United States Patient Care Summary (US-PCS) Implementation Guide
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United States Patient Care Summary (US-PCS) Implementation Guide - Downloaded Version 1.0.0 See the Directory of published versions

: Example US-PCS Bundle with Data in All 7 Sections

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{
  "resourceType" : "Bundle",
  "id" : "US-PCS-Bundle-All-7-Sections",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/pcs/StructureDefinition/Bundle-us-pcs"
    ]
  },
  "language" : "en",
  "identifier" : {
    "system" : "https://example.org/fhir/identifier/bundle-id",
    "value" : "ac7a747c-a2c9-493c-ba39-4ac6997eed1e"
  },
  "type" : "document",
  "timestamp" : "2026-03-21T18:53:00.8116604+00:00",
  "entry" : [
    {
      "fullUrl" : "https://fhir.example.org/fhir/Composition/514af4c1-194d-48b4-8afe-7be09d3f895a",
      "resource" : {
        "resourceType" : "Composition",
        "id" : "514af4c1-194d-48b4-8afe-7be09d3f895a",
        "meta" : {
          "versionId" : "1",
          "profile" : [
            🔗 "http://hl7.org/fhir/us/pcs/StructureDefinition/Composition-us-pcs"
          ]
        },
        "language" : "en",
        "text" : {
          "status" : "generated"
        },
        "identifier" : {
          "system" : "https://example.org/fhir/identifier/composition-id",
          "value" : "ac7a747c-a2c9-493c-ba39-4ac6997eed1e"
        },
        "status" : "final",
        "type" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "60591-5",
              "display" : "Patient summary Document"
            }
          ]
        },
        "subject" : {
          "reference" : "https://fhir.example.org/fhir/Patient/DEF1234"
        },
        "date" : "2026-03-21T18:53:00.8116604+00:00",
        "author" : [
          {
            "reference" : "https://fhir.example.org/fhir/Organization/8dcf67a5-b677-4c4f-94c6-a4cf41c9a522"
          }
        ],
        "title" : "US Patient Care Summary",
        "confidentiality" : "N",
        "attester" : [
          {
            "mode" : "professional",
            "time" : "2026-03-21T18:53:00.8116604+00:00",
            "party" : {
              "reference" : "https://fhir.example.org/fhir/PractitionerRole/75ed6f24-9a7e-4568-9c05-91b6d4786743"
            }
          }
        ],
        "custodian" : {
          "reference" : "https://fhir.example.org/fhir/Organization/8dcf67a5-b677-4c4f-94c6-a4cf41c9a522"
        },
        "event" : [
          {
            "code" : [
              {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/v3-ActClass",
                    "code" : "PCPR"
                  }
                ]
              }
            ],
            "period" : {
              "end" : "2026-03-21T18:53:00.8116604+00:00"
            }
          }
        ],
        "section" : [
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/note",
                "valueAnnotation" : {
                  "text" : "Includes Condition.clinicalStatus of: active, recurrence, relapse or remission; Excludes Condition.verificationStatus of entered-in-error"
                }
              }
            ],
            "title" : "Problem List",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "11450-4",
                  "display" : "Problem list - Reported"
                }
              ]
            },
            "text" : {
              "extension" : [
                {
                  "extension" : [
                    {
                      "url" : "htmlid",
                      "valueString" : "8039e4a7-d459-454c-92a5-6c17ca2a824b"
                    },
                    {
                      "url" : "data",
                      "valueUri" : "https://fhir.example.org/fhir/Condition/8039e4a7-d459-454c-92a5-6c17ca2a824b"
                    }
                  ],
                  "url" : "http://hl7.org/fhir/StructureDefinition/textLink"
                },
                {
                  "extension" : [
                    {
                      "url" : "htmlid",
                      "valueString" : "f8ab8ac1-56d1-4239-8303-dc70c1a3d0e1"
                    },
                    {
                      "url" : "data",
                      "valueUri" : "https://fhir.example.org/fhir/Condition/f8ab8ac1-56d1-4239-8303-dc70c1a3d0e1"
                    }
                  ],
                  "url" : "http://hl7.org/fhir/StructureDefinition/textLink"
                }
              ],
              "status" : "generated"
            },
            "entry" : [
              {
                "reference" : "https://fhir.example.org/fhir/Condition/8039e4a7-d459-454c-92a5-6c17ca2a824b"
              },
              {
                "reference" : "https://fhir.example.org/fhir/Condition/f8ab8ac1-56d1-4239-8303-dc70c1a3d0e1"
              }
            ]
          },
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/note",
                "valueAnnotation" : {
                  "text" : "Includes AllergyIntolerance.clinicalStatus of active; Excludes AllergyIntolerance.verificationStatus of entered-in-error"
                }
              }
            ],
