Da Vinci - Payer Coverage Decision Exchange (PCDE)
1.0.0 - STU 1

Da Vinci - Payer Coverage Decision Exchange (PCDE), published by HL7 International - Financial Management Work Group. This is not an authorized publication; it is the continuous build for version 1.0.0). This version is based on the current content of https://github.com/HL7/davinci-pcde/ and changes regularly. See the Directory of published versions

## : PCDE Document example - JSON Representation

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    {
      "resourceType" : "Bundle",
      "id" : "pcde-document",
      "meta" : {
        "lastUpdated" : "2019-07-21T11:01:00+05:00"
      },
      "identifier" : {
        "system" : "http://originalinsuranceinc.com/documentIDs",
        "value" : "A12345"
      },
      "type" : "document",
      "timestamp" : "2019-07-21T11:01:00+05:00",
      "entry" : [
        {
          "fullUrl" : "http://originalinsuranceinc.com/fhir/Composition/1",
          "resource" : {
            "resourceType" : "Composition",
            "id" : "1",
            "meta" : {
              "profile" : [
                "http://hl7.org/fhir/us/davinci-pcde/StructureDefinition/profile-composition"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Composition</b></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 Composition \"1\" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-composition.html\">PCDE Coverage Transition Composition Profile</a></p></div><p><b>status</b>: final</p><p><b>type</b>: Coverage Transition Document <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-PCDEtempCodes.html\">PCDE Temporary Codes</a>#pcde)</span></p><p><b>date</b>: 2019-07-21 11:09:00+0700</p><p><b>author</b>: <a href=\"#Practitioner_1\">See above (Practitioner/1)</a></p><p><b>title</b>: Coverage Decision Exchange Document (Joe Smith, 2019-07-21)</p><h3>Events</h3><table class=\"grid\"><tr><td>-</td><td><b>Detail</b></td></tr><tr><td>*</td><td><a href=\"#Coverage_1\">See above (Coverage/1)</a></td></tr></table></div>"
            },
            "status" : "final",
            "type" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/us/davinci-pcde/CodeSystem/PCDEtempCodes",
                  "code" : "pcde"
                }
              ]
            },
            "subject" : {
              "reference" : "Patient/1"
            },
            "date" : "2019-07-21T23:09:00+07:00",
            "author" : [
              {
                "reference" : "Practitioner/1"
              }
            ],
            "title" : "Coverage Decision Exchange Document (Joe Smith, 2019-07-21)",
            "event" : [
              {
                "detail" : [
                  {
                    "reference" : "Coverage/1"
                  }
                ]
              }
            ],
            "section" : [
              {
                "title" : "Active Treatments",
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/davinci-pcde/CodeSystem/PCDEtempCodes",
                      "code" : "activeTreatment"
                    }
                  ]
                },
                "section" : [
                  {
                    "title" : "Consulation re: MCI",
                    "code" : {
                      "coding" : [
                        {
                          "system" : "http://hl7.org/fhir/us/davinci-pcde/CodeSystem/PCDEtempCodes",
                          "code" : "treatment"
                        }
                      ]
                    },
                    "entry" : [
                      {
                        "reference" : "CarePlan/1"
                      }
                    ]
                  },
                  {
                    "title" : "Prior coverage",
                    "code" : {
                      "coding" : [
                        {
                          "system" : "http://hl7.org/fhir/us/davinci-pcde/CodeSystem/PCDEtempCodes",
                          "code" : "priorCoverage"
                        }
                      ]
                    },
                    "entry" : [
                      {
                        "reference" : "Claim/1"
                      },
                      {
                        "reference" : "ClaimResponse/1"
                      }
                    ]
                  },
                  {
                    "title" : "Supporting information",
                    "code" : {
                      "coding" : [
                        {
                          "system" : "http://hl7.org/fhir/us/davinci-pcde/CodeSystem/PCDEtempCodes",
                          "code" : "supportingInfo"
                        }
                      ]
                    },
                    "text" : {
                      "status" : "generated",
                      "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n                                Joe Smith is a subscriber to Maryland Capital Insurance Company. During a regular physical, Dr. James Gardener, Joe’s primary care physician, diagnosed a potential heart problem, acute myocardial infarction; unspecified site. \n                                Dr. Gardener had referred Joe to Dr. Susan Watson, a cardiologist for a consultation.\n                                During the consultation examination, Dr. Watson determined that Joe’s diagnosis requires hospitalization and a surgical procedure, a triple bypass venous graft. \n                                The operation and recovery was at Montgomery Hospital.\n                            </div>"
