bundle-bser-referral-message-bundle-eve-everywoman
type: Bundle
node role: treeRoot
id:
  v: bundle-bser-referral-message-bundle-eve-everywoman
meta:
  profile:
    v: http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralMessageBundle
    link: http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralMessageBundle
type:
  v: message
entry:
  full url:
    v: http://example.org/fhir/MessageHeader/messageheader-bser-referral-messageheader
  resource: messageheader-bser-referral-messageheader
entry:
  full url:
    v: http://example.org/fhir/ServiceRequest/servicerequest-bser-referral-servicerequest-arthritis
  resource: servicerequest-bser-referral-servicerequest-arthritis
entry:
  full url:
    v: http://example.org/fhir/Patient/patient-bser-patient-eve-everywoman
  resource: patient-bser-patient-eve-everywoman
entry:
  full url:
    v: http://example.org/fhir/Task/task-bser-referral-task
  resource: task-bser-referral-task
entry:
  full url:
    v: http://example.org/fhir/PractitionerRole/practitionerrole-us-core-practitionerrole-referral-initiator
  resource: practitionerrole-us-core-practitionerrole-referral-initiator
entry:
  full url:
    v: http://example.org/fhir/PractitionerRole/practitionerrole-us-core-practitionerrole-referral-recipient
  resource: practitionerrole-us-core-practitionerrole-referral-recipient
entry:
  full url:
    v: http://example.org/fhir/Organization/organization-us-core-organization-saint-luke
  resource: organization-us-core-organization-saint-luke
entry:
  full url:
    v: http://example.org/fhir/Coverage/coverage-bser-coverage-eve-everywoman
  resource: coverage-bser-coverage-eve-everywoman
entry:
  full url:
    v: http://example.org/fhir/Bundle/bundle-bser-referral-request-document-bundle-eve-everywoman
  resource: bundle-bser-referral-request-document-bundle-eve-everywoman
entry:
  full url:
    v: http://example.org/fhir/Consent/consent-bser-patientconsent-eve-everywoman
  resource: consent-bser-patientconsent-eve-everywoman

messageheader-bser-referral-messageheader
type: MessageHeader
id:
  v: messageheader-bser-referral-messageheader
meta:
  profile:
    v: http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralMessageHeader
    link: http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralMessageHeader
text:
  status:
    v: generated
  div: Generated Narrative: MessageHeader messageheader-bser-referral-messageheader Profile: BSeR Referral Message Header event: eventType I12: REF/RRI - Patient referral Destinations - Endpoint Receiver * http://www.saintlukeshealthsystem.org/fhir/endpoint PractitionerRole Primary Care Clinic/Center sender: PractitionerRole Primary Care Clinic/Center Sources - Name Software Version Contact Endpoint * Acme Central Patient Registry FooBar Patient Manager 3.1.45.AABB +1 (555) 123 4567 http://www.saintlukeshealthsystem.org/fhir reason: REF/RRI - Patient referral focus: Task Fulfill the focal request
event: Coding
  system:
    v: http://terminology.hl7.org/CodeSystem/v2-0003
  code:
    v: I12
  display:
    v: REF/RRI - Patient referral
destination:
  endpoint:
    v: http://www.saintlukeshealthsystem.org/fhir/endpoint
  receiver:
    link: http://hl7.org/fhir/us/bser/PractitionerRole/practitionerrole-us-core-practitionerrole-referral-recipient
    reference:
      v: PractitionerRole/practitionerrole-us-core-practitionerrole-referral-recipient
sender:
  link: http://hl7.org/fhir/us/bser/PractitionerRole/practitionerrole-us-core-practitionerrole-referral-initiator
  reference:
    v: PractitionerRole/practitionerrole-us-core-practitionerrole-referral-initiator
source:
  name:
    v: Acme Central Patient Registry
  software:
    v: FooBar Patient Manager
  version:
    v: 3.1.45.AABB
  contact:
    system:
      v: phone
    value:
      v: +1 (555) 123 4567
  endpoint:
    v: http://www.saintlukeshealthsystem.org/fhir
reason:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/v2-0003
    code:
      v: I12
    display:
      v: REF/RRI - Patient referral
focus:
  link: http://hl7.org/fhir/us/bser/Task/task-bser-referral-task
  reference:
    v: Task/task-bser-referral-task

