PACIO Sample Data Depot
0.1.0 - draft

PACIO Sample Data Depot, published by MITRE. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/paciowg/sample-data-fsh/ and changes regularly. See the Directory of published versions

## Example Bundle: 46349c26-30b3-4f36-94a6-f9ddfe4b7426

Last updated: 2025-06-20 16:47:25+0000

Bundle 46349c26-30b3-4f36-94a6-f9ddfe4b7426 of type searchset

Entry 1 - fullUrl = https://gw.interop.community/cmspqrs/open/Questionnaire/44249-1

Search:Mode = match

Resource Questionnaire:

> version: 1; Last updated: 2025-05-28 18:06:29+0000;

> Information Source: #aLYUC2N4J9eLQ33k

> Structure

> LinkID | Text | Cardinality | Type | Description & Constraints
> --- | --- | --- | --- | ---
> PHQ_quick_depression_assessment_panel |  |  | Questionnaire | http://loinc.org/q/44249-1
> 14363 | PHQ-9.1. Little interest or pleasure in doing things | 1..1 | choice | Options: 4 options
> 14364 | PHQ-9.2. Feeling down, depressed, or hopeless | 1..1 | choice | Options: 4 options
> 14365 | Trouble falling or staying asleep, or sleeping too much | 1..1 | choice | Options: 4 options
> 14366 | Feeling tired or having little energy | 1..1 | choice | Options: 4 options
> 14367 | Poor appetite or overeating | 1..1 | choice | Options: 4 options
> 14368 | Feeling bad about yourself-or that you are a failure or have let yourself or your family down | 1..1 | choice | Options: 4 options
> 14369 | Trouble concentrating on things, such as reading the newspaper or watching television | 1..1 | choice | Options: 4 options
> 14370 | Moving or speaking so slowly that other people could have noticed. Or the opposite-being so fidgety or restless that you have been moving around a lot more than usual | 1..1 | choice | Options: 4 options
> 14371 | Thoughts that you would be better off dead, or of hurting yourself in some way | 0..1 | choice | Options: 4 options
> 57492 | How difficult have these problems made it for you to do your work, take care of things at home, or get along with other people? | 0..1 | choice | Options: 4 options
> 14372 | Patient health questionnaire 9 item total score | 0..1 | decimal |
> Documentation for this format

> Options Sets

> Answer options for 14363

> - http://loinc.org#LA6568-5 ("Not at all")
> - http://loinc.org#LA6569-3 ("Several days")
> - http://loinc.org#LA6570-1 ("More than half the days")
> - http://loinc.org#LA6571-9 ("Nearly every day")

> Answer options for 14364

> - http://loinc.org#LA6568-5 ("Not at all")
> - http://loinc.org#LA6569-3 ("Several days")
> - http://loinc.org#LA6570-1 ("More than half the days")
> - http://loinc.org#LA6571-9 ("Nearly every day")

> Answer options for 14365

> - http://loinc.org#LA6568-5 ("Not at all")
> - http://loinc.org#LA6569-3 ("Several days")
> - http://loinc.org#LA6570-1 ("More than half the days")
> - http://loinc.org#LA6571-9 ("Nearly every day")

> Answer options for 14366

> - http://loinc.org#LA6568-5 ("Not at all")
> - http://loinc.org#LA6569-3 ("Several days")
> - http://loinc.org#LA6570-1 ("More than half the days")
> - http://loinc.org#LA6571-9 ("Nearly every day")

> Answer options for 14367

> - http://loinc.org#LA6568-5 ("Not at all")
> - http://loinc.org#LA6569-3 ("Several days")
> - http://loinc.org#LA6570-1 ("More than half the days")
> - http://loinc.org#LA6571-9 ("Nearly every day")

> Answer options for 14368

> - http://loinc.org#LA6568-5 ("Not at all")
> - http://loinc.org#LA6569-3 ("Several days")
> - http://loinc.org#LA6570-1 ("More than half the days")
> - http://loinc.org#LA6571-9 ("Nearly every day")

> Answer options for 14369

> - http://loinc.org#LA6568-5 ("Not at all")
> - http://loinc.org#LA6569-3 ("Several days")
> - http://loinc.org#LA6570-1 ("More than half the days")
> - http://loinc.org#LA6571-9 ("Nearly every day")

> Answer options for 14370

> - http://loinc.org#LA6568-5 ("Not at all")
> - http://loinc.org#LA6569-3 ("Several days")
> - http://loinc.org#LA6570-1 ("More than half the days")
> - http://loinc.org#LA6571-9 ("Nearly every day")

> Answer options for 14371

> - http://loinc.org#LA6568-5 ("Not at all")
> - http://loinc.org#LA6569-3 ("Several days")
> - http://loinc.org#LA6570-1 ("More than half the days")
> - http://loinc.org#LA6571-9 ("Nearly every day")

