# betsysmith-johnson01-SMP-Bundle-02-SNFDischarge - PACIO Sample Data Depot v0.1.0

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **betsysmith-johnson01-SMP-Bundle-02-SNFDischarge**

## Example Bundle: betsysmith-johnson01-SMP-Bundle-02-SNFDischarge

Profile: [Standardized Medication Profile - Bundle Medication List](http://hl7.org/fhir/us/smp/STU1/StructureDefinition-smp-bundle.html)

Bundle betsysmith-johnson01-SMP-Bundle-02-SNFDischarge of type collection

-------

Entry 1 - fullUrl = urn:patient-betsysmith-johnson01

Resource Patient:

> 

Last updated: 2021-03-29 14:25:34-0500; Language: en-US

Profile: [US Core Patient Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-patient.html)

Smith-Johnson, Betsy Female, DoB: 1950-11-15 ( http://hl7.org/fhir/sid/us-medicare#United States Medicare Number#1PA3D58WH16)
-------

-------

Entry 2 - fullUrl = urn:bsj1-smp-medListNew-2

Resource List:

> 

## MedicationList for scene 2 - SNF




## Resource Content

```json
{
  "resourceType" : "Bundle",
  "id" : "betsysmith-johnson01-SMP-Bundle-02-SNFDischarge",
  "meta" : {
    "profile" : ["http://hl7.org/fhir/us/smp/StructureDefinition/smp-bundle"]
  },
  "type" : "collection",
  "timestamp" : "2025-07-02T09:00:00Z",
  "entry" : [
    {
      "fullUrl" : "urn:patient-betsysmith-johnson01",
      "resource" : {
        "resourceType" : "Patient",
        "id" : "patient-betsysmith-johnson01",
        "meta" : {
          "lastUpdated" : "2021-03-29T14:25:34.001-05:00",
          "profile" : [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
          ]
        },
        "language" : "en-US",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en-US\" lang=\"en-US\"><a name=\"Patient_patient-betsysmith-johnson01\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient patient-betsysmith-johnson01</b></p><a name=\"patient-betsysmith-johnson01\"> </a><a name=\"hcpatient-betsysmith-johnson01\"> </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\">Last updated: 2021-03-29 14:25:34-0500; Language: en-US</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-patient.html\">US Core Patient Profile</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Smith-Johnson, Betsy Female, DoB: 1950-11-15 ( http://hl7.org/fhir/sid/us-medicare#United States Medicare Number#1PA3D58WH16)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Record is active\">Active:</td><td>true</td><td style=\"background-color: #f3f5da\" title=\"Known Marital status of Patient\">Marital Status:</td><td colspan=\"3\"><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-NullFlavor UNK}\">unknown</span></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Other Ids (see the one above)\">Other Ids:</td><td colspan=\"3\"><ul><li>Medical Record Number/1032702 (use: usual, )</li><li><a href=\"http://terminology.hl7.org/6.1.0/NamingSystem-ssn.html\" title=\"United States Social Security Number (SSN).  Assigned by the U.S. Social Security Administration.  Note: IRS assigned ITINs are often used as drop-ins for social security numbers.  The SSN is represented in resources with dashes removed. See http://www.ssa.gov/.\">United States Social Security Number</a>/SS</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\"><ul><li>ph: 555-555-1111(Mobile)</li><li><a href=\"mailto:mmoen+betsysmithjohnson@mydirectives.com\">mmoen+betsysmithjohnson@mydirectives.com</a></li><li>17040 E Warren Avenue, Detroit, MI 48224</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Language spoken\">Language:</td><td colspan=\"3\"><span title=\"Codes:{urn:ietf:bcp:47 en}\">English</span> (preferred)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Nominated Contact: son\">son:</td><td colspan=\"3\"><ul><li>Charles Johnson</li><li>17040 E Warren Avenue, Detroit, MI 48224</li><li>ph: (555) 555-2222</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Nominated Contact: daughter in-law\">daughter in-law:</td><td colspan=\"3\"><ul><li>Lisa Johnson</li><li>17040 E Warren Avenue, Detroit, MI 48224</li><li>ph: (555) 555-3333</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html#3) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories:\n\n - American Indian or Alaska Native\n - Asian\n - Black or African American\n - Native Hawaiian or Other Pacific Islander\n - White.\">US Core Race Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://hl7.org/fhir/us/core/STU4/CodeSystem-cdcrec.html#cdcrec-2106-3\">Race &amp; Ethnicity - CDC: 2106-3</a> (White)</li><li>text: White</li></ul></td></tr></table></div>"
        },
        "extension" : [
          {
            "extension" : [
              {
                "url" : "ombCategory",