servicerequest-bser-referral-servicerequest-arthritis
type: ServiceRequest
id:
  v: servicerequest-bser-referral-servicerequest-arthritis
meta:
  profile:
    v: http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralServiceRequest
    link: http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralServiceRequest
text:
  status:
    v: generated
  div: Generated Narrative: ServiceRequest servicerequest-bser-referral-servicerequest-arthritis Profile: BSeR Referral Service Request identifier: Placer Identifier/88888888, Filler Identifier/99999999 status: Active intent: Order category: Lifestyle education (procedure) code: Patient referral subject: Eve Everywoman occurrence: 2020-01-09 authoredOn: 2020-02-14 requester: Henry Seven, MD performer: Hailey Eight, MD reasonCode: Arthritis (disorder) insurance: Coverage: identifier = Member Number: 12345; status = active; type = extended healthcare; relationship = self; period = 2019-05-23 --> 2020-05-23 supportingInfo: Bundle: identifier = UUID:2be4b4e4-6df1-4cb2-a947-c70fa0eda54c; type = document; timestamp = 2020-01-06 22:13:23+0000 Consent: status = active; scope = Privacy Consent; category = information access; dateTime = 2019-05-23; policyRule = opt-in
identifier:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: PLAC
  value:
    v: 88888888
  assigner:
    link: http://hl7.org/fhir/us/bser/Organization/organization-us-core-organization-saint-luke
    reference:
      v: Organization/organization-us-core-organization-saint-luke
identifier:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: FILL
  value:
    v: 99999999
  assigner:
    link: http://hl7.org/fhir/us/bser/Organization/organization-us-core-organization-saint-luke
    reference:
      v: Organization/organization-us-core-organization-saint-luke
status:
  v: active
intent:
  v: order
category:
  coding: http://snomed.info/id/313204009
    system:
      v: http://snomed.info/sct
    code:
      v: 313204009
    display:
      v: Lifestyle education (procedure)
code:
  coding: http://snomed.info/id/3457005
    system:
      v: http://snomed.info/sct
    code:
      v: 3457005
    display:
      v: Patient referral
subject:
  link: http://hl7.org/fhir/us/bser/Patient/patient-us-core-patient-eve-everywoman
  reference:
    v: Patient/patient-us-core-patient-eve-everywoman
  display:
    v: Eve Everywoman
occurrence: dateTime
  v: 2020-01-09
authored on:
  v: 2020-02-14
requester:
  link: http://hl7.org/fhir/us/bser/PractitionerRole/practitionerrole-us-core-practitionerrole-referral-initiator
  reference:
    v: PractitionerRole/practitionerrole-us-core-practitionerrole-referral-initiator
  display:
    v: Henry Seven, MD
performer:
  link: http://hl7.org/fhir/us/bser/PractitionerRole/practitionerrole-us-core-practitionerrole-referral-recipient
  reference:
    v: PractitionerRole/practitionerrole-us-core-practitionerrole-referral-recipient
  display:
    v: Hailey Eight, MD
reason code:
  coding: http://snomed.info/id/3723001
    system:
      v: http://snomed.info/sct
    code:
      v: 3723001
    display:
      v: Arthritis (disorder)
  text:
    v: Arthritis (disorder)
insurance:
  link: http://hl7.org/fhir/us/bser/Coverage/coverage-bser-coverage-eve-everywoman
  reference:
    v: Coverage/coverage-bser-coverage-eve-everywoman
supporting info:
  link: http://hl7.org/fhir/us/bser/Bundle/bundle-bser-referral-request-document-bundle-eve-everywoman
  reference:
    v: Bundle/bundle-bser-referral-request-document-bundle-eve-everywoman
supporting info:
  link: http://hl7.org/fhir/us/bser/Consent/consent-bser-patientconsent-eve-everywoman
  reference:
    v: Consent/consent-bser-patientconsent-eve-everywoman

patient-bser-patient-eve-everywoman
type: Patient
id:
  v: patient-bser-patient-eve-everywoman
id:
  v: patient-bser-patient-eve-everywoman
meta:
  profile:
    v: http://hl7.org/fhir/us/bser/StructureDefinition/bser-patient
    link: http://hl7.org/fhir/us/bser/StructureDefinition/bser-patient
meta:
  profile:
    v: http://hl7.org/fhir/us/bser/StructureDefinition/bser-patient
    link: http://hl7.org/fhir/us/bser/StructureDefinition/bser-patient
text:
  status:
    v: generated
  div: Generated Narrative: Patient patient-bser-patient-eve-everywoman Profile: BSeR Patient Eve L Everywoman Female, DoB: 1974-11-24 ( Medical Record Number: 1032702 (use: usual, )) Active: true Contact Detail ph: 1-(404)555-1212(Home) eve.everywoman@example.com 5101 Peachtree St NE Atlanta GA 30302 US Links: Also see: RelatedPerson Eve L Everywoman <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: ombCategory: CDC Race and Ethnicity 2186-5: Not Hispanic or Latino text: Not Hispanic or Latino US Core Birth Sex Extension F <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) 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: - American Indian or Alaska Native - Asian - Black or African American - Native Hawaiian or Other Pacific Islander - White.">US Core Race Extension: ombCategory: CDC Race and Ethnicity 2106-3: White text: White
extension:
  extension:
    url:
      v: ombCategory
    value: Coding
      system:
        v: urn:oid:2.16.840.1.113883.6.238
      code:
        v: 2106-3
      display:
        v: White
  extension:
    url:
      v: text
    value: string
      v: White
  url:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race
extension:
  extension:
    url:
      v: ombCategory
    value: Coding
      system:
        v: urn:oid:2.16.840.1.113883.6.238
      code:
        v: 2186-5
      display:
        v: Not Hispanic or Latino
  extension:
    url:
      v: text
    value: string
      v: Not Hispanic or Latino
  url:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
extension:
  url:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex
  value: code
    v: F
extension:
  extension:
    url:
      v: ombCategory
    value: Coding
      system:
        v: urn:oid:2.16.840.1.113883.6.238
      code:
        v: 2106-3
      display:
        v: White
  extension:
    url:
      v: text
    value: string
      v: White
  url:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race
extension:
  extension:
    url:
      v: ombCategory
    value: Coding
      system:
        v: urn:oid:2.16.840.1.113883.6.238
      code:
        v: 2186-5
      display:
        v: Not Hispanic or Latino
  extension:
    url:
      v: text
    value: string
      v: Not Hispanic or Latino
  url:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
extension:
  url:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex
  value: code
    v: F
identifier:
  use:
    v: usual
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: MR
      display:
        v: Medical Record Number
  system:
    v: http://hospital.smarthealthit.org
  value:
    v: 1032702
identifier:
  use:
    v: usual
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: MR
      display:
        v: Medical Record Number
  system:
    v: http://hospital.smarthealthit.org
  value:
    v: 1032702
active:
  v: true
active:
  v: true
name:
  family:
    v: Everywoman
  given:
    v: Eve
  given:
    v: L
name:
  family:
    v: Everywoman
  given:
    v: Eve
  given:
    v: L
telecom:
  system:
    v: phone
  value:
    v: 1-(404)555-1212
  use:
    v: home
telecom:
  system:
    v: email
telecom:
  system:
    v: phone
  value:
    v: 1-(404)555-1212
  use:
    v: home
telecom:
  system:
    v: email
gender:
  v: female
gender:
  v: female
birth date:
  v: 1974-11-24
birth date:
  v: 1974-11-24
address:
  line:
    v: 5101 Peachtree St NE
  city:
    v: Atlanta
  state:
    v: GA
  postal code:
    v: 30302
  country:
    v: US
address:
  line:
    v: 5101 Peachtree St NE
  city:
    v: Atlanta
  state:
    v: GA
  postal code:
    v: 30302
  country:
    v: US
link:
  other:
    link: http://hl7.org/fhir/us/bser/RelatedPerson/relatedperson-us-core-relatedperson-self-eve-everywoman
    reference:
      v: RelatedPerson/relatedperson-us-core-relatedperson-self-eve-everywoman

