Electronic Long-Term Services and Supports (eLTSS) Release 1 - US Realm
2.0.0 - STU2 United States of America flag

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

Example ServiceRequest: service2

Page standards status: Informative

Generated Narrative: ServiceRequest

ResourceServiceRequest "service2" Version"1" Updated"2020-09-03 10:16:03-0400"

Information Source: #KZ0jzPjXDrhCiMif!

Profile: ServiceRequest_eltss

status: active

intent: plan

code: Non-emergency transportation; encounter/trip (Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes#T2003)

quantity: 2 trips (Details: NCI Thesaurus codeC141286 = 'Transportation')/1 month (Details: UCUM codemo = 'mo')

subject: Patient/patientBSJ1 " SMITH-JOHNSON"

occurrence: 2020-07-01 --> 2020-12-31

performer: Organization/provider2a "The Transporter, Inc."

reasonReference: Condition/need1

insurance: Coverage/coverage1

supportingInfo: Claim/claim1

note: Service provider will provide a reminder the business day before the trip, and will call when on the way.