                "valueCoding" : {
                  "system" : "urn:oid:2.16.840.1.113883.6.238",
                  "code" : "2106-3",
                  "display" : "White"
                }
              },
              {
                "url" : "text",
                "valueString" : "White"
              }
            ],
            "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
          }
        ],
        "identifier" : [
          {
            "use" : "usual",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "MR",
                  "display" : "Medical Record Number"
                }
              ],
              "text" : "Medical Record Number"
            },
            "system" : "http://hospital.smarthealthit.org",
            "value" : "1032702"
          },
          {
            "system" : "http://hl7.org/fhir/sid/us-medicare",
            "value" : "1PA3D58WH16",
            "assigner" : {
              "display" : "Medicare"
            }
          },
          {
            "system" : "http://hl7.org/fhir/sid/us-ssn",
            "value" : "SS"
          }
        ],
        "active" : true,
        "name" : [
          {
            "use" : "usual",
            "text" : "Smith-Johnson, Betsy",
            "family" : "Smith-Johnson",
            "given" : ["Betsy"]
          }
        ],
        "telecom" : [
          {
            "system" : "phone",
            "value" : "555-555-1111",
            "use" : "mobile"
          },
          {
            "system" : "email",
            "value" : "mmoen+betsysmithjohnson@mydirectives.com",
            "use" : "mobile"
          }
        ],
        "gender" : "female",
        "birthDate" : "1950-11-15",
        "address" : [
          {
            "text" : "17040 E Warren Avenue, Detroit, MI 48224",
            "line" : ["17040 E Warren Avenue"],
            "city" : "Detroit",
            "state" : "MI",
            "postalCode" : "48224",
            "country" : "US",
            "period" : {
              "start" : "2016-12-06"
            }
          }
        ],
        "maritalStatus" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
              "code" : "UNK"
            }
          ]
        },
        "contact" : [
          {
            "relationship" : [
              {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
                    "code" : "SONC"
                  }
                ]
              }
            ],
            "name" : {
              "text" : "Charles Johnson"
            },
            "telecom" : [
              {
                "system" : "phone",
                "value" : "(555) 555-2222"
              }
            ],
            "address" : {
              "text" : "17040 E Warren Avenue, Detroit, MI 48224"
            }
          },
          {
            "relationship" : [
              {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
                    "code" : "DAUINLAW"
                  }
                ]
              }
            ],
            "name" : {
              "text" : "Lisa Johnson"
            },
            "telecom" : [
              {
                "system" : "phone",
                "value" : "(555) 555-3333"
              }
            ],
            "address" : {
              "text" : "17040 E Warren Avenue, Detroit, MI 48224"
            }
          }
        ],
        "communication" : [
          {
            "language" : {
              "coding" : [
                {
                  "system" : "urn:ietf:bcp:47",
                  "code" : "en",
                  "display" : "English"
                }
              ]
            },
            "preferred" : true
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:bsj1-smp-medListNew-2",
      "resource" : {
        "resourceType" : "List",
        "id" : "bsj1-smp-medListNew-2",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"List_bsj1-smp-medListNew-2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: List bsj1-smp-medListNew-2</b></p><a name=\"bsj1-smp-medListNew-2\"> </a><a name=\"hcbsj1-smp-medListNew-2\"> </a><h2>MedicationList for scene 2 - SNF</h2><table class=\"clstu\"><tr><td>Date: 2025-07-01 16:15:00-0800 </td><td>Mode: Working List </td><td>Status: Current </td><td>Code: Reconciled medication list [Identifier] Episode Pharmacy </td></tr><tr><td>Subject: <a href=\"Patient-patient-betsysmith-johnson01.html\">Betsy Smith-Johnson</a>Source: </td></tr></table><table class=\"grid\"><tr style=\"backgound-color: #eeeeee\"><td><b>Items</b></td></tr><tr><td><a href=\"MedicationStatement-bsj1-smp-medstmt-jardiance-2-1.html\">Jardiance 10 MG Oral