this page: Patient/patientBSJ1</p></div>"
},
"clinicalStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "active"
}
]
},
"verificationStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code" : "confirmed"
}
]
},
"category" : [
{
"coding" : [
{
"system" : "http://hl7.org/fhir/us/core/CodeSystem/condition-category",
"code" : "health-concern",
"display" : "Health Concern"
}
]
},
{
"coding" : [
{
"system" : "http://hl7.org/fhir/us/eltss/CodeSystem/eltss-condition-category-code",
"code" : "assessed-need"
}
]
},
{
"coding" : [
{
"system" : "http://hl7.org/fhir/us/core/CodeSystem/us-core-category",
"code" : "cognitive-status"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "35489007",
"display" : "Depressive disorder (disorder)"
}
],
"text" : "Depression (on treatment)"
},
"subject" : {
🔗 "reference" : "Patient/patientBSJ1"
}
}
},
{
"fullUrl" : "https://hl7.org/fhir/Condition/need4",
"resource" : {
"resourceType" : "Condition",
"id" : "need4",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Condition-eltss"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Condition_need4\"> </a><p><b>Generated Narrative: Condition </b><a name=\"need4\"> </a><a name=\"hcneed4\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceCondition "need4" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Condition-eltss.html\">Condition_eltss</a></p></div><p><b>Condition Due To</b>: See on this page: Condition/need3</p><p><b>clinicalStatus</b>: Active <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html\">Condition Clinical Status Codes</a>#active)</span></p><p><b>verificationStatus</b>: Confirmed <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-ver-status.html\">ConditionVerificationStatus</a>#confirmed)</span></p><p><b>category</b>: Health Concern <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/us/core/STU6.1/CodeSystem-condition-category.html\">US Core Condition Category Extension Codes</a>#health-concern)</span>, Assessed Need <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-eltss-condition-category-code.html\">eLTSS Condition Category Codes</a>#assessed-need)</span>, SDOH <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/us/core/STU6.1/CodeSystem-us-core-category.html\">US Core Category</a>#sdoh)</span></p><p><b>code</b>: Needs physical exercises <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#183301007 "Physical exercises (regime/therapy)")</span></p><p><b>subject</b>: See on this page: Patient/patientBSJ1</p></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/condition-dueTo",
"valueReference" : {
🔗 "reference" : "Condition/need3"
}
}
],
"clinicalStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "active"
}
]
},
"verificationStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code" : "confirmed"
}
]
},
"category" : [
{
"coding" : [
{
"system" : "http://hl7.org/fhir/us/core/CodeSystem/condition-category",
"code" : "health-concern",
"display" : "Health Concern"
}
]
},
{
"coding" : [
{
"system" : "http://hl7.org/fhir/us/eltss/CodeSystem/eltss-condition-category-code",
"code" : "assessed-need"
}
]
},
{
"coding" : [
{
"system" : "http://hl7.org/fhir/us/core/CodeSystem/us-core-category",
"code" : "sdoh"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "183301007",
"display" : "Physical exercises (regime/therapy)"
}
],
"text" : "Needs physical exercises"
},
"subject" : {
🔗 "reference" : "Patient/patientBSJ1"
}
}
},
{
"fullUrl" : "https://hl7.org/fhir/Observation/pref1",
"resource" : {
"resourceType" : "Observation",
"id" : "pref1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Observation-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_pref1\"> </a><p><b>Generated Narrative: Observation </b><a name=\"pref1\"> </a><a name=\"hcpref1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceObservation "pref1" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Observation-eltss.html\">Observation_eltss</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Social History <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#social-history)</span></p><p><b>code</b>: Care experience preference <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#95541-9)</span></p><p><b>subject</b>: See on this page: Patient/patientBSJ1</p><p><b>effective</b>: 2013-04-02 10:30:10+0100</p><p><b>issued</b>: Apr 3, 2013, 2:30:10 PM</p><p><b>performer</b>: See on this page: Practitioner/caremgr1: Care Manager</p><p><b>value</b>: Accessing the ICWP Waiver for her current service needs, and would like to remain on ICWP and continue with her current services.</p></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "social-history",
"display" : "Social History"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "95541-9",
"display" : "Care experience preference"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"effectiveDateTime" : "2013-04-02T10:30:10+01:00",
"issued" : "2013-04-03T15:30:10+01:00",
"performer" : [
{
🔗 "reference" : "Practitioner/caremgr1",
"display" : "Care Manager"
}
],
"valueString" : "Accessing the ICWP Waiver for her current service needs, and would like to remain on ICWP and continue with her current services."
