# Referral Authorization Bundle Example - Da Vinci Prior Authorization Support (PAS) FHIR IG v2.2.0-ballot

## Example Bundle: Referral Authorization Bundle Example



## Resource Content

```json
{
  "resourceType" : "Bundle",
  "id" : "ReferralAuthorizationBundleExample",
  "meta" : {
    "profile" : [
      "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle"
    ]
  },
  "language" : "en",
  "identifier" : {
    "system" : "http://example.org/SUBMITTER_TRANSACTION_IDENTIFIER",
    "value" : "A12345"
  },
  "type" : "collection",
  "timestamp" : "2005-05-02T11:01:00+05:00",
  "entry" : [
    {
      "fullUrl" : "http://example.org/fhir/Claim/ReferralAuthorizationExample",
      "resource" : {
        "resourceType" : "Claim",
        "id" : "ReferralAuthorizationExample",
        "meta" : {
          "profile" : [
            "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim"
          ]
        },
        "text" : {
          "status" : "extensions",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_ReferralAuthorizationExample\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Claim ReferralAuthorizationExample</b></p><a name=\"ReferralAuthorizationExample\"> </a><a name=\"hcReferralAuthorizationExample\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-claim.html\">PAS Claim</a></p></div><p><b>LevelOfServiceCode</b>: <span title=\"Codes:{https://codesystem.x12.org/005010/1338 U}\">Urgent</span></p><p><b>identifier</b>: <code>urn:trnorg:9012345678</code>/111099</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type professional}\">Professional</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>: 2005-05-02 11:01:00+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-ReferralPractitionerRoleExample.html\">PractitionerRole: telecom = ph: 4029993456</a></td></tr></table><h3>SupportingInfos</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>Category</b></td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td/><td>1</td><td><span title=\"Codes:{http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes additionalInformation}\">Additional Information</span></td><td><a href=\"DocumentReference-DocumentReferenceExample.html\">DocumentReference: status = current; type = Physician procedure note; category = Clinical Note</a></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 G89.4}\">Chronic pain syndrome</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 SC}\">Specialty Care 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>RequestedService</b>: <a href=\"ServiceRequest-ReferralRequestExample.html\">ServiceRequest Consultation</a></p><p><b>EPSDTIndicator</b>: false</p><p><b>NursingHomeResidentialStatus</b>: <span title=\"Codes:{https://codesystem.x12.org/005010/1345 2}\">Newly Admitted</span></p><p><b>NursingHomeLevelOfCare</b>: <span title=\"Codes:{https://codesystem.x12.org/005010/1337 2}\">Intermediate Care Facility (ICF)</span></p><p><b>RevenueUnitRateLimit</b>: 100</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 3}\">Consultation</span></p><p><b>productOrService</b>: <span title=\"Codes:{https://codesystem.x12.org/005010/1365 3}\">Consultation</span></p><p><b>location</b>: <span title=\"Codes:{https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set 11}\">Office</span></p></blockquote></div>"
        },
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-levelOfServiceCode",
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "https://codesystem.x12.org/005010/1338",
                  "code" : "U",
                  "display" : "Urgent"
                }
              ]
            }
          }
        ],
        "identifier" : [
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierJurisdiction",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "https://www.usps.com/",
                      "code" : "MA"
                    }
                  ]
                }
              },
              {
                "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierSubDepartment",
                "valueString" : "223412"
              }
            ],
            "system" : "urn:trnorg:9012345678",
            "value" : "111099",
            "assigner" : {
              "identifier" : {
                "system" : "http://example.org/USER_ASSIGNED",
                "value" : "9012345678"
              }
            }
          }
        ],
        "status" : "active",
        "type" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
              "code" : "professional"
            }
          ]
        },
        "use" : "preauthorization",
        "patient" : {
          "reference" : "Patient/SubscriberExample"
        },
        "created" : "2005-05-02T11:01:00+05:00",
        "insurer" : {
          "reference" : "Organization/InsurerExample"
        },
        "provider" : {
          "reference" : "Organization/UMOExample"
        },
        "priority" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
              "code" : "normal"
            }
          ]
        },
        "careTeam" : [
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope",
                "valueBoolean" : true
              }
            ],
            "sequence" : 1,
            "provider" : {
              "reference" : "PractitionerRole/ReferralPractitionerRoleExample"
            }
          }
        ],
        "supportingInfo" : [
          {
            "extension" : [
              {
                "extension" : [
                  {
                    "url" : "reportTypeCode",
                    "valueCodeableConcept" : {
                      "coding" : [
                        {
                          "system" : "https://codesystem.x12.org/005010/755",
                          "code" : "PY",
                          "display" : "Physician's Report"
                        }
                      ]
                    }
                  },
                  {
                    "url" : "transmissionMethod",
                    "valueCodeableConcept" : {
                      "coding" : [
                        {
                          "system" : "https://codesystem.x12.org/005010/756",
                          "code" : "EL",
                          "display" : "Electronically Only"
                        }
                      ]
                    }
                  },
                  {
                    "url" : "controlNumber",
                    "valueString" : "111222"
                  },
                  {
                    "url" : "description",
                    "valueString" : "A procedure note included to provide details of what has been tried before the referral."