            "title" : "Allergies and Intolerances",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "48765-2",
                  "display" : "Allergies and adverse reactions Document"
                }
              ]
            },
            "text" : {
              "extension" : [
                {
                  "extension" : [
                    {
                      "url" : "htmlid",
                      "valueString" : "9838cf73-c30d-4aa5-8ed8-36a079060b81"
                    },
                    {
                      "url" : "data",
                      "valueUri" : "https://fhir.example.org/fhir/AllergyIntolerance/9838cf73-c30d-4aa5-8ed8-36a079060b81"
                    }
                  ],
                  "url" : "http://hl7.org/fhir/StructureDefinition/textLink"
                }
              ],
              "status" : "generated"
            },
            "entry" : [
              {
                "reference" : "https://fhir.example.org/fhir/AllergyIntolerance/9838cf73-c30d-4aa5-8ed8-36a079060b81"
              }
            ]
          },
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/note",
                "valueAnnotation" : {
                  "text" : "Includes MedicationRequest.status of active and MedicationRequest.intent of order or plan. Excludes MedicationRequest.doNotPerform is true"
                }
              }
            ],
            "title" : "Medication Summary",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "10160-0",
                  "display" : "History of Medication use Narrative"
                }
              ]
            },
            "text" : {
              "extension" : [
                {
                  "extension" : [
                    {
                      "url" : "htmlid",
                      "valueString" : "c3d31980-2a88-45b6-a7af-3fe8d32cc6fa"
                    },
                    {
                      "url" : "data",
                      "valueUri" : "https://fhir.example.org/fhir/MedicationRequest/c3d31980-2a88-45b6-a7af-3fe8d32cc6fa"
                    }
                  ],
                  "url" : "http://hl7.org/fhir/StructureDefinition/textLink"
                }
              ],
              "status" : "generated"
            },
            "entry" : [
              {
                "reference" : "https://fhir.example.org/fhir/MedicationRequest/c3d31980-2a88-45b6-a7af-3fe8d32cc6fa"
              }
            ]
          },
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/note",
                "valueAnnotation" : {
                  "text" : "Includes short-term immunizations within past 24 months. Includes lifetime immunizations with long duration"
                }
              }
            ],
            "title" : "Immunizations",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "11369-6",
                  "display" : "History of Immunization note"
                }
              ]
            },
            "text" : {
              "extension" : [
                {
                  "extension" : [
                    {
                      "url" : "htmlid",
                      "valueString" : "17b5a6d7-307b-4726-8c8c-0031e61582ce"
                    },
                    {
                      "url" : "data",
                      "valueUri" : "https://fhir.example.org/fhir/Immunization/17b5a6d7-307b-4726-8c8c-0031e61582ce"
                    }
                  ],
                  "url" : "http://hl7.org/fhir/StructureDefinition/textLink"
                }
              ],
              "status" : "generated"
            },
            "entry" : [
              {
                "reference" : "https://fhir.example.org/fhir/Immunization/17b5a6d7-307b-4726-8c8c-0031e61582ce"
              }
            ]
          },
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/note",
                "valueAnnotation" : {
                  "text" : "Includes diagnostic reports, laboratory and imaging observations from the past 90 days"
                }
              }
            ],
            "title" : "Results",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "30954-2",
                  "display" : "Relevant diagnostic tests/laboratory data note"
                }
              ]
            },
            "text" : {
              "extension" : [
                {
                  "extension" : [
                    {
                      "url" : "htmlid",
                      "valueString" : "b0187efd-5f9b-474d-87bc-efebf877449a"
                    },
                    {
                      "url" : "data",
                      "valueUri" : "https://fhir.example.org/fhir/Observation/b0187efd-5f9b-474d-87bc-efebf877449a"
                    }
                  ],
                  "url" : "http://hl7.org/fhir/StructureDefinition/textLink"
                }
              ],
              "status" : "generated"
            },
            "entry" : [
              {
                "reference" : "https://fhir.example.org/fhir/Observation/b0187efd-5f9b-474d-87bc-efebf877449a"
              }
            ]
          },
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/note",
                "valueAnnotation" : {
