{
  "resourceType" : "Bundle",
  "id" : "bundle-oncology-diagnostic",
  "type" : "transaction",
  "entry" : [{
    "fullUrl" : "urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d",
    "resource" : {
      "resourceType" : "Patient",
      "id" : "Inline-Instance-for-oncology-diagnostic-1",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_Inline-Instance-for-oncology-diagnostic-1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient Inline-Instance-for-oncology-diagnostic-1</b></p><a name=\"Inline-Instance-for-oncology-diagnostic-1\"> </a><a name=\"hcInline-Instance-for-oncology-diagnostic-1\"> </a><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Carrot John Mr  Male, DoB: 1962-12-31 ( 1007)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Patient Links\">Links:</td><td colspan=\"3\"><ul><li>General Practitioner: <a href=\"Bundle-bundle-oncology-diagnostic.html#urn-uuid-a48256f8-db37-44e0-a0f6-d7af16c7c9ef\">Akerman Philip Prof (4654765876)</a></li></ul></td></tr></table></div>"
      },
      "identifier" : [{
        "value" : "1007"
      }],
      "name" : [{
        "given" : ["Carrot",
        "John",
        "Mr"]
      }],
      "gender" : "male",
      "birthDate" : "1962-12-31",
      "generalPractitioner" : [{
        "reference" : "urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Patient"
    }
  },
  {
    "fullUrl" : "urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef",
    "resource" : {
      "resourceType" : "Practitioner",
      "id" : "Inline-Instance-for-oncology-diagnostic-2",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_Inline-Instance-for-oncology-diagnostic-2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner Inline-Instance-for-oncology-diagnostic-2</b></p><a name=\"Inline-Instance-for-oncology-diagnostic-2\"> </a><a name=\"hcInline-Instance-for-oncology-diagnostic-2\"> </a><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Akerman Philip Prof (4654765876)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Practitioner\">Contact Detail</td><td colspan=\"3\">Castro Valley CA </td></tr></table></div>"
      },
      "identifier" : [{
        "value" : "4654765876"
      }],
      "name" : [{
        "given" : ["Akerman",
        "Philip",
        "Prof"]
      }],
      "address" : [{
        "city" : "Castro Valley",
        "state" : "CA"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Practitioner"
    }
  },
  {
    "fullUrl" : "urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d",
    "resource" : {
      "resourceType" : "Specimen",
      "id" : "Inline-Instance-for-oncology-diagnostic-3",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Specimen_Inline-Instance-for-oncology-diagnostic-3\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Specimen Inline-Instance-for-oncology-diagnostic-3</b></p><a name=\"Inline-Instance-for-oncology-diagnostic-3\"> </a><a name=\"hcInline-Instance-for-oncology-diagnostic-3\"> </a><p><b>identifier</b>: 076e1948-2217-11e9-94d8-12e241dc1f66</p><p><b>status</b>: Available</p><p><b>subject</b>: <a href=\"Bundle-bundle-oncology-diagnostic.html#urn-uuid-d0b4affa-91d6-46d1-af01-b30d9f16ef6d\">Carrot John Mr  Male, DoB: 1962-12-31 ( 1007)</a></p><h3>Collections</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Collector</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"Bundle-bundle-oncology-diagnostic.html#urn-uuid-a48256f8-db37-44e0-a0f6-d7af16c7c9ef\">Akerman Philip Prof (4654765876)</a></td></tr></table></div>"
      },
      "identifier" : [{
        "value" : "076e1948-2217-11e9-94d8-12e241dc1f66"
      }],
      "status" : "available",
      "subject" : {
        "reference" : "urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"
      },
      "collection" : {
        "collector" : {
          "reference" : "urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"
        }
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Specimen"
    }
  },
  {
    "fullUrl" : "urn:uuid:40e85eda-4d31-4bd2-a5a0-c39d63f9824f",
    "resource" : {
      "resourceType" : "Observation",
