Da Vinci Prior Authorization Support (PAS) FHIR IG
2.1.0 - STU 2.1 United States of America flag

Da Vinci Prior Authorization Support (PAS) FHIR IG, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pas/ and changes regularly. See the Directory of published versions

: Surgical Admission Request Bundle Example - TTL Representation

Raw ttl | Download

@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:Bundle ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "SurgicalRequestBundleExample"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle>     ] )
  ] ; # 
  fhir:identifier [
fhir:system [ fhir:v "http://example.org/SUBMITTER_TRANSACTION_IDENTIFIER"^^xsd:anyURI ] ;
fhir:value [ fhir:v "16139462398" ]
  ] ; # 
  fhir:type [ fhir:v "collection"] ; # 
  fhir:timestamp [ fhir:v "2020-06-24T07:34:00+05:00"^^xsd:dateTime] ; # 
  fhir:entry ( [
fhir:fullUrl [ fhir:v "http://example.org/fhir/Claim/SurgicalAuthorizationRequestExample"^^xsd:anyURI ] ;
    ( fhir:resource <http://example.org/fhir/Claim/SurgicalAuthorizationRequestExample> )
  ] [
fhir:fullUrl [ fhir:v "http://example.org/fhir/Organization/UMOExample"^^xsd:anyURI ] ;
    ( fhir:resource <http://example.org/fhir/Organization/UMOExample> )
  ] [
fhir:fullUrl [ fhir:v "http://example.org/fhir/Organization/InsurerExample"^^xsd:anyURI ] ;
    ( fhir:resource <http://example.org/fhir/Organization/InsurerExample> )
  ] [
fhir:fullUrl [ fhir:v "http://example.org/fhir/Coverage/InsuranceExample"^^xsd:anyURI ] ;
    ( fhir:resource <http://example.org/fhir/Coverage/InsuranceExample> )
  ] [
fhir:fullUrl [ fhir:v "http://example.org/fhir/Patient/SubscriberExample"^^xsd:anyURI ] ;
    ( fhir:resource <http://example.org/fhir/Patient/SubscriberExample> )
  ] [
fhir:fullUrl [ fhir:v "http://example.org/fhir/Encounter/SurgicalEncounterExample"^^xsd:anyURI ] ;
    ( fhir:resource <http://example.org/fhir/Encounter/SurgicalEncounterExample> )
  ] [
fhir:fullUrl [ fhir:v "http://example.org/fhir/PractitionerRole/SurgicalPractitionerRoleExample"^^xsd:anyURI ] ;
    ( fhir:resource <http://example.org/fhir/PractitionerRole/SurgicalPractitionerRoleExample> )
  ] [
fhir:fullUrl [ fhir:v "http://example.org/fhir/Practitioner/SurgicalPractitionerExample"^^xsd:anyURI ] ;
    ( fhir:resource <http://example.org/fhir/Practitioner/SurgicalPractitionerExample> )
  ] [
fhir:fullUrl [ fhir:v "http://example.org/fhir/Location/SurgicalLocationExample"^^xsd:anyURI ] ;
    ( fhir:resource <http://example.org/fhir/Location/SurgicalLocationExample> )
  ] ) . # 