}
},
{
"fullUrl" : "https://hl7.org/fhir/Organization/provider2a",
"resource" : {
"resourceType" : "Organization",
"id" : "provider2a",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_provider2a\"> </a><p><b>Generated Narrative: Organization </b><a name=\"provider2a\"> </a><a name=\"hcprovider2a\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceOrganization "provider2a" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-organization.html\">US Core Organization Profile</a></p></div><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.5.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/1144221847, <a href=\"http://terminology.hl7.org/5.5.0/NamingSystem-CLIA.html\" title=\""The Centers for Medicare & Medicaid Services (CMS) regulates all laboratory testing (except research) performed on humans in the U.S. through the Clinical Laboratory Improvement Amendments (CLIA). In total, CLIA covers approximately 330,000 laboratory entities. The Division of Clinical Laboratory Improvement & Quality, within the Quality, Safety & Oversight Group, under the Center for Clinical Standards and Quality (CCSQ) has the responsibility for implementing the CLIA Program.\r\n\r\nThe objective of the CLIA program is to ensure quality laboratory testing. Although all clinical laboratories must be properly certified to receive Medicare or Medicaid payments, CLIA has no direct Medicare or Medicaid program responsibilities."\r\n\r\nCMS CLIA certified laboratories will be assigned a10-digit alphanumeric CLIA identification number, with the "D" in the third position identifying the provider/supplier as a laboratory certified under CLIA."\r\n\r\nCLIA is maintained by CMS. It is in the public domain and free to use without restriction.\r\n\r\nSee http://cms.gov/regulations-and-guidance/legislation/clia.\">Clinical Laboratory Improvement Amendments</a>/12D4567890</p><p><b>active</b>: true</p><p><b>name</b>: The Transporter, Inc.</p><p><b>telecom</b>: ph: (210) 555 1313</p><p><b>address</b>: 111 Business Street, San Antonio, TX 78212</p></div>"
},
"identifier" : [
{
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "1144221847"
},
{
"system" : "urn:oid:2.16.840.1.113883.4.7",
"value" : "12D4567890"
}
],
"active" : true,
"name" : "The Transporter, Inc.",
"telecom" : [
{
"system" : "phone",
"value" : "(210) 555 1313"
}
],
"address" : [
{
"text" : "111 Business Street, San Antonio, TX 78212"
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/Practitioner/provider2b",
"resource" : {
"resourceType" : "Practitioner",
"id" : "provider2b",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_provider2b\"> </a><p><b>Generated Narrative: Practitioner </b><a name=\"provider2b\"> </a><a name=\"hcprovider2b\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourcePractitioner "provider2b" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Practitioner-eltss.html\">Practitioner_eltss</a></p></div><p><b>identifier</b>: <code>http://www.acme.org/practitioners</code>/11223344</p><p><b>name</b>: Bill Driver</p><p><b>telecom</b>: ph: (210) 111 2222</p></div>"
},
"identifier" : [
{
"system" : "http://www.acme.org/practitioners",
"value" : "11223344"
}
],
"name" : [
{
"text" : "Bill Driver",
"family" : "Driver",
"given" : [
"Bill"
]
}
],
"telecom" : [
{
"system" : "phone",
"value" : "(210) 111 2222"
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/Practitioner/provider3",
"resource" : {
"resourceType" : "Practitioner",
"id" : "provider3",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_provider3\"> </a><p><b>Generated Narrative: Practitioner </b><a name=\"provider3\"> </a><a name=\"hcprovider3\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourcePractitioner "provider3" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Practitioner-eltss.html\">Practitioner_eltss</a></p></div><p><b>identifier</b>: <code>http://www.acme.org/practitioners</code>/987654</p><p><b>name</b>: Lisa Educator</p><p><b>telecom</b>: ph: (210) 555 1213</p></div>"
},
"identifier" : [
{
"system" : "http://www.acme.org/practitioners",
"value" : "987654"
}
],
"name" : [
{
"text" : "Lisa Educator",
"family" : "Educator",
"given" : [
"Lisa"
]
}
],
"telecom" : [
{
"system" : "phone",
"value" : "(210) 555 1213"
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/Practitioner/provider4",
"resource" : {
"resourceType" : "Practitioner",
"id" : "provider4",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_provider4\"> </a><p><b>Generated Narrative: Practitioner </b><a name=\"provider4\"> </a><a name=\"hcprovider4\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourcePractitioner "provider4" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Practitioner-eltss.html\">Practitioner_eltss</a></p></div><p><b>identifier</b>: <code>http://www.acme.org/practitioners</code>/987657</p><p><b>name</b>: Norma Trainer</p><p><b>telecom</b>: ph: (210) 555 1214</p></div>"