                  "text" : "Includes all major procedures with lasting clinical implications and all procedures from last 90 days"
                }
              }
            ],
            "title" : "History of Procedures",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "47519-4",
                  "display" : "History of Procedures Document"
                }
              ]
            },
            "text" : {
              "extension" : [
                {
                  "extension" : [
                    {
                      "url" : "htmlid",
                      "valueString" : "fb04f2f5-d5b6-4031-85e9-547c78deb658"
                    },
                    {
                      "url" : "data",
                      "valueUri" : "https://fhir.example.org/fhir/Procedure/fb04f2f5-d5b6-4031-85e9-547c78deb658"
                    }
                  ],
                  "url" : "http://hl7.org/fhir/StructureDefinition/textLink"
                }
              ],
              "status" : "generated"
            },
            "entry" : [
              {
                "reference" : "https://fhir.example.org/fhir/Procedure/fb04f2f5-d5b6-4031-85e9-547c78deb658"
              }
            ]
          },
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/note",
                "valueAnnotation" : {
                  "text" : "Include all emergency room and inpatient encounters in the past 12 months. Include all ambulatory encounters in the past 6 months"
                }
              }
            ],
            "title" : "Encounters",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "46240-8",
                  "display" : "History of Hospitalizations+Outpatient visits Narrative"
                }
              ]
            },
            "text" : {
              "extension" : [
                {
                  "extension" : [
                    {
                      "url" : "htmlid",
                      "valueString" : "e8be20b8-6f24-4204-8eca-6bc8ecd2b26b"
                    },
                    {
                      "url" : "data",
                      "valueUri" : "https://fhir.example.org/fhir/Encounter/e8be20b8-6f24-4204-8eca-6bc8ecd2b26b"
                    }
                  ],
                  "url" : "http://hl7.org/fhir/StructureDefinition/textLink"
                },
                {
                  "extension" : [
                    {
                      "url" : "htmlid",
                      "valueString" : "e11bfacd-557d-416b-bb7f-165afc68bca0"
                    },
                    {
                      "url" : "data",
                      "valueUri" : "https://fhir.example.org/fhir/Encounter/e11bfacd-557d-416b-bb7f-165afc68bca0"
                    }
                  ],
                  "url" : "http://hl7.org/fhir/StructureDefinition/textLink"
                }
              ],
              "status" : "generated"
            },
            "entry" : [
              {
                "reference" : "https://fhir.example.org/fhir/Encounter/e8be20b8-6f24-4204-8eca-6bc8ecd2b26b"
              },
              {
                "reference" : "https://fhir.example.org/fhir/Encounter/e11bfacd-557d-416b-bb7f-165afc68bca0"
              }
            ]
          }
        ]
      }
    },
    {
      "fullUrl" : "https://fhir.example.org/fhir/Patient/DEF1234",
      "resource" : {
        "resourceType" : "Patient",
        "id" : "DEF1234",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
          ]
        },
        "language" : "en",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><a name=\"Patient_DEF1234\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient DEF1234</b></p><a name=\"DEF1234\"> </a><a name=\"hcDEF1234\"> </a><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\">Language: en</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-patient.html\">US Core Patient Profile</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">John Shaw (old) Male, DoB: 1986-02-21 ( Medical Record Number:\u00a03104721\u00a0(use:\u00a0usual,\u00a0))</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Record is active\">Active:</td><td colspan=\"3\">true</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\"><ul><li>ph: 555-555-5555(Home)</li><li><a href=\"mailto:john.shaw@example.com\">john.shaw@example.com</a></li><li>49 Meadow St Mounds OK 74047 US (old)</li><li>183 Mountain View St Mounds OK 74048 US </li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.\">US Core Ethnicity Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/6.2.0/CodeSystem-CDCREC.html#CDCREC-2135-2\">CDC Race and Ethnicity: 2135-2</a> (Hispanic or Latino)</li><li>text: Hispanic or Latino</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html#3) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories:\n\n - American Indian or Alaska Native\n - Asian\n - Black or African American\n - Native Hawaiian or Other Pacific Islander\n - White.\">US Core Race Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/6.2.0/CodeSystem-CDCREC.html#CDCREC-2106-3\">CDC Race and Ethnicity: 2106-3</a> (White)</li><li>ombCategory: <a href=\"http://terminology.hl7.org/6.2.0/CodeSystem-CDCREC.html#CDCREC-1002-5\">CDC Race and Ethnicity: 1002-5</a> (American Indian or Alaska Native)</li><li>ombCategory: <a href=\"http://terminology.hl7.org/6.2.0/CodeSystem-CDCREC.html#CDCREC-2028-9\">CDC Race and Ethnicity: 2028-9</a> (Asian)</li><li>text: Mixed</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"This Extension profile represents a tribe or band with which a person associates and, optionally, whether they are enrolled.\">US Core Tribal Affiliation Extension:</td><td colspan=\"3\"><ul><li>tribalAffiliation: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-TribalEntityUS 187}\">Shoshone</span></li><li>isEnrolled: false</li></ul></td></tr></table></div>"
