Standard wheelchair request (id = "wheelchair-request")

<?xml version="1.0" encoding="UTF-8"?>

<DeviceRequest xmlns="http://hl7.org/fhir">
  <id value="wheelchair-request"/> 
  <identifier> 
    <value value="wheelchair_request.1"/> 
  </identifier> 
  <status value="active"/> 
  <intent value="order"/> 
  <priority value="routine"/> 
  <product> 
    <concept> 
      <coding> 
        <system value="http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"/> 
        <code value="K0001"/> 
      </coding> 
      <text value="Standard wheelchair"/> 
    </concept> 
  </product> 
  <subject> 
    <reference value="Patient/bob"/> 
  </subject> 
  <occurrencePeriod> 
    <start value="2025-05-01"/> 
    <end value="2025-07-06"/> 
  </occurrencePeriod> 
  <authoredOn value="2025-05-01T09:33:27+07:00"/> 
  <requester> 
    <reference value="Practitioner/example"/> 
    <display value="Dr. Adam Careful"/> 
  </requester> 
  <reason> 
    <concept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="11865081000119107"/> 
      </coding> 
      <text value="Injury of left leg"/> 
    </concept> 
  </reason> 
  <insurance> 
    <reference value="Coverage/primiary-insurance"/> 
    <display value="Blue Cross Blue Shield"/> 
  </insurance> 
  <location> 
    <concept> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/> 
        <code value="PTRES"/> 
      </coding> 
      <text value="Patient's Residence"/> 
    </concept> 
  </location> 
  <supportingInfo> 
    <reference value="Observation/cognitive-status-observation"/> 
  </supportingInfo> 
  <note> 
    <text value="Patient has a broken left fibula and requires a wheelchair to move about their
     home while immobilizing the leg during recovery. Because the patient is a fall
     risk, as indicated after a cognitive assessment was completed, other mobility devices
     are not appropriate. A home assessment has been completed and the patient will
     be able to use the wheelchair without home modifications"/> 
  </note> 
</DeviceRequest>