Tablet</a></td></tr><tr><td><a href=\"MedicationStatement-bsj1-smp-medstmt-lipitor-2-2.html\">Lipitor 40 MG Oral Tablet</a></td></tr><tr><td><a href=\"MedicationStatement-bsj1-smp-medstmt-metformin-2-3.html\">metFORMIN hydrochloride 500 MG Oral Tablet</a></td></tr><tr><td><a href=\"MedicationStatement-bsj1-smp-medstmt-polyethylene-2-4.html\">polyethylene glycol 3350 17000 MG Powder for Oral Solution</a></td></tr><tr><td><a href=\"MedicationStatement-bsj1-smp-medstmt-sertraline-2-5.html\">sertraline 25 MG Oral Tablet</a></td></tr><tr><td><a href=\"MedicationStatement-bsj1-smp-medstmt-acetaminophen-2-6.html\">acetaminophen 325 MG Oral Tablet</a></td></tr><tr><td><a href=\"MedicationStatement-bsj1-smp-medstmt-carvedilol-2-7.html\">carvedilol 6.25 MG Oral Tablet</a></td></tr><tr><td><a href=\"MedicationStatement-bsj1-smp-medstmt-clopidogrel-2-8.html\">clopidogrel 75 MG Oral Tablet</a></td></tr><tr><td><a href=\"MedicationStatement-bsj1-smp-medstmt-ferrous-2-9.html\">ferrous gluconate 240 MG Oral Tablet</a></td></tr><tr><td><a href=\"MedicationStatement-bsj1-smp-medstmt-ferrous-2-10.html\">ferrous sulfate 44 MG/ML Oral Solution</a></td></tr><tr><td><a href=\"MedicationStatement-bsj1-smp-medstmt-insulin-2-11.html\">insulin isophane, human 70 UNT/ML / insulin, regular, human 30 UNT/ML Injectable Suspension</a></td></tr><tr><td><a href=\"MedicationStatement-bsj1-smp-medstmt-jardiance-2-12.html\">Jardiance 10 MG Oral Tablet</a></td></tr></table></div>"
        },
        "status" : "current",
        "mode" : "working",
        "title" : "MedicationList for scene 2 - SNF",
        "code" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "104203-5",
              "display" : "Reconciled medication list [Identifier] Episode Pharmacy"
            }
          ]
        },
        "subject" : {
          "reference" : "Patient/patient-betsysmith-johnson01",
          "display" : "Betsy Smith-Johnson"
        },
        "date" : "2025-07-01T16:15:00-08:00",
        "source" : {
          "reference" : "PractitionerRole/PractitionerRole-MD-HemaOnko"
        },
        "entry" : [
          {
            "item" : {
              "reference" : "MedicationStatement/bsj1-smp-medstmt-jardiance-2-1",
              "display" : "Jardiance 10 MG Oral Tablet"
            }
          },
          {
            "item" : {
              "reference" : "MedicationStatement/bsj1-smp-medstmt-lipitor-2-2",
              "display" : "Lipitor 40 MG Oral Tablet"
            }
          },
          {
            "item" : {
              "reference" : "MedicationStatement/bsj1-smp-medstmt-metformin-2-3",
              "display" : "metFORMIN hydrochloride 500 MG Oral Tablet"
            }
          },
          {
            "item" : {
              "reference" : "MedicationStatement/bsj1-smp-medstmt-polyethylene-2-4",
              "display" : "polyethylene glycol 3350 17000 MG Powder for Oral Solution"
            }
          },
          {
            "item" : {
              "reference" : "MedicationStatement/bsj1-smp-medstmt-sertraline-2-5",
              "display" : "sertraline 25 MG Oral Tablet"
            }
          },
          {
            "item" : {
              "reference" : "MedicationStatement/bsj1-smp-medstmt-acetaminophen-2-6",
              "display" : "acetaminophen 325 MG Oral Tablet"
            }
          },
          {
            "item" : {
              "reference" : "MedicationStatement/bsj1-smp-medstmt-carvedilol-2-7",
              "display" : "carvedilol 6.25 MG Oral Tablet"
            }
          },
          {
            "item" : {
              "reference" : "MedicationStatement/bsj1-smp-medstmt-clopidogrel-2-8",
              "display" : "clopidogrel 75 MG Oral Tablet"
            }
          },
          {
            "item" : {
              "reference" : "MedicationStatement/bsj1-smp-medstmt-ferrous-2-9",
              "display" : "ferrous gluconate 240 MG Oral Tablet"
            }
          },
          {
            "item" : {
              "reference" : "MedicationStatement/bsj1-smp-medstmt-ferrous-2-10",
              "display" : "ferrous sulfate 44 MG/ML Oral Solution"
            }
          },
          {
            "item" : {
              "reference" : "MedicationStatement/bsj1-smp-medstmt-insulin-2-11",
              "display" : "insulin isophane, human 70 UNT/ML / insulin, regular, human 30 UNT/ML Injectable Suspension"
            }
          },
          {
            "item" : {
              "reference" : "MedicationStatement/bsj1-smp-medstmt-jardiance-2-12",
              "display" : "Jardiance 10 MG Oral Tablet"
            }
          }
        ]
      }
    }
  ]
}

```