> Answer options for 57492

> - http://loinc.org#LA6572-7 ("Not difficult at all")
> - http://loinc.org#LA6573-5 ("Somewhat difficult")
> - http://loinc.org#LA6575-0 ("Very difficult")
> - http://loinc.org#LA6574-3 ("Extremely difficult")

Entry 2 - fullUrl = https://gw.interop.community/cmspqrs/open/Questionnaire/52

Search:Mode = match

Resource Questionnaire:

> version: 1; Last updated: 2025-06-10 19:04:47+0000;

> Information Source: #zOBHLc4oJjsM2fkp

> Structure

> LinkID | Text | Cardinality | Type | Flags | Description & Constraints
> --- | --- | --- | --- | --- | ---
> ZBI-22 | Zarit Burden Interview (ZBI) |  | Questionnaire |  | https://globalalliantinc.com/fhir/questionnaires/ZBI-22#1.0.0
> mbi | What is this patient's Medicare Beneficiary Identifier (MBI)? | 1..1 | string |  |
> first_name | What is the patient's first name? | 1..1 | string |  | Max Length: 100
> last_name | What is the patient's last name? | 1..1 | string |  | Max Length: 100
> date_of_birth | What is this patient's date of birth? | 1..1 | date |  |
> pcg_first_name | What is the primary caregiver's first name? | 1..1 | string |  | Max Length: 100
> pcg_last_name | What is the primary caregiver's last name? | 1..1 | string |  | Max Length: 100
> assessment_date | Please report the date this assessment was complete. | 1..1 | date |  |
> ask_more | Do you feel that your relative asks for more help than he/she needs? | 1..1 | choice |  | Options: 5 options
> enough_time | Do you feel that because of the time you spend with your relative that you don't have enough time for yourself? | 1..1 | choice |  | Options: 5 options
> stressed | Do you feel stressed between caring for your relative and trying to meet other responsibilities for your family or work? | 1..1 | choice |  | Options: 5 options
> embarrassed | Do you feel embarrassed over your relative's behavior? | 1..1 | choice |  | Options: 5 options
> angry | Do you feel angry when you are around your relative? | 1..1 | choice |  | Options: 5 options
> affects_relationships | Do you feel that your relative currently affects your relationship with other family members or friends in a negative way? | 1..1 | choice |  | Options: 5 options
> afraid_future | Are you afraid what the future holds for your relative? | 1..1 | choice |  | Options: 5 options
> dependent | Do you feel your relative is dependent upon you? | 1..1 | choice |  | Options: 5 options
> strained | Do you feel strained when you are around your relative? | 1..1 | choice |  | Options: 5 options
> health_suffered | Do you feel your health has suffered because of your involvement with your relative? | 1..1 | choice |  | Options: 5 options
> privacy | Do you feel that you don't have as much privacy as you would like, because of your relative? | 1..1 | choice |  | Options: 5 options
> social_life | Do you feel that your social life has suffered because you are caring for your relative? | 1..1 | choice |  | Options: 5 options
> uncomfortable | Do you feel uncomfortable about having friends over, because of your relative? | 1..1 | choice |  | Options: 5 options
> expectation | Do you feel that your relative seems to expect you to take care of him/her, as if you were the only one he/she could depend on? | 1..1 | choice |  | Options: 5 options
> enough_money | Do you feel that you don't have enough money to care for your relative, in addition to the rest of your expenses? | 1..1 | choice |  | Options: 5 options
> much_longer | Do you feel that you will be unable to take care of your relative much longer? | 1..1 | choice |  | Options: 5 options
> lost_control | Do you feel you have lost control of your life since your relative's illness? | 1..1 | choice |  | Options: 5 options
> leave_care | Do you wish you could just leave the care of your relative to someone else? | 1..1 | choice |  | Options: 5 options
> uncertain | Do you feel uncertain about what to do about your relative? | 1..1 | choice |  | Options: 5 options
> do_more | Do you feel you should be doing more for your relative? | 1..1 | choice |  | Options: 5 options
> better_job | Do you feel you could do a better job in caring for your relative? | 1..1 | choice |  | Options: 5 options
> overall_burden | Overall, how burdened do you feel in caring for your relative? | 1..1 | choice |  | Options: 5 options
> Documentation for this format

> Options Sets

> Answer options for ask_more

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for enough_time

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for stressed

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for embarrassed

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for angry

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for affects_relationships

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for afraid_future

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for dependent

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for strained

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for health_suffered

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for privacy

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for social_life

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for uncomfortable

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for expectation

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for enough_money

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for much_longer

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for lost_control

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for leave_care

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for uncertain

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for do_more

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for better_job

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for overall_burden

> - null#0 ("Not at all")
> - null#1 ("A little bit")
> - null#2 ("Moderately")
> - null#3 ("Quite a bit")
> - null#4 ("Extremely")