<http://example.org/fhir/Claim/SurgicalAuthorizationRequestExample> a fhir:Claim ;
  fhir:id [ fhir:v "SurgicalAuthorizationRequestExample"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_SurgicalAuthorizationRequestExample\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Claim SurgicalAuthorizationRequestExample</b></p><a name=\"SurgicalAuthorizationRequestExample\"> </a><a name=\"hcSurgicalAuthorizationRequestExample\"> </a><a name=\"SurgicalAuthorizationRequestExample-en-US\"> </a><p><b>LevelOfServiceCode</b>: <span title=\"Codes:{https://codesystem.x12.org/005010/1338 E}\">Elective</span></p><p><b>Extension Definition for Claim.encounter for Version 5.0</b>: <a href=\"Encounter-SurgicalEncounterExample.html\">Encounter: extension = Still a patient; status = planned; class = ambulatory (ActCode#AMB); type = 2; period = 2020-07-02 --&gt; 2020-07-09</a></p><blockquote><p><b>ConditionCode</b></p><ul><li>category: <span title=\"Codes:{https://codesystem.x12.org/005010/1136 07}\">07</span></li><li>indicator: true</li><li>code: <span title=\"Codes:{https://codesystem.x12.org/005010/1321 09}\">09</span></li></ul></blockquote><p><b>identifier</b>: <code>http://example.org/PATIENT_EVENT_TRACE_NUMBER</code>/16139462398</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type institutional}\">Institutional</span></p><p><b>use</b>: Preauthorization</p><p><b>patient</b>: <a href=\"Patient-SubscriberExample.html\">JOE SMITH  Male, DoB Unknown ( Member Number)</a></p><p><b>created</b>: 2020-06-24 07:34:00+0500</p><p><b>insurer</b>: <a href=\"Organization-InsurerExample.html\">Organization MARYLAND CAPITAL INSURANCE COMPANY</a></p><p><b>provider</b>: <a href=\"Organization-UMOExample.html\">Organization DR. JOE SMITH CORPORATION</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><h3>CareTeams</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>Provider</b></td></tr><tr><td style=\"display: none\">*</td><td/><td>1</td><td><a href=\"PractitionerRole-SurgicalPractitionerRoleExample.html\">PractitionerRole</a></td></tr></table><h3>SupportingInfos</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Category</b></td><td><b>Timing[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes admissionDates}\">Admission Dates</span></td><td>2020-07-02 --&gt; 2020-07-09</td></tr></table><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td style=\"display: none\">*</td><td/><td>1</td><td><span title=\"Codes:{http://hl7.org/fhir/sid/icd-10-cm C18.9}\">Malignant neoplasm of colon, unspecified</span></td></tr></table><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td><a href=\"Coverage-InsuranceExample.html\">Coverage: status = active; subscriberId = 1122334455; relationship = Self</a></td></tr></table><blockquote><p><b>item</b></p><p><b>ServiceItemRequestType</b>: <span title=\"Codes:{https://codesystem.x12.org/005010/1525 AR}\">Admission Review</span></p><p><b>CertificationType</b>: <span title=\"Codes:{https://codesystem.x12.org/005010/1322 I}\">Initial</span></p><p><b>ItemTraceNumber</b>: <code>http://example.org/ITEM_TRACE_NUMBER</code>/1122334</p><p><b>AuthorizationNumber</b>: 1122445</p><p><b>AdministrationReferenceNumber</b>: 9988311</p><p><b>sequence</b>: 1</p><p><b>careTeamSequence</b>: 1</p><p><b>diagnosisSequence</b>: 1</p><p><b>category</b>: <span title=\"Codes:{https://codesystem.x12.org/005010/1365 2}\">Surgical</span></p><p><b>productOrService</b>: <span title=\"Codes:{http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets 33510}\">Under Venous Grafting Only for Coronary Artery Bypass</span></p><p><b>location</b>: <span title=\"Codes:{https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set 21}\">21</span></p></blockquote></div>"
  ] ; # 
  fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-levelOfServiceCode"^^xsd:anyURI ] ;
fhir:value [
a fhir:CodeableConcept ;
      ( fhir:coding [
fhir:system [ fhir:v "https://codesystem.x12.org/005010/1338"^^xsd:anyURI ] ;
fhir:code [ fhir:v "E" ] ;
fhir:display [ fhir:v "Elective" ]       ] )     ]
  ] [
fhir:url [ fhir:v "http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.encounter"^^xsd:anyURI ] ;
fhir:value [
a fhir:Reference ;
fhir:reference [ fhir:v "Encounter/SurgicalEncounterExample" ]     ]
  ] [
    ( fhir:extension [
fhir:url [ fhir:v "category"^^xsd:anyURI ] ;
fhir:value [
a fhir:CodeableConcept ;
        ( fhir:coding [
fhir:system [ fhir:v "https://codesystem.x12.org/005010/1136"^^xsd:anyURI ] ;
fhir:code [ fhir:v "07" ]         ] )       ]     ] [
fhir:url [ fhir:v "indicator"^^xsd:anyURI ] ;
