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

## Example Patient: Submit Claim Beneficiary Example

Language: en

Profile: [PAS Beneficiary Patient](StructureDefinition-profile-beneficiary.md)

JESSE SMITH Female, DoB: 1947-01-18 ( Member Number)

-------

| | |
| :--- | :--- |
| Multiple Birth: | 1 |
| Contact Detail | US |



## Resource Content

```json
{
  "resourceType" : "Patient",
  "id" : "BeneficiaryExample",
  "meta" : {
    "profile" : [
      "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary"
    ]
  },
  "language" : "en",
  "identifier" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "MB"
          }
        ]
      },
      "system" : "http://example.org/MIN",
      "value" : "12345678902"
    }
  ],
  "name" : [
    {
      "family" : "SMITH",
      "given" : ["JESSE"]
    }
  ],
  "gender" : "female",
  "birthDate" : "1947-01-18",
  "address" : [
    {
      "country" : "US"
    }
  ],
  "multipleBirthInteger" : 1
}

```
