From 6425ea48f016e60581f570bb7498da6cd38623ae Mon Sep 17 00:00:00 2001 From: Jason Kulatunga Date: Wed, 5 Oct 2022 22:01:23 -0700 Subject: [PATCH] adding Base64 methods Adding tests for BaseClient Adding Fhir401Client Adding fixtures for BaseClient and Fhir401Client --- README.md | 3 + .../lib/conduit/fhir/base/base_client.spec.ts | 65 +- .../src/lib/conduit/fhir/base/base_client.ts | 26 +- .../fhir/base/fhir401_r4_client.spec.ts | 80 + .../conduit/fhir/base/fhir401_r4_client.ts | 62 + .../fixtures/BaseClient_GetFhirVersion.json | 1990 ++ .../base/fixtures/BaseClient_GetRequest.json | 159 + .../fixtures/FHIR401Client_ProcessBundle.json | 16695 ++++++++++++++++ frontend/src/lib/conduit/interface.ts | 33 +- frontend/src/lib/database/constants.ts | 3 +- frontend/src/lib/database/interface.ts | 10 + .../lib/database/pouchdb_repository.spec.ts | 2 +- .../src/lib/database/pouchdb_repository.ts | 36 + .../src/lib/models/database/resource_fhir.ts | 32 + frontend/src/lib/models/database/source.ts | 6 +- frontend/src/lib/utils/base64.ts | 8 + frontend/tsconfig.spec.json | 1 + 17 files changed, 19179 insertions(+), 32 deletions(-) create mode 100644 frontend/src/lib/conduit/fhir/base/fhir401_r4_client.spec.ts create mode 100644 frontend/src/lib/conduit/fhir/base/fhir401_r4_client.ts create mode 100644 frontend/src/lib/conduit/fhir/base/fixtures/BaseClient_GetFhirVersion.json create mode 100644 frontend/src/lib/conduit/fhir/base/fixtures/BaseClient_GetRequest.json create mode 100644 frontend/src/lib/conduit/fhir/base/fixtures/FHIR401Client_ProcessBundle.json create mode 100644 frontend/src/lib/models/database/resource_fhir.ts create mode 100644 frontend/src/lib/utils/base64.ts diff --git a/README.md b/README.md index 244ce683..9dc55377 100644 --- a/README.md +++ b/README.md @@ -6,3 +6,6 @@ Find & replace the following - `fastenhealth` - find and replace this with your binary name - make sure you rename the folder as well. +# Running tests + +- ng test --include='**/base_client.spec.ts' diff --git a/frontend/src/lib/conduit/fhir/base/base_client.spec.ts b/frontend/src/lib/conduit/fhir/base/base_client.spec.ts index f63ba260..d501ef81 100644 --- a/frontend/src/lib/conduit/fhir/base/base_client.spec.ts +++ b/frontend/src/lib/conduit/fhir/base/base_client.spec.ts @@ -1,6 +1,8 @@ - import {BaseClient} from './base_client'; import {Source} from '../../../models/database/source'; +import * as BaseClient_GetRequest from './fixtures/BaseClient_GetRequest.json'; +import * as BaseClient_GetFhirVersion from './fixtures/BaseClient_GetFhirVersion.json'; + class TestClient extends BaseClient { constructor(source: Source) { @@ -13,25 +15,19 @@ describe('BaseClient', () => { beforeEach(async () => { client = new TestClient(new Source({ - "authorization_endpoint": "https://auth.logicahealth.org/authorize", - "token_endpoint": "https://auth.logicahealth.org/token", - "introspection_endpoint": "https://auth.logicahealth.org/introspect", - "userinfo_endpoint": "", - "scopes_supported": ["openid", "fhirUser", "patient/*.read", "offline_access"], - "issuer": "https://auth.logicahealth.org", - "grant_types_supported": ["authorization_code"], - "response_types_supported": ["code"], - "aud": "", - "code_challenge_methods_supported": ["S256"], - "api_endpoint_base_url": "https://api.logicahealth.org/fastenhealth/data", - "client_id": "12b14c49-a4da-42f7-9e6f-2f19db622962", - "redirect_uri": "https://lighthouse.fastenhealth.com/sandbox/callback/logica", + "authorization_endpoint": "https://fhirsandbox.healthit.gov/open/r4/authorize", + "token_endpoint": "https://fhirsandbox.healthit.gov/open/r4/token", + "introspection_endpoint": "", + "issuer": "https://fhirsandbox.healthit.go", + "api_endpoint_base_url": "https://fhirsandbox.healthit.gov/secure/r4/fhir", + "client_id": "9ad3ML0upIMiawLVdM5-DiPinGcv7M", + "redirect_uri": "https://lighthouse.fastenhealth.com/sandbox/callback/healthit", "confidential": false, - "source_type": "logica", - "patient": "smart-1288992", - "access_token": "xxx.xxx.xxx", - "refresh_token": "xxx.xxx.", - "expires_at": 1664949030, + "source_type": "healthit", + "patient": "placeholder", + "access_token": "2e1be8c72d4d5225aae264a1fb7e1d3e", + "refresh_token": "", + "expires_at": 16649837100, //aug 11, 2497 (for testing) })); }); @@ -41,14 +37,35 @@ describe('BaseClient', () => { describe('GetRequest', () => { it('should make an authorized request', async () => { - const resp = await client.GetRequest("Patient/smart-1288992") - expect(resp).toEqual({ - resourceType: "Patient", - id: "source:aetna:patient" - }); + //setup + let response = new Response(JSON.stringify(BaseClient_GetRequest)); + Object.defineProperty(response, "url", { value: `${client.source.api_endpoint_base_url}/Patient/${client.source.patient}`}); + spyOn(window, "fetch").and.returnValue(Promise.resolve(response)); + + //test + const resp = await client.GetRequest(`Patient/${client.source.patient}`) + + //expect + expect(resp.resourceType).toEqual("Patient"); + expect(resp.id).toEqual("123d41e1-0f71-4e9f-8eb2-d1b1330201a6"); }); }) + describe('GetFhirVersion', () => { + it('should make an authorized request', async () => { + //setup + let response = new Response(JSON.stringify(BaseClient_GetFhirVersion)); + Object.defineProperty(response, "url", { value: `${client.source.api_endpoint_base_url}/metadata`}); + spyOn(window, "fetch").and.returnValue(Promise.resolve(response)); + + //test + const resp = await client.GetFhirVersion() + + //expect + expect(resp).toEqual("4.0.1"); + }); + }); + }) diff --git a/frontend/src/lib/conduit/fhir/base/base_client.ts b/frontend/src/lib/conduit/fhir/base/base_client.ts index 10916bae..b16c1fe4 100644 --- a/frontend/src/lib/conduit/fhir/base/base_client.ts +++ b/frontend/src/lib/conduit/fhir/base/base_client.ts @@ -1,6 +1,6 @@ import {Source} from '../../../models/database/source'; import * as Oauth from '@panva/oauth4webapi'; -import {IResourceInterface} from '../../interface'; +import {IResourceRaw} from '../../interface'; // BaseClient is an abstract/partial class, its intended to be used by FHIR clients, and generically handle OAuth requests. export abstract class BaseClient { @@ -26,8 +26,14 @@ export abstract class BaseClient { } } + public async GetFhirVersion(): Promise { + return this.GetRequest("metadata") + .then((resp) => { + return resp.fhirVersion + }) + } - public async GetRequest(resourceSubpathOrNext: string): Promise { + public async GetRequest(resourceSubpathOrNext: string): Promise { //check if the url is absolute let resourceUrl: string @@ -53,6 +59,22 @@ export abstract class BaseClient { // return err } + ///////////////////////////////////////////////////////////////////////////// + // Protected methods + ///////////////////////////////////////////////////////////////////////////// + + protected GetPatientBundle(patientId: string): Promise { + return this.GetRequest(`Patient/${patientId}/$everything`) + } + + protected GetPatient(patientId: string): Promise { + return this.GetRequest(`Patient/${patientId}`) + } + + ///////////////////////////////////////////////////////////////////////////// + // Private methods + ///////////////////////////////////////////////////////////////////////////// + private async refreshExpiredTokenIfRequired(source: Source): Promise { //check if token has expired, and a refreshtoken is available // Note: source.expires_at is in seconds, Date.now() is in milliseconds. diff --git a/frontend/src/lib/conduit/fhir/base/fhir401_r4_client.spec.ts b/frontend/src/lib/conduit/fhir/base/fhir401_r4_client.spec.ts new file mode 100644 index 00000000..a389851b --- /dev/null +++ b/frontend/src/lib/conduit/fhir/base/fhir401_r4_client.spec.ts @@ -0,0 +1,80 @@ +import {FHIR401Client} from './fhir401_r4_client'; +import {Source} from '../../../models/database/source'; +import * as FHIR401Client_ProcessBundle from './fixtures/FHIR401Client_ProcessBundle.json'; +import {IResourceBundleRaw} from '../../interface'; +import {ResourceFhir} from '../../../models/database/resource_fhir'; +import {NewRepositiory} from '../../../database/pouchdb_repository'; +import {Base64} from '../../../utils/base64'; + +class TestClient extends FHIR401Client { + constructor(source: Source) { + super(source); + } + + public async ProcessBundle(bundle: IResourceBundleRaw): Promise { + return super.ProcessBundle(bundle); + } +} + +describe('FHIR401Client', () => { + let client: TestClient; + + beforeEach(async () => { + client = new TestClient(new Source({ + "_id": "source:aetna:12345", + "authorization_endpoint": "https://fhirsandbox.healthit.gov/open/r4/authorize", + "token_endpoint": "https://fhirsandbox.healthit.gov/open/r4/token", + "introspection_endpoint": "", + "issuer": "https://fhirsandbox.healthit.go", + "api_endpoint_base_url": "https://fhirsandbox.healthit.gov/secure/r4/fhir", + "client_id": "9ad3ML0upIMiawLVdM5-DiPinGcv7M", + "redirect_uri": "https://lighthouse.fastenhealth.com/sandbox/callback/healthit", + "confidential": false, + "source_type": "healthit", + "patient": "placeholder", + "access_token": "2e1be8c72d4d5225aae264a1fb7e1d3e", + "refresh_token": "", + "expires_at": 16649837100, //aug 11, 2497 (for testing) + })); + }); + + it('should be created', () => { + expect(client).toBeTruthy(); + }); + + describe('ProcessBundle', () => { + it('should correctly wrap each BundleEntry with ResourceFhir', async () => { + + //setup + + //test + const resp = await client.ProcessBundle(FHIR401Client_ProcessBundle) + //expect + expect(resp.length).toEqual(206); + expect(resp[0].source_resource_id).toEqual("c088b7af-fc41-43cc-ab80-4a9ab8d47cd9"); + expect(resp[0].source_resource_type).toEqual("Patient"); + }); + }) + + describe('SyncAll', () => { + it('should correctly add resources to the database', async () => { + //setup + let response = new Response(JSON.stringify(FHIR401Client_ProcessBundle)); + Object.defineProperty(response, "url", { value: `${client.source.api_endpoint_base_url}/Patient/${client.source.patient}/$everything`}); + spyOn(window, "fetch").and.returnValue(Promise.resolve(response)); + const db = NewRepositiory("fastentest") + + //test + const resp = await client.SyncAll(db) + const firstResourceFhir = resp[0] + const resourceIdParts = firstResourceFhir.split(":") + + //expect + expect(resp.length).toEqual(206); + expect(firstResourceFhir).toEqual('resource_fhir:c291cmNlOmFldG5hOjEyMzQ1:Patient:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9'); + expect(Base64.Decode(resourceIdParts[1])).toEqual("source:aetna:12345"); + + }); + }) + +}) diff --git a/frontend/src/lib/conduit/fhir/base/fhir401_r4_client.ts b/frontend/src/lib/conduit/fhir/base/fhir401_r4_client.ts new file mode 100644 index 00000000..e4363f8b --- /dev/null +++ b/frontend/src/lib/conduit/fhir/base/fhir401_r4_client.ts @@ -0,0 +1,62 @@ +import {IClient, IResourceBundleRaw, IResourceRaw} from '../../interface'; +import {BaseClient} from './base_client'; +import {Source} from '../../../models/database/source'; +import {IDatabaseRepository} from '../../../database/interface'; +import {ResourceFhir} from '../../../models/database/resource_fhir'; + +export class FHIR401Client extends BaseClient implements IClient { + + //clients extending this class must validate fhirVersion matches using conformance/metadata url. + fhirVersion = "4.0.1" + + constructor(source: Source) { + super(source); + } + + public async SyncAll(db: IDatabaseRepository): Promise { + const bundle = await this.GetPatientBundle(this.source.patient) + + const wrappedResourceModels = await this.ProcessBundle(bundle) + //todo, create the resources in dependency order + + //TODO bulk insert + // for(let dbModel of wrappedResourceModels){ + // db.CreateResource(dbModel) + // } + console.log(wrappedResourceModels) + return db.CreateResources(wrappedResourceModels) + + } + + public async SyncAllBundle(db: IDatabaseRepository, bundleFile: any): Promise { + return Promise.resolve(undefined); + } + + ///////////////////////////////////////////////////////////////////////////// + // Protected methods + ///////////////////////////////////////////////////////////////////////////// + protected async ProcessBundle(bundle: IResourceBundleRaw): Promise { + // console.log(bundle) + // process each entry in bundle + return bundle.entry + .filter((bundleEntry) => { + return bundleEntry.resource.id // keep this entry if it has an ID, skip otherwise. + }) + .map((bundleEntry) => { + const wrappedResourceModel = new ResourceFhir() + wrappedResourceModel.source_id = this.source._id + wrappedResourceModel.source_resource_id = bundleEntry.resource.id + wrappedResourceModel.source_resource_type = bundleEntry.resource.resourceType + wrappedResourceModel.resource_raw = bundleEntry.resource + // TODO find a way to safely/consistently get the resource updated date (and other metadata) which shoudl be added to the model. + // wrappedResourceModel.updated_at = bundleEntry.resource.meta?.lastUpdated + return wrappedResourceModel + }) + + + } + + ///////////////////////////////////////////////////////////////////////////// + // Private methods + ///////////////////////////////////////////////////////////////////////////// +} diff --git a/frontend/src/lib/conduit/fhir/base/fixtures/BaseClient_GetFhirVersion.json b/frontend/src/lib/conduit/fhir/base/fixtures/BaseClient_GetFhirVersion.json new file mode 100644 index 00000000..42174507 --- /dev/null +++ b/frontend/src/lib/conduit/fhir/base/fixtures/BaseClient_GetFhirVersion.json @@ -0,0 +1,1990 @@ +{ + "date": "2021-08-13T12:25:53.113552", + "fhirVersion": "4.0.1", + "format": [ + "application/fhir+json" + ], + "implementation": { + "description": "PatientAccess API", + "url": "https://p-hi2.digitaledge.cigna.com/PatientAccess/v1" + }, + "kind": "instance", + "publisher": "Cigna, Inc.", + "rest": [ + { + "mode": "server", + "resource": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "search-type" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "searchParam": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-allergyintolerance-patient", + "documentation": "The client **SHALL** provide at least a id value and **MAY** provide both the Type and id values.