      "id" : "Inline-Instance-for-oncology-diagnostic-4",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/molecular-biomarker"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_Inline-Instance-for-oncology-diagnostic-4\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation Inline-Instance-for-oncology-diagnostic-4</b></p><a name=\"Inline-Instance-for-oncology-diagnostic-4\"> </a><a name=\"hcInline-Instance-for-oncology-diagnostic-4\"> </a><div style=\"display: inline-block; background-color: #fbffeb; 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-molecular-biomarker.html\">Molecular Biomarker</a></p></div><p><b>status</b>: Final</p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>, <span title=\"Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs biomarker-category}\">Biomarker Category</span>, <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}\">Genetics</span></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 94076-7}\">Mutations/Megabase [# Ratio] in Tumor</span></p><p><b>subject</b>: <a href=\"Bundle-bundle-oncology-diagnostic.html#urn-uuid-d0b4affa-91d6-46d1-af01-b30d9f16ef6d\">Carrot John Mr  Male, DoB: 1962-12-31 ( 1007)</a></p><p><b>effective</b>: 2019-03-05</p><p><b>performer</b>: <a href=\"Bundle-bundle-oncology-diagnostic.html#urn-uuid-a48256f8-db37-44e0-a0f6-d7af16c7c9ef\">Akerman Philip Prof (4654765876)</a></p><p><b>value</b>: 25 Mutations/Megabase<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  code1/1000000 = '1/1000000')</span></p><p><b>specimen</b>: <a href=\"Bundle-bundle-oncology-diagnostic.html#urn-uuid-a5d6a6a9-4859-480e-85b2-56974fef3b9d\">Specimen: identifier = 076e1948-2217-11e9-94d8-12e241dc1f66; status = available</a></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs biomarker-category}\">Biomarker Category</span></td><td><span title=\"Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/molecular-biomarker-ontology-cs molgen}\">molecular sequence adjacent category</span></td></tr></table></div>"
      },
      "status" : "final",
      "category" : [{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
          "code" : "laboratory"
        }]
      },
      {
        "coding" : [{
          "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs",
          "code" : "biomarker-category"
        }]
      },
      {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
          "code" : "GE"
        }]
      }],
      "code" : {
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "94076-7",
          "display" : "Mutations/Megabase [# Ratio] in Tumor"
        }]
      },
      "subject" : {
        "reference" : "urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"
      },
      "effectiveDateTime" : "2019-03-05",
      "performer" : [{
        "reference" : "urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"
      }],
      "valueQuantity" : {
        "value" : 25,
        "unit" : "Mutations/Megabase",
        "system" : "http://unitsofmeasure.org",
        "code" : "1/1000000"
      },
      "specimen" : {
        "reference" : "urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"
      },
      "component" : [{
        "code" : {
          "coding" : [{
            "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs",
            "code" : "biomarker-category"
          }]
        },
        "valueCodeableConcept" : {
          "coding" : [{
            "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/molecular-biomarker-ontology-cs",
            "code" : "molgen",
            "display" : "molecular sequence adjacent category"
          }]
        }
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Observation"
    }
  },
  {
    "fullUrl" : "urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d",
    "resource" : {
      "resourceType" : "Observation",
      "id" : "Inline-Instance-for-oncology-diagnostic-5",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/variant"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_Inline-Instance-for-oncology-diagnostic-5\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation Inline-Instance-for-oncology-diagnostic-5</b></p><a name=\"Inline-Instance-for-oncology-diagnostic-5\"> </a><a name=\"hcInline-Instance-for-oncology-diagnostic-5\"> </a><div style=\"display: inline-block; background-color: #fbffeb; 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-variant.html\">Variant</a></p></div><p><b>status</b>: Final</p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>, <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}\">Genetics</span></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 69548-6}\">Genetic variant assessment</span></p><p><b>subject</b>: <a href=\"Bundle-bundle-oncology-diagnostic.html#urn-uuid-d0b4affa-91d6-46d1-af01-b30d9f16ef6d\">Carrot John Mr  Male, DoB: 1962-12-31 ( 1007)</a></p><p><b>effective</b>: 2019-03-05</p><p><b>performer</b>: <a href=\"Bundle-bundle-oncology-diagnostic.html#urn-uuid-a48256f8-db37-44e0-a0f6-d7af16c7c9ef\">Akerman