                  }
                ],
                "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-documentInformation"
              }
            ],
            "sequence" : 1,
            "category" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
                  "code" : "additionalInformation"
                }
              ]
            },
            "valueReference" : {
              "reference" : "DocumentReference/DocumentReferenceExample"
            }
          }
        ],
        "diagnosis" : [
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate",
                "valueDate" : "2021-05-10"
              }
            ],
            "sequence" : 1,
            "diagnosisCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/sid/icd-10-cm",
                  "code" : "G89.4"
                }
              ]
            }
          }
        ],
        "insurance" : [
          {
            "sequence" : 1,
            "focal" : true,
            "coverage" : {
              "reference" : "Coverage/InsuranceExample"
            }
          }
        ],
        "item" : [
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "https://codesystem.x12.org/005010/1525",
                      "code" : "SC",
                      "display" : "Specialty Care Review"
                    }
                  ]
                }
              },
              {
                "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "https://codesystem.x12.org/005010/1322",
                      "code" : "I",
                      "display" : "Initial"
                    }
                  ]
                }
              },
              {
                "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber",
                "valueIdentifier" : {
                  "system" : "http://example.org/ITEM_TRACE_NUMBER",
                  "value" : "1122334"
                }
              },
              {
                "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber",
                "valueString" : "1122445"
              },
              {
                "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber",
                "valueString" : "9988311"
              },
              {
                "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService",
                "valueReference" : {
                  "reference" : "ServiceRequest/ReferralRequestExample"
                }
              },
              {
                "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator",
                "valueBoolean" : false
              },
              {
                "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "https://codesystem.x12.org/005010/1345",
                      "code" : "2",
                      "display" : "Newly Admitted"
                    }
                  ]
                }
              },
              {
                "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeLevelOfCare",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "https://codesystem.x12.org/005010/1337",
                      "code" : "2",
                      "display" : "Intermediate Care Facility (ICF)"
                    }
                  ]
                }
              },
              {
                "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueUnitRateLimit",
                "valueDecimal" : 100
              }
            ],
            "sequence" : 1,
            "careTeamSequence" : [1],
            "diagnosisSequence" : [1],
            "category" : {
              "coding" : [
                {
                  "system" : "https://codesystem.x12.org/005010/1365",
                  "code" : "3",
                  "display" : "Consultation"
                }
              ]
            },
            "productOrService" : {
              "coding" : [
                {
                  "system" : "https://codesystem.x12.org/005010/1365",
                  "code" : "3",
                  "display" : "Consultation"
                }
              ]
            },
            "locationCodeableConcept" : {
              "coding" : [
                {
                  "system" : "https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set",
                  "code" : "11"
                }
              ]
            }
          }
        ]
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/Organization/UMOExample",
      "resource" : {
        "resourceType" : "Organization",
        "id" : "UMOExample",
        "meta" : {
          "profile" : [
            "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor"
          ]
        },
        "text" : {
          "status" : "generated",
          "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><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-requestor.html\">PAS Requestor Organization</a></p></div><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/6.2.0/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>"
        },
        "identifier" : [
          {
            "system" : "http://hl7.org/fhir/sid/us-npi",
            "value" : "8189991234"
