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 in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
<Bundle xmlns="http://hl7.org/fhir">
<id value="2039212f3fa5406bb4ffd4a"/>
<type value="collection"/>
<link>
<relation value="self"/>
<url value="https://example.com/base/CarePlan/253/$all-eltss-careplan"/>
</link>
<entry>
<fullUrl value="https://hl7.org/fhir/Patient/patientBSJ1"/>
<resource>
<Patient>
<id value="patientBSJ1"/>
<meta>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Patient-eltss"/>
</meta>
<text>
<status value="extensions"/>
<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 (use: usual)</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>
</text>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race">
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2106-3"/>
<display value="White"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="White"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity">
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2186-5"/>
<display value="Not Hispanic or Latino"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="Not Hispanic or Latino"/>
</extension>
</extension>
<identifier>
<use value="usual"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MR"/>
<display value="Medical Record Number"/>
</coding>
</type>
<system value="http://hl7.org/fhir/sid/us-medicare"/>
<value value="10A3D58WH1600"/>
</identifier>
<active value="true"/>
<name>
<text value="Betsy Smith-Johnson"/>
<family value="Smith-Johnson"/>
<given value="Betsy"/>
</name>
<telecom>
<system value="phone"/>
<value value="210-222-1111"/>
<use value="mobile"/>
</telecom>
<gender value="female"/>
<birthDate value="1950-11-01"/>
<address>
<text value="111 Maple Ct, San Antonio, TX 78212"/>
<line value="111 Maple Ct"/>
<city value="San Antonio"/>
<district value="Bexar"/>
<state value="TX"/>
<postalCode value="78212"/>
</address>
<maritalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-MaritalStatus"/>
<code value="U"/>
<display value="unmarried"/>
</coding>
<text value="Not married"/>
</maritalStatus>
<contact>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="SONC"/>
<display value="Son"/>
</coding>
</relationship>
<relationship>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0131"/>
<code value="C"/>
<display value="Emergency Contact"/>
</coding>
</relationship>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="GUARD"/>
<display value="Guardian"/>
</coding>
</relationship>
<name>
<text value="Charles Johnson"/>
<family value="Johnson"/>
<given value="Charles"/>
</name>
<telecom>
<system value="phone"/>
<value value="(210) 222-3333"/>
</telecom>
<address>
<text value="100 Montana St., San Antonio, TX 78203"/>
</address>
</contact>
<contact>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="DAUC"/>
<display value="Daughter"/>
</coding>
</relationship>
<name>
<text value="Debra Johnson"/>
<family value="Johnson"/>
<given value="Debra"/>
</name>
<telecom>
<system value="phone"/>
<value value="(410) 444-5555"/>
</telecom>
<address>
<text value="333 W. Camden St., Baltimore, MD 21201"/>
</address>
</contact>
<communication>
<language>
<coding>
<system value="urn:ietf:bcp:47"/>
<code value="en"/>
<display value="English"/>
</coding>
<text value="US"/>
</language>
<preferred value="true"/>
</communication>
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/CarePlan/careplan1"/>
<resource>
<CarePlan>
<id value="careplan1"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/CarePlan-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<intent value="plan"/>
<category>
<coding>
<system
value="http://hl7.org/fhir/us/core/CodeSystem/careplan-category"/>
<code value="assess-plan"/>
</coding>
</category>
<title value="Betsy Smith Johnson's Services and Supports Plan"/>
<description
value="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 value="Patient/patientBSJ1"/>
</subject>
<period>
<start value="2020-05-01"/>
<end value="2020-12-31"/>
</period>
<author>🔗
<reference value="Practitioner/planner1"/>
</author>
<addresses>🔗
<reference value="Condition/need1"/>
</addresses>
<addresses>🔗
<reference value="Condition/need2"/>
</addresses>
<addresses>🔗
<reference value="Condition/need3"/>
</addresses>
<addresses>🔗
<reference value="Condition/need4"/>
</addresses>
<supportingInfo>🔗
<reference value="Observation/strength1"/>
</supportingInfo>
<supportingInfo>🔗
<reference value="Observation/strength2"/>
</supportingInfo>
<supportingInfo>🔗
<reference value="Observation/pref1"/>
</supportingInfo>
<supportingInfo>🔗
<reference value="QuestionnaireResponse/questionnaireresponse1"/>
</supportingInfo>
<supportingInfo>🔗
<reference value="Contract/contract1"/>
</supportingInfo>
<supportingInfo>🔗
<reference value="RiskAssessment/risk1"/>
</supportingInfo>
<goal>🔗
<reference value="Goal/goal1"/>
</goal>
<goal>🔗
<reference value="Goal/goal2"/>
</goal>
<activity>
<reference>🔗