                    },
                    "entry" : [
                      {
                        "reference" : "DocumentReference/1"
                      }
                    ]
                  }
                ]
              }
            ]
          }
        },
        {
          "fullUrl" : "http://originalinsuranceinc.com/fhir/Patient/1",
          "resource" : {
            "resourceType" : "Patient",
            "id" : "1",
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Patient</b></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 \"1\" </p></div><p><b>identifier</b>: id: 444222222</p><p><b>name</b>: JOE SMITH </p><p><b>gender</b>: male</p></div>"
            },
            "identifier" : [
              {
                "system" : "http://originalinsuranceinc.com/fhir/NamingSystem/client-ids",
                "value" : "444222222"
              }
            ],
            "name" : [
              {
                "family" : "SMITH",
                "given" : [
                  "JOE"
                ]
              }
            ],
            "gender" : "male"
          }
        },
        {
          "fullUrl" : "http://originalinsuranceinc.com/fhir/Coverage/1",
          "resource" : {
            "resourceType" : "Coverage",
            "id" : "1",
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Coverage</b></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 \"1\" </p></div><p><b>status</b>: active</p><p><b>subscriberId</b>: 12345678</p><p><b>beneficiary</b>: <a href=\"#Patient_1\">See above (Patient/1)</a></p><p><b>payor</b>: <a href=\"#Organization_1\">See above (Organization/1)</a></p></div>"
            },
            "status" : "active",
            "subscriberId" : "12345678",
            "beneficiary" : {
              "reference" : "Patient/1"
            },
            "payor" : [
              {
                "reference" : "Organization/1"
              }
            ]
          }
        },
        {
          "fullUrl" : "http://originalinsuranceinc.com/fhir/Organization/1",
          "resource" : {
            "resourceType" : "Organization",
            "id" : "1",
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b></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 \"1\" </p></div><p><b>identifier</b>: id: 789312</p><p><b>active</b>: true</p><p><b>name</b>: MARYLAND CAPITAL INSURANCE COMPANY</p></div>"
            },
            "identifier" : [
              {
                "system" : "http://originalinsuranceinc.com/fhir/NamingSystem/ETIN",
                "value" : "789312"
              }
            ],
            "active" : true,
            "name" : "MARYLAND CAPITAL INSURANCE COMPANY"
          }
        },
        {
          "fullUrl" : "http://originalinsuranceinc.com/fhir/CarePlan/1",
          "resource" : {
            "resourceType" : "CarePlan",
            "id" : "1",
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: CarePlan</b></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 CarePlan \"1\" </p></div><p><b>instantiatesUri</b>: <a href=\"http://originalinsuranceinc.com/consultReviewURI\">http://originalinsuranceinc.com/consultReviewURI</a></p><p><b>status</b>: active</p><p><b>intent</b>: plan</p><p><b>category</b>: Assessment and Plan of Treatment <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-careplan-category.html\">US Core CarePlan Category Extension Codes</a>#assess-plan)</span></p><p><b>subject</b>: <a href=\"#Patient_1\">See above (Patient/1)</a></p><blockquote><p><b>activity</b></p><h3>Details</h3><table class=\"grid\"><tr><td>-</td><td><b>Code</b></td><td><b>ReasonReference</b></td><td><b>Status</b></td></tr><tr><td>*</td><td>Consultation <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (SERVICE_TYPE_CODE#3)</span></td><td><a href=\"#Condition_1\">See above (Condition/1)</a></td><td>in-progress</td></tr></table></blockquote></div>"
            },
            "instantiatesUri" : [
              "http://originalinsuranceinc.com/consultReviewURI"
            ],
            "status" : "active",
            "intent" : "plan",
            "category" : [
              {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/us/core/CodeSystem/careplan-category",
                    "code" : "assess-plan"
                  }
                ]
              }
            ],
            "subject" : {
              "reference" : "Patient/1"
            },
            "activity" : [
              {
                "detail" : {
                  "code" : {
                    "coding" : [
                      {
                        "system" : "http://example.org/SERVICE_TYPE_CODE",
                        "code" : "3",
                        "display" : "Consultation"
                      }
                    ]
                  },
                  "reasonReference" : [
                    {
                      "reference" : "Condition/1"
                    }
                  ],
                  "status" : "in-progress"
                }
              }
            ]
          }
        },
        {
          "fullUrl" : "http://originalinsuranceinc.com/fhir/Claim/1",
          "resource" : {
            "resourceType" : "Claim",
            "id" : "1",