        },
        "extension" : [
          {
            "extension" : [
              {
                "url" : "ombCategory",
                "valueCoding" : {
                  "system" : "urn:oid:2.16.840.1.113883.6.238",
                  "code" : "2106-3",
                  "display" : "White"
                }
              },
              {
                "url" : "ombCategory",
                "valueCoding" : {
                  "system" : "urn:oid:2.16.840.1.113883.6.238",
                  "code" : "1002-5",
                  "display" : "American Indian or Alaska Native"
                }
              },
              {
                "url" : "ombCategory",
                "valueCoding" : {
                  "system" : "urn:oid:2.16.840.1.113883.6.238",
                  "code" : "2028-9",
                  "display" : "Asian"
                }
              },
              {
                "url" : "text",
                "valueString" : "Mixed"
              }
            ],
            "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
          },
          {
            "extension" : [
              {
                "url" : "ombCategory",
                "valueCoding" : {
                  "system" : "urn:oid:2.16.840.1.113883.6.238",
                  "code" : "2135-2",
                  "display" : "Hispanic or Latino"
                }
              },
              {
                "url" : "text",
                "valueString" : "Hispanic or Latino"
              }
            ],
            "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
          },
          {
            "extension" : [
              {
                "url" : "tribalAffiliation",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/v3-TribalEntityUS",
                      "code" : "187",
                      "display" : "Paiute-Shoshone Tribe of the Fallon Reservation and Colony, Nevada"
                    }
                  ],
                  "text" : "Shoshone"
                }
              },
              {
                "url" : "isEnrolled",
                "valueBoolean" : false
              }
            ],
            "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-tribal-affiliation"
          },
          {
            "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-individual-sex",
            "valueCoding" : {
              "system" : "http://snomed.info/sct",
              "code" : "248153007",
              "display" : "Male"
            }
          }
        ],
        "identifier" : [
          {
            "use" : "usual",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "MR",
                  "display" : "Medical Record Number"
                }
              ],
              "text" : "Medical Record Number"
            },
            "system" : "https://example.org/fhir/identifier/medical-record-number",
            "value" : "3104721"
          }
        ],
        "active" : true,
        "name" : [
          {
            "use" : "old",
            "family" : "Shaw",
            "given" : [
              "John"
            ],
            "period" : {
              "start" : "1986-02-21"
            }
          }
        ],
        "telecom" : [
          {
            "system" : "phone",
            "value" : "555-555-5555",
            "use" : "home"
          },
          {
            "system" : "email",
            "value" : "john.shaw@example.com"
          }
        ],
        "gender" : "male",
        "birthDate" : "1986-02-21",
        "address" : [
          {
            "use" : "old",
            "line" : [
              "49 Meadow St"
            ],
            "city" : "Mounds",
            "state" : "OK",
            "postalCode" : "74047",
            "country" : "US",
            "period" : {
              "start" : "2016-12-06",
              "end" : "2020-07-22"
            }
          },
          {
            "line" : [
              "183 Mountain View St"
            ],
            "city" : "Mounds",
            "state" : "OK",
            "postalCode" : "74048",
            "country" : "US",
            "period" : {
              "start" : "2020-07-22"
            }
          }
        ]
      }
    },
    {
      "fullUrl" : "https://fhir.example.org/fhir/Organization/8dcf67a5-b677-4c4f-94c6-a4cf41c9a522",
      "resource" : {
        "resourceType" : "Organization",
        "id" : "8dcf67a5-b677-4c4f-94c6-a4cf41c9a522",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization|6.1.0"