Entry 3 - fullUrl = https://gw.interop.community/cmspqrs/open/Questionnaire/questionnaire-ZBI22

Search:Mode = match

Resource Questionnaire:

> version: 1; Last updated: 2025-06-12 13:01:35+0000;

> Information Source: #jhl8BZ4aslKK0xGI

> Structure

> LinkID | Text | Cardinality | Type | Flags | Description & Constraints
> --- | --- | --- | --- | --- | ---
> ZBI-22 | Zarit Burden Interview (ZBI) |  | Questionnaire |  | https://globalalliantinc.com/fhir/questionnaires/ZBI-22#0.1.0
> first_name | What is the patient's first name? | 1..1 | string |  | Max Length: 100
> last_name | What is the patient's last name? | 1..1 | string |  | Max Length: 100
> date_of_birth | What is this patient's date of birth? | 1..1 | date |  |
> mbi | What is this patient's Medicare Beneficiary Identifier (MBI)? | 1..1 | string |  |
> pcg_first_name | What is the primary caregiver's first name? | 1..1 | string |  | Max Length: 100
> pcg_last_name | What is the primary caregiver's last name? | 1..1 | string |  | Max Length: 100
> assessment_date | Please report the date this assessment was complete. | 1..1 | date |  |
> ask_more | Do you feel that your relative asks for more help than he/she needs? | 1..1 | choice |  | Options: 5 options
> enough_time | Do you feel that because of the time you spend with your relative that you don’t have enough time for yourself? | 1..1 | choice |  | Options: 5 options
> stressed | Do you feel stressed between caring for your relative and trying to meet other responsibilities for your family or work? | 1..1 | choice |  | Options: 5 options
> embarrassed | Do you feel embarrassed over your relative’s behavior? | 1..1 | choice |  | Options: 5 options
> angry | Do you feel angry when you are around your relative? | 1..1 | choice |  | Options: 5 options
> affects_relationships | Do you feel that your relative currently affects your relationship with other family members or friends in a negative way? | 1..1 | choice |  | Options: 5 options
> afraid_future | Are you afraid what the future holds for your relative? | 1..1 | choice |  | Options: 5 options
> dependent | Do you feel your relative is dependent upon you? | 1..1 | choice |  | Options: 5 options
> strained | Do you feel strained when you are around your relative? | 1..1 | choice |  | Options: 5 options
> health_suffered | Do you feel your health has suffered because of your involvement with your relative? | 1..1 | choice |  | Options: 5 options
> privacy | Do you feel that you don’t have as much privacy as you would like, because of your relative? | 1..1 | choice |  | Options: 5 options
> social_life | Do you feel that your social life has suffered because you are caring for your relative? | 1..1 | choice |  | Options: 5 options
> uncomfortable | Do you feel uncomfortable about having friends over, because of your relative? | 1..1 | choice |  | Options: 5 options
> expectation | Do you feel that your relative seems to expect you to take care of him/her, as if you were the only one he/she could depend on? | 1..1 | choice |  | Options: 5 options
> enough_money | Do you feel that you don’t have enough money to care for your relative, in addition to the rest of your expenses? | 1..1 | choice |  | Options: 5 options
> much_longer | Do you feel that you will be unable to take care of your relative much longer? | 1..1 | choice |  | Options: 5 options
> lost_control | Do you feel you have lost control of your life since your relative’s illness? | 1..1 | choice |  | Options: 5 options
> leave_care | Do you wish you could just leave the care of your relative to someone else? | 1..1 | choice |  | Options: 5 options
> uncertain | Do you feel uncertain about what to do about your relative? | 1..1 | choice |  | Options: 5 options
> do_more | Do you feel you should be doing more for your relative? | 1..1 | choice |  | Options: 5 options
> better_job | Do you feel you could do a better job in caring for your relative? | 1..1 | choice |  | Options: 5 options
> overall_burden | Overall, how burdened do you feel in caring for your relative? | 1..1 | choice |  | Options: 5 options
> Documentation for this format

> Options Sets

> Answer options for ask_more

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for enough_time

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for stressed

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for embarrassed

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for angry

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for affects_relationships

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for afraid_future

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for dependent

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for strained

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for health_suffered

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for privacy

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for social_life

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for uncomfortable

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for expectation

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for enough_money

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for much_longer

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for lost_control

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for leave_care

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for uncertain

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for do_more

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for better_job

> - null#0 ("Never")
> - null#1 ("Rarely")
> - null#2 ("Sometimes")
> - null#3 ("Quite Frequently")
> - null#4 ("Nearly Always")

> Answer options for overall_burden

> - null#0 ("Not at all")
> - null#1 ("A little bit")
> - null#2 ("Moderately")
> - null#3 ("Quite a bit")
> - null#4 ("Extremely")