CDC FHIR® Implementation Guide: Anonymized Electronic Initial Case Reporting (eICR), published by APHL. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/lantanagroup/FHIR-us-eicr-anonymized/ and changes regularly. See the Directory of published versions

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: eICR NOT Anonymized Patient Example: NOT Anonymized - XML Representation

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<Patient xmlns="http://hl7.org/fhir">
  <id value="patient-anon-not"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-patient"/>
  </meta>
  <text>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/data-absent-reason">
      <valueCode value="masked"/>
    </extension>
    <status value="empty"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p>MASKED</p></div>
  </text>
  <extension
             url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race">
    <extension url="text">
      <valueString value="White"/>
    </extension>
    <extension url="ombCategory">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2106-3"/>
        <display value="White"/>
      </valueCoding>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity">
    <extension url="text">
      <valueString value="Not Hispanic or Latino"/>
    </extension>
    <extension url="ombCategory">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2186-5"/>
        <display value="Not Hispanic or Latino"/>
      </valueCoding>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex">
    <valueCode value="F"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-genderidentity-extension">
    <extension url="value">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/v3-NullFlavor"/>
          <code value="ASKU"/>
          <display value="asked but unknown"/>
        </coding>
        <text value="asked but unknown"/>
      </valueCodeableConcept>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-tribal-affiliation-extension">
    <extension url="TribeName">
      <valueCoding>
        <system
                value="http://terminology.hl7.org/CodeSystem/v3-TribalEntityUS"/>
        <code value="91"/>
        <display
                 value="Fort Mojave Indian Tribe of Arizona, California &amp; Nevada"/>
      </valueCoding>
    </extension>
    <extension url="EnrolledTribeMember">
      <valueBoolean value="true"/>
    </extension>
  </extension>
  <identifier>
    <use value="usual"/>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="MR"/>
        <display value="Medical Record Number"/>
      </coding>
    </type>
    <system value="http://hospital.smarthealthit.org"/>
    <value value="1032702"/>
  </identifier>
  <active value="true"/>
  <name>
    <family value="Everywoman"/>
    <given value="Eve"/>
    <given value="L"/>
  </name>
  <telecom>
    <system value="phone"/>
    <value value="1-(404)555-1212"/>
    <use value="home"/>
  </telecom>
  <telecom>
    <system value="email"/>
    <value value="eve.everywoman@example.com"/>
  </telecom>
  <gender value="female"/>
  <birthDate>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/data-absent-reason">
      <valueCode value="masked"/>
    </extension>
  </birthDate>
  <deceasedBoolean value="false"/>
  <address>
    <line value="5101 Peachtree St NE"/>
    <city value="Atlanta"/>
    <state value="GA"/>
    <postalCode value="30302"/>
    <country value="US"/>
  </address>
  <contact>
    <relationship>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v3-RoleClass"/>
        <code value="GUARD"/>
      </coding>
    </relationship>
    <name>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/data-absent-reason">
        <valueCode value="masked"/>
      </extension>
    </name>
    <telecom>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/data-absent-reason">
        <valueCode value="masked"/>
      </extension>
    </telecom>
    <address>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/data-absent-reason">
        <valueCode value="masked"/>
      </extension>
    </address>
  </contact>
  <communication>
    <language>
      <coding>
        <system value="urn:ietf:bcp:47"/>
        <code value="en"/>
        <display value="English"/>
      </coding>
    </language>
  </communication>
</Patient>