<reference value="ServiceRequest/service1"/>
<display value="Service 1"/>
</reference>
</activity>
<activity>
<reference>🔗
<reference value="ServiceRequest/service2"/>
<display value="Service 2"/>
</reference>
</activity>
<activity>
<reference>🔗
<reference value="ServiceRequest/service3"/>
<display value="Service 3"/>
</reference>
</activity>
<activity>
<reference>🔗
<reference value="ServiceRequest/service4"/>
<display value="Service 4"/>
</reference>
</activity>
<activity>
<progress>
<time value="2020-05-10"/>
<text value="Betsy will start doing balance exercises"/>
</progress>
<reference>🔗
<reference value="Task/Task1"/>
<display value="Task1"/>
</reference>
</activity>
<activity>
<progress>
<time value="2020-05-10"/>
<text
value="Betsy working on mobility to dance at son's upcoming wedding"/>
</progress>
<reference>🔗
<reference value="Task/Task2"/>
<display value="Task2"/>
</reference>
</activity>
</CarePlan>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Task/Task1"/>
<resource>
<Task>
<id value="Task1"/>
<text>
<status value="extensions"/>
<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>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal">
<valueReference>🔗
<reference value="Goal/goal1"/>
</valueReference>
</extension>
<status value="ready"/>
<intent value="order"/>
<priority value="routine"/>
<code>
<coding>
<system value="http://hl7.org/fhir/CodeSystem/task-code"/>
<code value="fulfill"/>
<display value="Fulfill the focal request"/>
</coding>
</code>
<description value="Perform exercises to improve balance skills."/>
<for>🔗
<reference value="Patient/patientBSJ1"/>
<display value="Betsy"/>
</for>
<requester>🔗
<reference value="Practitioner/planner1"/>
<display value="Mark Planner"/>
</requester>
<owner>🔗
<reference value="Patient/patientBSJ1"/>
<display value="Betsy"/>
</owner>
</Task>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Task/Task2"/>
<resource>
<Task>
<id value="Task2"/>
<text>
<status value="extensions"/>
<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>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal">
<valueReference>🔗
<reference value="Goal/goal2"/>
</valueReference>
</extension>
<status value="ready"/>
<intent value="order"/>
<priority value="routine"/>
<code>
<coding>
<system value="http://hl7.org/fhir/CodeSystem/task-code"/>
<code value="fulfill"/>
<display value="Fulfill the focal request"/>
</coding>
</code>
<description
value="Son working with Besty to work on mobility to dance at son's upcoming wedding."/>
<for>🔗
<reference value="Patient/patientBSJ1"/>
<display value="Betsy"/>
</for>
<requester>🔗
<reference value="Practitioner/planner1"/>
<display value="Mark Planner"/>
</requester>
<owner>🔗
<reference value="RelatedPerson/son1"/>
<display value="Charles - Betsy's son"/>
</owner>
</Task>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Goal/goal2"/>
<resource>
<Goal>
<id value="goal2"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Goal-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<lifecycleStatus value="accepted"/>
<description>
<text value="Dance at son's upcoming wedding"/>
</description>
<subject>🔗
<reference value="Patient/patientBSJ1"/>
</subject>
</Goal>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Goal/goal1"/>
<resource>
<Goal>
<id value="goal1"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Goal-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<lifecycleStatus value="accepted"/>
<description>
<text value="Improve balance skills"/>
</description>
<subject>🔗
<reference value="Patient/patientBSJ1"/>
</subject>
</Goal>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Practitioner/planner1"/>
<resource>
<Practitioner>
<id value="planner1"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="9941339100"/>
</identifier>
<identifier>
<system value="http://www.acme.org/practitioners"/>
<value value="25456"/>
</identifier>
<name>
<text value="Mark Planner"/>
<family value="Planner"/>
<given value="Mark"/>
</name>
<telecom>
<system value="phone"/>
<value value="(210) 555 1221"/>
</telecom>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/ServiceRequest/service2"/>
<resource>
<ServiceRequest>
<id value="service2"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/ServiceRequest-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<intent value="plan"/>
<code>
<coding>
<system
value="http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"/>
<code value="T2003"/>
</coding>
<text value="Non-emergency transportation; encounter/trip"/>
</code>
<quantityRatio>
<numerator>
<value value="2"/>
<unit value="trips"/>
<system
value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C141286"/>
</numerator>
<denominator>
<value value="1"/>
<unit value="month"/>
<system value="http://unitsofmeasure.org"/>
<code value="mo"/>
</denominator>
</quantityRatio>
<subject>🔗
<reference value="Patient/patientBSJ1"/>