task-bser-referral-task
type: Task
id:
  v: task-bser-referral-task
meta:
  profile:
    v: http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralTask
    link: http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralTask
text:
  status:
    v: generated
  div: Generated Narrative: Task task-bser-referral-task Profile: BSeR Referral Task identifier: Placer Identifier/66666666, Filler Identifier/77777777 status: Requested businessStatus: Service Request Fulfillment Completed intent: order code: Fulfill the focal request focus: ServiceRequest Patient referral for: Patient/patient-us-core-patient-eve-everywoman authoredOn: 2020-01-15 14:43:32-0400 requester: PractitionerRole Primary Care Clinic/Center owner: PractitionerRole Primary Care Clinic/Center Outputs - Type Value[x] * Arthritis referral feedback Bundle: identifier = UUID:2be4b4e4-6df1-4cb2-a947-c70fa0eda54e; type = document; timestamp = 2020-01-07 09:25:00+0000
identifier:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: PLAC
  value:
    v: 66666666
  assigner:
    link: http://hl7.org/fhir/us/bser/Organization/organization-us-core-organization-saint-luke
    reference:
      v: Organization/organization-us-core-organization-saint-luke
identifier:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: FILL
  value:
    v: 77777777
  assigner:
    link: http://hl7.org/fhir/us/bser/Organization/organization-us-core-organization-saint-luke
    reference:
      v: Organization/organization-us-core-organization-saint-luke
status:
  v: requested
business status:
  coding:
    system:
      v: http://hl7.org/fhir/us/bser/CodeSystem/TaskBusinessStatusCS
    code:
      v: 7.0
    display:
      v: Service Request Fulfillment Completed
intent:
  v: order
code:
  coding:
    system:
      v: http://hl7.org/fhir/CodeSystem/task-code
    code:
      v: fulfill
focus:
  link: http://hl7.org/fhir/us/bser/ServiceRequest/servicerequest-bser-referral-servicerequest-arthritis
  reference:
    v: ServiceRequest/servicerequest-bser-referral-servicerequest-arthritis
for:
  link: http://hl7.org/fhir/us/bser/Patient/patient-us-core-patient-eve-everywoman
  reference:
    v: Patient/patient-us-core-patient-eve-everywoman
authored on:
  v: 2020-01-15T14:43:32-04:00
requester:
  link: http://hl7.org/fhir/us/bser/PractitionerRole/practitionerrole-us-core-practitionerrole-referral-initiator
  reference:
    v: PractitionerRole/practitionerrole-us-core-practitionerrole-referral-initiator
owner:
  link: http://hl7.org/fhir/us/bser/PractitionerRole/practitionerrole-us-core-practitionerrole-referral-recipient
  reference:
    v: PractitionerRole/practitionerrole-us-core-practitionerrole-referral-recipient
output:
  type:
    text:
      v: Arthritis referral feedback
  value: Reference
    link: http://hl7.org/fhir/us/bser/Bundle/bundle-bser-referral-feedback-document-bundle-eve-everywoman
    reference:
      v: Bundle/bundle-bser-referral-feedback-document-bundle-eve-everywoman

