Data Exchange For Quality Measures Implementation Guide
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Data Exchange For Quality Measures Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 5.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-deqm/ and changes regularly. See the Directory of published versions

: Gaps Bundle Closed Individual MeasureReport01 - JSON Representation

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{
  "resourceType" : "Bundle",
  "id" : "single-gaps-closed-indv-report01",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-bundle-deqm"
    ]
  },
  "identifier" : {
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:uuid:f119bdf2-eeb9-47b2-8dc1-e2068cc3c4ae"
  },
  "type" : "document",
  "timestamp" : "2020-06-30T13:08:53+00:00",
  "entry" : [
    {
      "fullUrl" : "http://example.org/fhir/gaps/Composition/gaps-composition02",
      "resource" : {
        "resourceType" : "Composition",
        "id" : "gaps-composition02",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-composition-deqm"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Composition_gaps-composition02\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Composition gaps-composition02</b></p><a name=\"gaps-composition02\"> </a><a name=\"hcgaps-composition02\"> </a><a name=\"gaps-composition02-en-US\"> </a><p><b>status</b>: Final</p><p><b>type</b>: <span title=\"Codes:{http://loinc.org 96315-7}\">Gaps in care report</span></p><p><b>date</b>: 2020-06-30 13:08:53+0000</p><p><b>author</b>: <a href=\"Organization-gaps-organization-reportingvendor.html\">Organization GapsReportingVendor01</a></p><p><b>title</b>: Care Gap Report for patient gaps-patient02</p></div>"
        },
        "status" : "final",
        "type" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "96315-7",
              "display" : "Gaps in care report"
            }
          ]
        },
        "subject" : {
          🔗 "reference" : "Patient/gaps-patient02"
        },
        "date" : "2020-06-30T13:08:53+00:00",
        "author" : [
          {
            🔗 "reference" : "Organization/gaps-organization-reportingvendor"
          }
        ],
        "title" : "Care Gap Report for patient gaps-patient02",
        "section" : [
          {
            "title" : "Colorectal Cancer Screening",
            "focus" : {
              🔗 "reference" : "MeasureReport/gaps-indv-measurereport03"
            },
            "entry" : [
              {
                🔗 "reference" : "DetectedIssue/gaps-detectedissue03"
              }
            ]
          }
        ]
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/gaps/DetectedIssue/gaps-detectedissue03",
      "resource" : {
        "resourceType" : "DetectedIssue",
        "id" : "gaps-detectedissue03",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-detectedissue-deqm"
          ]
        },
        "text" : {
          "status" : "extensions",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"DetectedIssue_gaps-detectedissue03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: DetectedIssue gaps-detectedissue03</b></p><a name=\"gaps-detectedissue03\"> </a><a name=\"hcgaps-detectedissue03\"> </a><a name=\"gaps-detectedissue03-en-US\"> </a><p><b>DEQM Gap Status Modifier Extension</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-deqm/CodeSystem/gaps-status closed-gap}\">Closed Gap</span></p><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode CAREGAP}\">Caregap</span></p><p><b>patient</b>: <a href=\"Patient-gaps-patient02.html\">Thomas Ludwich  Male, DoB: 1957-01-01 ( Medical Record Number: 999996992\u00a0(use:\u00a0usual,\u00a0))</a></p><h3>Evidences</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Detail</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"MeasureReport-gaps-indv-measurereport03.html\">MeasureReport: extension = Proportion,urn:oid:2.16.840.1.113883.3.2074.1#0015HQN9BD3304E,-&gt;Organization GapsReportingVendor01; status = complete; type = individual; measure = http://hl7.org/fhir/us/davinci-deqm/Measure/measure-exm130-example; date = 2020-06-30 13:08:52+0000; period = 2020-01-01 --&gt; 2020-12-31; improvementNotation = Increased score indicates improvement</a></td></tr></table></div>"
        },
        "modifierExtension" : [
          {
            "url" : "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-gapStatus",
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/us/davinci-deqm/CodeSystem/gaps-status",
                  "code" : "closed-gap"
                }
              ]
            }
          }
        ],
        "status" : "final",
        "code" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
              "code" : "CAREGAP",