</subject>
<occurrencePeriod>
<start value="2020-07-01"/>
<end value="2020-12-31"/>
</occurrencePeriod>
<performer>🔗
<reference value="Organization/provider2a"/>
</performer>
<reasonReference>🔗
<reference value="Condition/need1"/>
</reasonReference>
<insurance>🔗
<reference value="Coverage/coverage1"/>
</insurance>
<supportingInfo>🔗
<reference value="Claim/claim1"/>
</supportingInfo>
<note>
<text
value="Service provider will provide a reminder the business day before the trip, and will call when on the way."/>
</note>
</ServiceRequest>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/ServiceRequest/service3"/>
<resource>
<ServiceRequest>
<id value="service3"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/ServiceRequest-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<intent value="plan"/>
<code>
<coding>
<system
value="http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"/>
<code value="G0108"/>
</coding>
<text
value="Diabetes outpatient self-management training services, individual, per 30 minutes"/>
</code>
<quantityRatio>
<numerator>
<value value="1"/>
<unit value="visit"/>
<system
value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C25716"/>
</numerator>
<denominator>
<value value="1"/>
<unit value="week"/>
<system value="http://unitsofmeasure.org"/>
<code value="wk"/>
</denominator>
</quantityRatio>
<subject>🔗
<reference value="Patient/patientBSJ1"/>
</subject>
<occurrencePeriod>
<start value="2020-05-01"/>
<end value="2020-08-01"/>
</occurrencePeriod>
<performer>🔗
<reference value="Practitioner/provider3"/>
</performer>
<reasonReference>🔗
<reference value="Condition/need2"/>
</reasonReference>
<supportingInfo>🔗
<reference value="Claim/claim2"/>
</supportingInfo>
</ServiceRequest>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/ServiceRequest/service4"/>
<resource>
<ServiceRequest>
<id value="service4"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/ServiceRequest-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<intent value="plan"/>
<code>
<coding>
<system
value="http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"/>
<code value="97110"/>
</coding>
<text value="therapeutic exercises to improve balance skills"/>
</code>
<quantityRatio>
<numerator>
<value value="1"/>
<unit value="visit"/>
<system
value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C25716"/>
</numerator>
<denominator>
<value value="1"/>
<unit value="week"/>
<system value="http://unitsofmeasure.org"/>
<code value="wk"/>
</denominator>
</quantityRatio>
<subject>🔗
<reference value="Patient/patientBSJ1"/>
</subject>
<occurrencePeriod>
<start value="2020-05-01"/>
<end value="2020-08-01"/>
</occurrencePeriod>
<performer>🔗
<reference value="Practitioner/provider4"/>
</performer>
<reasonReference>🔗
<reference value="Condition/need1"/>
</reasonReference>
<supportingInfo>🔗
<reference value="Goal/goal1"/>
</supportingInfo>
<supportingInfo>🔗
<reference value="Goal/goal2"/>
</supportingInfo>
<supportingInfo>🔗
<reference value="Claim/claim3"/>
</supportingInfo>
</ServiceRequest>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/RelatedPerson/son1"/>
<resource>
<RelatedPerson>
<id value="son1"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/RelatedPerson-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<active value="true"/>
<patient>🔗
<reference value="Patient/patientBSJ1"/>
</patient>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="SONC"/>
</coding>
</relationship>
<name>
<text value="Charles Johnson"/>
<family value="Charles"/>
<given value="Johnson"/>
</name>
</RelatedPerson>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Observation/strength1"/>
<resource>
<Observation>
<id value="strength1"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Observation-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="social-history"/>
<display value="Social History"/>
</coding>
</category>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/eltss/CodeSystem/eltss-observation-codes-temporary"/>
<code value="strength"/>
<display value="Strength"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/patientBSJ1"/>
</subject>
<effectiveDateTime value="2013-04-02T10:30:10+01:00"/>
<issued value="2013-04-03T15:30:10+01:00"/>
<performer>🔗
<reference value="Practitioner/caremgr1"/>
<display value="Care Manager"/>
</performer>
<valueString value="Able to manage her bills."/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Observation/strength2"/>
<resource>
<Observation>
<id value="strength2"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Observation-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="social-history"/>
<display value="Social History"/>
</coding>
</category>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/eltss/CodeSystem/eltss-observation-codes-temporary"/>
<code value="strength"/>
<display value="Strength"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/patientBSJ1"/>