practitionerrole-us-core-practitionerrole-referral-initiator
type: PractitionerRole
id:
  v: practitionerrole-us-core-practitionerrole-referral-initiator
id:
  v: practitionerrole-us-core-practitionerrole-referral-initiator
meta:
  profile:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole
    link: http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole
meta:
  profile:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole
    link: http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole
text:
  status:
    v: generated
  div: Generated Narrative: PractitionerRole practitionerrole-us-core-practitionerrole-referral-initiator Profile: US Core PractitionerRole Profile identifier: NPI/1111111111 practitioner: Henry Seven, MD organization: Organization Saint Luke's Hospital of Kansas City code: Primary Care Clinic/Center specialty: Family Practice telecom: henry.seven@example.com
identifier:
  system:
    v: http://hl7.org/fhir/sid/us-npi
  value:
    v: 1111111111
identifier:
  system:
    v: http://hl7.org/fhir/sid/us-npi
  value:
    v: 1111111111
practitioner:
  link: http://hl7.org/fhir/us/bser/Practitioner/practitioner-us-core-practitioner-henry-seven
  reference:
    v: Practitioner/practitioner-us-core-practitioner-henry-seven
  display:
    v: Henry Seven, MD
practitioner:
  link: http://hl7.org/fhir/us/bser/Practitioner/practitioner-us-core-practitioner-henry-seven
  reference:
    v: Practitioner/practitioner-us-core-practitioner-henry-seven
  display:
    v: Henry Seven, MD
organization:
  link: http://hl7.org/fhir/us/bser/Organization/organization-us-core-organization-saint-luke
  reference:
    v: Organization/organization-us-core-organization-saint-luke
organization:
  link: http://hl7.org/fhir/us/bser/Organization/organization-us-core-organization-saint-luke
  reference:
    v: Organization/organization-us-core-organization-saint-luke
code:
  coding:
    system:
      v: http://nucc.org/provider-taxonomy
    code:
      v: 261QP2300X
    display:
      v: Primary Care Clinic/Center
code:
  coding:
    system:
      v: http://nucc.org/provider-taxonomy
    code:
      v: 261QP2300X
    display:
      v: Primary Care Clinic/Center
specialty:
  coding: http://snomed.info/id/419772000
    system:
      v: http://snomed.info/sct
    code:
      v: 419772000
    display:
      v: Family Practice
specialty:
  coding: http://snomed.info/id/419772000
    system:
      v: http://snomed.info/sct
    code:
      v: 419772000
    display:
      v: Family Practice
telecom:
  system:
    v: email
telecom:
  system:
    v: email

practitionerrole-us-core-practitionerrole-referral-recipient
type: PractitionerRole
id:
  v: practitionerrole-us-core-practitionerrole-referral-recipient
meta:
  profile:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole
    link: http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole
text:
  status:
    v: generated
  div: Generated Narrative: PractitionerRole practitionerrole-us-core-practitionerrole-referral-recipient Profile: US Core PractitionerRole Profile identifier: NPI/2222222222 practitioner: Hailey Eight, MD organization: Organization Saint Luke's Hospital of Kansas City code: Primary Care Clinic/Center specialty: Family Practice telecom: hailey.eight@example.com
identifier:
  system:
    v: http://hl7.org/fhir/sid/us-npi
  value:
    v: 2222222222
practitioner:
  link: http://hl7.org/fhir/us/bser/Practitioner/practitioner-us-core-practitioner-hailey-eight
  reference:
    v: Practitioner/practitioner-us-core-practitioner-hailey-eight
  display:
    v: Hailey Eight, MD
organization:
  link: http://hl7.org/fhir/us/bser/Organization/organization-us-core-organization-saint-luke
  reference:
    v: Organization/organization-us-core-organization-saint-luke
code:
  coding:
    system:
      v: http://nucc.org/provider-taxonomy
    code:
      v: 261QP2300X
    display:
      v: Primary Care Clinic/Center
specialty:
  coding: http://snomed.info/id/419772000
    system:
      v: http://snomed.info/sct
    code:
      v: 419772000
    display:
      v: Family Practice
telecom:
  system:
    v: email

organization-us-core-organization-saint-luke
type: Organization
id:
  v: organization-us-core-organization-saint-luke
id:
  v: organization-us-core-organization-saint-luke
meta:
  profile:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization
    link: http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization
meta:
  profile:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization
    link: http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization
text:
  status:
    v: generated
  div: Generated Narrative: Organization organization-us-core-organization-saint-luke Profile: US Core Organization Profile identifier: NPI/1063494177 active: true type: Healthcare Provider name: Saint Luke's Hospital of Kansas City telecom: ph: (816)932-2000(Work), http://www.saintlukeshealthsystem.org/locations/saint-lukes-hospital-kansas-city(Work) address: 4401 Wornall Rd, Amherst MA 64111
identifier:
  system:
    v: http://hl7.org/fhir/sid/us-npi
  value:
    v: 1063494177
identifier:
  system:
    v: http://hl7.org/fhir/sid/us-npi
  value:
    v: 1063494177
active:
  v: true
active:
  v: true
type:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/organization-type
    code:
      v: prov
    display:
      v: Healthcare Provider
type:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/organization-type
    code:
      v: prov
    display:
      v: Healthcare Provider
name:
  v: Saint Luke's Hospital of Kansas City
name:
  v: Saint Luke's Hospital of Kansas City
telecom:
  system:
    v: phone
  value:
    v: (816)932-2000
  use:
    v: work
telecom:
  system:
    v: other
  value:
    v: http://www.saintlukeshealthsystem.org/locations/saint-lukes-hospital-kansas-city
  use:
    v: work
telecom:
  system:
    v: phone
  value:
    v: (816)932-2000
  use:
    v: work
telecom:
  system:
    v: other
  value:
    v: http://www.saintlukeshealthsystem.org/locations/saint-lukes-hospital-kansas-city
  use:
    v: work
address:
  line:
    v: 4401 Wornall Rd,
  city:
    v: Amherst
  state:
    v: MA
  postal code:
    v: 64111
address:
  line:
    v: 4401 Wornall Rd,
  city:
    v: Amherst
  state:
    v: MA
  postal code:
    v: 64111