},
"identifier" : [
{
"system" : "http://www.acme.org/practitioners",
"value" : "987657"
}
],
"name" : [
{
"text" : "Norma Trainer",
"family" : "Trainer",
"given" : [
"Norma"
]
}
],
"telecom" : [
{
"system" : "phone",
"value" : "(210) 555 1214"
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/PractitionerRole/PractitionerRole-1",
"resource" : {
"resourceType" : "PractitionerRole",
"id" : "PractitionerRole-1",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/PractitionerRole-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"PractitionerRole_PractitionerRole-1\"> </a><p><b>Generated Narrative: PractitionerRole </b><a name=\"PractitionerRole-1\"> </a><a name=\"hcPractitionerRole-1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourcePractitionerRole "PractitionerRole-1" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-PractitionerRole-eltss.html\">eLTSS PractitionerRole Profile</a></p></div><p><b>practitioner</b>: See on this page: Practitioner/caremgr1: Sam Monitor</p><p><b>organization</b>: See on this page: Organization/funding1: Texas Department of Community Health</p><p><b>code</b>: Community Health Worker <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (provider-taxonomy#172V00000X)</span></p><p><b>specialty</b>: Case Manager/Care Coordinator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (provider-taxonomy#171M00000X)</span></p><p><b>location</b>: See on this page: Location/communitysite: Health Level Seven International</p><p><b>telecom</b>: ph: (210) 555 1222</p></div>"
},
"practitioner" : {
🔗 "reference" : "Practitioner/caremgr1",
"display" : "Sam Monitor"
},
"organization" : {
🔗 "reference" : "Organization/funding1",
"display" : "Texas Department of Community Health"
},
"code" : [
{
"coding" : [
{
"system" : "http://nucc.org/provider-taxonomy",
"code" : "172V00000X",
"display" : "Community Health Worker"
}
]
}
],
"specialty" : [
{
"coding" : [
{
"system" : "http://nucc.org/provider-taxonomy",
"code" : "171M00000X",
"display" : "Case Manager/Care Coordinator"
}
]
}
],
"location" : [
{
🔗 "reference" : "Location/communitysite",
"display" : "Health Level Seven International"
}
],
"telecom" : [
{
"system" : "phone",
"value" : "(210) 555 1222"
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/Location/communitysite",
"resource" : {
"resourceType" : "Location",
"id" : "communitysite",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Location-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Location_communitysite\"> </a><p><b>Generated Narrative: Location </b><a name=\"communitysite\"> </a><a name=\"hccommunitysite\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceLocation "communitysite" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Location-eltss.html\">Location_eltss</a></p></div><p><b>name</b>: In Home</p><p><b>address</b>: 7430 Louis Pasteur Dr, San Antonio, TX 78229</p></div>"
},
"name" : "In Home",
"address" : {
"text" : "7430 Louis Pasteur Dr, San Antonio, TX 78229"
}
}
},
{
"fullUrl" : "https://hl7.org/fhir/Questionnaire/questionnaire1",
"resource" : {
"resourceType" : "Questionnaire",
"id" : "questionnaire1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Questionnaire-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Questionnaire_questionnaire1\"> </a><p><b>Generated Narrative: Questionnaire </b><a name=\"questionnaire1\"> </a><a name=\"hcquestionnaire1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceQuestionnaire "questionnaire1" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Questionnaire-eltss.html\">Questionnaire_eltss</a></p></div><p><b>url</b>: <code>http://hl7.org/fhir/us/eltss/Questionnaire/questionnaire1</code></p><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.5.0/NamingSystem-uri.html\" title=\"As defined by RFC 3986 (http://www.ietf.org/rfc/rfc3986.txt)(with many schemes defined in many RFCs). For OIDs and UUIDs, use the URN form (urn:oid:(note: lowercase) and urn:uuid:). See http://www.ietf.org/rfc/rfc3001.txt and http://www.ietf.org/rfc/rfc4122.txt \r\n\r\nThis oid is used as an identifier II.root to indicate the the extension is an absolute URI (technically, an IRI). Typically, this is used for OIDs and GUIDs. Note that when this OID is used with OIDs and GUIDs, the II.extension should start with urn:oid or urn:uuid: \r\n\r\nNote that this OID is created to aid with interconversion between CDA and FHIR - FHIR uses urn:ietf:rfc:3986 as equivalent to this OID. URIs as identifiers appear more commonly in FHIR.\r\n\r\nThis OID may also be used in CD.codeSystem.