</subject>
<effectiveDateTime value="2013-04-02T10:30:10+01:00"/>
<issued value="2013-04-03T15:30:10+01:00"/>
<performer>🔗
<reference value="Practitioner/caremgr1"/>
<display value="Care Manager"/>
</performer>
<valueString value="Independent walking with cane."/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Practitioner/caremgr1"/>
<resource>
<Practitioner>
<id value="caremgr1"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="1144221847"/>
</identifier>
<identifier>
<system value="http://www.acme.org/practitioners"/>
<value value="25457"/>
</identifier>
<name>
<text value="Sam Monitor"/>
<family value="Monitor"/>
<given value="Sam"/>
</name>
<telecom>
<system value="phone"/>
<value value="(210) 224 1599"/>
</telecom>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/CarePlan/careplan2"/>
<resource>
<CarePlan>
<id value="careplan2"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/CarePlan-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<partOf>🔗
<reference value="CarePlan/careplan1"/>
</partOf>
<status value="active"/>
<intent value="plan"/>
<category>
<coding>
<system
value="http://hl7.org/fhir/us/core/CodeSystem/careplan-category"/>
<code value="assess-plan"/>
</coding>
</category>
<description
value="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 value="Patient/patientBSJ1"/>
</subject>
</CarePlan>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Claim/claim1"/>
<resource>
<Claim>
<id value="claim1"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Claim-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
<code value="professional"/>
</coding>
</type>
<use value="claim"/>
<patient>🔗
<reference value="Patient/patientBSJ1"/>
</patient>
<created value="2020-05-01"/>
<provider>🔗
<reference value="Organization/funding1"/>
</provider>
<priority>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/processpriority"/>
<code value="normal"/>
</coding>
</priority>
<insurance>
<sequence value="1"/>
<focal value="true"/>
<coverage>🔗
<reference value="Coverage/coverage1"/>
</coverage>
</insurance>
<item>
<sequence value="1"/>
<productOrService>
<coding>
<system
value="http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"/>
<code value="T2003"/>
</coding>
</productOrService>
<unitPrice>
<value value="60"/>
<currency value="USD"/>
</unitPrice>
<net>
<value value="600"/>
<currency value="USD"/>
</net>
</item>
</Claim>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Claim/claim2"/>
<resource>
<Claim>
<id value="claim2"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Claim-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
<code value="professional"/>
</coding>
</type>
<use value="claim"/>
<patient>🔗
<reference value="Patient/patientBSJ1"/>
</patient>
<created value="2020-05-01"/>
<provider>🔗
<reference value="Organization/funding1"/>
</provider>
<priority>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/processpriority"/>
<code value="normal"/>
</coding>
</priority>
<insurance>
<sequence value="1"/>
<focal value="true"/>
<coverage>🔗
<reference value="Coverage/coverage1"/>
</coverage>
</insurance>
<item>
<sequence value="1"/>
<productOrService>
<coding>
<system
value="http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"/>
<code value="G0108"/>
</coding>
</productOrService>
<unitPrice>
<value value="55"/>
<currency value="USD"/>
</unitPrice>
<net>
<value value="660"/>
<currency value="USD"/>
</net>
</item>
</Claim>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Claim/claim3"/>
<resource>
<Claim>
<id value="claim3"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Claim-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
<code value="professional"/>
</coding>
</type>
<use value="claim"/>
<patient>🔗
<reference value="Patient/patientBSJ1"/>
</patient>
<created value="2020-05-01"/>
<provider>🔗
<reference value="Organization/funding1"/>
</provider>
<priority>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/processpriority"/>
<code value="normal"/>
</coding>
</priority>
<insurance>
<sequence value="1"/>
<focal value="true"/>
<coverage>🔗
<reference value="Coverage/coverage1"/>
</coverage>
</insurance>
<item>
<sequence value="1"/>
<productOrService>
<coding>
<system value="http://www.ama-assn.org/go/cpt"/>
<code value="97110"/>
</coding>
</productOrService>
<unitPrice>
<value value="65"/>
<currency value="USD"/>
</unitPrice>
<net>
<value value="780"/>
<currency value="USD"/>
</net>
</item>
</Claim>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Contract/contract1"/>
<resource>
<Contract>
<id value="contract1"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Contract-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<signer>
<type>
<system
value="http://terminology.hl7.org/CodeSystem/contractsignertypecodes"/>
<code value="PAT"/>
</type>
<party>🔗
<reference value="Patient/patientBSJ1"/>
</party>
<signature>
<type>