fhir:value [ fhir:v "true"^^xsd:boolean ]     ] [
fhir:url [ fhir:v "code"^^xsd:anyURI ] ;
fhir:value [
a fhir:CodeableConcept ;
        ( fhir:coding [
fhir:system [ fhir:v "https://codesystem.x12.org/005010/1321"^^xsd:anyURI ] ;
fhir:code [ fhir:v "09" ]         ] )       ]     ] ) ;
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-conditionCode"^^xsd:anyURI ]
  ] ) ; # 
  fhir:identifier ( [
fhir:system [ fhir:v "http://example.org/PATIENT_EVENT_TRACE_NUMBER"^^xsd:anyURI ] ;
fhir:value [ fhir:v "16139462398" ] ;
fhir:assigner [
fhir:identifier [
fhir:system [ fhir:v "http://example.org/USER_ASSIGNED"^^xsd:anyURI ] ;
fhir:value [ fhir:v "3030240928" ]       ]     ]
  ] ) ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:type [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "institutional" ]     ] )
  ] ; # 
  fhir:use [ fhir:v "preauthorization"] ; # 
  fhir:patient [
fhir:reference [ fhir:v "Patient/SubscriberExample" ]
  ] ; # 
  fhir:created [ fhir:v "2020-06-24T07:34:00+05:00"^^xsd:dateTime] ; # 
  fhir:insurer [
fhir:reference [ fhir:v "Organization/InsurerExample" ]
  ] ; # 
  fhir:provider [
fhir:reference [ fhir:v "Organization/UMOExample" ]
  ] ; # 
  fhir:priority [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/processpriority"^^xsd:anyURI ] ;
fhir:code [ fhir:v "normal" ]     ] )
  ] ; # 
  fhir:careTeam ( [
    ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope"^^xsd:anyURI ] ;
fhir:value [ fhir:v "true"^^xsd:boolean ]     ] ) ;
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:provider [
fhir:reference [ fhir:v "PractitionerRole/SurgicalPractitionerRoleExample" ]     ]
  ] ) ; # 
  fhir:supportingInfo ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:category [
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"^^xsd:anyURI ] ;
fhir:code [ fhir:v "admissionDates" ]       ] )     ] ;
fhir:timing [
a fhir:Period ;
fhir:start [ fhir:v "2020-07-02"^^xsd:date ] ;
fhir:end [ fhir:v "2020-07-09"^^xsd:date ]     ]
  ] ) ; # 
  fhir:diagnosis ( [
    ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate"^^xsd:anyURI ] ;
fhir:value [ fhir:v "2020-06-24"^^xsd:date ]     ] ) ;
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:diagnosis [
a fhir:CodeableConcept ;
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/sid/icd-10-cm"^^xsd:anyURI ] ;
fhir:code [ fhir:v "C18.9" ]       ] )     ]
  ] ) ; # 
  fhir:insurance ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:focal [ fhir:v "true"^^xsd:boolean ] ;
fhir:coverage [
fhir:reference [ fhir:v "Coverage/InsuranceExample" ]     ]
  ] ) ; # 
  fhir:item ( [
    ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType"^^xsd:anyURI ] ;
fhir:value [
a fhir:CodeableConcept ;
        ( fhir:coding [
fhir:system [ fhir:v "https://codesystem.x12.org/005010/1525"^^xsd:anyURI ] ;
fhir:code [ fhir:v "AR" ] ;
fhir:display [ fhir:v "Admission Review" ]         ] )       ]     ] [
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType"^^xsd:anyURI ] ;
fhir:value [
a fhir:CodeableConcept ;
        ( fhir:coding [
fhir:system [ fhir:v "https://codesystem.x12.org/005010/1322"^^xsd:anyURI ] ;
fhir:code [ fhir:v "I" ] ;
fhir:display [ fhir:v "Initial" ]         ] )       ]     ] [
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber"^^xsd:anyURI ] ;
fhir:value [
a fhir:Identifier ;
fhir:system [ fhir:v "http://example.org/ITEM_TRACE_NUMBER"^^xsd:anyURI ] ;
fhir:value [ fhir:v "1122334" ]       ]     ] [
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber"^^xsd:anyURI ] ;
fhir:value [ fhir:v "1122445" ]     ] [
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber"^^xsd:anyURI ] ;
fhir:value [ fhir:v "9988311" ]     ] ) ;
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
    ( fhir:careTeamSequence [ fhir:v "1"^^xsd:positiveInteger ] ) ;
    ( fhir:diagnosisSequence [ fhir:v "1"^^xsd:positiveInteger ] ) ;
fhir:category [
      ( fhir:coding [
fhir:system [ fhir:v "https://codesystem.x12.org/005010/1365"^^xsd:anyURI ] ;
fhir:code [ fhir:v "2" ] ;
fhir:display [ fhir:v "Surgical" ]       ] )     ] ;
fhir:productOrService [
      ( fhir:coding [
fhir:system [ fhir:v "http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"^^xsd:anyURI ] ;
fhir:code [ fhir:v "33510" ] ;
fhir:display [ fhir:v "Under Venous Grafting Only for Coronary Artery Bypass" ]       ] )     ] ;
fhir:location [
a fhir:CodeableConcept ;
      ( fhir:coding [
fhir:system [ fhir:v "https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set"^^xsd:anyURI ] ;
fhir:code [ fhir:v "21" ]       ] )     ]
  ] ) . # 