          ]
        },
        "language" : "en",
        "text" : {
          "status" : "generated"
        },
        "identifier" : [
          {
            "system" : "http://hl7.org/fhir/sid/us-npi",
            "value" : "1407071236"
          }
        ],
        "active" : true,
        "type" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/organization-type",
                "code" : "prov",
                "display" : "Healthcare Provider"
              }
            ]
          }
        ],
        "name" : "Acme Clinic",
        "telecom" : [
          {
            "system" : "phone",
            "value" : "(+1) 734-677-7777"
          },
          {
            "system" : "email",
            "value" : "customer-service@acme-clinic.org"
          }
        ],
        "address" : [
          {
            "line" : [
              "3300 WASHTENAW AVE STE 227"
            ],
            "city" : "AMHERST",
            "state" : "MA",
            "postalCode" : "01002",
            "country" : "USA"
          }
        ]
      }
    },
    {
      "fullUrl" : "https://fhir.example.org/fhir/PractitionerRole/75ed6f24-9a7e-4568-9c05-91b6d4786743",
      "resource" : {
        "resourceType" : "PractitionerRole",
        "id" : "75ed6f24-9a7e-4568-9c05-91b6d4786743",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole|6.1.0"
          ]
        },
        "language" : "en",
        "text" : {
          "status" : "generated"
        },
        "practitioner" : {
          "reference" : "https://fhir.example.org/fhir/Practitioner/19c24876-ccf8-45e7-8b66-462317e970f1",
          "display" : "Brenda Jennings Richard MD"
        },
        "organization" : {
          "reference" : "https://fhir.example.org/fhir/Organization/acme-lab",
          "display" : "Acme Lab"
        },
        "code" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationFunction",
                "code" : "PCP",
                "display" : "primary care physician"
              },
              {
                "system" : "http://snomed.info/sct",
                "code" : "446050000",
                "display" : "Primary care physician"
              }
            ]
          }
        ],
        "specialty" : [
          {
            "coding" : [
              {
                "system" : "http://snomed.info/sct",
                "code" : "419772000",
                "display" : "Family practice"
              }
            ]
          }
        ],
        "location" : [
          {
            "reference" : "https://fhir.example.org/fhir/Location/hl7east",
            "display" : "Health Level Seven International"
          }
        ],
        "endpoint" : [
          {
            "reference" : "https://fhir1.example.org/fhir/Endpoint/Endpoint-71",
            "display" : "Westwood Physicians Organization ADT"
          },
          {
            "reference" : "https://fhir2.example.org/fhir/R4/Endpoint/Endpoint-71",
            "display" : "Brenda.Jennings.Richard.MD@direct.example.org"
          }
        ]
      }
    },
    {
      "fullUrl" : "https://fhir.example.org/fhir/Practitioner/19c24876-ccf8-45e7-8b66-462317e970f1",
      "resource" : {
        "resourceType" : "Practitioner",
        "id" : "19c24876-ccf8-45e7-8b66-462317e970f1",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|6.1.0"
          ]
        },
        "language" : "en",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><a name=\"Practitioner_19c24876-ccf8-45e7-8b66-462317e970f1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner 19c24876-ccf8-45e7-8b66-462317e970f1</b></p><a name=\"19c24876-ccf8-45e7-8b66-462317e970f1\"> </a><a name=\"hc19c24876-ccf8-45e7-8b66-462317e970f1\"> </a><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\">Language: en</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-practitioner.html\">US Core Practitioner Profile</a> version: 6.1.0</p></div><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/7.2.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/9941339100</p><p><b>name</b>: Brenda Richard </p><p><b>address</b>: 1003 HEALTHCARE DR AMHERST MA 01002 (work)</p></div>"
        },
        "identifier" : [
          {
            "system" : "http://hl7.org/fhir/sid/us-npi",
            "value" : "9941339100"
          }
        ],
        "name" : [
          {
            "family" : "Richard",
            "given" : [
              "Brenda"
            ],
            "prefix" : [
              "Dr"
            ]
          }
        ],
        "address" : [
          {
            "use" : "work",
            "line" : [
              "1003 HEALTHCARE DR"
            ],
            "city" : "AMHERST",
            "state" : "MA",
            "postalCode" : "01002"
          }
        ]
      }
    },
    {
      "fullUrl" : "https://fhir.example.org/fhir/AllergyIntolerance/9838cf73-c30d-4aa5-8ed8-36a079060b81",
      "resource" : {
        "resourceType" : "AllergyIntolerance",
        "id" : "9838cf73-c30d-4aa5-8ed8-36a079060b81",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance|6.1.0"
          ]
        },
        "language" : "en",
        "text" : {
          "status" : "generated"