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Claim</b></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 \"1\" </p></div><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/3.1.0/CodeSystem-claim-type.html\">Claim Type Codes</a>#professional)</span></p><p><b>use</b>: preauthorization</p><p><b>patient</b>: <a href=\"#Patient_1\">See above (Patient/1)</a></p><p><b>created</b>: 2019-07-20</p><p><b>insurer</b>: <a href=\"#Organization_1\">See above (Organization/1)</a></p><p><b>provider</b>: <a href=\"http://example.org/fhir/Organization/provider\">http://example.org/fhir/Organization/provider</a></p><p><b>priority</b>: Normal <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-processpriority.html\">Process Priority Codes</a>#normal)</span></p><h3>CareTeams</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Provider</b></td></tr><tr><td>*</td><td>1</td><td><a href=\"http://example.org/fhir/Organization/provider\">http://example.org/fhir/Organization/provider</a></td></tr></table><h3>Diagnoses</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td>*</td><td>1</td><td>Chronic pain syndrome <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/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>-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td>*</td><td>1</td><td>true</td><td><a href=\"#Coverage_1\">See above (Coverage/1)</a></td></tr></table><h3>Items</h3><table class=\"grid\"><tr><td>-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>CareTeamSequence</b></td><td><b>DiagnosisSequence</b></td><td><b>ProductOrService</b></td><td><b>Location[x]</b></td></tr><tr><td>*</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>11 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-CMSPlaceofServiceCodes.html\">CMS Place of Service Codes (POS)</a>#11)</span></td></tr></table></div>"
            },
            "identifier" : [
              {
                "system" : "http://example.org/PATIENT_EVENT_TRACE_NUMBER",
                "value" : "111099",
                "assigner" : {
                  "identifier" : {
                    "system" : "http://example.org/USER_ASSIGNED",
                    "value" : "9012345678"
                  }
                }
              }
            ],
            "status" : "active",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
                  "code" : "professional"
                }
              ]
            },
            "use" : "preauthorization",
            "patient" : {
              "reference" : "Patient/1"
            },
            "created" : "2019-07-20",
            "insurer" : {
              "reference" : "Organization/1"
            },
            "provider" : {
              "reference" : "http://example.org/fhir/Organization/provider"
            },
            "priority" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
                  "code" : "normal",
                  "display" : "Normal"
                }
              ]
            },
            "careTeam" : [
              {
                "sequence" : 1,
                "provider" : {
                  "reference" : "http://example.org/fhir/Organization/provider"
                }
              }
            ],
            "diagnosis" : [
              {
                "sequence" : 1,
                "diagnosisCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/sid/icd-10-cm",
                      "code" : "G89.4"
                    }
                  ]
                }
              }
            ],
            "insurance" : [
              {
                "sequence" : 1,
                "focal" : true,
                "coverage" : {
                  "reference" : "Coverage/1"
                }
              }
            ],
            "item" : [
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType",
                    "valueCodeableConcept" : {
                      "coding" : [
                        {
                          "system" : "http://codesystem.x12.org/005010/1525",
                          "code" : "SC",
                          "display" : "Specialty Care Review"
                        }
                      ]
                    }
                  },
                  {
                    "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType",
                    "valueCodeableConcept" : {
                      "coding" : [
                        {
                          "system" : "http://codesystem.x12.org/005010/1322",
                          "code" : "I",
                          "display" : "Initial"
                        }
                      ]
                    }
                  },
                  {
                    "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService",
                    "valueReference" : {
                      "reference" : "ServiceRequest/1"
                    }
                  }
                ],
                "sequence" : 1,
                "careTeamSequence" : [
                  1
                ],
                "diagnosisSequence" : [
                  1
                ],
                "productOrService" : {
                  "coding" : [
                    {
                      "system" : "http://codesystem.x12.org/005010/1365",
                      "code" : "3",
                      "display" : "Consultation"
                    }
                  ]
                },
                "locationCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set",