<http://example.org/fhir/Organization/UMOExample> a fhir:Organization ;
  fhir:id [ fhir:v "UMOExample"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_UMOExample\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization UMOExample</b></p><a name=\"UMOExample\"> </a><a name=\"hcUMOExample\"> </a><a name=\"UMOExample-en-US\"> </a><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.3.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/8189991234</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{https://codesystem.x12.org/005010/98 X3}\">X3</span></p><p><b>name</b>: DR. JOE SMITH CORPORATION</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>"
  ] ; # 
  fhir:identifier ( [
fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "8189991234" ]
  ] ) ; # 
  fhir:active [ fhir:v "true"^^xsd:boolean] ; # 
  fhir:type ( [
    ( fhir:coding [
fhir:system [ fhir:v "https://codesystem.x12.org/005010/98"^^xsd:anyURI ] ;
fhir:code [ fhir:v "X3" ]     ] )
  ] ) ; # 
  fhir:name [ fhir:v "DR. JOE SMITH CORPORATION"] ; # 
  fhir:address ( [
    ( fhir:line [ fhir:v "111 1ST STREET" ] ) ;
fhir:city [ fhir:v "SAN DIEGO" ] ;
fhir:state [ fhir:v "CA" ] ;
fhir:postalCode [ fhir:v "92101" ] ;
fhir:country [ fhir:v "US" ]
  ] ) . # 