          }
        ],
        "active" : true,
        "type" : [
          {
            "coding" : [
              {
                "system" : "https://codesystem.x12.org/005010/98",
                "code" : "X3"
              }
            ]
          }
        ],
        "name" : "DR. JOE SMITH CORPORATION",
        "address" : [
          {
            "line" : ["111 1ST STREET"],
            "city" : "SAN DIEGO",
            "state" : "CA",
            "postalCode" : "92101",
            "country" : "US"
          }
        ]
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/Organization/InsurerExample",
      "resource" : {
        "resourceType" : "Organization",
        "id" : "InsurerExample",
        "meta" : {
          "profile" : [
            "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer"
          ]
        },
        "text" : {
          "status" : "generated",
          "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><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-insurer.html\">PAS Insurer Organization</a></p></div><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/6.2.0/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>"
        },
        "identifier" : [
          {
            "system" : "http://hl7.org/fhir/sid/us-npi",
            "value" : "1234567893"
          }
        ],
        "active" : true,
        "type" : [
          {
            "coding" : [
              {
                "system" : "https://codesystem.x12.org/005010/98",
                "code" : "PR"
              }
            ]
          }
        ],
        "name" : "MARYLAND CAPITAL INSURANCE COMPANY"
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/Coverage/InsuranceExample",
      "resource" : {
        "resourceType" : "Coverage",
        "id" : "InsuranceExample",
        "meta" : {
          "profile" : [
            "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-coverage"
          ]
        },
        "text" : {
          "status" : "generated",
          "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><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-coverage.html\">PAS Coverage</a></p></div><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>"
        },
        "status" : "active",
        "subscriberId" : "1122334455",
        "beneficiary" : {
          "reference" : "Patient/SubscriberExample"
        },
        "relationship" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
              "code" : "self"
            },
            {
              "system" : "https://codesystem.x12.org/005010/1069",
              "code" : "18"
            }
          ]
        },
        "payor" : [
          {
            "reference" : "Organization/InsurerExample"
          }
        ]
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/Patient/SubscriberExample",
      "resource" : {
        "resourceType" : "Patient",
        "id" : "SubscriberExample",
        "meta" : {
          "profile" : [
            "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber"
          ]
        },
        "text" : {
          "status" : "generated",
          "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><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-subscriber.html\">PAS Subscriber Patient</a></p></div><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>"
        },
        "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"
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/ServiceRequest/ReferralRequestExample",
      "resource" : {
        "resourceType" : "ServiceRequest",
        "id" : "ReferralRequestExample",
        "meta" : {
          "profile" : [
            "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-servicerequest"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ServiceRequest_ReferralRequestExample\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ServiceRequest ReferralRequestExample</b></p><a name=\"ReferralRequestExample\"> </a><a name=\"hcReferralRequestExample\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-servicerequest.html\">PAS Service Request</a></p></div><p><b>status</b>: Active</p><p><b>intent</b>: Order</p><p><b>code</b>: <span title=\"Codes:{https://codesystem.x12.org/005010/1365 3}\">Consultation</span></p><p><b>quantity</b>: 1 visit<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  code1 = '1')</span></p><p><b>subject</b>: <a href=\"Patient-SubscriberExample.html\">JOE SMITH  Male, DoB Unknown ( Member Number)</a></p></div>"
        },
        "status" : "active",
        "intent" : "order",
        "code" : {
          "coding" : [
            {
              "system" : "https://codesystem.x12.org/005010/1365",
              "code" : "3",
              "display" : "Consultation"
            }
          ]
        },
        "quantityQuantity" : {
          "value" : 1,
          "unit" : "visit",
          "system" : "http://unitsofmeasure.org",
          "code" : "1"
        },
        "subject" : {
          "reference" : "Patient/SubscriberExample"
        }
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/PractitionerRole/ReferralPractitionerRoleExample",