        },
        "clinicalStatus" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
              "code" : "active"
            }
          ]
        },
        "verificationStatus" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
              "code" : "confirmed"
            }
          ]
        },
        "category" : [
          "medication"
        ],
        "criticality" : "high",
        "code" : {
          "coding" : [
            {
              "system" : "http://snomed.info/sct",
              "version" : "http://snomed.info/sct/731000124108",
              "code" : "763875007",
              "display" : "Product containing sulfonamide (product)"
            }
          ],
          "text" : "sulfonamide antibacterial"
        },
        "patient" : {
          "reference" : "https://fhir.example.org/fhir/Patient/DEF1234",
          "display" : "John Shaw"
        },
        "reaction" : [
          {
            "manifestation" : [
              {
                "coding" : [
                  {
                    "system" : "http://snomed.info/sct",
                    "version" : "http://snomed.info/sct/731000124108",
                    "code" : "271807003",
                    "display" : "skin rash"
                  }
                ],
                "text" : "skin rash"
              }
            ],
            "severity" : "mild"
          }
        ]
      }
    },
    {
      "fullUrl" : "https://fhir.example.org/fhir/Condition/8039e4a7-d459-454c-92a5-6c17ca2a824b",
      "resource" : {
        "resourceType" : "Condition",
        "id" : "8039e4a7-d459-454c-92a5-6c17ca2a824b",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns"
          ]
        },
        "language" : "en",
        "text" : {
          "status" : "extensions"
        },
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/condition-assertedDate",
            "valueDateTime" : "2016-08-10"
          }
        ],
        "clinicalStatus" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
              "code" : "active",
              "display" : "Active"
            }
          ],
          "text" : "Active"
        },
        "verificationStatus" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
              "code" : "confirmed",
              "display" : "Confirmed"
            }
          ],
          "text" : "Confirmed"
        },
        "category" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/condition-category",
                "code" : "problem-list-item",
                "display" : "Problem List Item"
              }
            ],
            "text" : "Problem List Item"
          }
        ],
        "code" : {
          "coding" : [
            {
              "system" : "http://snomed.info/sct",
              "code" : "51868009",
              "display" : "Ulcer of duodenum (disorder)"
            }
          ],
          "text" : "Active Duodenal Ulcer"
        },
        "subject" : {
          "reference" : "https://fhir.example.org/fhir/Patient/DEF1234",
          "display" : "John Shaw"
        },
        "recordedDate" : "2016-08-10T07:15:07-08:00"
      }
    },
    {
      "fullUrl" : "https://fhir.example.org/fhir/Condition/f8ab8ac1-56d1-4239-8303-dc70c1a3d0e1",
      "resource" : {
        "resourceType" : "Condition",
        "id" : "f8ab8ac1-56d1-4239-8303-dc70c1a3d0e1",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns"
          ]
        },
        "language" : "en",
        "text" : {
          "status" : "extensions"
        },
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/condition-assertedDate",
            "valueDateTime" : "2016-08-10"
          }
        ],
        "clinicalStatus" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
              "code" : "active",
              "display" : "Active"
            }
          ],
          "text" : "Active"
        },
        "verificationStatus" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
              "code" : "confirmed",
              "display" : "Confirmed"
            }
          ],
          "text" : "Confirmed"
        },
        "category" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/condition-category",
                "code" : "problem-list-item",
                "display" : "Problem List Item"
              }
            ],
            "text" : "Problem List Item"
          }
        ],
        "code" : {
          "coding" : [
            {
              "system" : "http://snomed.info/sct",
              "code" : "44054006",
              "display" : "Diabetes mellitus type 2 (disorder)"
            }
          ],
          "text" : "Diabetes mellitus type 2 (disorder)"
        },
        "subject" : {
          "reference" : "https://fhir.example.org/fhir/Patient/DEF1234",
          "display" : "John Shaw"
        },
        "recordedDate" : "2016-08-10T07:15:07-08:00"
      }
    },
    {
      "fullUrl" : "https://fhir.example.org/fhir/MedicationRequest/c3d31980-2a88-45b6-a7af-3fe8d32cc6fa",
      "resource" : {
        "resourceType" : "MedicationRequest",
        "id" : "c3d31980-2a88-45b6-a7af-3fe8d32cc6fa",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest"
          ]