<system value="urn:iso-astm:E1762-95:2013"/>
<code value="1.2.840.10065.1.12.1.7"/>
</type>
<when value="2020-04-02T03:00:00Z"/>
<who>🔗
<reference value="Patient/patientBSJ1"/>
</who>
<data
value="R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="/>
</signature>
</signer>
<signer>
<type>
<system
value="http://terminology.hl7.org/CodeSystem/contractsignertypecodes"/>
<code value="GUARD"/>
</type>
<party>🔗
<reference value="RelatedPerson/guardian1"/>
</party>
<signature>
<type>
<system value="urn:iso-astm:E1762-95:2013"/>
<code value="1.2.840.10065.1.12.1.7"/>
</type>
<when value="2020-04-02T03:00:00Z"/>
<who>🔗
<reference value="RelatedPerson/guardian1"/>
</who>
<data
value="R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="/>
</signature>
</signer>
<signer>
<type>
<system
value="http://terminology.hl7.org/CodeSystem/contractsignertypecodes"/>
<code value="AUT"/>
</type>
<party>🔗
<reference value="Practitioner/planner1"/>
</party>
<signature>
<type>
<system value="urn:iso-astm:E1762-95:2013"/>
<code value="1.2.840.10065.1.12.1.1"/>
</type>
<when value="2020-04-02T03:00:00Z"/>
<who>🔗
<reference value="Practitioner/planner1"/>
</who>
<data
value="R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="/>
</signature>
</signer>
<signer>
<type>
<system
value="http://terminology.hl7.org/CodeSystem/contractsignertypecodes"/>
<code value="COAUTH"/>
</type>
<party>🔗
<reference value="Practitioner/caremgr1"/>
</party>
<signature>
<type>
<system value="urn:iso-astm:E1762-95:2013"/>
<code value="1.2.840.10065.1.12.1.1"/>
</type>
<when value="2020-04-02T03:00:00Z"/>
<who>🔗
<reference value="Practitioner/caremgr1"/>
</who>
<data
value="R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="/>
</signature>
</signer>
<signer>
<type>
<system
value="http://terminology.hl7.org/CodeSystem/contractsignertypecodes"/>
<code value="HPROV"/>
</type>
<party>🔗
<reference value="Practitioner/provider3"/>
</party>
<signature>
<type>
<system value="urn:iso-astm:E1762-95:2013"/>
<code value="1.2.840.10065.1.12.1.7"/>
</type>
<when value="2020-04-02T03:00:00Z"/>
<who>🔗
<reference value="Practitioner/provider3"/>
</who>
<data
value="R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="/>
</signature>
</signer>
<signer>
<type>
<system
value="http://terminology.hl7.org/CodeSystem/contractsignertypecodes"/>
<code value="HPROV"/>
</type>
<party>🔗
<reference value="Practitioner/provider2b"/>
</party>
<signature>
<type>
<system value="urn:iso-astm:E1762-95:2013"/>
<code value="1.2.840.10065.1.12.1.7"/>
</type>
<when value="2020-04-02T03:00:00Z"/>
<who>🔗
<reference value="Practitioner/provider2b"/>
</who>
<data
value="R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="/>
</signature>
</signer>
<signer>
<type>
<system
value="http://terminology.hl7.org/CodeSystem/contractsignertypecodes"/>
<code value="HPROV"/>
</type>
<party>🔗
<reference value="RelatedPerson/son1"/>
</party>
<signature>
<type>
<system value="urn:iso-astm:E1762-95:2013"/>
<code value="1.2.840.10065.1.12.1.7"/>
</type>
<when value="2020-04-02T03:00:00Z"/>
<who>🔗
<reference value="RelatedPerson/son1"/>
</who>
<data
value="R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="/>
</signature>
</signer>
<signer>
<type>
<system
value="http://terminology.hl7.org/CodeSystem/contractsignertypecodes"/>
<code value="HPROV"/>
</type>
<party>🔗
<reference value="Practitioner/provider4"/>
</party>
<signature>
<type>
<system value="urn:iso-astm:E1762-95:2013"/>
<code value="1.2.840.10065.1.12.1.7"/>
</type>
<when value="2020-04-02T03:00:00Z"/>
<who>🔗
<reference value="Practitioner/provider4"/>
</who>
<data
value="R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="/>
</signature>
</signer>
</Contract>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Coverage/coverage1"/>
<resource>
<Coverage>
<id value="coverage1"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<beneficiary>🔗
<reference value="Patient/patientBSJ1"/>
</beneficiary>
<payor>🔗
<reference value="Organization/funding1"/>
</payor>
</Coverage>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/EpisodeOfCare/episode1"/>
<resource>
<EpisodeOfCare>
<id value="episode1"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/EpisodeOfCare-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<patient>🔗
<reference value="Patient/patientBSJ1"/>
</patient>
<careManager>🔗
<reference value="Practitioner/caremgr1"/>
</careManager>
</EpisodeOfCare>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Organization/funding1"/>
<resource>
<Organization>
<id value="funding1"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"/>
</meta>
<text>
<status value="generated"/>
<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.
The 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."
CMS 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."
CLIA is maintained by CMS. It is in the public domain and free to use without restriction.