                      "code" : "11"
                    }
                  ]
                }
              }
            ]
          }
        },
        {
          "fullUrl" : "http://originalinsuranceinc.com/fhir/ClaimResponse/1",
          "resource" : {
            "resourceType" : "ClaimResponse",
            "id" : "1",
            "text" : {
              "status" : "extensions",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: ClaimResponse</b></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 ClaimResponse \"1\" </p></div><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/3.1.0/CodeSystem-claim-type.html\">Claim Type Codes</a>#professional)</span></p><p><b>use</b>: preauthorization</p><p><b>patient</b>: <a href=\"#Patient_1\">See above (Patient/1)</a></p><p><b>created</b>: 2019-07-20</p><p><b>insurer</b>: <a href=\"#Organization_1\">See above (Organization/1)</a></p><p><b>requestor</b>: <a href=\"http://example.org/fhir/Organization/provider\">http://example.org/fhir/Organization/provider</a></p><p><b>outcome</b>: complete</p><blockquote><p><b>item</b></p><blockquote><p><b>ReviewAction</b></p><p><b>value</b>: AUTH0001</p><p><b>value</b>: Certified in total <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (306#A1)</span></p></blockquote><p><b>AuthorizedDate</b>: 2005-05-02 --&gt; 2005-06-02</p><p><b>itemSequence</b>: 1</p><h3>Adjudications</h3><table class=\"grid\"><tr><td>-</td><td><b>Category</b></td></tr><tr><td>*</td><td>Submitted Amount <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-adjudication.html\">Adjudication Value Codes</a>#submitted)</span></td></tr></table></blockquote></div>"
            },
            "identifier" : [
              {
                "system" : "http://example.org/PATIENT_EVENT_TRACE_NUMBER",
                "value" : "111099",
                "assigner" : {
                  "identifier" : {
                    "system" : "http://example.org/USER_ASSIGNED",
                    "value" : "9012345678"
                  }
                }
              }
            ],
            "status" : "active",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
                  "code" : "professional"
                }
              ]
            },
            "use" : "preauthorization",
            "patient" : {
              "reference" : "Patient/1"
            },
            "created" : "2019-07-20",
            "insurer" : {
              "reference" : "Organization/1"
            },
            "requestor" : {
              "reference" : "http://example.org/fhir/Organization/provider"
            },
            "outcome" : "complete",
            "item" : [
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction",
                    "extension" : [
                      {
                        "url" : "number",
                        "valueString" : "AUTH0001"
                      },
                      {
                        "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewActionCode",
                        "valueCodeableConcept" : {
                          "coding" : [
                            {
                              "system" : "http://codesystem.x12.org/005010/306",
                              "code" : "A1",
                              "display" : "Certified in total"
                            }
                          ]
                        }
                      }
                    ]
                  },
                  {
                    "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDate",
                    "valuePeriod" : {
                      "start" : "2005-05-02",
                      "end" : "2005-06-02"
                    }
                  }
                ],
                "itemSequence" : 1,
                "adjudication" : [
                  {
                    "category" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
                          "code" : "submitted"
                        }
                      ]
                    }
                  }
                ]
              }
            ]
          }
        },
        {
          "fullUrl" : "http://originalinsuranceinc.com/fhir/Practitioner/1",
          "resource" : {
            "resourceType" : "Practitioner",
            "id" : "1",
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Practitioner</b></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 \"1\" </p></div><p><b>identifier</b>: id: 8189991234</p><p><b>name</b>: JAMES GARDENER </p></div>"
            },
            "identifier" : [
              {
                "system" : "http://originalinsuranceinc.com/fhir/NamingSystem/ETIN",
                "value" : "8189991234"
              }
            ],
            "name" : [
              {
                "family" : "GARDENER",
                "given" : [
                  "JAMES"
                ]
              }
            ]
          }
        },
        {
          "fullUrl" : "http://originalinsuranceinc.com/fhir/ServiceRequest/1",
          "resource" : {
            "resourceType" : "ServiceRequest",
            "id" : "1",
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: ServiceRequest</b></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 \"1\" </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 VS</p><p><b>subject</b>: <a href=\"#Patient_1\">See above (Patient/1)</a></p><p><b>performer</b>: <a href=\"#PractitionerRole_1\">See above (PractitionerRole/1)</a></p></div>"
