# Submit Claim Subscriber Example - Da Vinci Prior Authorization Support (PAS) FHIR IG v2.2.0-ballot

## Example Patient: Submit Claim Subscriber Example

Language: en

Profile: [PAS Subscriber Patient](StructureDefinition-profile-subscriber.md)

JOE SMITH Male, DoB Unknown ( Member Number)

-------

| | |
| :--- | :--- |
|  | RU |



## Resource Content

```json
{
  "resourceType" : "Patient",
  "id" : "SubscriberExample",
  "meta" : {
    "profile" : [
      "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber"
    ]
  },
  "language" : "en",
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-militaryStatus",
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "https://codesystem.x12.org/005010/584",
            "code" : "RU"
          }
        ]
      }
    }
  ],
  "identifier" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "MB"
          }
        ]
      },
      "system" : "http://example.org/MIN",
      "value" : "12345678901"
    }
  ],
  "name" : [
    {
      "family" : "SMITH",
      "given" : ["JOE"]
    }
  ],
  "gender" : "male"
}

```