See 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>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="1144221847"/>
</identifier>
<identifier>
<system value="urn:oid:2.16.840.1.113883.4.7"/>
<value value="12D4567890"/>
</identifier>
<active value="true"/>
<name value="Texas Department of Community Health"/>
<address>
<text value="7430 Louis Pasteur Dr, San Antonio, TX 78229"/>
</address>
</Organization>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/RelatedPerson/guardian1"/>
<resource>
<RelatedPerson>
<id value="guardian1"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/RelatedPerson-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<active value="true"/>
<patient>🔗
<reference value="Patient/patientBSJ1"/>
</patient>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="GUARD"/>
</coding>
</relationship>
<name>
<text value="Charles Johnson"/>
<family value="Charles"/>
<given value="Johnson"/>
</name>
</RelatedPerson>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Location/location1"/>
<resource>
<Location>
<id value="location1"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Location-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<name value="In Home"/>
<address>
<text value="111 Maple Ct, San Antonio, TX 78212"/>
</address>
</Location>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Condition/need1"/>
<resource>
<Condition>
<id value="need1"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Condition-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
</coding>
</clinicalStatus>
<verificationStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="confirmed"/>
</coding>
</verificationStatus>
<category>
<coding>
<system
value="http://hl7.org/fhir/us/core/CodeSystem/condition-category"/>
<code value="health-concern"/>
<display value="Health Concern"/>
</coding>
</category>
<category>
<coding>
<system
value="http://hl7.org/fhir/us/eltss/CodeSystem/eltss-condition-category-code"/>
<code value="assessed-need"/>
</coding>
</category>
<category>
<coding>
<system
value="http://hl7.org/fhir/us/core/CodeSystem/us-core-category"/>
<code value="sdoh"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="713458007"/>
<display value="Lack of access to transportation (finding)"/>
</coding>
<text value="Needs transportation"/>
</code>
<subject>🔗
<reference value="Patient/patientBSJ1"/>
</subject>
</Condition>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Condition/need2"/>
<resource>
<Condition>
<id value="need2"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Condition-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
</coding>
</clinicalStatus>
<verificationStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="confirmed"/>
</coding>
</verificationStatus>
<category>
<coding>
<system
value="http://hl7.org/fhir/us/core/CodeSystem/condition-category"/>
<code value="health-concern"/>
<display value="Health Concern"/>
</coding>
</category>
<category>
<coding>
<system
value="http://hl7.org/fhir/us/eltss/CodeSystem/eltss-condition-category-code"/>
<code value="assessed-need"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="734920002"/>
<display value="Diabetes mellitus education service"/>
</coding>
<text value="Needs health / nutrition education for diabetes"/>
</code>
<subject>🔗
<reference value="Patient/patientBSJ1"/>
</subject>
</Condition>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Condition/need3"/>
<resource>
<Condition>
<id value="need3"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Condition-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
</coding>
</clinicalStatus>
<verificationStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="confirmed"/>
</coding>
</verificationStatus>
<category>
<coding>
<system
value="http://hl7.org/fhir/us/core/CodeSystem/condition-category"/>
<code value="health-concern"/>
<display value="Health Concern"/>
</coding>
</category>
<category>
<coding>
<system
value="http://hl7.org/fhir/us/eltss/CodeSystem/eltss-condition-category-code"/>
<code value="assessed-need"/>
</coding>
</category>
<category>
<coding>
<system
value="http://hl7.org/fhir/us/core/CodeSystem/us-core-category"/>
<code value="cognitive-status"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="35489007"/>
<display value="Depressive disorder (disorder)"/>
</coding>
<text value="Depression (on treatment)"/>
</code>
<subject>🔗
<reference value="Patient/patientBSJ1"/>
</subject>
</Condition>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Condition/need4"/>
<resource>
<Condition>
<id value="need4"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Condition-eltss"/>
</meta>
<text>
<status value="extensions"/>
<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>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/condition-dueTo">
<valueReference>🔗
<reference value="Condition/need3"/>
</valueReference>
</extension>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
</coding>
</clinicalStatus>
<verificationStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="confirmed"/>
</coding>
</verificationStatus>
<category>
<coding>
<system
value="http://hl7.org/fhir/us/core/CodeSystem/condition-category"/>
<code value="health-concern"/>
<display value="Health Concern"/>
</coding>
</category>
<category>
<coding>
<system
value="http://hl7.org/fhir/us/eltss/CodeSystem/eltss-condition-category-code"/>
<code value="assessed-need"/>
</coding>
</category>
<category>
<coding>
<system
value="http://hl7.org/fhir/us/core/CodeSystem/us-core-category"/>
<code value="sdoh"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="183301007"/>
<display value="Physical exercises (regime/therapy)"/>
</coding>
<text value="Needs physical exercises"/>
</code>
<subject>🔗
<reference value="Patient/patientBSJ1"/>
</subject>
</Condition>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Observation/pref1"/>
<resource>
<Observation>
<id value="pref1"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Observation-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="social-history"/>
<display value="Social History"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="95541-9"/>
<display value="Care experience preference"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/patientBSJ1"/>
</subject>
<effectiveDateTime value="2013-04-02T10:30:10+01:00"/>
<issued value="2013-04-03T15:30:10+01:00"/>
<performer>🔗
<reference value="Practitioner/caremgr1"/>
<display value="Care Manager"/>
</performer>
<valueString
value="Accessing the ICWP Waiver for her current service needs, and would like to remain on ICWP and continue with her current services."/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Organization/provider2a"/>
<resource>
<Organization>
<id value="provider2a"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"/>
</meta>
<text>
<status value="generated"/>
<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.