            },
            "status" : "active",
            "intent" : "order",
            "code" : {
              "coding" : [
                {
                  "system" : "http://codesystem.x12.org/005010/1365",
                  "code" : "3",
                  "display" : "Consultation"
                }
              ]
            },
            "quantityQuantity" : {
              "value" : 1,
              "unit" : "VS"
            },
            "subject" : {
              "reference" : "Patient/1"
            },
            "performer" : [
              {
                "reference" : "PractitionerRole/1"
              }
            ]
          }
        },
        {
          "fullUrl" : "http://originalinsuranceinc.com/fhir/Condition/1",
          "resource" : {
            "resourceType" : "Condition",
            "id" : "1",
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Condition</b></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 Condition \"1\" </p></div><p><b>category</b>: Encounter Diagnosis <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-condition-category.html\">Condition Category Codes</a>#encounter-diagnosis)</span></p><p><b>code</b>: Acute myocardial infarction of unspecified site, episode of care unspecified <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (icd-9-cm#410.90)</span></p><p><b>subject</b>: <a href=\"#Patient_1\">See above (Patient/1)</a></p><p><b>recordedDate</b>: 2005-04-30</p></div>"
            },
            "category" : [
              {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/condition-category",
                    "code" : "encounter-diagnosis"
                  }
                ]
              }
            ],
            "code" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/sid/icd-9-cm",
                  "code" : "410.90"
                }
              ]
            },
            "subject" : {
              "reference" : "Patient/1"
            },
            "recordedDate" : "2005-04-30"
          }
        },
        {
          "fullUrl" : "http://originalinsuranceinc.com/fhir/PractitionerRole/1",
          "resource" : {
            "resourceType" : "PractitionerRole",
            "id" : "1",
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: PractitionerRole</b></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 \"1\" </p></div><p><b>practitioner</b>: <a href=\"#Practitioner_2\">See above (Practitioner/2)</a></p><p><b>code</b>: Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (ENTITY_IDENTIFIER_CODE#1P)</span></p></div>"
            },
            "practitioner" : {
              "reference" : "Practitioner/2"
            },
            "code" : [
              {
                "coding" : [
                  {
                    "system" : "http://example.org/fhir/NamingSystem/ENTITY_IDENTIFIER_CODE",
                    "code" : "1P",
                    "display" : "Provider"
                  }
                ]
              }
            ]
          }
        },
        {
          "fullUrl" : "http://originalinsuranceinc.com/fhir/Practitioner/2",
          "resource" : {
            "resourceType" : "Practitioner",
            "id" : "2",
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Practitioner</b></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 \"2\" </p></div><p><b>identifier</b>: id: 987654321</p><p><b>name</b>: SUSAN WATSON </p><p><b>telecom</b>: ph: 4029993456</p></div>"
            },
            "identifier" : [
              {
                "system" : "http://originalinsuranceinc.com/fhir/NamingSystem/practitioner-id",
                "value" : "987654321"
              }
            ],
            "name" : [
              {
                "family" : "WATSON",
                "given" : [
                  "SUSAN"
                ]
              }
            ],
            "telecom" : [
              {
                "system" : "phone",
                "value" : "4029993456"
              }
            ]
          }
        },
        {
          "fullUrl" : "http://originalinsuranceinc.com/fhir/DocumentReference/1",
          "resource" : {
            "resourceType" : "DocumentReference",
            "id" : "1",
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: DocumentReference</b></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 DocumentReference \"1\" </p></div><p><b>status</b>: current</p><p><b>docStatus</b>: final</p><p><b>type</b>: Discharge summary <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#18842-5)</span></p><p><b>subject</b>: <a href=\"#Patient_1\">See above (Patient/1)</a></p><p><b>author</b>: <a href=\"#Practitioner_1\">See above (Practitioner/1)</a></p><blockquote><p><b>content</b></p></blockquote></div>"
            },
            "status" : "current",
            "docStatus" : "final",
            "type" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "18842-5"
                }
              ]
            },
            "subject" : {
              "reference" : "Patient/1"
            },
            "author" : [
              {
                "reference" : "Practitioner/1"
              }
            ],
            "content" : [
              {
                "attachment" : {
                  "url" : "http://originalinsuranceinc.com/fhir/Binary/DischargeSummaryDocument"
                }
              }
            ]
          }
        }
      ]
    }