coverage-bser-coverage-eve-everywoman
type: Coverage
id:
  v: coverage-bser-coverage-eve-everywoman
meta:
  profile:
    v: http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-Coverage
    link: http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-Coverage
text:
  status:
    v: generated
  div: Generated Narrative: Coverage coverage-bser-coverage-eve-everywoman Profile: BSeR Coverage identifier: Member Number/12345 status: Active type: extended healthcare subscriber: Eve Everywoman beneficiary: Eve Everywoman relationship: self period: 2019-05-23 --> 2020-05-23 payor: Organization Saint Luke's Hospital of Kansas City class type: Group value: 123 name: Full Coverage: Medical, Dental, Pharmacy, Vision, EHC class type: Plan value: P7 name: Includes afterlife benefits class type: Class value: SILVER name: Silver: Family Plan spouse only class type: SubClass value: Tier2 name: Low deductible, max $20 copay class type: Sequence value: 9 class type: RX Id value: MDF12345 class type: RX BIN value: 987654 class type: RX Group value: M35PT class type: RX PCN value: 234516 class type: Sequence value: 9
identifier:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: MB
      display:
        v: Member Number
  system:
    v: http://benefitsinc.com/certificate
  value:
    v: 12345
status:
  v: active
type:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/v3-ActCode
    code:
      v: EHCPOL
    display:
      v: extended healthcare
subscriber:
  link: http://hl7.org/fhir/us/bser/RelatedPerson/relatedperson-us-core-relatedperson-self-eve-everywoman
  reference:
    v: RelatedPerson/relatedperson-us-core-relatedperson-self-eve-everywoman
  display:
    v: Eve Everywoman
beneficiary:
  link: http://hl7.org/fhir/us/bser/Patient/patient-us-core-patient-eve-everywoman
  reference:
    v: Patient/patient-us-core-patient-eve-everywoman
  display:
    v: Eve Everywoman
relationship:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/v3-RoleCode
    code:
      v: ONESELF
    display:
      v: self
  text:
    v: self
period:
  start:
    v: 2019-05-23
  end:
    v: 2020-05-23
payor:
  link: http://hl7.org/fhir/us/bser/Organization/organization-us-core-organization-saint-luke
  reference:
    v: Organization/organization-us-core-organization-saint-luke
class:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/coverage-class
      code:
        v: group
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/coverage-class
      code:
        v: subgroup
  value:
    v: 123
  name:
    v: Full Coverage: Medical, Dental, Pharmacy, Vision, EHC
class:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/coverage-class
      code:
        v: plan
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/coverage-class
      code:
        v: subplan
  value:
    v: P7
  name:
    v: Includes afterlife benefits
class:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/coverage-class
      code:
        v: class
  value:
    v: SILVER
  name:
    v: Silver: Family Plan spouse only
class:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/coverage-class
      code:
        v: subclass
  value:
    v: Tier2
  name:
    v: Low deductible, max $20 copay
class:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/coverage-class
      code:
        v: sequence
  value:
    v: 9
class:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/coverage-class
      code:
        v: rxid
  value:
    v: MDF12345
class:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/coverage-class
      code:
        v: rxbin
  value:
    v: 987654
class:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/coverage-class
      code:
        v: rxgroup
  value:
    v: M35PT
class:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/coverage-class
      code:
        v: rxpcn
  value:
    v: 234516
class:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/coverage-class
      code:
        v: sequence
  value:
    v: 9