The 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."
CMS 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."
CLIA is maintained by CMS. It is in the public domain and free to use without restriction.
See 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>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="1144221847"/>
</identifier>
<identifier>
<system value="urn:oid:2.16.840.1.113883.4.7"/>
<value value="12D4567890"/>
</identifier>
<active value="true"/>
<name value="The Transporter, Inc."/>
<telecom>
<system value="phone"/>
<value value="(210) 555 1313"/>
</telecom>
<address>
<text value="111 Business Street, San Antonio, TX 78212"/>
</address>
</Organization>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Practitioner/provider2b"/>
<resource>
<Practitioner>
<id value="provider2b"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<system value="http://www.acme.org/practitioners"/>
<value value="11223344"/>
</identifier>
<name>
<text value="Bill Driver"/>
<family value="Driver"/>
<given value="Bill"/>
</name>
<telecom>
<system value="phone"/>
<value value="(210) 111 2222"/>
</telecom>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Practitioner/provider3"/>
<resource>
<Practitioner>
<id value="provider3"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<system value="http://www.acme.org/practitioners"/>
<value value="987654"/>
</identifier>
<name>
<text value="Lisa Educator"/>
<family value="Educator"/>
<given value="Lisa"/>
</name>
<telecom>
<system value="phone"/>
<value value="(210) 555 1213"/>
</telecom>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Practitioner/provider4"/>
<resource>
<Practitioner>
<id value="provider4"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<system value="http://www.acme.org/practitioners"/>
<value value="987657"/>
</identifier>
<name>
<text value="Norma Trainer"/>
<family value="Trainer"/>
<given value="Norma"/>
</name>
<telecom>
<system value="phone"/>
<value value="(210) 555 1214"/>
</telecom>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl
value="https://hl7.org/fhir/PractitionerRole/PractitionerRole-1"/>
<resource>
<PractitionerRole>
<id value="PractitionerRole-1"/>
<meta>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/PractitionerRole-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<practitioner>🔗
<reference value="Practitioner/caremgr1"/>
<display value="Sam Monitor"/>
</practitioner>
<organization>🔗
<reference value="Organization/funding1"/>
<display value="Texas Department of Community Health"/>
</organization>
<code>
<coding>
<system value="http://nucc.org/provider-taxonomy"/>
<code value="172V00000X"/>
<display value="Community Health Worker"/>
</coding>
</code>
<specialty>
<coding>
<system value="http://nucc.org/provider-taxonomy"/>
<code value="171M00000X"/>
<display value="Case Manager/Care Coordinator"/>
</coding>
</specialty>
<location>🔗
<reference value="Location/communitysite"/>
<display value="Health Level Seven International"/>
</location>
<telecom>
<system value="phone"/>
<value value="(210) 555 1222"/>
</telecom>
</PractitionerRole>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Location/communitysite"/>
<resource>
<Location>
<id value="communitysite"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Location-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<name value="In Home"/>
<address>
<text value="7430 Louis Pasteur Dr, San Antonio, TX 78229"/>
</address>
</Location>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/Questionnaire/questionnaire1"/>
<resource>
<Questionnaire>
<id value="questionnaire1"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/Questionnaire-eltss"/>
</meta>
<text>
<status value="generated"/>
<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
This 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:
Note 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.
