Da Vinci Prior Authorization Support (PAS) FHIR IG
2.2.0-ballot - STU 2.2 - Ballot

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 2.2.0-ballot 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

Page standards status: Informative

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    <Patient xmlns="http://hl7.org/fhir">
      <id value="SubscriberExample"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber"/>
      </meta>
      <language value="en"/>
      <text>
        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en"><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">Language: en</p><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>
      </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>