bundle-bser-referral-request-document-bundle-eve-everywoman
type: Bundle
id:
  v: bundle-bser-referral-request-document-bundle-eve-everywoman
meta:
  profile:
    v: http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralRequestDocumentBundle
    link: http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralRequestDocumentBundle
identifier:
  system:
    v: urn:ietf:rfc:3986
type:
  v: document
timestamp:
  v: 2020-01-06T22:13:23Z
entry:
  full url:
    v: http://example.org/fhir/Composition/composition-bser-referral-request-arthritis-everywoman
  resource: composition-bser-referral-request-arthritis-everywoman
entry:
  full url:
    v: http://example.org/fhir/Observation/observation-us-core-blood-pressure-eve-everywoman
  resource: observation-us-core-blood-pressure-eve-everywoman
entry:
  full url:
    v: http://example.org/fhir/Observation/observation-us-core-body-height-eve-everywoman
  resource: observation-us-core-body-height-eve-everywoman
entry:
  full url:
    v: http://example.org/fhir/PractitionerRole/practitionerrole-us-core-practitionerrole-referral-initiator
  resource: practitionerrole-us-core-practitionerrole-referral-initiator
entry:
  full url:
    v: http://example.org/fhir/Observation/observation-us-core-bmi-eve-everywoman
  resource: observation-us-core-bmi-eve-everywoman
entry:
  full url:
    v: http://example.org/fhir/Observation/observation-us-core-social-history-education-eve-everywoman
  resource: observation-us-core-social-history-education-eve-everywoman
entry:
  full url:
    v: http://example.org/fhir/MedicationRequest/medicationrequest-us-core-medicationrequest-eve-everywoman
  resource: medicationrequest-us-core-medicationrequest-eve-everywoman
entry:
  full url:
    v: http://example.org/fhir/Observation/observation-us-core-body-weight-eve-everywoman
  resource: observation-us-core-body-weight-eve-everywoman
entry:
  full url:
    v: http://example.org/fhir/Patient/patient-bser-patient-eve-everywoman
  resource: patient-bser-patient-eve-everywoman
entry:
  full url:
    v: http://example.org/fhir/AllergyIntolerance/allergyintolerance-us-core-allergyint-eve-everywoman
  resource: allergyintolerance-us-core-allergyint-eve-everywoman
entry:
  full url:
    v: http://example.org/fhir/Practitioner/practitioner-us-core-practitioner-henry-seven
  resource: practitioner-us-core-practitioner-henry-seven
entry:
  full url:
    v: http://example.org/fhir/Organization/organization-us-core-organization-saint-luke
  resource: organization-us-core-organization-saint-luke

composition-bser-referral-request-arthritis-everywoman
type: Composition
id:
  v: composition-bser-referral-request-arthritis-everywoman
meta:
  profile:
    v: http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralRequestComposition
    link: http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralRequestComposition
status:
  v: final
type:
  coding: https://loinc.org/rdf/57133-1
    system:
      v: http://loinc.org
    code:
      v: 57133-1
    display:
      v: Referral note
subject:
  link: http://hl7.org/fhir/us/bser/Patient/patient-us-core-patient-eve-everywoman
  reference:
    v: Patient/patient-us-core-patient-eve-everywoman
  display:
    v: Eve Everywoman
date:
  v: 2020-01-02T22:13:23Z
author:
  link: http://hl7.org/fhir/us/bser/PractitionerRole/practitionerrole-us-core-practitionerrole-referral-initiator
  reference:
    v: PractitionerRole/practitionerrole-us-core-practitionerrole-referral-initiator
  display:
    v: Henry Seven, MD
title:
  v: Referral request
section:
  title:
    v: Other Supporting Information
  code:
    coding:
      system:
        v: http://hl7.org/fhir/us/bser/CodeSystem/bser
      code:
        v: OSI
      display:
        v: Other Supporting Information
  entry:
    link: http://hl7.org/fhir/us/bser/Observation/observation-us-core-social-history-education-eve-everywoman
    reference:
      v: Observation/observation-us-core-social-history-education-eve-everywoman
section:
  title:
    v: Arthritis Referral Request Supporting Information
  code:
    coding:
      system:
        v: http://hl7.org/fhir/us/bser/CodeSystem/bser
      code:
        v: ARSI
      display:
        v: Arthritis Referral Supporting Information
  entry:
    link: http://hl7.org/fhir/us/bser/AllergyIntolerance/allergyintolerance-us-core-allergyint-eve-everywoman
    reference:
      v: AllergyIntolerance/allergyintolerance-us-core-allergyint-eve-everywoman
  entry:
    link: http://hl7.org/fhir/us/bser/MedicationRequest/medicationrequest-us-core-medicationrequest-eve-everywoman
    reference:
      v: MedicationRequest/medicationrequest-us-core-medicationrequest-eve-everywoman
  entry:
    link: http://hl7.org/fhir/us/bser/Observation/observation-us-core-blood-pressure-eve-everywoman
    reference:
      v: Observation/observation-us-core-blood-pressure-eve-everywoman
  entry:
    link: http://hl7.org/fhir/us/bser/Observation/observation-us-core-body-height-eve-everywoman
    reference:
      v: Observation/observation-us-core-body-height-eve-everywoman
  entry:
    link: http://hl7.org/fhir/us/bser/Observation/observation-us-core-body-weight-eve-everywoman
    reference:
      v: Observation/observation-us-core-body-weight-eve-everywoman
  entry:
    link: http://hl7.org/fhir/us/bser/Observation/observation-us-core-bmi-eve-everywoman
    reference:
      v: Observation/observation-us-core-bmi-eve-everywoman