              "display" : "Caregap"
            }
          ]
        },
        "patient" : {
          🔗 "reference" : "Patient/gaps-patient02"
        },
        "evidence" : [
          {
            "detail" : [
              {
                🔗 "reference" : "MeasureReport/gaps-indv-measurereport03"
              }
            ]
          }
        ]
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/gaps/MeasureReport/gaps-indv-measurereport03",
      "resource" : {
        "resourceType" : "MeasureReport",
        "id" : "gaps-indv-measurereport03",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"
          ]
        },
        "text" : {
          "status" : "extensions",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MeasureReport_gaps-indv-measurereport03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MeasureReport gaps-indv-measurereport03</b></p><a name=\"gaps-indv-measurereport03\"> </a><a name=\"hcgaps-indv-measurereport03\"> </a><a name=\"gaps-indv-measurereport03-en-US\"> </a><p><b>DEQM Measure Scoring Extension</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-scoring proportion}\">Proportion</span></p><p><b>DEQM Certification Identifier Extension</b>: <code>urn:oid:2.16.840.1.113883.3.2074.1</code>/0015HQN9BD3304E</p><p><b>DEQM Reporting Vendor Extension</b>: <a href=\"Organization-gaps-organization-reportingvendor.html\">Organization GapsReportingVendor01</a></p><p><b>status</b>: Complete</p><p><b>type</b>: Individual</p><p><b>measure</b>: <a href=\"Measure-measure-exm130-example.html\">Colorectal Cancer Screening Measure</a></p><p><b>subject</b>: <a href=\"Patient-gaps-patient02.html\">Thomas Ludwich  Male, DoB: 1957-01-01 ( Medical Record Number: 999996992\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>date</b>: 2020-06-30 13:08:52+0000</p><p><b>reporter</b>: <a href=\"Organization-gaps-organization-reportingvendor.html\">Organization GapsReportingVendor01</a></p><p><b>period</b>: 2020-01-01 --&gt; 2020-12-31</p><p><b>improvementNotation</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-improvement-notation increase}\">Increased score indicates improvement</span></p><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-exm130</blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-population initial-population}\">Initial Population</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-population numerator}\">Numerator</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-population denominator}\">Denominator</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-population denominator-exclusion}\">Denominator Exclusion</span></p><p><b>count</b>: 0</p></blockquote><p><b>measureScore</b>: 1.0</p></blockquote><p><b>evaluatedResource</b>: </p><ul><li><a href=\"Encounter-gaps-encounter02.html\">Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using time for code selection, 15-29 minutes of total time is spent on the date of the encounter.; period = 2020-03-05 07:00:00+0000 --&gt; 2020-03-05 10:00:00+0000</a></li><li><a href=\"Patient-gaps-patient02.html\">Thomas Ludwich  Male, DoB: 1957-01-01 ( Medical Record Number: 999996992\u00a0(use:\u00a0usual,\u00a0))</a></li><li><a href=\"Procedure-gaps-procedure01.html\">Procedure Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps</a></li></ul></div>"
        },
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring",
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
                  "code" : "proportion"
                }
              ]
            }
          },
          {
            "url" : "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-certificationIdentifier",
            "valueIdentifier" : {
              "system" : "urn:oid:2.16.840.1.113883.3.2074.1",
              "value" : "0015HQN9BD3304E"
            }
          },
          {
            "url" : "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-reportingVendor",
            "valueReference" : {
              🔗 "reference" : "Organization/gaps-organization-reportingvendor"
            }
          }
        ],
        "status" : "complete",
        "type" : "individual",
        "measure" : "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-exm130-example",
        "subject" : {
          🔗 "reference" : "Patient/gaps-patient02"
        },
        "date" : "2020-06-30T13:08:52+00:00",
        "reporter" : {
          🔗 "reference" : "Organization/gaps-organization-reportingvendor"
        },
        "period" : {
          "start" : "2020-01-01",
          "end" : "2020-12-31"
        },
        "improvementNotation" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
              "code" : "increase"
            }
          ]
        },
        "group" : [
          {