\n\nThe server **SHALL** support both.", + "name": "patient", + "type": "reference" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/Resource-lastUpdated", + "name": "_lastUpdated", + "type": "date" + } + ], + "searchRevInclude": [ + "Provenance:target" + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance" + ], + "type": "AllergyIntolerance" + }, + { + "extension": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "url": "required", + "valueString": "patient" + }, + { + "url": "required", + "valueString": "category" + } + ], + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination" + }, + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "search-type" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "searchParam": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-careplan-category", + "documentation": "The client **SHALL** provide at least a code value and **MAY** provide both the system and code values.\n\nThe server **SHALL** support both.", + "name": "category", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-careplan-patient", + "documentation": "The client **SHALL** provide at least a id value and **MAY** provide both the Type and id values.\n\nThe server **SHALL** support both.", + "name": "patient", + "type": "reference" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/Resource-lastUpdated", + "name": "_lastUpdated", + "type": "date" + } + ], + "searchRevInclude": [ + "Provenance:target" + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan" + ], + "type": "CarePlan" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "url": "required", + "valueString": "patient" + }, + { + "url": "required", + "valueString": "status" + } + ], + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "search-type" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "searchParam": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-careteam-patient", + "documentation": "The client **SHALL** provide at least a id value and **MAY** provide both the Type and id values.\n\nThe server **SHALL** support both.", + "name": "patient", + "type": "reference" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-careteam-status", + "documentation": "The client **SHALL** provide at least a code value and **MAY** provide both the system and code values.\n\nThe server **SHALL** support both.", + "name": "status", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/Resource-lastUpdated", + "name": "_lastUpdated", + "type": "date" + } + ], + "searchRevInclude": [ + "Provenance:target" + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam" + ], + "type": "CareTeam" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "search-type" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "searchParam": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-condition-patient", + "documentation": "The client **SHALL** provide at least a id value and **MAY** provide both the Type and id values.\n\nThe server **SHALL** support both.", + "name": "patient", + "type": "reference" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/Resource-lastUpdated", + "name": "_lastUpdated", + "type": "date" + } + ], + "searchRevInclude": [ + "Provenance:target" + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition" + ], + "type": "Condition" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "search-type" + } + ], + "searchInclude": [ + "Coverage:payor" + ], + "searchParam": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "documentation": "The client **SHALL** provide at least a id value and **MAY** provide both the Type and id values.\n\nThe server **SHALL** support both.", + "name": "patient", + "type": "reference" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/Resource-lastUpdated", + "name": "_lastUpdated", + "type": "date" + } + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage" + ], + "type": "Coverage" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "search-type" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "searchParam": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-device-patient", + "documentation": "The client **SHALL** provide at least a id value and **MAY** provide both the Type and id values.\n\nThe server **SHALL** support both.", + "name": "patient", + "type": "reference" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/Resource-lastUpdated", + "name": "_lastUpdated", + "type": "date" + } + ], + "searchRevInclude": [ + "Provenance:target" + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-implantable-device" + ], + "type": "Device" + }, + { + "extension": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "url": "required", + "valueString": "patient" + }, + { + "url": "required", + "valueString": "category" + }, + { + "url": "required", + "valueString": "date" + } + ], + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "url": "required", + "valueString": "patient" + }, + { + "url": "required", + "valueString": "category" + } + ], + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination" + }, + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "url": "required", + "valueString": "patient" + }, + { + "url": "required", + "valueString": "code" + } + ], + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "search-type" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "searchParam": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-diagnosticreport-category", + "documentation": "The client **SHALL** provide at least a code value and **MAY** provide both the system and code values.\n\nThe server **SHALL** support both.", + "name": "category", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-diagnosticreport-code", + "documentation": "The client **SHALL** provide at least a code value and **MAY** provide both the system and code values.\n\nThe server **SHALL** support both.", + "name": "code", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-diagnosticreport-date", + "documentation": "A client **SHALL** provide a value precise to the *second + time offset*.\n\nA server **SHALL** support a value precise to the *second + time offset*.", + "name": "date", + "type": "date" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-diagnosticreport-patient", + "documentation": "The client **SHALL** provide at least a id value and **MAY** provide both the Type and id values.