Electronic Long-Term Services and Supports (eLTSS) Release 1 - US Realm
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This page is part of the electronic Long-Term Services and Supports Implementation Guide (v2.0.0-ballot: STU2 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

: patientBSJ1 - JSON Representation

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{
  "resourceType" : "Patient",
  "id" : "patientBSJ1",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Patient-eltss"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\"><b>Betsy Smith-Johnson</b> female, DoB: 1950-11-01 ( Medical Record Number:\u00a0<a href=\"http://terminology.hl7.org/5.3.0/NamingSystem-medicareHIC.html\">#</a>10A3D58WH1600\u00a0(use:\u00a0USUAL))</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Record is active\">Active:</td><td>true</td><td style=\"background-color: #f3f5da\" title=\"Known Marital status of Patient\">Marital Status:</td><td colspan=\"3\"><span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus U}\">Not married</span></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Details:</td><td colspan=\"3\"><ul><li>ph: 210-222-1111(MOBILE)</li><li>111 Maple Ct, San Antonio, TX 78212</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Languages spoken\">Language:</td><td colspan=\"3\"><span title=\"Codes: {urn:ietf:bcp:47 en}\">US</span> (preferred)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Patient contact\">Contact</td><td colspan=\"3\"><ul><li>Charles Johnson</li><li>Relationships: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-RoleCode SONC}\">Son</span>, <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v2-0131 C}\">Emergency Contact</span>, <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-RoleCode GUARD}\">Guardian</span></li><li>100 Montana St., San Antonio, TX 78203</li><li>ph: (210) 222-3333</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Nominated Contact: Daughter\">Daughter:</td><td colspan=\"3\"><ul><li>Debra Johnson</li><li>333 W. Camden St., Baltimore, MD 21201</li><li>ph: (410) 444-5555</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.\">US Core Ethnicity Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-cdcrec.html#cdcrec-2186-5\">Race &amp; Ethnicity - CDC</a> 2186-5: Not Hispanic or Latino</li><li>text: Not Hispanic or Latino</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories:\n\n - American Indian or Alaska Native\n - Asian\n - Black or African American\n - Native Hawaiian or Other Pacific Islander\n - White.\">US Core Race Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-cdcrec.html#cdcrec-2106-3\">Race &amp; Ethnicity - CDC</a> 2106-3: White</li><li>text: White</li></ul></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
    }
  ]
}