      "resource" : {
        "resourceType" : "PractitionerRole",
        "id" : "ReferralPractitionerRoleExample",
        "meta" : {
          "profile" : [
            "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"PractitionerRole_ReferralPractitionerRoleExample\"> </a><p class=\"res-header-id\"><b>Generated Narrative: PractitionerRole ReferralPractitionerRoleExample</b></p><a name=\"ReferralPractitionerRoleExample\"> </a><a name=\"hcReferralPractitionerRoleExample\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-practitionerrole.html\">PAS PractitionerRole</a></p></div><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><p><b>telecom</b>: ph: 4029993456</p></div>"
        },
        "practitioner" : {
          "reference" : "Practitioner/ReferralPractitionerExample"
        },
        "location" : [
          {
            "reference" : "Location/ReferralLocationExample"
          }
        ],
        "telecom" : [
          {
            "system" : "phone",
            "value" : "4029993456"
          }
        ]
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/Practitioner/ReferralPractitionerExample",
      "resource" : {
        "resourceType" : "Practitioner",
        "id" : "ReferralPractitionerExample",
        "meta" : {
          "profile" : [
            "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_ReferralPractitionerExample\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner ReferralPractitionerExample</b></p><a name=\"ReferralPractitionerExample\"> </a><a name=\"hcReferralPractitionerExample\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-practitioner.html\">PAS Practitioner</a></p></div><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/6.2.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/1234567893</p><p><b>name</b>: SUSAN WATSON </p></div>"
        },
        "identifier" : [
          {
            "system" : "http://hl7.org/fhir/sid/us-npi",
            "value" : "1234567893"
          }
        ],
        "name" : [
          {
            "family" : "WATSON",
            "given" : ["SUSAN"]
          }
        ]
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/Location/ReferralLocationExample",
      "resource" : {
        "resourceType" : "Location",
        "id" : "ReferralLocationExample",
        "meta" : {
          "profile" : [
            "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-location"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Location_ReferralLocationExample\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Location ReferralLocationExample</b></p><a name=\"ReferralLocationExample\"> </a><a name=\"hcReferralLocationExample\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-location.html\">PAS Location Profile</a></p></div><p><b>name</b>: REFERRAL CLINIC</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>"
        },
        "name" : "REFERRAL CLINIC",
        "address" : {
          "line" : ["111 1ST STREET"],
          "city" : "SAN DIEGO",
          "state" : "CA",
          "postalCode" : "92101",
          "country" : "US"
        }
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/DocumentReference/DocumentReferenceExample",
      "resource" : {
        "resourceType" : "DocumentReference",
        "id" : "DocumentReferenceExample",
        "meta" : {
          "profile" : [
            "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-documentreference"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"DocumentReference_DocumentReferenceExample\"> </a><p class=\"res-header-id\"><b>Generated Narrative: DocumentReference DocumentReferenceExample</b></p><a name=\"DocumentReferenceExample\"> </a><a name=\"hcDocumentReferenceExample\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-documentreference.html\">PAS Document Reference</a></p></div><p><b>status</b>: Current</p><p><b>type</b>: <span title=\"Codes:{http://loinc.org 11505-5}\">Physician procedure note</span></p><p><b>category</b>: <span title=\"Codes:{http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category clinical-note}\">Clinical Note</span></p><p><b>subject</b>: <a href=\"Patient-SubscriberExample.html\">JOE SMITH  Male, DoB Unknown ( Member Number)</a></p><blockquote><p><b>content</b></p><h3>Attachments</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ContentType</b></td><td><b>Data</b></td></tr><tr><td style=\"display: none\">*</td><td>text/plain</td><td><code>VGhpcyBpcyBzYW1wbGUgYmFzZTY0IGVuY29kaW5nLg==</code></td></tr></table></blockquote></div>"
        },
        "status" : "current",
        "type" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "11505-5"
            }
          ]
        },
        "category" : [
          {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
                "code" : "clinical-note"
              }
            ]
          }
        ],
        "subject" : {
          "reference" : "Patient/SubscriberExample"
        },
        "content" : [
          {
            "attachment" : {
              "contentType" : "text/plain",
              "data" : "VGhpcyBpcyBzYW1wbGUgYmFzZTY0IGVuY29kaW5nLg=="
            }
          }
        ]
      }
    }
  ]
}

```
