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
<Parameters xmlns="http://hl7.org/fhir">
<id value="parameters-rems-etasu-input"/>
<parameter>
<name value="patient"/>
<resource>
<Patient>
<id value="example-patient-123"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2025-04-10T01:10:26.457-04:00"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-medicare"/>
<value value="0V843229061TB"/>
</identifier>
<name>
<use value="official"/>
<family value="Samuels"/>
<given value="August"/>
</name>
<gender value="male"/>
<birthDate value="1989-03-12"/>
<address>
<use value="home"/>
<type value="both"/>
<line value="10023 Oakways Ln"/>
<city value="Concord"/>
<state value="MA"/>
<postalCode value="01742"/>
</address>
</Patient>
</resource>
</parameter>
<parameter>
<name value="medication"/>
<resource>
<Medication>
<id value="123-mr-IPledge-med"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><div class="hapiHeaderText">iPledge Medication</div></div>
</text>
<code>
<coding>
<system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="6064"/>
<display value="isotretinoin"/>
</coding>
<coding>
<system value="http://hl7.org/fhir/sid/ndc"/>
<code value="0245-0571-01"/>
</coding>
</code>
</Medication>
</resource>
</parameter>
</Parameters>