observation-us-core-blood-pressure-eve-everywoman
type: Observation
id:
  v: observation-us-core-blood-pressure-eve-everywoman
meta:
  profile:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure
    link: http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure
status:
  v: final
category:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/observation-category
    code:
      v: vital-signs
    display:
      v: Vital Signs
  text:
    v: Vital Signs
code:
  coding: https://loinc.org/rdf/85354-9
    system:
      v: http://loinc.org
    code:
      v: 85354-9
    display:
      v: Blood Pressure panel with all children optional
  text:
    v: Blood Pressure systolic & diastolic
subject:
  link: http://hl7.org/fhir/us/bser/Patient/patient-us-core-patient-eve-everywoman
  reference:
    v: Patient/patient-us-core-patient-eve-everywoman
  display:
    v: Eve Everywoman
effective: dateTime
  v: 2019-01-17
performer:
  link: http://hl7.org/fhir/us/bser/Practitioner/practitioner-us-core-practitioner-henry-seven
  reference:
    v: Practitioner/practitioner-us-core-practitioner-henry-seven
component:
  code:
    coding: https://loinc.org/rdf/8480-6
      system:
        v: http://loinc.org
      code:
        v: 8480-6
      display:
        v: Systolic Blood Pressure
  value: Quantity
    value:
      v: 107
    unit:
      v: mmHg
    system:
      v: http://unitsofmeasure.org
    code:
      v: mm[Hg]
component:
  code:
    coding: https://loinc.org/rdf/8462-4
      system:
        v: http://loinc.org
      code:
        v: 8462-4
      display:
        v: Diastolic Blood Pressure
  value: Quantity
    value:
      v: 60
    unit:
      v: mmHg
    system:
      v: http://unitsofmeasure.org
    code:
      v: mm[Hg]

observation-us-core-body-height-eve-everywoman
type: Observation
id:
  v: observation-us-core-body-height-eve-everywoman
meta:
  profile:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height
    link: http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height
status:
  v: final
category:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/observation-category
    code:
      v: vital-signs
    display:
      v: Vital Signs
  text:
    v: Vital Signs
code:
  coding: https://loinc.org/rdf/8302-2
    system:
      v: http://loinc.org
    code:
      v: 8302-2
    display:
      v: Body height
  text:
    v: Body height
subject:
  link: http://hl7.org/fhir/us/bser/Patient/patient-us-core-patient-eve-everywoman
  reference:
    v: Patient/patient-us-core-patient-eve-everywoman
  display:
    v: Eve Everywoman
effective: dateTime
  v: 2019-01-17
performer:
  link: http://hl7.org/fhir/us/bser/Practitioner/practitioner-us-core-practitioner-henry-seven
  reference:
    v: Practitioner/practitioner-us-core-practitioner-henry-seven
value: Quantity
  value:
    v: 68
  unit:
    v: in
  system:
    v: http://unitsofmeasure.org
  code:
    v: [in_i]

observation-us-core-bmi-eve-everywoman
type: Observation
id:
  v: observation-us-core-bmi-eve-everywoman
meta:
  profile:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi
    link: http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi
status:
  v: final
category:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/observation-category
    code:
      v: vital-signs
    display:
      v: Vital Signs
  text:
    v: Vital Signs
code:
  coding: https://loinc.org/rdf/39156-5
    system:
      v: http://loinc.org
    code:
      v: 39156-5
    display:
      v: Body mass index (BMI) [Ratio]
  text:
    v: BMI
subject:
  link: http://hl7.org/fhir/us/bser/Patient/patient-us-core-patient-eve-everywoman
  reference:
    v: Patient/patient-us-core-patient-eve-everywoman
  display:
    v: Eve Everywoman
effective: dateTime
  v: 2019-01-17
performer:
  link: http://hl7.org/fhir/us/bser/Practitioner/practitioner-us-core-practitioner-henry-seven
  reference:
    v: Practitioner/practitioner-us-core-practitioner-henry-seven
value: Quantity
  value:
    v: 29
  unit:
    v: kg/m2
  system:
    v: http://unitsofmeasure.org
  code:
    v: kg/m2

observation-us-core-social-history-education-eve-everywoman
type: Observation
id:
  v: observation-us-core-social-history-education-eve-everywoman
meta:
  profile:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history
    link: http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history
status:
  v: final
category:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/observation-category
    code:
      v: social-history
    display:
      v: Social History
  text:
    v: Social History
code:
  coding: https://loinc.org/rdf/82589-3
    system:
      v: http://loinc.org
    code:
      v: 82589-3
    display:
      v: Highest level of education
subject:
  link: http://hl7.org/fhir/us/bser/Patient/patient-us-core-patient-eve-everywoman
  reference:
    v: Patient/patient-us-core-patient-eve-everywoman
  display:
    v: Eve Everywoman
effective: dateTime
  v: 2019-01-17
performer:
  link: http://hl7.org/fhir/us/bser/PractitionerRole/practitionerrole-us-core-practitionerrole-referral-initiator
  reference:
    v: PractitionerRole/practitionerrole-us-core-practitionerrole-referral-initiator
value: CodeableConcept
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/v3-EducationLevel
    code:
      v: ELEM
    display:
      v: Elementary School
  text:
    v: Elementary School

medicationrequest-us-core-medicationrequest-eve-everywoman
type: MedicationRequest
id:
  v: medicationrequest-us-core-medicationrequest-eve-everywoman
meta:
  profile:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest
    link: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest
status:
  v: active
intent:
  v: instance-order
medication: CodeableConcept
  coding: http://snomed.info/id/27658006
    system:
      v: http://snomed.info/sct
    code:
      v: 27658006
    display:
      v: Amoxicillin-containing product
subject:
  link: http://hl7.org/fhir/us/bser/Patient/patient-us-core-patient-eve-everywoman
  reference:
    v: Patient/patient-us-core-patient-eve-everywoman
  display:
    v: Eve Everywoman
authored on:
  v: 2019-01-17
requester:
  link: http://hl7.org/fhir/us/bser/Practitioner/practitioner-us-core-practitioner-hailey-eight
  reference:
    v: Practitioner/practitioner-us-core-practitioner-hailey-eight
dosage instruction:
  text:
    v: bid