\n\nThe server **SHALL** support both.", + "name": "patient", + "type": "reference" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/Resource-lastUpdated", + "name": "_lastUpdated", + "type": "date" + } + ], + "searchRevInclude": [ + "Provenance:target" + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-lab", + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" + ], + "type": "DiagnosticReport" + }, + { + "extension": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "url": "required", + "valueString": "patient" + }, + { + "url": "required", + "valueString": "category" + }, + { + "url": "required", + "valueString": "date" + } + ], + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "url": "required", + "valueString": "patient" + }, + { + "url": "required", + "valueString": "type" + } + ], + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "url": "required", + "valueString": "patient" + }, + { + "url": "required", + "valueString": "category" + } + ], + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination" + }, + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "search-type" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "searchParam": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-documentreference-id", + "name": "_id", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-documentreference-category", + "documentation": "The client **SHALL** provide at least a code value and **MAY** provide both the system and code values.\n\nThe server **SHALL** support both.", + "name": "category", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-documentreference-date", + "documentation": "A client **SHALL** provide a value precise to the *second + time offset*.\n\nA server **SHALL** support a value precise to the *second + time offset*.", + "name": "date", + "type": "date" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-documentreference-patient", + "documentation": "The client **SHALL** provide at least a id value and **MAY** provide both the Type and id values.\n\nThe server **SHALL** support both.", + "name": "patient", + "type": "reference" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-documentreference-period", + "documentation": "A client **SHALL** provide a value precise to the *second + time offset*.\n\nA server **SHALL** support a value precise to the *second + time offset*.", + "name": "period", + "type": "date" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-documentreference-type", + "documentation": "The client **SHALL** provide at least a code value and **MAY** provide both the system and code values.\n\nThe server **SHALL** support both.", + "name": "type", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/Resource-lastUpdated", + "name": "_lastUpdated", + "type": "date" + } + ], + "searchRevInclude": [ + "Provenance:target" + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" + ], + "type": "DocumentReference" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "url": "required", + "valueString": "date" + }, + { + "url": "required", + "valueString": "patient" + } + ], + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "search-type" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "searchParam": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-encounter-id", + "name": "_id", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-encounter-date", + "documentation": "A client **SHALL** provide a value precise to the *second + time offset*.\n\nA server **SHALL** support a value precise to the *second + time offset*.", + "name": "date", + "type": "date" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-encounter-patient", + "documentation": "The client **SHALL** provide at least a id value and **MAY** provide both the Type and id values.\n\nThe server **SHALL** support both.", + "name": "patient", + "type": "reference" + } + ], + "searchRevInclude": [ + "Provenance:target" + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" + ], + "type": "Encounter" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "search-type" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read", + "documentation": "Searches using service-date, _lastUpdated, or type require a patient search argument.\n\n_include:* SHALL be supported.\n" + } + ], + "searchInclude": [ + "ExplanationOfBenefit:*", + "ExplanationOfBenefit:care-team", + "ExplanationOfBenefit:coverage", + "ExplanationOfBenefit:insurer", + "ExplanationOfBenefit:patient", + "ExplanationOfBenefit:provider" + ], + "searchParam": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/Resource-id", + "name": "_id", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/Resource-lastUpdated", + "name": "_lastUpdated", + "type": "date" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/carin-bb/SearchParameter/explanationofbenefit-identifier", + "name": "identifier", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/carin-bb/SearchParameter/explanationofbenefit-patient", + "name": "patient", + "type": "reference" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/carin-bb/SearchParameter/explanationofbenefit-service-date", + "name": "service-date", + "type": "date" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/carin-bb/SearchParameter/explanationofbenefit-type", + "name": "type", + "type": "token" + } + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit", + "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional", + "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional", + "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Pharmacy", + "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Professional-NonClinician" + ], + "type": "ExplanationOfBenefit" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "search-type" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "searchParam": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-goal-patient", + "documentation": "The client **SHALL** provide at least a id value and **MAY** provide both the Type and id values.\n\nThe server **SHALL** support both.", + "name": "patient", + "type": "reference" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/Resource-lastUpdated", + "name": "_lastUpdated", + "type": "date" + } + ], + "searchRevInclude": [ + "Provenance:target" + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-goal" + ], + "type": "Goal" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "search-type" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "searchInclude": [ + "*", + "Immunization:location", + "Immunization:manufacturer", + "Immunization:patient", + "Immunization:performer", + "Immunization:reaction", + "Immunization:reason-reference" + ], + "searchParam": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-immunization-patient", + "documentation": "The client **SHALL** provide at least a id value and **MAY** provide both the Type and id values.