<http://example.org/fhir/Organization/InsurerExample> a fhir:Organization ;
  fhir:id [ fhir:v "InsurerExample"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_InsurerExample\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization InsurerExample</b></p><a name=\"InsurerExample\"> </a><a name=\"hcInsurerExample\"> </a><a name=\"InsurerExample-en-US\"> </a><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.3.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/1234567893</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{https://codesystem.x12.org/005010/98 PR}\">PR</span></p><p><b>name</b>: MARYLAND CAPITAL INSURANCE COMPANY</p></div>"
  ] ; # 
  fhir:identifier ( [
fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "1234567893" ]
  ] ) ; # 
  fhir:active [ fhir:v "true"^^xsd:boolean] ; # 
  fhir:type ( [
    ( fhir:coding [
fhir:system [ fhir:v "https://codesystem.x12.org/005010/98"^^xsd:anyURI ] ;
fhir:code [ fhir:v "PR" ]     ] )
  ] ) ; # 
  fhir:name [ fhir:v "MARYLAND CAPITAL INSURANCE COMPANY"] . # 

<http://example.org/fhir/Coverage/InsuranceExample> a fhir:Coverage ;
  fhir:id [ fhir:v "InsuranceExample"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-coverage"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-coverage>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Coverage_InsuranceExample\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage InsuranceExample</b></p><a name=\"InsuranceExample\"> </a><a name=\"hcInsuranceExample\"> </a><a name=\"InsuranceExample-en-US\"> </a><p><b>status</b>: Active</p><p><b>subscriberId</b>: 1122334455</p><p><b>beneficiary</b>: <a href=\"Patient-SubscriberExample.html\">JOE SMITH  Male, DoB Unknown ( Member Number)</a></p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}, {https://codesystem.x12.org/005010/1069 18}\">Self</span></p><p><b>payor</b>: <a href=\"Organization-InsurerExample.html\">Organization MARYLAND CAPITAL INSURANCE COMPANY</a></p></div>"
  ] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:subscriberId [ fhir:v "1122334455"] ; # 
  fhir:beneficiary [
fhir:reference [ fhir:v "Patient/SubscriberExample" ]
  ] ; # 
  fhir:relationship [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/subscriber-relationship"^^xsd:anyURI ] ;
fhir:code [ fhir:v "self" ]     ] [
fhir:system [ fhir:v "https://codesystem.x12.org/005010/1069"^^xsd:anyURI ] ;
fhir:code [ fhir:v "18" ]     ] )
  ] ; # 
  fhir:payor ( [
fhir:reference [ fhir:v "Organization/InsurerExample" ]
  ] ) . # 

<http://example.org/fhir/Patient/SubscriberExample> a fhir:Patient ;
  fhir:id [ fhir:v "SubscriberExample"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_SubscriberExample\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient SubscriberExample</b></p><a name=\"SubscriberExample\"> </a><a name=\"hcSubscriberExample\"> </a><a name=\"SubscriberExample-en-US\"> </a><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">JOE SMITH  Male, DoB Unknown ( Member Number)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"A patient's military status.\"><a href=\"StructureDefinition-extension-militaryStatus.html\"/></td><td colspan=\"3\"><span title=\"Codes:{https://codesystem.x12.org/005010/584 RU}\">RU</span></td></tr></table></div>"
  ] ; # 
  fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-militaryStatus"^^xsd:anyURI ] ;
fhir:value [
a fhir:CodeableConcept ;
      ( fhir:coding [
fhir:system [ fhir:v "https://codesystem.x12.org/005010/584"^^xsd:anyURI ] ;
fhir:code [ fhir:v "RU" ]       ] )     ]
  ] ) ; # 
  fhir:identifier ( [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "MB" ]       ] )     ] ;
fhir:system [ fhir:v "http://example.org/MIN"^^xsd:anyURI ] ;
fhir:value [ fhir:v "12345678901" ]
  ] ) ; # 
  fhir:name ( [
fhir:family [ fhir:v "SMITH" ] ;
    ( fhir:given [ fhir:v "JOE" ] )
  ] ) ; # 
  fhir:gender [ fhir:v "male"] . # 

<http://example.org/fhir/Encounter/SurgicalEncounterExample> a fhir:Encounter ;
  fhir:id [ fhir:v "SurgicalEncounterExample"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-encounter"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-encounter>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Encounter_SurgicalEncounterExample\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Encounter SurgicalEncounterExample</b></p><a name=\"SurgicalEncounterExample\"> </a><a name=\"hcSurgicalEncounterExample\"> </a><a name=\"SurgicalEncounterExample-en-US\"> </a><p><b>PatientStatus</b>: <span title=\"Codes:{https://www.nubc.org/CodeSystem/PatDischargeStatus 30}\">Still a patient</span></p><p><b>status</b>: Planned</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:{https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit 2}\">2</span></p><p><b>subject</b>: <a href=\"Patient-SubscriberExample.html\">JOE SMITH  Male, DoB Unknown ( Member Number)</a></p><p><b>period</b>: 2020-07-02 --&gt; 2020-07-09</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>AdmitSource</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.nubc.org/CodeSystem/PointOfOrigin 5}\">5</span></td></tr></table></div>"
  ] ; # 
  fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-patientStatus"^^xsd:anyURI ] ;
fhir:value [
a fhir:CodeableConcept ;
      ( fhir:coding [
fhir:system [ fhir:v "https://www.nubc.org/CodeSystem/PatDischargeStatus"^^xsd:anyURI ] ;
fhir:code [ fhir:v "30" ] ;
fhir:display [ fhir:v "Still a patient" ]       ] )     ]
  ] ) ; # 
  fhir:status [ fhir:v "planned"] ; # 
  fhir:class [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:code [ fhir:v "AMB" ]
  ] ; # 
  fhir:type ( [
    ( fhir:coding [
fhir:system [ fhir:v "https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit"^^xsd:anyURI ] ;
fhir:code [ fhir:v "2" ]     ] )
  ] ) ; # 
  fhir:subject [
fhir:reference [ fhir:v "Patient/SubscriberExample" ]
  ] ; # 
  fhir:period [
fhir:start [ fhir:v "2020-07-02"^^xsd:date ] ;
fhir:end [ fhir:v "2020-07-09"^^xsd:date ]
  ] ; # 
  fhir:hospitalization [
fhir:admitSource [
      ( fhir:coding [
fhir:system [ fhir:v "https://www.nubc.org/CodeSystem/PointOfOrigin"^^xsd:anyURI ] ;
fhir:code [ fhir:v "5" ]       ] )     ]
  ] . # 

