Da Vinci Prior Authorization Support (PAS) FHIR IG
2.1.0 - STU 2 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

: Submit Claim Subscriber Example - XML Representation

Page standards status: Informative

Raw xml | Download


<Patient xmlns="http://hl7.org/fhir">
  <id value="SubscriberExample"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><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>
  </text>
  <extension
             url="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-militaryStatus">
    <valueCodeableConcept>
      <coding>
        <system value="https://codesystem.x12.org/005010/584"/>
        <code value="RU"/>
      </coding>
    </valueCodeableConcept>
  </extension>
  <identifier>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="MB"/>
      </coding>
    </type>
    <system value="http://example.org/MIN"/>
    <value value="12345678901"/>
  </identifier>
  <name>
    <family value="SMITH"/>
    <given value="JOE"/>
  </name>
  <gender value="male"/>
</Patient>