        },
        "language" : "en",
        "text" : {
          "status" : "generated"
        },
        "status" : "active",
        "intent" : "order",
        "medicationCodeableConcept" : {
          "coding" : [
            {
              "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
              "code" : "582620",
              "display" : "Nizatidine 15 MG/ML Oral Solution [Axid]"
            }
          ],
          "text" : "Nizatidine 15 MG/ML Oral Solution [Axid]"
        },
        "subject" : {
          "reference" : "https://fhir.example.org/fhir/Patient/DEF1234",
          "display" : "Amy Shaw"
        },
        "authoredOn" : "2008-04-05",
        "requester" : {
          "reference" : "https://fhir.example.org/fhir/Practitioner/practitioner-1",
          "display" : "Ronald Bone, MD"
        },
        "reasonCode" : [
          {
            "coding" : [
              {
                "system" : "http://snomed.info/sct",
                "code" : "51868009",
                "display" : "Ulcer of duodenum (disorder)"
              }
            ],
            "text" : "Active Duodenal Ulcer"
          }
        ],
        "dosageInstruction" : [
          {
            "text" : "10 mL bid",
            "timing" : {
              "repeat" : {
                "boundsPeriod" : {
                  "start" : "2008-04-05"
                },
                "frequency" : 2,
                "period" : 1,
                "periodUnit" : "d"
              }
            },
            "doseAndRate" : [
              {
                "doseQuantity" : {
                  "value" : 10,
                  "unit" : "ml",
                  "system" : "http://unitsofmeasure.org",
                  "code" : "mL"
                }
              }
            ]
          }
        ],
        "dispenseRequest" : {
          "numberOfRepeatsAllowed" : 1,
          "quantity" : {
            "value" : 480,
            "unit" : "mL",
            "system" : "http://unitsofmeasure.org",
            "code" : "mL"
          },
          "expectedSupplyDuration" : {
            "value" : 30,
            "unit" : "days",
            "system" : "http://unitsofmeasure.org",
            "code" : "d"
          }
        }
      }
    },
    {
      "fullUrl" : "https://fhir.example.org/fhir/Immunization/17b5a6d7-307b-4726-8c8c-0031e61582ce",
      "resource" : {
        "resourceType" : "Immunization",
        "id" : "17b5a6d7-307b-4726-8c8c-0031e61582ce",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization"
          ]
        },
        "language" : "en",
        "text" : {
          "status" : "generated"
        },
        "status" : "completed",
        "vaccineCode" : {
          "coding" : [
            {
              "system" : "http://hl7.org/fhir/sid/cvx",
              "code" : "197",
              "display" : "Influenza, high-dose, quadrivalent, PF"
            }
          ],
          "text" : "Influenza, high-dose, quadrivalent, PF"
        },
        "patient" : {
          "reference" : "https://fhir.example.org/fhir/Patient/DEF1234",
          "display" : "John Shaw"
        },
        "occurrenceDateTime" : "2020-11-19T12:46:57-08:00",
        "primarySource" : false
      }
    },
    {
      "fullUrl" : "https://fhir.example.org/fhir/Observation/b0187efd-5f9b-474d-87bc-efebf877449a",
      "resource" : {
        "resourceType" : "Observation",
        "id" : "b0187efd-5f9b-474d-87bc-efebf877449a",
        "meta" : {
          "versionId" : "914",
          "lastUpdated" : "2016-03-09T15:29:57.277+00:00",
          "profile" : [
            🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"
          ]
        },
        "language" : "en",
        "text" : {
          "status" : "generated"
        },
        "status" : "final",
        "category" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
                "code" : "laboratory",
                "display" : "Laboratory"
              }
            ],
            "text" : "Laboratory"
          }
        ],
        "code" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "2951-2",
              "display" : "Sodium SerPl-sCnc"
            }
          ],
          "text" : "Sodium SerPl-sCnc"
        },
        "subject" : {
          "reference" : "https://fhir.example.org/fhir/Patient/DEF1234",
          "display" : "John Shaw"
        },
        "effectiveDateTime" : "2005-07-05",
        "performer" : [
          {
            "reference" : "https://fhir.example.org/fhir/Practitioner/practitioner-1",
            "display" : "Ronald Bone, MD"
          }
        ],
        "valueQuantity" : {
          "value" : 137,
          "unit" : "mmol/L",
          "system" : "http://unitsofmeasure.org"
        },
        "specimen" : {
          "reference" : "https://fhir.example.org/fhir/Specimen/specimen-example-serum",
          "display" : "Serum specimen"
        },
        "referenceRange" : [
          {
            "low" : {
              "value" : 135,
              "unit" : "mmol/L",
              "system" : "http://unitsofmeasure.org",
              "code" : "mmol/L"
            },
            "high" : {
              "value" : 145,
