Bundle SurgicalRequestBundleExample of type collection

Entry 1 - fullUrl = http://example.org/fhir/Claim/SurgicalAuthorizationRequestExample

Resource Claim:

Generated Narrative: Claim

ResourceClaim "SurgicalAuthorizationRequestExample"

Profile: PAS Claim

LevelOfServiceCode: Elective (1338#E)

Extension Definition for Claim.encounter for Version 5.0: See on this page: Encounter/SurgicalEncounterExample

ConditionCode

url

category

value: 07 (1136#07)

url

indicator

value: true

url

code

value: 09 (1321#09)

identifier: http://example.org/PATIENT_EVENT_TRACE_NUMBER/16139462398

status: ACTIVE

type: Institutional (Claim Type Codes#institutional)

use: PREAUTHORIZATION

patient: See on this page: Patient/SubscriberExample

created: 2020-06-24 07:34:00+0500

insurer: See on this page: Organization/InsurerExample

provider: See on this page: Organization/UMOExample

priority: Normal (Process Priority Codes#normal)

CareTeams

-	Extension	Sequence	Provider
*		1	See on this page: PractitionerRole/SurgicalPractitionerRoleExample

SupportingInfos

-	Sequence	Category	Timing[x]
*	1	Admission Dates (PAS Temporary Codes#admissionDates)	2020-07-02 --> 2020-07-09

Diagnoses

-	Extension	Sequence	Diagnosis[x]
*		1	Malignant neoplasm of colon, unspecified (International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)#C18.9)

Insurances

-	Sequence	Focal	Coverage
*	1	true	See on this page: Coverage/InsuranceExample

Items

-	Extension	Sequence	CareTeamSequence	DiagnosisSequence	Category	ProductOrService	Location[x]
*	, , , ,	1	1	1	Surgical (1365#2)	Under Venous Grafting Only for Coronary Artery Bypass (Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes#33510)	21 (CMS Place of Service Codes (POS)#21)

Entry 2 - fullUrl = http://example.org/fhir/Organization/UMOExample

Resource Organization:

Generated Narrative: Organization

ResourceOrganization "UMOExample"

Profile: PAS Requestor Organization

identifier: NPI/8189991234

active: true

type: X3 (98#X3)

name: DR. JOE SMITH CORPORATION

Contacts

-	Address
*	111 1ST STREET SAN DIEGO CA 92101 US

Entry 3 - fullUrl = http://example.org/fhir/Organization/InsurerExample

Resource Organization:

Generated Narrative: Organization

ResourceOrganization "InsurerExample"

Profile: PAS Insurer Organization

identifier: NPI/789312

active: true

type: PR (98#PR)

name: MARYLAND CAPITAL INSURANCE COMPANY

Entry 4 - fullUrl = http://example.org/fhir/Coverage/InsuranceExample

Resource Coverage:

Generated Narrative: Coverage

ResourceCoverage "InsuranceExample"

Profile: PAS Coverage

status: ACTIVE

beneficiary: See on this page: Patient/SubscriberExample

Entry 5 - fullUrl = http://example.org/fhir/Patient/SubscriberExample

Resource Patient:

Anonymous Patient Male, DoB: ( http://example.org/MIN#12345678901)

Entry 6 - fullUrl = http://example.org/fhir/Encounter/SurgicalEncounterExample

Resource Encounter:

Not done yet

Entry 7 - fullUrl = http://example.org/fhir/PractitionerRole/SurgicalPractitionerRoleExample

Resource PractitionerRole:

Generated Narrative: PractitionerRole

ResourcePractitionerRole "SurgicalPractitionerRoleExample"

Profile: PAS PractitionerRole

practitioner: Practitioner/ReferralPractitionerExample " WATSON"

location: Location/ReferralLocationExample "REFERRAL CLINIC"

Entry 8 - fullUrl = http://example.org/fhir/Practitioner/SurgicalPractitionerExample

Resource Practitioner:

Generated Narrative: Practitioner

ResourcePractitioner "SurgicalPractitionerExample"

Profile: PAS Practitioner

identifier: NPI/987654321

name: SUSAN WATSON

telecom: ph: 4029993456

Entry 9 - fullUrl = http://example.org/fhir/Location/SurgicalLocationExample

Resource Location:

Generated Narrative: Location

ResourceLocation "SurgicalLocationExample"

Profile: PAS Location Profile

name: REFERRAL CLINIC

address: 111 1ST STREET SAN DIEGO CA 92101 US