This 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>
</text>
<url
value="http://hl7.org/fhir/us/eltss/Questionnaire/questionnaire1"/>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:oid:2.999"/>
</identifier>
<name value="Questionnaire1"/>
<status value="active"/>
<item>
<linkId value="q1"/>
<text value="Did you choose the setting in which you reside?"/>
<type value="boolean"/>
</item>
<item>
<linkId value="q2"/>
<text
value="What alternative home and community-based settings were considered?"/>
<type value="string"/>
</item>
<item>
<linkId value="q3"/>
<text
value="Were you given a choice of services outlined in the plan?"/>
<type value="boolean"/>
</item>
<item>
<linkId value="q4"/>
<text
value="Did you participate in the selection of services outlined in the plan?"/>
<type value="boolean"/>
</item>
<item>
<linkId value="q5"/>
<text value="Do you agree to the services outlined in the plan?"/>
<type value="boolean"/>
</item>
<item>
<linkId value="q6"/>
<text
value="Were you offered a choice of providers for each service?"/>
<type value="boolean"/>
</item>
<item>
<linkId value="q7"/>
<text
value="Do you feel you made an informed choice in selecting the provider for each service?"/>
<type value="boolean"/>
</item>
</Questionnaire>
</resource>
</entry>
<entry>
<fullUrl
value="https://hl7.org/fhir/QuestionnaireResponse/questionnaireresponse1"/>
<resource>
<QuestionnaireResponse>
<id value="questionnaireresponse1"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/QuestionnaireResponse-eltss"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<questionnaire
value="http://hl7.org/fhir/us/eltss/Questionnaire/questionnaire1"/>
<status value="completed"/>
<subject>🔗
<reference value="Patient/patientBSJ1"/>
</subject>
<authored value="2020-09-03T10:16:03.512-04:00"/>
<item>
<linkId value="q1"/>
<answer>
<valueBoolean value="true"/>
</answer>
</item>
<item>
<linkId value="q2"/>
<answer>
<valueString value="Assisted living facility"/>
</answer>
</item>
<item>
<linkId value="q3"/>
<answer>
<valueBoolean value="true"/>
</answer>
</item>
<item>
<linkId value="q4"/>
<answer>
<valueBoolean value="true"/>
</answer>
</item>
<item>
<linkId value="q5"/>
<answer>
<valueBoolean value="true"/>
</answer>
</item>
<item>
<linkId value="q6"/>
<answer>
<valueBoolean value="true"/>
</answer>
</item>
<item>
<linkId value="q7"/>
<answer>
<valueBoolean value="true"/>
</answer>
</item>
</QuestionnaireResponse>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/RiskAssessment/risk1"/>
<resource>
<RiskAssessment>
<id value="risk1"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/RiskAssessment-eltss"/>
</meta>
<text>
<status value="extensions"/>
<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>
</text>
<extension
url="http://hl7.org/fhir/us/eltss/StructureDefinition/eltss-RiskPlan">
<valueReference>
<display
value="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."/>
</valueReference>
</extension>
<status value="final"/>
<subject>🔗
<reference value="Patient/patientBSJ1"/>
</subject>
<prediction>
<outcome>
<coding>
<system value="http://snomed.info/sct"/>
<code value="129839007"/>
</coding>
<text value="At risk for falls (finding)"/>
</outcome>
</prediction>
<prediction>
<outcome>
<coding>
<system value="http://snomed.info/sct"/>
<code value="866240007"/>
</coding>
<text value="At risk of stroke"/>
</outcome>
</prediction>
<mitigation
value="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."/>
</RiskAssessment>
</resource>
</entry>
<entry>
<fullUrl value="https://hl7.org/fhir/ServiceRequest/service1"/>
<resource>
<ServiceRequest>
<id value="service1"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2020-09-03T10:16:03.512-04:00"/>
<source value="#KZ0jzPjXDrhCiMif"/>
<profile
value="http://hl7.org/fhir/us/eltss/StructureDefinition/ServiceRequest-eltss"/>
</meta>
<text>
<status value="extensions"/>
<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>
</text>
<extension
url="http://hl7.org/fhir/us/eltss/StructureDefinition/eltss-directedBy">
<valueCodeableConcept>
<text value="self"/>
</valueCodeableConcept>
</extension>
<status value="active"/>
<intent value="plan"/>
<code>
<coding>
<system
value="http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"/>
<code value="E0241"/>
</coding>
<text value="Bath tub wall rail, each"/>
</code>
<quantityQuantity>
<value value="1"/>
<unit value="install"/>
<system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C81906"/>
</quantityQuantity>
<subject>🔗
<reference value="Patient/patientBSJ1"/>
</subject>
<occurrencePeriod>
<start value="2020-05-01"/>
<end value="2020-12-31"/>
</occurrencePeriod>
<performer>🔗
<reference value="RelatedPerson/son1"/>
</performer>
<locationReference>🔗
<reference value="Location/location1"/>
</locationReference>
<supportingInfo>🔗
<reference value="RiskAssessment/risk1"/>
</supportingInfo>
</ServiceRequest>
</resource>
</entry>
</Bundle>
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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