            "id" : "group-exm130",
            "population" : [
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code" : "initial-population",
                      "display" : "Initial Population"
                    }
                  ]
                },
                "count" : 1
              },
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code" : "numerator",
                      "display" : "Numerator"
                    }
                  ]
                },
                "count" : 1
              },
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code" : "denominator",
                      "display" : "Denominator"
                    }
                  ]
                },
                "count" : 1
              },
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code" : "denominator-exclusion",
                      "display" : "Denominator Exclusion"
                    }
                  ]
                },
                "count" : 0
              }
            ],
            "measureScore" : {
              "value" : 1.0
            }
          }
        ],
        "evaluatedResource" : [
          {
            🔗 "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference",
                "valueString" : "initial-population"
              },
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference",
                "valueString" : "denominator"
              }
            ],
            "reference" : "Encounter/gaps-encounter02"
          },
          {
            🔗 "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference",
                "valueString" : "initial-population"
              },
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference",
                "valueString" : "denominator"
              }
            ],
            "reference" : "Patient/gaps-patient02"
          },
          {
            🔗 "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference",
                "valueString" : "numerator"
              }
            ],
            "reference" : "Procedure/gaps-procedure01"
          }
        ]
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/gaps/Encounter/gaps-encounter02",
      "resource" : {
        "resourceType" : "Encounter",
        "id" : "gaps-encounter02",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Encounter_gaps-encounter02\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Encounter gaps-encounter02</b></p><a name=\"gaps-encounter02\"> </a><a name=\"hcgaps-encounter02\"> </a><a name=\"gaps-encounter02-en-US\"> </a><p><b>status</b>: Finished</p><p><b>class</b>: <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-AMB\">ActCode AMB</a>: ambulatory</p><p><b>type</b>: <span title=\"Codes:{http://www.ama-assn.org/go/cpt 99202}\">Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using time for code selection, 15-29 minutes of total time is spent on the date of the encounter.</span></p><p><b>subject</b>: <a href=\"Patient-gaps-patient02.html\">Thomas Ludwich  Male, DoB: 1957-01-01 ( Medical Record Number: 999996992\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>period</b>: 2020-03-05 07:00:00+0000 --&gt; 2020-03-05 10:00:00+0000</p></div>"
        },
        "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" : "99202",
                "display" : "Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using time for code selection, 15-29 minutes of total time is spent on the date of the encounter."
              }
            ]
          }
        ],
        "subject" : {
          🔗 "reference" : "Patient/gaps-patient02"
        },
        "period" : {
          "start" : "2020-03-05T07:00:00-00:00",
          "end" : "2020-03-05T10:00:00-00:00"
        }
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/gaps/Procedure/gaps-procedure01",
      "resource" : {
        "resourceType" : "Procedure",
        "id" : "gaps-procedure01",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"
          ]
        },
        "text" : {
          "status" : "extensions",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Procedure_gaps-procedure01\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Procedure gaps-procedure01</b></p><a name=\"gaps-procedure01\"> </a><a name=\"hcgaps-procedure01\"> </a><a name=\"gaps-procedure01-en-US\"> </a><p><b>QICore Not Done Recorded</b>: 2018-09-10 09:00:00+0000</p><p><b>status</b>: Completed</p><p><b>code</b>: <span title=\"Codes:{http://www.ama-assn.org/go/cpt 45384}\">Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps</span></p><p><b>subject</b>: <a href=\"Patient-gaps-patient02.html\">Thomas Ludwich  Male, DoB: 1957-01-01 ( Medical Record Number: 999996992\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>performed</b>: 2018-09-10 08:00:00+0000 --&gt; 2018-09-10 09:00:00+0000</p></div>"