Philip Prof (4654765876)</a></p><p><b>value</b>: <span title=\"Codes:{http://loinc.org LA9633-4}\">Present</span></p><p><b>method</b>: <span title=\"Codes:{http://loinc.org LA26398-0}\">Sequencing</span></p><p><b>specimen</b>: <a href=\"Bundle-bundle-oncology-diagnostic.html#urn-uuid-a5d6a6a9-4859-480e-85b2-56974fef3b9d\">Specimen: identifier = 076e1948-2217-11e9-94d8-12e241dc1f66; status = available</a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 62374-4}\">Human reference sequence assembly version</span></p><p><b>value</b>: <span title=\"Codes:{http://loinc.org LA14029-5}\">GRCh37</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 81290-9}\">Genomic DNA change (gHGVS)</span></p><p><b>value</b>: <span title=\"Codes:{http://varnomen.hgvs.org NC_000007.13:g.140453136A&gt;T}\">NC_000007.13:g.140453136A&gt;T</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 81252-9}\">Discrete genetic variant</span></p><p><b>value</b>: <span title=\"Codes:{http://www.ncbi.nlm.nih.gov/clinvar 13961}\">Clinvar ID 13961</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 48005-3}\">Amino acid change (pHGVS)</span></p><p><b>value</b>: <span title=\"Codes:{http://varnomen.hgvs.org NP_004324.2:p.Val600Glu}\">NP_004324.2:p.Val600Glu</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 48018-6}\">Gene studied ID</span></p><p><b>value</b>: <span title=\"Codes:{http://www.genenames.org HGNC:1097}\">BRAF</span></p></blockquote></div>"
      },
      "status" : "final",
      "category" : [{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
          "code" : "laboratory"
        }]
      },
      {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
          "code" : "GE"
        }]
      }],
      "code" : {
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "69548-6",
          "display" : "Genetic variant assessment"
        }]
      },
      "subject" : {
        "reference" : "urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"
      },
      "effectiveDateTime" : "2019-03-05",
      "performer" : [{
        "reference" : "urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"
      }],
      "valueCodeableConcept" : {
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "LA9633-4",
          "display" : "Present"
        }]
      },
      "method" : {
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "LA26398-0",
          "display" : "Sequencing"
        }]
      },
      "specimen" : {
        "reference" : "urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"
      },
      "component" : [{
        "code" : {
          "coding" : [{
            "system" : "http://loinc.org",
            "code" : "62374-4",
            "display" : "Human reference sequence assembly version"
          }]
        },
        "valueCodeableConcept" : {
          "coding" : [{
            "system" : "http://loinc.org",
            "code" : "LA14029-5",
            "display" : "GRCh37"
          }]
        }
      },
      {
        "code" : {
          "coding" : [{
            "system" : "http://loinc.org",
            "code" : "81290-9",
            "display" : "Genomic DNA change (gHGVS)"
          }]
        },
        "valueCodeableConcept" : {
          "coding" : [{
            "system" : "http://varnomen.hgvs.org",
            "code" : "NC_000007.13:g.140453136A>T",
            "display" : "NC_000007.13:g.140453136A>T"
          }]
        }
      },
      {
        "code" : {
          "coding" : [{
            "system" : "http://loinc.org",
            "code" : "81252-9",
            "display" : "Discrete genetic variant"
          }]
        },
        "valueCodeableConcept" : {
          "coding" : [{
            "system" : "http://www.ncbi.nlm.nih.gov/clinvar",
            "code" : "13961",
            "display" : "Clinvar ID 13961"
          }]
        }
      },
      {
        "code" : {
          "coding" : [{
            "system" : "http://loinc.org",
            "code" : "48005-3",
            "display" : "Amino acid change (pHGVS)"
          }]
        },
        "valueCodeableConcept" : {
          "coding" : [{
            "system" : "http://varnomen.hgvs.org",
            "code" : "NP_004324.2:p.Val600Glu",
            "display" : "NP_004324.2:p.Val600Glu"
          }]
        }
      },
      {
        "code" : {
          "coding" : [{
            "system" : "http://loinc.org",
            "code" : "48018-6",
            "display" : "Gene studied ID"
          }]
        },
        "valueCodeableConcept" : {
          "coding" : [{
