Da Vinci Prior Authorization Support (PAS) FHIR IG
2.0.1 - STU 2
Da Vinci Prior Authorization Support (PAS) FHIR IG
2.0.1 - STU 2
This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v2.0.1: STU 2) 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
@prefix fhir: <http://hl7.org/fhir/> . @prefix owl: <http://www.w3.org/2002/07/owl#> . @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> . @prefix xsd: <http://www.w3.org/2001/XMLSchema#> . # - resource ------------------------------------------------------------------- a fhir:Bundle ; fhir:nodeRole fhir:treeRoot ; fhir:id [ fhir:v "ReferralAuthorizationBundleExample"] ; # fhir:meta [ ( fhir:profile [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle> ] ) ] ; # fhir:identifier [ fhir:system [ fhir:v "http://example.org/SUBMITTER_TRANSACTION_IDENTIFIER"^^xsd:anyURI ] ; fhir:value [ fhir:v "A12345" ] ] ; # fhir:type [ fhir:v "collection"] ; # fhir:timestamp [ fhir:v "2005-05-02T11:01:00+05:00"^^xsd:dateTime] ; # fhir:entry ( [ fhir:fullUrl [ fhir:v "http://example.org/fhir/Claim/ReferralAuthorizationExample"^^xsd:anyURI ] ; ( fhir:resource <http://example.org/fhir/Claim/ReferralAuthorizationExample> ) ] [ fhir:fullUrl [ fhir:v "http://example.org/fhir/Organization/UMOExample"^^xsd:anyURI ] ; ( fhir:resource <http://example.org/fhir/Organization/UMOExample> ) ] [ fhir:fullUrl [ fhir:v "http://example.org/fhir/Organization/InsurerExample"^^xsd:anyURI ] ; ( fhir:resource <http://example.org/fhir/Organization/InsurerExample> ) ] [ fhir:fullUrl [ fhir:v "http://example.org/fhir/Coverage/InsuranceExample"^^xsd:anyURI ] ; ( fhir:resource <http://example.org/fhir/Coverage/InsuranceExample> ) ] [ fhir:fullUrl [ fhir:v "http://example.org/fhir/Patient/SubscriberExample"^^xsd:anyURI ] ; ( fhir:resource <http://example.org/fhir/Patient/SubscriberExample> ) ] [ fhir:fullUrl [ fhir:v "http://example.org/fhir/ServiceRequest/ReferralRequestExample"^^xsd:anyURI ] ; ( fhir:resource <http://example.org/fhir/ServiceRequest/ReferralRequestExample> ) ] [ fhir:fullUrl [ fhir:v "http://example.org/fhir/PractitionerRole/ReferralPractitionerRoleExample"^^xsd:anyURI ] ; ( fhir:resource <http://example.org/fhir/PractitionerRole/ReferralPractitionerRoleExample> ) ] [ fhir:fullUrl [ fhir:v "http://example.org/fhir/Practitioner/ReferralPractitionerExample"^^xsd:anyURI ] ; ( fhir:resource <http://example.org/fhir/Practitioner/ReferralPractitionerExample> ) ] [ fhir:fullUrl [ fhir:v "http://example.org/fhir/Location/ReferralLocationExample"^^xsd:anyURI ] ; ( fhir:resource <http://example.org/fhir/Location/ReferralLocationExample> ) ] ) . # <http://example.org/fhir/Claim/ReferralAuthorizationExample> a fhir:Claim ; fhir:id [ fhir:v "ReferralAuthorizationExample"] ; # fhir:meta [ ( fhir:profile [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "extensions" ] ; fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Claim</b><a name=\"ReferralAuthorizationExample\"> </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\">Resource Claim "ReferralAuthorizationExample" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-claim.html\">PAS Claim</a></p></div><p><b>LevelOfServiceCode</b>: Urgent <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (1338#U)</span></p><p><b>identifier</b>: id: 111099</p><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/5.0.0/CodeSystem-claim-type.html\">Claim Type Codes</a>#professional)</span></p><p><b>use</b>: preauthorization</p><p><b>patient</b>: <a href=\"#Patient_SubscriberExample\">See above (Patient/SubscriberExample)</a></p><p><b>created</b>: 2005-05-02 11:01:00+0500</p><p><b>insurer</b>: <a href=\"#Organization_InsurerExample\">See above (Organization/InsurerExample)</a></p><p><b>provider</b>: <a href=\"#Organization_UMOExample\">See above (Organization/UMOExample)</a></p><p><b>priority</b>: Normal <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-processpriority.html\">Process Priority Codes</a>#normal)</span></p><h3>CareTeams</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>Provider</b></td></tr><tr><td style=\"display: none\">*</td><td/><td>1</td><td><a href=\"#PractitionerRole_ReferralPractitionerRoleExample\">See above (PractitionerRole/ReferralPractitionerRoleExample)</a></td></tr></table><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td style=\"display: none\">*</td><td/><td>1</td><td>G89.4 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-icd10CM.html\">International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)</a>#G89.4)</span></td></tr></table><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><a href=\"#Coverage_InsuranceExample\">See above (Coverage/InsuranceExample)</a></td></tr></table><h3>Items</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>CareTeamSequence</b></td><td><b>DiagnosisSequence</b></td><td><b>Category</b></td><td><b>ProductOrService</b></td><td><b>Location[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>, , , , , , , , , </td><td>1</td><td>1</td><td>1</td><td>Consultation <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (1365#3)</span></td><td>Consultation <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (1365#3)</span></td><td>11 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-CMSPlaceofServiceCodes.html\">CMS Place of Service Codes (POS)</a>#11)</span></td></tr></table></div>" ] ; # fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-levelOfServiceCode"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "https://codesystem.x12.org/005010/1338"^^xsd:anyURI ] ; fhir:code [ fhir:v "U" ] ; fhir:display [ fhir:v "Urgent" ] ] ) ] ] ) ; # fhir:identifier ( [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierJurisdiction"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "https://www.usps.com/"^^xsd:anyURI ] ; fhir:code [ fhir:v "MA" ] ] ) ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierSubDepartment"^^xsd:anyURI ] ; fhir:value [ fhir:v "223412" ] ] ) ; fhir:system [ fhir:v "http://example.org/PATIENT_EVENT_TRACE_NUMBER"^^xsd:anyURI ] ; fhir:value [ fhir:v "111099" ] ; fhir:assigner [ fhir:identifier [ fhir:system [ fhir:v "http://example.org/USER_ASSIGNED"^^xsd:anyURI ] ; fhir:value [ fhir:v "9012345678" ] ] ] ] ) ; # fhir:status [ fhir:v "active"] ; # fhir:type [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ] ; fhir:code [ fhir:v "professional" ] ] ) ] ; # fhir:use [ fhir:v "preauthorization"] ; # fhir:patient [ fhir:reference [ fhir:v "Patient/SubscriberExample" ] ] ; # fhir:created [ fhir:v "2005-05-02T11:01:00+05:00"^^xsd:dateTime] ; # fhir:insurer [ fhir:reference [ fhir:v "Organization/InsurerExample" ] ] ; # fhir:provider [ fhir:reference [ fhir:v "Organization/UMOExample" ] ] ; # fhir:priority [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/processpriority"^^xsd:anyURI ] ; fhir:code [ fhir:v "normal" ] ] ) ] ; # fhir:careTeam ( [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope"^^xsd:anyURI ] ; fhir:value [ fhir:v "true"^^xsd:boolean ] ] ) ; fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:provider [ fhir:reference [ fhir:v "PractitionerRole/ReferralPractitionerRoleExample" ] ] ] ) ; # fhir:diagnosis ( [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate"^^xsd:anyURI ] ; fhir:value [ fhir:v "2021-05-10"^^xsd:date ] ] ) ; fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:diagnosis [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://hl7.org/fhir/sid/icd-10-cm"^^xsd:anyURI ] ; fhir:code [ fhir:v "G89.4" ] ] ) ] ] ) ; # fhir:insurance ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:focal [ fhir:v "true"^^xsd:boolean ] ; fhir:coverage [ fhir:reference [ fhir:v "Coverage/InsuranceExample" ] ] ] ) ; # fhir:item ( [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber"^^xsd:anyURI ] ; fhir:value [ a fhir:Identifier ; fhir:system [ fhir:v "http://example.org/ITEM_TRACE_NUMBER"^^xsd:anyURI ] ; fhir:value [ fhir:v "1122334" ] ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber"^^xsd:anyURI ] ; fhir:value [ fhir:v "1122445" ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber"^^xsd:anyURI ] ; fhir:value [ fhir:v "9988311" ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "https://codesystem.x12.org/005010/1525"^^xsd:anyURI ] ; fhir:code [ fhir:v "SC" ] ; fhir:display [ fhir:v "Specialty Care Review" ] ] ) ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "https://codesystem.x12.org/005010/1322"^^xsd:anyURI ] ; fhir:code [ fhir:v "I" ] ; fhir:display [ fhir:v "Initial" ] ] ) ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService"^^xsd:anyURI ] ; fhir:value [ a fhir:Reference ; fhir:reference [ fhir:v "ServiceRequest/ReferralRequestExample" ] ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator"^^xsd:anyURI ] ; fhir:value [ fhir:v "false"^^xsd:boolean ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "https://codesystem.x12.org/005010/1345"^^xsd:anyURI ] ; fhir:code [ fhir:v "2" ] ; fhir:display [ fhir:v "Newly Admitted" ] ] ) ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeLevelOfCare"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "https://codesystem.x12.org/005010/1337"^^xsd:anyURI ] ; fhir:code [ fhir:v "2" ] ; fhir:display [ fhir:v "Intermediate Care Facility (ICF)" ] ] ) ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueUnitRateLimit"^^xsd:anyURI ] ; fhir:value [ fhir:v "100"^^xsd:decimal ] ] ) ; fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; ( fhir:careTeamSequence [ fhir:v "1"^^xsd:positiveInteger ] ) ; ( fhir:diagnosisSequence [ fhir:v "1"^^xsd:positiveInteger ] ) ; fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "https://codesystem.x12.org/005010/1365"^^xsd:anyURI ] ; fhir:code [ fhir:v "3" ] ; fhir:display [ fhir:v "Consultation" ] ] ) ] ; fhir:productOrService [ ( fhir:coding [ fhir:system [ fhir:v "https://codesystem.x12.org/005010/1365"^^xsd:anyURI ] ; fhir:code [ fhir:v "3" ] ; fhir:display [ fhir:v "Consultation" ] ] ) ] ; fhir:location [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set"^^xsd:anyURI ] ; fhir:code [ fhir:v "11" ] ] ) ] ] ) . # <http://example.org/fhir/Organization/UMOExample> a fhir:Organization ; fhir:id [ fhir:v "UMOExample"] ; # fhir:meta [ ( fhir:profile [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b><a name=\"UMOExample\"> </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\">Resource Organization "UMOExample" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-requestor.html\">PAS Requestor Organization</a></p></div><p><b>identifier</b>: id: <a href=\"http://terminology.hl7.org/5.0.0/NamingSystem-npi.html\">#</a>8189991234</p><p><b>active</b>: true</p><p><b>type</b>: X3 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (98#X3)</span></p><p><b>name</b>: DR. JOE SMITH CORPORATION</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>" ] ; # fhir:identifier ( [ fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ; fhir:value [ fhir:v "8189991234" ] ] ) ; # fhir:active [ fhir:v "true"^^xsd:boolean] ; # fhir:type ( [ ( fhir:coding [ fhir:system [ fhir:v "https://codesystem.x12.org/005010/98"^^xsd:anyURI ] ; fhir:code [ fhir:v "X3" ] ] ) ] ) ; # fhir:name [ fhir:v "DR. JOE SMITH CORPORATION"] ; # fhir:address ( [ ( fhir:line [ fhir:v "111 1ST STREET" ] ) ; fhir:city [ fhir:v "SAN DIEGO" ] ; fhir:state [ fhir:v "CA" ] ; fhir:postalCode [ fhir:v "92101" ] ; fhir:country [ fhir:v "US" ] ] ) . # <http://example.org/fhir/Organization/InsurerExample> a fhir:Organization ; fhir:id [ fhir:v "InsurerExample"] ; # fhir:meta [ ( fhir:profile [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b><a name=\"InsurerExample\"> </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\">Resource Organization "InsurerExample" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-insurer.html\">PAS Insurer Organization</a></p></div><p><b>identifier</b>: id: <a href=\"http://terminology.hl7.org/5.0.0/NamingSystem-npi.html\">#</a>789312</p><p><b>active</b>: true</p><p><b>type</b>: PR <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (98#PR)</span></p><p><b>name</b>: MARYLAND CAPITAL INSURANCE COMPANY</p></div>" ] ; # fhir:identifier ( [ fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ; fhir:value [ fhir:v "789312" ] ] ) ; # fhir:active [ fhir:v "true"^^xsd:boolean] ; # fhir:type ( [ ( fhir:coding [ fhir:system [ fhir:v "https://codesystem.x12.org/005010/98"^^xsd:anyURI ] ; fhir:code [ fhir:v "PR" ] ] ) ] ) ; # fhir:name [ fhir:v "MARYLAND CAPITAL INSURANCE COMPANY"] . # <http://example.org/fhir/Coverage/InsuranceExample> a fhir:Coverage ; fhir:id [ fhir:v "InsuranceExample"] ; # fhir:meta [ ( fhir:profile [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-coverage"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-coverage> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Coverage</b><a name=\"InsuranceExample\"> </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\">Resource Coverage "InsuranceExample" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-coverage.html\">PAS Coverage</a></p></div><p><b>status</b>: active</p><p><b>beneficiary</b>: <a href=\"#Patient_SubscriberExample\">See above (Patient/SubscriberExample)</a></p><p><b>payor</b>: <a href=\"#Organization_InsurerExample\">See above (Organization/InsurerExample)</a></p></div>" ] ; # fhir:status [ fhir:v "active"] ; # fhir:beneficiary [ fhir:reference [ fhir:v "Patient/SubscriberExample" ] ] ; # fhir:payor ( [ fhir:reference [ fhir:v "Organization/InsurerExample" ] ] ) . # <http://example.org/fhir/Patient/SubscriberExample> a fhir:Patient ; fhir:id [ fhir:v "SubscriberExample"] ; # fhir:meta [ ( fhir:profile [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "extensions" ] ; fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Patient</b><a name=\"SubscriberExample\"> </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\">Resource Patient "SubscriberExample" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-subscriber.html\">PAS Subscriber Patient</a></p></div><p><b>MilitaryStatus</b>: RU <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (584#RU)</span></p><p><b>identifier</b>: id: 12345678901</p><p><b>name</b>: JOE SMITH </p><p><b>gender</b>: male</p></div>" ] ; # fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-militaryStatus"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "https://codesystem.x12.org/005010/584"^^xsd:anyURI ] ; fhir:code [ fhir:v "RU" ] ] ) ] ] ) ; # fhir:identifier ( [ fhir:system [ fhir:v "http://example.org/MIN"^^xsd:anyURI ] ; fhir:value [ fhir:v "12345678901" ] ] ) ; # fhir:name ( [ fhir:family [ fhir:v "SMITH" ] ; ( fhir:given [ fhir:v "JOE" ] ) ] ) ; # fhir:gender [ fhir:v "male"] . # <http://example.org/fhir/ServiceRequest/ReferralRequestExample> a fhir:ServiceRequest ; fhir:id [ fhir:v "ReferralRequestExample"] ; # fhir:meta [ ( fhir:profile [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-servicerequest"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-servicerequest> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: ServiceRequest</b><a name=\"ReferralRequestExample\"> </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\">Resource ServiceRequest "ReferralRequestExample" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-servicerequest.html\">PAS Service Request</a></p></div><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>code</b>: Consultation <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (1365#3)</span></p><p><b>quantity</b>: 1 visit<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code 1 = '1')</span></p><p><b>subject</b>: <a href=\"#Patient_SubscriberExample\">See above (Patient/SubscriberExample)</a></p></div>" ] ; # fhir:status [ fhir:v "active"] ; # fhir:intent [ fhir:v "order"] ; # fhir:code [ ( fhir:coding [ fhir:system [ fhir:v "https://codesystem.x12.org/005010/1365"^^xsd:anyURI ] ; fhir:code [ fhir:v "3" ] ; fhir:display [ fhir:v "Consultation" ] ] ) ] ; # fhir:quantity [ a fhir:Quantity ; fhir:value [ fhir:v "1"^^xsd:decimal ] ; fhir:unit [ fhir:v "visit" ] ; fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ; fhir:code [ fhir:v "1" ] ] ; # fhir:subject [ fhir:reference [ fhir:v "Patient/SubscriberExample" ] ] . # <http://example.org/fhir/PractitionerRole/ReferralPractitionerRoleExample> a fhir:PractitionerRole ; fhir:id [ fhir:v "ReferralPractitionerRoleExample"] ; # fhir:meta [ ( fhir:profile [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: PractitionerRole</b><a name=\"ReferralPractitionerRoleExample\"> </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\">Resource PractitionerRole "ReferralPractitionerRoleExample" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-practitionerrole.html\">PAS PractitionerRole</a></p></div><p><b>practitioner</b>: <a href=\"#Practitioner_ReferralPractitionerExample\">See above (Practitioner/ReferralPractitionerExample)</a></p><p><b>location</b>: <a href=\"#Location_ReferralLocationExample\">See above (Location/ReferralLocationExample)</a></p></div>" ] ; # fhir:practitioner [ fhir:reference [ fhir:v "Practitioner/ReferralPractitionerExample" ] ] ; # fhir:location ( [ fhir:reference [ fhir:v "Location/ReferralLocationExample" ] ] ) . # <http://example.org/fhir/Practitioner/ReferralPractitionerExample> a fhir:Practitioner ; fhir:id [ fhir:v "ReferralPractitionerExample"] ; # fhir:meta [ ( fhir:profile [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Practitioner</b><a name=\"ReferralPractitionerExample\"> </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\">Resource Practitioner "ReferralPractitionerExample" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-practitioner.html\">PAS Practitioner</a></p></div><p><b>identifier</b>: id: <a href=\"http://terminology.hl7.org/5.0.0/NamingSystem-npi.html\">#</a>987654321</p><p><b>name</b>: SUSAN WATSON </p><p><b>telecom</b>: ph: 4029993456</p></div>" ] ; # fhir:identifier ( [ fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ; fhir:value [ fhir:v "987654321" ] ] ) ; # fhir:name ( [ fhir:family [ fhir:v "WATSON" ] ; ( fhir:given [ fhir:v "SUSAN" ] ) ] ) ; # fhir:telecom ( [ fhir:system [ fhir:v "phone" ] ; fhir:value [ fhir:v "4029993456" ] ] ) . # <http://example.org/fhir/Location/ReferralLocationExample> a fhir:Location ; fhir:id [ fhir:v "ReferralLocationExample"] ; # fhir:meta [ ( fhir:profile [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-location"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-location> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Location</b><a name=\"ReferralLocationExample\"> </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\">Resource Location "ReferralLocationExample" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-location.html\">PAS Location Profile</a></p></div><p><b>name</b>: REFERRAL CLINIC</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>" ] ; # fhir:name [ fhir:v "REFERRAL CLINIC"] ; # fhir:address [ ( fhir:line [ fhir:v "111 1ST STREET" ] ) ; fhir:city [ fhir:v "SAN DIEGO" ] ; fhir:state [ fhir:v "CA" ] ; fhir:postalCode [ fhir:v "92101" ] ; fhir:country [ fhir:v "US" ] ] . #
IG © 2020+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-pas#2.0.1 based on FHIR 4.0.1. Generated 2023-12-01
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