              "unit" : "mmol/L",
              "system" : "http://unitsofmeasure.org",
              "code" : "mmol/L"
            },
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/referencerange-meaning",
                  "code" : "normal",
                  "display" : "Normal Range"
                }
              ],
              "text" : "Normal Range"
            }
          }
        ]
      }
    },
    {
      "fullUrl" : "https://fhir.example.org/fhir/Procedure/fb04f2f5-d5b6-4031-85e9-547c78deb658",
      "resource" : {
        "resourceType" : "Procedure",
        "id" : "fb04f2f5-d5b6-4031-85e9-547c78deb658",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure|6.1.0"
          ]
        },
        "language" : "en",
        "text" : {
          "status" : "generated"
        },
        "identifier" : [
          {
            "system" : "urn:ietf:rfc:3986",
            "value" : "urn:uuid:b2a737f2-2fdb-49c1-b097-dac173d07aff"
          }
        ],
        "basedOn" : [
          {
            "reference" : "https://fhir.example.org/fhir/ServiceRequest/34c2af5e-14e3-41c0-9f65-4e5128e48e47"
          }
        ],
        "status" : "completed",
        "code" : {
          "coding" : [
            {
              "system" : "http://www.ama-assn.org/go/cpt",
              "code" : "33249"
            }
          ],
          "text" : "Insertion or replacement of permanent implantable defibrillator system with transvenous lead(s), single or dual chamber"
        },
        "subject" : {
          "reference" : "https://fhir.example.org/fhir/Patient/DEF1234"
        },
        "performedPeriod" : {
          "start" : "2019-03-26T12:55:26-07:00",
          "end" : "2019-03-26T13:25:26-07:00"
        },
        "performer" : [
          {
            "actor" : {
              "reference" : "https://fhir.example.org/fhir/Practitioner/19c24876-ccf8-45e7-8b66-462317e970f1"
            }
          }
        ],
        "focalDevice" : [
          {
            "manipulated" : {
              "reference" : "https://fhir.example.org/fhir/Device/udi-2"
            }
          }
        ]
      }
    },
    {
      "fullUrl" : "https://fhir.example.org/fhir/Encounter/e8be20b8-6f24-4204-8eca-6bc8ecd2b26b",
      "resource" : {
        "resourceType" : "Encounter",
        "id" : "e8be20b8-6f24-4204-8eca-6bc8ecd2b26b",
        "meta" : {
          "lastUpdated" : "2024-01-28T16:06:21-08:00",
          "profile" : [
            🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter|6.1.0"
          ]
        },
        "language" : "en",
        "text" : {
          "status" : "extensions"
        },
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-interpreter-needed",
            "valueCoding" : {
              "system" : "http://snomed.info/sct",
              "code" : "373066001"
            }
          }
        ],
        "status" : "finished",
        "class" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code" : "AMB",
          "display" : "ambulatory"
        },
        "type" : [
          {
            "coding" : [
              {
                "system" : "http://www.ama-assn.org/go/cpt",
                "code" : "99211"
              }
            ],
            "text" : "Office Visit"
          }
        ],
        "subject" : {
          "reference" : "https://fhir.example.org/fhir/Patient/DEF1234"
        },
        "period" : {
          "start" : "2026-03-17T17:00:14-05:00",
          "end" : "2026-03-17T18:00:14-05:00"
        },
        "location" : [
          {
            "location" : {
              "reference" : "https://fhir.example.org/fhir/Location/hl7east",
              "display" : "HL7 East Ambulatory"
            }
          }
        ]
      }
    },
    {
      "fullUrl" : "https://fhir.example.org/fhir/Encounter/e11bfacd-557d-416b-bb7f-165afc68bca0",
      "resource" : {
        "resourceType" : "Encounter",
        "id" : "e11bfacd-557d-416b-bb7f-165afc68bca0",
        "meta" : {
          "lastUpdated" : "2024-01-28T16:06:21-08:00",
          "profile" : [
            🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter|6.1.0"
          ]
        },
        "language" : "en",
        "text" : {
          "status" : "generated"
        },
        "status" : "finished",
        "class" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code" : "IMP",
          "display" : "inpatient encounter"
        },
        "type" : [
          {
            "coding" : [
              {
                "system" : "http://snomed.info/sct",
                "code" : "261665006",
                "display" : "Unknown (qualifier value)"
              }
            ],
            "text" : "Hospitalization"
          }
        ],
        "subject" : {
          "reference" : "https://fhir.example.org/fhir/Patient/DEF1234"
        },
        "period" : {
          "start" : "2026-01-17T17:00:14-05:00",
          "end" : "2026-01-20T18:00:14-05:00"
        },
        "location" : [
          {
            "location" : {
              "reference" : "https://fhir.example.org/fhir/Location/hospital",
              "display" : "Holy Family Hospital"
            }
          }
        ]
      }
    }
  ]
}