        },
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-recorded",
            "valueDateTime" : "2018-09-10T09:00:00-00:00"
          }
        ],
        "status" : "completed",
        "code" : {
          "coding" : [
            {
              "system" : "http://www.ama-assn.org/go/cpt",
              "code" : "45384",
              "display" : "Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"
            }
          ]
        },
        "subject" : {
          🔗 "reference" : "Patient/gaps-patient02"
        },
        "performedPeriod" : {
          "start" : "2018-09-10T08:00:00-00:00",
          "end" : "2018-09-10T09:00:00-00:00"
        }
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/gaps/Patient/gaps-patient02",
      "resource" : {
        "resourceType" : "Patient",
        "id" : "gaps-patient02",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_gaps-patient02\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient gaps-patient02</b></p><a name=\"gaps-patient02\"> </a><a name=\"hcgaps-patient02\"> </a><a name=\"gaps-patient02-en-US\"> </a><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Thomas Ludwich  Male, DoB: 1957-01-01 ( Medical Record Number: 999996992\u00a0(use:\u00a0usual,\u00a0))</p><hr/><table class=\"grid\"><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/5.5.0/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/5.5.0/CodeSystem-CDCREC.html#CDCREC-2028-9\">CDC Race and Ethnicity 2028-9</a>: Asian</li><li>text: Asian</li></ul></td></tr></table></div>"
        },
        "extension" : [
          {
            "extension" : [
              {
                "url" : "ombCategory",
                "valueCoding" : {
                  "system" : "urn:oid:2.16.840.1.113883.6.238",
                  "code" : "2028-9",
                  "display" : "Asian"
                }
              },
              {
                "url" : "text",
                "valueString" : "Asian"
              }
            ],
            "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"
          }
        ],
        "identifier" : [
          {
            "use" : "usual",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "MR",
                  "display" : "Medical Record Number"
                }
              ]
            },
            "system" : "http://hospital.smarthealthit.org",
            "value" : "999996992"
          }
        ],
        "name" : [
          {
            "family" : "Ludwich",
            "given" : [
              "Thomas"
            ]
          }
        ],
        "gender" : "male",
        "birthDate" : "1957-01-01"
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/gaps/Organization/gaps-organization-reportingvendor",
      "resource" : {
        "resourceType" : "Organization",
        "id" : "gaps-organization-reportingvendor",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_gaps-organization-reportingvendor\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization gaps-organization-reportingvendor</b></p><a name=\"gaps-organization-reportingvendor\"> </a><a name=\"hcgaps-organization-reportingvendor\"> </a><a name=\"gaps-organization-reportingvendor-en-US\"> </a><p><b>identifier</b>: Tax ID number/123446789\u00a0(use:\u00a0official,\u00a0)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type pay}\">Payer</span></p><p><b>name</b>: GapsReportingVendor01</p><p><b>telecom</b>: ph: (+1) 401-545-1212</p><p><b>address</b>: 13 Drive Street Cityplace MA 01101 USA </p></div>"
        },
        "identifier" : [
          {
            "use" : "official",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "TAX",
                  "display" : "Tax ID number"
                }
              ]
            },
            "system" : "urn:oid:2.16.840.1.113883.4.4",
            "value" : "123446789",
            "assigner" : {
              "display" : "www.irs.gov"
            }
          }
        ],
        "active" : true,
        "type" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/organization-type",
                "code" : "pay",
                "display" : "Payer"
              }
            ]
          }
        ],
        "name" : "GapsReportingVendor01",
        "telecom" : [
          {
            "system" : "phone",
            "value" : "(+1) 401-545-1212"
          }
        ],
        "address" : [
          {
            "line" : [
              "13 Drive Street"
            ],
            "city" : "Cityplace",
            "state" : "MA",
            "postalCode" : "01101",
            "country" : "USA"
          }
        ]
      }
    }
  ]
}