<http://example.org/fhir/PractitionerRole/SurgicalPractitionerRoleExample> a fhir:PractitionerRole ;
  fhir:id [ fhir:v "SurgicalPractitionerRoleExample"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"PractitionerRole_SurgicalPractitionerRoleExample\"> </a><p class=\"res-header-id\"><b>Generated Narrative: PractitionerRole SurgicalPractitionerRoleExample</b></p><a name=\"SurgicalPractitionerRoleExample\"> </a><a name=\"hcSurgicalPractitionerRoleExample\"> </a><a name=\"SurgicalPractitionerRoleExample-en-US\"> </a><p><b>practitioner</b>: <a href=\"Practitioner-ReferralPractitionerExample.html\">Practitioner SUSAN WATSON </a></p><p><b>location</b>: <a href=\"Location-ReferralLocationExample.html\">Location REFERRAL CLINIC</a></p></div>"
  ] ; # 
  fhir:practitioner [
fhir:reference [ fhir:v "Practitioner/ReferralPractitionerExample" ]
  ] ; # 
  fhir:location ( [
fhir:reference [ fhir:v "Location/ReferralLocationExample" ]
  ] ) . # 

<http://example.org/fhir/Practitioner/SurgicalPractitionerExample> a fhir:Practitioner ;
  fhir:id [ fhir:v "SurgicalPractitionerExample"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_SurgicalPractitionerExample\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner SurgicalPractitionerExample</b></p><a name=\"SurgicalPractitionerExample\"> </a><a name=\"hcSurgicalPractitionerExample\"> </a><a name=\"SurgicalPractitionerExample-en-US\"> </a><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.3.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/1234567893</p><p><b>name</b>: SUSAN WATSON </p><p><b>telecom</b>: ph: 4029993456</p></div>"
  ] ; # 
  fhir:identifier ( [
fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "1234567893" ]
  ] ) ; # 
  fhir:name ( [
fhir:family [ fhir:v "WATSON" ] ;
    ( fhir:given [ fhir:v "SUSAN" ] )
  ] ) ; # 
  fhir:telecom ( [
fhir:system [ fhir:v "phone" ] ;
fhir:value [ fhir:v "4029993456" ]
  ] ) . # 

<http://example.org/fhir/Location/SurgicalLocationExample> a fhir:Location ;
  fhir:id [ fhir:v "SurgicalLocationExample"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-location"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-location>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Location_SurgicalLocationExample\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Location SurgicalLocationExample</b></p><a name=\"SurgicalLocationExample\"> </a><a name=\"hcSurgicalLocationExample\"> </a><a name=\"SurgicalLocationExample-en-US\"> </a><p><b>name</b>: REFERRAL CLINIC</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>"
  ] ; # 
  fhir:name [ fhir:v "REFERRAL CLINIC"] ; # 
  fhir:address [
    ( fhir:line [ fhir:v "111 1ST STREET" ] ) ;
fhir:city [ fhir:v "SAN DIEGO" ] ;
fhir:state [ fhir:v "CA" ] ;
fhir:postalCode [ fhir:v "92101" ] ;
fhir:country [ fhir:v "US" ]
  ] . #