            "system" : "http://www.genenames.org",
            "code" : "HGNC:1097",
            "display" : "BRAF"
          }]
        }
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Observation"
    }
  },
  {
    "fullUrl" : "urn:uuid:1bf9642d-fd1c-4819-8c5d-44fae4bad524",
    "resource" : {
      "resourceType" : "Observation",
      "id" : "Inline-Instance-for-oncology-diagnostic-6",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/diagnostic-implication"]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_Inline-Instance-for-oncology-diagnostic-6\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation Inline-Instance-for-oncology-diagnostic-6</b></p><a name=\"Inline-Instance-for-oncology-diagnostic-6\"> </a><a name=\"hcInline-Instance-for-oncology-diagnostic-6\"> </a><div style=\"display: inline-block; background-color: #fbffeb; 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-diagnostic-implication.html\">Diagnostic Implication</a></p></div><p><b>Related artifact</b>: No display for RelatedArtifact  (type: justification; display: https://pmkb.weill.cornell.edu/therapies/103)</p><p><b>status</b>: Final</p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>, <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}\">Genetics</span></p><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs diagnostic-implication}\">Diagnostic Implication</span></p><p><b>subject</b>: <a href=\"Bundle-bundle-oncology-diagnostic.html#urn-uuid-d0b4affa-91d6-46d1-af01-b30d9f16ef6d\">Carrot John Mr  Male, DoB: 1962-12-31 ( 1007)</a></p><p><b>effective</b>: 2019-03-05</p><p><b>performer</b>: <a href=\"Bundle-bundle-oncology-diagnostic.html#urn-uuid-a48256f8-db37-44e0-a0f6-d7af16c7c9ef\">Akerman Philip Prof (4654765876)</a></p><p><b>method</b>: <span title=\"Codes:{http://loinc.org LA26811-2}\">Computational analysis</span></p><p><b>specimen</b>: <a href=\"Bundle-bundle-oncology-diagnostic.html#urn-uuid-a5d6a6a9-4859-480e-85b2-56974fef3b9d\">Specimen: identifier = 076e1948-2217-11e9-94d8-12e241dc1f66; status = available</a></p><p><b>derivedFrom</b>: <a href=\"Bundle-bundle-complexVariant-nonHGVS.html#urn-uuid-16fdd5fc-e665-48af-99e4-48d603f3e12d\">Observation Genetic variant assessment</a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 53037-8}\">Genetic variation clinical significance [Imp]</span></p><p><b>value</b>: <span title=\"Codes:{http://loinc.org LA6668-3}\">Pathogenic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 93044-6}\">Level of Evidence</span></p><p><b>value</b>: <span title=\"Codes:{http://loinc.org LA30200-2}\">Very strong evidence pathogenic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 81259-4}\">Associated phenotype</span></p><p><b>value</b>: <span title=\"Codes:\">melanoma</span></p></blockquote></div>"
      },
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact",
        "valueRelatedArtifact" : {
          "type" : "justification",
          "display" : "https://pmkb.weill.cornell.edu/therapies/103"
        }
      }],
      "status" : "final",
      "category" : [{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
          "code" : "laboratory"
        }]
      },
      {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
          "code" : "GE"
        }]
      }],
      "code" : {
        "coding" : [{
          "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs",
          "code" : "diagnostic-implication",
          "display" : "Diagnostic Implication"
        }]
      },
      "subject" : {
        "reference" : "urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"
      },
      "effectiveDateTime" : "2019-03-05",
      "performer" : [{
        "reference" : "urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"
      }],
      "method" : {
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "LA26811-2",
          "display" : "Computational analysis"
        }]
      },
      "specimen" : {
        "reference" : "urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"
      },
      "derivedFrom" : [{
        "reference" : "urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d"
      }],
      "component" : [{
        "code" : {
          "coding" : [{
            "system" : "http://loinc.org",
            "code" : "53037-8",
            "display" : "Genetic variation clinical significance [Imp]"
          }]
        },
        "valueCodeableConcept" : {
          "coding" : [{
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      "method" : "POST",
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