observation-us-core-body-weight-eve-everywoman
type: Observation
id:
  v: observation-us-core-body-weight-eve-everywoman
meta:
  profile:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight
    link: http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight
status:
  v: final
category:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/observation-category
    code:
      v: vital-signs
    display:
      v: Vital Signs
  text:
    v: Vital Signs
code:
  coding: https://loinc.org/rdf/29463-7
    system:
      v: http://loinc.org
    code:
      v: 29463-7
    display:
      v: Body weight
  text:
    v: Body weight
subject:
  link: http://hl7.org/fhir/us/bser/Patient/patient-us-core-patient-eve-everywoman
  reference:
    v: Patient/patient-us-core-patient-eve-everywoman
  display:
    v: Eve Everywoman
effective: dateTime
  v: 2019-01-17
performer:
  link: http://hl7.org/fhir/us/bser/Practitioner/practitioner-us-core-practitioner-henry-seven
  reference:
    v: Practitioner/practitioner-us-core-practitioner-henry-seven
value: Quantity
  value:
    v: 65
  unit:
    v: kg
  system:
    v: http://unitsofmeasure.org
  code:
    v: kg

allergyintolerance-us-core-allergyint-eve-everywoman
type: AllergyIntolerance
id:
  v: allergyintolerance-us-core-allergyint-eve-everywoman
meta:
  profile:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance
    link: http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance
clinical status:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical
    code:
      v: active
verification status:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/allergyintolerance-verification
    code:
      v: confirmed
category:
  v: medication
criticality:
  v: high
code:
  coding: http://snomed.info/id/387406002
    system:
      v: http://snomed.info/sct
    code:
      v: 387406002
    display:
      v: Sulfonamide (substance)
  text:
    v: sulfonamide antibacterial
patient:
  link: http://hl7.org/fhir/us/bser/Patient/patient-us-core-patient-eve-everywoman
  reference:
    v: Patient/patient-us-core-patient-eve-everywoman
  display:
    v: Eve Everywoman
reaction:
  manifestation:
    coding: http://snomed.info/id/271807003
      system:
        v: http://snomed.info/sct
      code:
        v: 271807003
      display:
        v: skin rash
    text:
      v: skin rash
  severity:
    v: mild

practitioner-us-core-practitioner-henry-seven
type: Practitioner
id:
  v: practitioner-us-core-practitioner-henry-seven
meta:
  profile:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner
    link: http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner
identifier:
  system:
    v: http://hl7.org/fhir/sid/us-npi
  value:
    v: 9941339108
name:
  family:
    v: Henry
  given:
    v: Seven
  suffix:
    v: M.D.
telecom:
  system:
    v: email
address:
  line:
    v: BMass Doctors
  line:
    v: 2100 North Ave
  city:
    v: Burlington
  state:
    v: MA
  postal code:
    v: 02368
  country:
    v: US

consent-bser-patientconsent-eve-everywoman
type: Consent
id:
  v: consent-bser-patientconsent-eve-everywoman
meta:
  profile:
    v: http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-PatientConsent
    link: http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-PatientConsent
text:
  status:
    v: generated
  div: Generated Narrative: Consent consent-bser-patientconsent-eve-everywoman Profile: BSeR Patient Consent status: Active scope: Privacy Consent category: information access patient: Eve Everywoman dateTime: 2019-05-23 performer: Eve Everywoman policyRule: opt-in provision type: Opt In Actors - Role Reference * custodian Organization Saint Luke's Hospital of Kansas City action: Access
status:
  v: active
scope:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/consentscope
    code:
      v: patient-privacy
category:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/v3-ActCode
    code:
      v: INFA
    display:
      v: information access
patient:
  link: http://hl7.org/fhir/us/bser/Patient/patient-us-core-patient-eve-everywoman
  reference:
    v: Patient/patient-us-core-patient-eve-everywoman
  display:
    v: Eve Everywoman
date time:
  v: 2019-05-23
performer:
  link: http://hl7.org/fhir/us/bser/Patient/patient-us-core-patient-eve-everywoman
  reference:
    v: Patient/patient-us-core-patient-eve-everywoman
  display:
    v: Eve Everywoman
policy rule:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/v3-ActCode
    code:
      v: OPTIN
provision:
  type:
    v: permit
  actor:
    reference:
      link: http://hl7.org/fhir/us/bser/Organization/organization-us-core-organization-saint-luke
      reference:
        v: Organization/organization-us-core-organization-saint-luke
  action:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/consentaction
      code:
        v: access

v: seealso

other:
  link: http://hl7.org/fhir/us/bser/RelatedPerson/relatedperson-us-core-relatedperson-self-eve-everywoman
  reference:
    v: RelatedPerson/relatedperson-us-core-relatedperson-self-eve-everywoman
type:
  v: seealso

v: CST