\">Uniform Resource Identifier (URI)</a>/urn:oid:2.999</p><p><b>name</b>: Questionnaire1</p><p><b>status</b>: active</p><blockquote><p><b>item</b></p><p><b>linkId</b>: q1</p><p><b>text</b>: Did you choose the setting in which you reside?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: q2</p><p><b>text</b>: What alternative home and community-based settings were considered?</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: q3</p><p><b>text</b>: Were you given a choice of services outlined in the plan?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: q4</p><p><b>text</b>: Did you participate in the selection of services outlined in the plan?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: q5</p><p><b>text</b>: Do you agree to the services outlined in the plan?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: q6</p><p><b>text</b>: Were you offered a choice of providers for each service?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: q7</p><p><b>text</b>: Do you feel you made an informed choice in selecting the provider for each service?</p><p><b>type</b>: boolean</p></blockquote></div>"
},
"url" : "http://hl7.org/fhir/us/eltss/Questionnaire/questionnaire1",
"identifier" : [
{
"system" : "urn:ietf:rfc:3986",
"value" : "urn:oid:2.999"
}
],
"name" : "Questionnaire1",
"status" : "active",
"item" : [
{
"linkId" : "q1",
"text" : "Did you choose the setting in which you reside?",
"type" : "boolean"
},
{
"linkId" : "q2",
"text" : "What alternative home and community-based settings were considered?",
"type" : "string"
},
{
"linkId" : "q3",
"text" : "Were you given a choice of services outlined in the plan?",
"type" : "boolean"
},
{
"linkId" : "q4",
"text" : "Did you participate in the selection of services outlined in the plan?",
"type" : "boolean"
},
{
"linkId" : "q5",
"text" : "Do you agree to the services outlined in the plan?",
"type" : "boolean"
},
{
"linkId" : "q6",
"text" : "Were you offered a choice of providers for each service?",
"type" : "boolean"
},
{
"linkId" : "q7",
"text" : "Do you feel you made an informed choice in selecting the provider for each service?",
"type" : "boolean"
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/QuestionnaireResponse/questionnaireresponse1",
"resource" : {
"resourceType" : "QuestionnaireResponse",
"id" : "questionnaireresponse1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/QuestionnaireResponse-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"QuestionnaireResponse_questionnaireresponse1\"> </a><p><b>Generated Narrative: QuestionnaireResponse </b><a name=\"questionnaireresponse1\"> </a><a name=\"hcquestionnaireresponse1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceQuestionnaireResponse "questionnaireresponse1" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-QuestionnaireResponse-eltss.html\">eLTSS QuestionnaireResponse Profile</a></p></div><p><b>questionnaire</b>: <a href=\"Questionnaire-questionnaire1.html\">Questionnaire1</a></p><p><b>status</b>: completed</p><p><b>subject</b>: See on this page: Patient/patientBSJ1</p><p><b>authored</b>: 2020-09-03 10:16:03-0400</p><blockquote><p><b>item</b></p><p><b>linkId</b>: q1</p><h3>Answers</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>true</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: q2</p><h3>Answers</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>Assisted living facility</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: q3</p><h3>Answers</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>true</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: q4</p><h3>Answers</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>true</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: q5</p><h3>Answers</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>true</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: q6</p><h3>Answers</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>true</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: q7</p><h3>Answers</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>true</td></tr></table></blockquote></div>"
},
"questionnaire" : "http://hl7.org/fhir/us/eltss/Questionnaire/questionnaire1",
"status" : "completed",
"subject" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"authored" : "2020-09-03T10:16:03.512-04:00",
"item" : [
{
"linkId" : "q1",
"answer" : [
{
"valueBoolean" : true
}
]
},
{
"linkId" : "q2",
"answer" : [
{
"valueString" : "Assisted living facility"
}
]
},
{
"linkId" : "q3",
"answer" : [
{
"valueBoolean" : true
}
]
},
{
"linkId" : "q4",
"answer" : [
{
"valueBoolean" : true
}
]
},
{
"linkId" : "q5",
"answer" : [
{
"valueBoolean" : true
}
]
},
{
"linkId" : "q6",
"answer" : [
{
"valueBoolean" : true
}
]
},
{
"linkId" : "q7",
"answer" : [
{