\n\nThe server **SHALL** support both.", + "name": "patient", + "type": "reference" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/Resource-lastUpdated", + "name": "_lastUpdated", + "type": "date" + }, + { + "name": "vaccine-code", + "type": "token", + "documentation": "Vaccine Product Administered" + } + ], + "searchRevInclude": [ + "Provenance:target" + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" + ], + "type": "Immunization" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "search-type" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "searchParam": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/Resource-id", + "name": "_id", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/clinical-identifier", + "name": "identifier", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/List-item", + "name": "item", + "type": "reference" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/List-status", + "name": "status", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/Resource-lastUpdated", + "name": "_lastUpdated", + "type": "date" + } + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-CoveragePlan" + ], + "type": "List" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-location" + ], + "type": "Location" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication" + ], + "type": "Medication" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "search-type" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "searchParam": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/davinci-drug-formulary/SearchParameter/DrugName", + "name": "DrugName", + "type": "string" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/davinci-drug-formulary/SearchParameter/DrugPlan", + "name": "DrugPlan", + "type": "string" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/davinci-drug-formulary/SearchParameter/DrugTier", + "name": "DrugTier", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/Resource-id", + "name": "_id", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/MedicationKnowledge-code", + "name": "code", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/Resource-lastUpdated", + "name": "_lastUpdated", + "type": "date" + } + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyDrug" + ], + "type": "MedicationKnowledge" + }, + { + "extension": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "url": "required", + "valueString": "patient" + }, + { + "url": "required", + "valueString": "intent" + }, + { + "url": "required", + "valueString": "status" + } + ], + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "url": "required", + "valueString": "patient" + }, + { + "url": "required", + "valueString": "intent" + } + ], + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination" + }, + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "search-type" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "searchInclude": [ + "MedicationRequest:medication" + ], + "searchParam": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-medicationrequest-intent", + "documentation": "The client **SHALL** provide at least a code value and **MAY** provide both the system and code values.\n\nThe server **SHALL** support both.", + "name": "intent", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-medicationrequest-patient", + "documentation": "The client **SHALL** provide at least a id value and **MAY** provide both the Type and id values.\n\nThe server **SHALL** support both.", + "name": "patient", + "type": "reference" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-medicationrequest-status", + "documentation": "The client **SHALL** provide at least a code value and **MAY** provide both the system and code values.\n\nThe server **SHALL** support both.", + "name": "status", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/Resource-lastUpdated", + "name": "_lastUpdated", + "type": "date" + } + ], + "searchRevInclude": [ + "Provenance:target" + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest" + ], + "type": "MedicationRequest" + }, + { + "extension": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "url": "required", + "valueString": "patient" + }, + { + "url": "required", + "valueString": "category" + }, + { + "url": "required", + "valueString": "date" + } + ], + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "url": "required", + "valueString": "patient" + }, + { + "url": "required", + "valueString": "category" + } + ], + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination" + }, + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "url": "required", + "valueString": "patient" + }, + { + "url": "required", + "valueString": "code" + } + ], + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "search-type" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "searchParam": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-observation-category", + "documentation": "The client **SHALL** provide at least a code value and **MAY** provide both the system and code values.\n\nThe server **SHALL** support both.", + "name": "category", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-observation-code", + "documentation": "The client **SHALL** provide at least a code value and **MAY** provide both the system and code values.\n\nThe server **SHALL** support both.", + "name": "code", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-observation-date", + "documentation": "A client **SHALL** provide a value precise to the *second + time offset*.\n\nA server **SHALL** support a value precise to the *second + time offset*.", + "name": "date", + "type": "date" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-observation-patient", + "documentation": "The client **SHALL** provide at least a id value and **MAY** provide both the Type and id values.\n\nThe server **SHALL** support both.", + "name": "patient", + "type": "reference" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/Resource-lastUpdated", + "name": "_lastUpdated", + "type": "date" + } + ], + "searchRevInclude": [ + "Provenance:target" + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi", + "http://hl7.org/fhir/us/core/StructureDefinition/head-occipital-frontal-circumference-percentile", + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate", + "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-weight-for-height", + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate", + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height", + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure", + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-pulse-oximetry", + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-vital-signs", + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-temperature", + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus", + "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-bmi-for-age", + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-head-circumference", + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight", + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" + ], + "type": "Observation" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization", + "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization" + ], + "type": "Organization" + }, + { + "extension": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "url": "required", + "valueString": "gender" + }, + { + "url": "required", + "valueString": "name" + } + ], + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "url": "required", + "valueString": "birthdate" + }, + { + "url": "required", + "valueString": "name" + } + ], + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination" + }, + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "search-type" + } + ], + "operation": [ + { + "definition": "https://spec.smarthealth.cards/artifacts/operation-patient-i-health-cards-issue.json", + "documentation": "This operation is used to return a signed vaccine credential", + "name": "health-cards-issue" + }, + { + "definition": "http://hl7.org/fhir/OperationDefinition/Patient-everything", + "documentation": "This operation is used to return all the information related to a patient", + "name": "everything" + } + ], + "searchParam": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-patient-id", + "name": "_id", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-patient-birthdate", + "documentation": "A client **SHALL** provide a value precise to the *day*.