This page is part of the US Medication REMS (v2.0.0-ballot: STU2 Ballot) based on FHIR (HL7® FHIR® Standard) R4. This version is a pre-release. The current official version is 1.0.0. For a full list of available versions, see the Directory of published versions
{
"resourceType" : "Parameters",
"id" : "parameters-rems-etasu-input",
"parameter" : [
{
"name" : "patient",
"resource" : {
"resourceType" : "Patient",
"id" : "example-patient-123",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2025-04-10T01:10:26.457-04:00"
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><div class=\"hapiHeaderText\">August <b>Samuels</b></div><table class=\"hapiPropertyTable\"><tbody><tr><td>Identifier</td><td>0V843229061TB</td></tr><tr><td>Address</td><td><span>10023 Oakways Ln</span><br/><span>Concord </span><span>MA</span></td></tr><tr><td>Date of birth</td><td><span>12 March 1989</span></td></tr></tbody></table></div>"
},
"identifier" : [
{
"system" : "http://hl7.org/fhir/sid/us-medicare",
"value" : "0V843229061TB"
}
],
"name" : [
{
"use" : "official",
"family" : "Samuels",
"given" : [
"August"
]
}
],
"gender" : "male",
"birthDate" : "1989-03-12",
"address" : [
{
"use" : "home",
"type" : "both",
"line" : [
"10023 Oakways Ln"
],
"city" : "Concord",
"state" : "MA",
"postalCode" : "01742"
}
]
}
},
{
"name" : "medication",
"resource" : {
"resourceType" : "Medication",
"id" : "123-mr-IPledge-med",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><div class=\"hapiHeaderText\">iPledge Medication</div></div>"
},
"code" : {
"coding" : [
{
"system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
"code" : "6064",
"display" : "isotretinoin"
},
{
"system" : "http://hl7.org/fhir/sid/ndc",
"code" : "0245-0571-01"
}
]
}
}
}
]
}