"valueBoolean" : true
}
]
}
]
}
},
{
"fullUrl" : "https://hl7.org/fhir/RiskAssessment/risk1",
"resource" : {
"resourceType" : "RiskAssessment",
"id" : "risk1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/RiskAssessment-eltss"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"RiskAssessment_risk1\"> </a><p><b>Generated Narrative: RiskAssessment </b><a name=\"risk1\"> </a><a name=\"hcrisk1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceRiskAssessment "risk1" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-RiskAssessment-eltss.html\">RiskAssessment_eltss</a></p></div><p><b>RiskPlan</b>: <span>: This points to a management plan for any risks. This is not the backup plan, which is an alternative plan for the CarePlan. The risk management plan is meant to help avoid needing the backup plan.</span></p><p><b>status</b>: final</p><p><b>subject</b>: See on this page: Patient/patientBSJ1</p><blockquote><p><b>prediction</b></p><p><b>outcome</b>: At risk for falls (finding) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#129839007)</span></p></blockquote><blockquote><p><b>prediction</b></p><p><b>outcome</b>: At risk of stroke <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#866240007)</span></p></blockquote><p><b>mitigation</b>: Betsy is at risk for falls and of having a stroke. Her risk is increased due to her depression medication. She has grab bars installed in the shower and is working on her balance with a trainer.</p></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/us/eltss/StructureDefinition/eltss-RiskPlan",
"valueReference" : {
"display" : "This points to a management plan for any risks. This is not the backup plan, which is an alternative plan for the CarePlan. The risk management plan is meant to help avoid needing the backup plan."
}
}
],
"status" : "final",
"subject" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"prediction" : [
{
"outcome" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "129839007"
}
],
"text" : "At risk for falls (finding)"
}
},
{
"outcome" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "866240007"
}
],
"text" : "At risk of stroke"
}
}
],
"mitigation" : "Betsy is at risk for falls and of having a stroke. Her risk is increased due to her depression medication. She has grab bars installed in the shower and is working on her balance with a trainer."
}
},
{
"fullUrl" : "https://hl7.org/fhir/ServiceRequest/service1",
"resource" : {
"resourceType" : "ServiceRequest",
"id" : "service1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/ServiceRequest-eltss"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ServiceRequest_service1\"> </a><p><b>Generated Narrative: ServiceRequest </b><a name=\"service1\"> </a><a name=\"hcservice1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceServiceRequest "service1" Version"1" Updated"2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ServiceRequest-eltss.html\">ServiceRequest_eltss</a></p></div><p><b>Eltss_directedBy</b>: self <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>status</b>: active</p><p><b>intent</b>: plan</p><p><b>code</b>: Bath tub wall rail, each <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-hcpcs-Level-II.html\">Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes</a>#E0241)</span></p><p><b>quantity</b>: 1 install<span style=\"background: LightGoldenRodYellow\"> (Details: NCI Thesaurus codeC81906 = 'Deploy')</span></p><p><b>subject</b>: See on this page: Patient/patientBSJ1</p><p><b>occurrence</b>: 2020-05-01 --> 2020-12-31</p><p><b>performer</b>: See on this page: RelatedPerson/son1</p><p><b>locationReference</b>: See on this page: Location/location1</p><p><b>supportingInfo</b>: See on this page: RiskAssessment/risk1</p></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/us/eltss/StructureDefinition/eltss-directedBy",
"valueCodeableConcept" : {
"text" : "self"
}
}
],
"status" : "active",
"intent" : "plan",
"code" : {
"coding" : [
{
"system" : "http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets",
"code" : "E0241"
}
],
"text" : "Bath tub wall rail, each"
},
"quantityQuantity" : {
"value" : 1,
"unit" : "install",
"system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
"code" : "C81906"
},
"subject" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"occurrencePeriod" : {
"start" : "2020-05-01",
"end" : "2020-12-31"
},
"performer" : [
{
🔗 "reference" : "RelatedPerson/son1"
}
],
"locationReference" : [
{
🔗 "reference" : "Location/location1"
}
],
"supportingInfo" : [
{
🔗 "reference" : "RiskAssessment/risk1"
}
]
}
}
]
}
IG © 2020+ HL7 International / Human and Social Services. Package hl7.fhir.us.eltss#2.0.0 based on FHIR 4.0.1. Generated 2024-05-27
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