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. For a full list of available versions, see the Directory of published versions

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: service3 - JSON Representation

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{
  "resourceType" : "ServiceRequest",
  "id" : "service3",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2020-09-03T10:16:03.512-04:00",
    "source" : "#KZ0jzPjXDrhCiMif",
    "profile" : [
      🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/ServiceRequest-eltss"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><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 &quot;service3&quot; Version&quot;1&quot; Updated&quot;2020-09-03 10:16:03-0400&quot; </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>: <a href=\"Patient-patientBSJ1.html\">Patient/patientBSJ1</a> &quot; SMITH-JOHNSON&quot;</p><p><b>occurrence</b>: 2020-05-01 --&gt; 2020-08-01</p><p><b>performer</b>: <a href=\"Practitioner-provider3.html\">Practitioner/provider3</a> &quot; EDUCATOR&quot;</p><p><b>reasonReference</b>: <a href=\"Condition-need2.html\">Condition/need2</a></p><p><b>supportingInfo</b>: <a href=\"Claim-claim2.html\">Claim/claim2</a></p></div>"
  },
  "status" : "active",
  "intent" : "plan",
  "code" : {
    "coding" : [
      {
        "system" : "http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets",
        "code" : "G0108"
      }
    ],
    "text" : "Diabetes outpatient self-management training services, individual, per 30 minutes"
  },
  "quantityRatio" : {
    "numerator" : {
      "value" : 1,
      "unit" : "visit",
      "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
      "code" : "C25716"
    },
    "denominator" : {
      "value" : 1,
      "unit" : "week",
      "system" : "http://unitsofmeasure.org",
      "code" : "wk"
    }
  },
  "subject" : {
    🔗 "reference" : "Patient/patientBSJ1"
  },
  "occurrencePeriod" : {
    "start" : "2020-05-01",
    "end" : "2020-08-01"
  },
  "performer" : [
    {
      🔗 "reference" : "Practitioner/provider3"
    }
  ],
  "reasonReference" : [
    {
      🔗 "reference" : "Condition/need2"
    }
  ],
  "supportingInfo" : [
    {
      🔗 "reference" : "Claim/claim2"
    }
  ]
}