\n\nA server **SHALL** support a value a value precise to the *day*.", + "name": "birthdate", + "type": "date" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-patient-gender", + "documentation": "The client **SHALL** provide at least a code value and **MAY** provide both the system and code values.\n\nThe server **SHALL** support both.", + "name": "gender", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-patient-identifier", + "documentation": "The client **SHALL** provide at least a code value and **MAY** provide both the system and code values.\n\nThe server **SHALL** support both.", + "name": "identifier", + "type": "token" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-patient-name", + "name": "name", + "type": "string" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/Resource-lastUpdated", + "name": "_lastUpdated", + "type": "date" + } + ], + "searchRevInclude": [ + "Provenance:target" + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient", + "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Patient" + ], + "type": "Patient" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner", + "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner" + ], + "type": "Practitioner" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole" + ], + "type": "PractitionerRole" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + }, + { + "url": "required", + "valueString": "patient" + }, + { + "url": "required", + "valueString": "date" + } + ], + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "search-type" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "searchParam": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-procedure-date", + "documentation": "A client **SHALL** provide a value precise to the *second + time offset*.\n\nA server **SHALL** support a value precise to the *second + time offset*.", + "name": "date", + "type": "date" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "definition": "http://hl7.org/fhir/us/core/SearchParameter/us-core-procedure-patient", + "documentation": "The client **SHALL** provide at least a id value and **MAY** provide both the Type and id values.\n\nThe server **SHALL** support both.", + "name": "patient", + "type": "reference" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "MAY" + } + ], + "definition": "http://hl7.org/fhir/SearchParameter/Resource-lastUpdated", + "name": "_lastUpdated", + "type": "date" + } + ], + "searchRevInclude": [ + "Provenance:target" + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" + ], + "type": "Procedure" + }, + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "interaction": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", + "valueCode": "SHALL" + } + ], + "code": "read" + } + ], + "supportedProfile": [ + "http://hl7.org/fhir/us/core/StructureDefinition/us-core-provenance" + ], + "type": "Provenance" + } + ], + "security": { + "extension": [ + { + "extension": [ + { + "url": "authorize", + "valueUri": "https://r-hi2.cigna.com/mga/sps/oauth/oauth20/authorize" + }, + { + "url": "token", + "valueUri": "https://r-hi2.cigna.com/mga/sps/oauth/oauth20/token" + } + ], + "url": "http://fhir-registry.smarthealthit.org/StructureDefinition/oauth-uris" + } + ], + "service": [ + { + "coding": [ + { + "code": "SMART-on-FHIR", + "system": "http://hl7.org/fhir/restful-security-service" + } + ], + "text": "OAuth2 using SMART-on-FHIR profile (see http://docs.smarthealthit.org)" + } + ] + } + } + ], + "status": "active", + "resourceType": "CapabilityStatement" +} diff --git a/frontend/src/lib/conduit/fhir/base/fixtures/BaseClient_GetRequest.json b/frontend/src/lib/conduit/fhir/base/fixtures/BaseClient_GetRequest.json new file mode 100644 index 00000000..be754145 --- /dev/null +++ b/frontend/src/lib/conduit/fhir/base/fixtures/BaseClient_GetRequest.json @@ -0,0 +1,159 @@ +{ + "resourceType": "Patient", + "id": "123d41e1-0f71-4e9f-8eb2-d1b1330201a6", + "meta": { + "versionId": "1.0" + }, + "extension": [ + { + "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race", + "extension": [ + { + "url": "ombCategory", + "valueCoding": { + "system": "urn:oid:2.16.840.1.113883.6.238", + "code": "2054-5", + "display": "Black or African American" + } + }, + { + "url": "text", + "valueString": "Black or African American" + } + ] + }, + { + "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity", + "extension": [ + { + "url": "ombCategory", + "valueCoding": { + "system": "urn:oid:2.16.840.1.113883.6.238", + "code": "2135-2", + "display": "Hispanic or Latino" + } + }, + { + "url": "text", + "valueString": "Hispanic or Latino" + } + ] + }, + { + "url": "http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName", + "valueString": "Ramona980 Franco581" + }, + { + "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex", + "valueCode": "M" + }, + { + "url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason", + "valueCode": "masked" + } + ], + "identifier": [ + { + "system": "https://github.com/synthetichealth/synthea", + "value": "123d41e1-0f71-4e9f-8eb2-d1b1330201a6" + }, + { + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/v2-0203", + "code": "MR", + "display": "Medical Record Number" + } + ] + }, + "system": "http://hospital.smarthealthit.org", + "value": "123d41e1-0f71-4e9f-8eb2-d1b1330201a6" + }, + { + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/v2-0203", + "code": "SS", + "display": "Social Security Number" + } + ] + }, + "system": "http://hl7.org/fhir/sid/us-ssn", + "value": "999-50-6731" + }, + { + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/v2-0203", + "code": "DL", + "display": "Drivers License" + } + ] + }, + "system": "urn:oid:2.16.840.1.113883.4.3.25", + "value": "S99957478" + } + ], + "name": [ + { + "use": "official", + "family": "Gutiérrez115", + "given": [ + "Hugo693" + ], + "prefix": [ + "Mr." + ] + } + ], + "telecom": [ + { + "system": "phone", + "value": "555-914-6475", + "use": "home" + } + ], + "gender": "male", + "birthDate": "1969-01-12", + "address": [ + { + "line": [ + "[\"293 Douglas Ramp\"]" + ], + "city": "Natick", + "state": "MA", + "postalCode": "01999", + "country": "US", + "period": { + "start": "1969-01-12T00:00:00+00:00" + } + } + ], + "maritalStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus", + "code": "M", + "display": "M" + } + ], + "text": "M" + }, + "multipleBirthBoolean": false, + "communication": [ + { + "language": { + "coding": [ + { + "system": "urn:ietf:bcp:47", + "code": "es", + "display": "Spanish" + } + ] + } + } + ] +} diff --git a/frontend/src/lib/conduit/fhir/base/fixtures/FHIR401Client_ProcessBundle.json b/frontend/src/lib/conduit/fhir/base/fixtures/FHIR401Client_ProcessBundle.json new file mode 100644 index 00000000..64e2c9c7 --- /dev/null +++ b/frontend/src/lib/conduit/fhir/base/fixtures/FHIR401Client_ProcessBundle.json @@ -0,0 +1,16695 @@ +{ + "resourceType": "Bundle", + "type": "transaction", + "entry": [ + { + "fullUrl": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "resource": { + "resourceType": "Patient", + "id": "c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "text": { + "status": "generated", + "div": "
Generated by Synthea.Version identifier: v2.4.0-404-ge7ce2295\n . Person seed: -2282623849526784568 Population seed: 0
" + }, + "extension": [ + { + "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race", + "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-ethnicity", + "extension": [ + { + "url": "ombCategory", + "valueCoding": { + "system": "urn:oid:2.16.840.1.113883.6.238", + "code": "2186-5", + "display": "Not Hispanic or Latino" + } + }, + { + "url": "text", + "valueString": "Not Hispanic or Latino" + } + ] + }, + { + "url": "http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName", + "valueString": "Sandra485 Cormier289" + }, + { + "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex", + "valueCode": "F" + }, + { + "url": "http://hl7.org/fhir/StructureDefinition/patient-birthPlace", + "valueAddress": { + "city": "Tewksbury", + "state": "Massachusetts", + "country": "US" + } + }, + { + "url": "http://synthetichealth.github.io/synthea/disability-adjusted-life-years", + "valueDecimal": 0.7742822202801629 + }, + { + "url": "http://synthetichealth.github.io/synthea/quality-adjusted-life-years", + "valueDecimal": 52.22571777971984 + } + ], + "identifier": [ + { + "system": "https://github.com/synthetichealth/synthea", + "value": "1e0a8bd3-3b82-4f17-b1d6-19043aa0db6b" + }, + { + "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": "1e0a8bd3-3b82-4f17-b1d6-19043aa0db6b" + }, + { + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/v2-0203", + "code": "SS", + "display": "Social Security Number" + } + ], + "text": "Social Security Number" + }, + "system": "http://hl7.org/fhir/sid/us-ssn", + "value": "999-76-3236" + }, + { + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/v2-0203", + "code": "DL", + "display": "Driver's License" + } + ], + "text": "Driver's License" + }, + "system": "urn:oid:2.16.840.1.113883.4.3.25", + "value": "S99995466" + }, + { + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/v2-0203", + "code": "PPN", + "display": "Passport Number" + } + ], + "text": "Passport Number" + }, + "system": "http://standardhealthrecord.org/fhir/StructureDefinition/passportNumber", + "value": "X41129973X" + } + ], + "name": [ + { + "use": "official", + "family": "Marks830", + "given": [ + "Alesha810" + ], + "prefix": [ + "Ms." + ] + } + ], + "telecom": [ + { + "system": "phone", + "value": "555-664-6121", + "use": "home" + } + ], + "gender": "female", + "birthDate": "1965-11-04", + "address": [ + { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/geolocation", + "extension": [ + { + "url": "latitude", + "valueDecimal": 42.60588776678466 + }, + { + "url": "longitude", + "valueDecimal": -71.0695322588603 + } + ] + } + ], + "line": [ + "165 Shanahan View" + ], + "city": "North Reading", + "state": "Massachusetts", + "country": "US" + } + ], + "maritalStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus", + "code": "S", + "display": "S" + } + ], + "text": "S" + }, + "multipleBirthBoolean": false, + "communication": [ + { + "language": { + "coding": [ + { + "system": "urn:ietf:bcp:47", + "code": "en-US", + "display": "English" + } + ], + "text": "English" + } + } + ] + }, + "request": { + "method": "POST", + "url": "Patient" + } + }, + { + "fullUrl": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "resource": { + "resourceType": "Organization", + "id": "f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "identifier": [ + { + "system": "https://github.com/synthetichealth/synthea", + "value": "f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4" + } + ], + "active": true, + "type": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/organization-type", + "code": "prov", + "display": "Healthcare Provider" + } + ], + "text": "Healthcare Provider" + } + ], + "name": "LAWRENCE GENERAL HOSPITAL", + "telecom": [ + { + "system": "phone", + "value": "9786834000" + } + ], + "address": [ + { + "line": [ + "ONE GENERAL STREET" + ], + "city": "LAWRENCE", + "state": "MA", + "postalCode": "01842", + "country": "US" + } + ] + }, + "request": { + "method": "POST", + "url": "Organization" + } + }, + { + "fullUrl": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e", + "resource": { + "resourceType": "Practitioner", + "id": "0000016d-3a85-4cca-0000-00000000001e", + "identifier": [ + { + "system": "http://hl7.org/fhir/sid/us-npi", + "value": "30" + } + ], + "active": true, + "name": [ + { + "family": "Lind531", + "given": [ + "Cedrick207" + ], + "prefix": [ + "Dr." + ] + } + ], + "telecom": [ + { + "system": "email", + "value": "Cedrick207.Lind531@example.com", + "use": "work" + } + ], + "address": [ + { + "line": [ + "ONE GENERAL STREET" + ], + "city": "LAWRENCE", + "state": "MA", + "postalCode": "01842", + "country": "US" + } + ], + "gender": "male" + }, + "request": { + "method": "POST", + "url": "Practitioner" + } + }, + { + "fullUrl": "urn:uuid:3879ad6c-0839-48f3-8e17-30d5637f874b", + "resource": { + "resourceType": "Encounter", + "id": "3879ad6c-0839-48f3-8e17-30d5637f874b", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "AMB" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185345009", + "display": "Encounter for symptom" + } + ], + "text": "Encounter for symptom" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e", + "display": "Dr. Cedrick207 Lind531" + } + } + ], + "period": { + "start": "1967-11-11T00:24:38-05:00", + "end": "1967-11-11T00:54:38-05:00" + }, + "reasonCode": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "233678006", + "display": "Childhood asthma" + } + ] + } + ], + "serviceProvider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:b86ed58d-d67e-4616-b028-51d5a2dd0552", + "resource": { + "resourceType": "MedicationRequest", + "id": "b86ed58d-d67e-4616-b028-51d5a2dd0552", + "status": "active", + "intent": "order", + "medicationCodeableConcept": { + "coding": [ + { + "system": "http://www.nlm.nih.gov/research/umls/rxnorm", + "code": "895994", + "display": "120 ACTUAT Fluticasone propionate 0.044 MG/ACTUAT Metered Dose Inhaler" + } + ], + "text": "120 ACTUAT Fluticasone propionate 0.044 MG/ACTUAT Metered Dose Inhaler" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:3879ad6c-0839-48f3-8e17-30d5637f874b" + }, + "authoredOn": "1967-11-11T00:24:38-05:00", + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e", + "display": "Dr. Cedrick207 Lind531" + }, + "dosageInstruction": [ + { + "sequence": 1, + "asNeededBoolean": true + } + ] + }, + "request": { + "method": "POST", + "url": "MedicationRequest" + } + }, + { + "fullUrl": "urn:uuid:ec24034c-62ae-4fa9-b53b-e5b3e14096fc", + "resource": { + "resourceType": "Claim", + "id": "ec24034c-62ae-4fa9-b53b-e5b3e14096fc", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "pharmacy" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "1967-11-11T00:24:38-05:00", + "end": "1967-11-11T00:54:38-05:00" + }, + "created": "1967-11-11T00:54:38-05:00", + "provider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "prescription": { + "reference": "urn:uuid:b86ed58d-d67e-4616-b028-51d5a2dd0552" + }, + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185345009", + "display": "Encounter for symptom" + } + ], + "text": "Encounter for symptom" + }, + "encounter": [ + { + "reference": "urn:uuid:3879ad6c-0839-48f3-8e17-30d5637f874b" + } + ] + } + ], + "total": { + "value": 21.1, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:0d99e987-eaff-4cdb-8b60-853feb003c5d", + "resource": { + "resourceType": "MedicationRequest", + "id": "0d99e987-eaff-4cdb-8b60-853feb003c5d", + "status": "active", + "intent": "order", + "medicationCodeableConcept": { + "coding": [ + { + "system": "http://www.nlm.nih.gov/research/umls/rxnorm", + "code": "745679", + "display": "200 ACTUAT Albuterol 0.09 MG/ACTUAT Metered Dose Inhaler" + } + ], + "text": "200 ACTUAT Albuterol 0.09 MG/ACTUAT Metered Dose Inhaler" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:3879ad6c-0839-48f3-8e17-30d5637f874b" + }, + "authoredOn": "1967-11-11T00:24:38-05:00", + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e", + "display": "Dr. Cedrick207 Lind531" + }, + "dosageInstruction": [ + { + "sequence": 1, + "asNeededBoolean": true + } + ] + }, + "request": { + "method": "POST", + "url": "MedicationRequest" + } + }, + { + "fullUrl": "urn:uuid:5df4777f-d82e-4815-bf56-dd1e647fdf13", + "resource": { + "resourceType": "Claim", + "id": "5df4777f-d82e-4815-bf56-dd1e647fdf13", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "pharmacy" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "1967-11-11T00:24:38-05:00", + "end": "1967-11-11T00:54:38-05:00" + }, + "created": "1967-11-11T00:54:38-05:00", + "provider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "prescription": { + "reference": "urn:uuid:0d99e987-eaff-4cdb-8b60-853feb003c5d" + }, + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185345009", + "display": "Encounter for symptom" + } + ], + "text": "Encounter for symptom" + }, + "encounter": [ + { + "reference": "urn:uuid:3879ad6c-0839-48f3-8e17-30d5637f874b" + } + ] + } + ], + "total": { + "value": 50.29, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:a55b85b0-5be8-47cb-b393-7b3d1b7e52e3", + "resource": { + "resourceType": "CareTeam", + "id": "a55b85b0-5be8-47cb-b393-7b3d1b7e52e3", + "status": "active", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:3879ad6c-0839-48f3-8e17-30d5637f874b" + }, + "period": { + "start": "1967-11-11T00:24:38-05:00" + }, + "participant": [ + { + "role": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "116153009", + "display": "Patient" + } + ], + "text": "Patient" + } + ], + "member": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + } + }, + { + "role": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "303118004", + "display": "Person in the healthcare environment (person)" + } + ], + "text": "Person in the healthcare environment (person)" + } + ], + "member": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e", + "display": "Dr. Cedrick207 Lind531" + } + }, + { + "role": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "303118004", + "display": "Healthcare related organization (qualifier value)" + } + ], + "text": "Healthcare related organization (qualifier value)" + } + ], + "member": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + } + } + ], + "reasonCode": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "233678006", + "display": "Childhood asthma" + } + ], + "text": "Childhood asthma" + } + ], + "managingOrganization": [ + { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + } + ] + }, + "request": { + "method": "POST", + "url": "CareTeam" + } + }, + { + "fullUrl": "urn:uuid:4e5c4e96-96e8-4e4e-b3cb-35b25cdd2cf9", + "resource": { + "resourceType": "CarePlan", + "id": "4e5c4e96-96e8-4e4e-b3cb-35b25cdd2cf9", + "text": { + "status": "generated", + "div": "
Care Plan for Asthma self management.
Activities:
  • Asthma self management
  • Asthma self management
  • Asthma self management

Care plan is meant to treat Childhood asthma.
" + }, + "status": "active", + "intent": "order", + "category": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "699728000", + "display": "Asthma self management" + } + ], + "text": "Asthma self management" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:3879ad6c-0839-48f3-8e17-30d5637f874b" + }, + "period": { + "start": "1967-11-11T00:24:38-05:00" + }, + "careTeam": [ + { + "reference": "urn:uuid:a55b85b0-5be8-47cb-b393-7b3d1b7e52e3" + } + ], + "activity": [ + { + "detail": { + "code": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "710818004", + "display": "Inhaled steroid therapy" + } + ], + "text": "Inhaled steroid therapy" + }, + "status": "in-progress", + "location": { + "display": "LAWRENCE GENERAL HOSPITAL" + } + } + }, + { + "detail": { + "code": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "708409001", + "display": "Home nebulizer therapy" + } + ], + "text": "Home nebulizer therapy" + }, + "status": "in-progress", + "location": { + "display": "LAWRENCE GENERAL HOSPITAL" + } + } + }, + { + "detail": { + "code": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "229298005", + "display": "Breathing control" + } + ], + "text": "Breathing control" + }, + "status": "in-progress", + "location": { + "display": "LAWRENCE GENERAL HOSPITAL" + } + } + } + ] + }, + "request": { + "method": "POST", + "url": "CarePlan" + } + }, + { + "fullUrl": "urn:uuid:8e08fd86-4a37-4b97-9636-1f9ac77b416d", + "resource": { + "resourceType": "Claim", + "id": "8e08fd86-4a37-4b97-9636-1f9ac77b416d", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "1967-11-11T00:24:38-05:00", + "end": "1967-11-11T00:54:38-05:00" + }, + "created": "1967-11-11T00:54:38-05:00", + "provider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185345009", + "display": "Encounter for symptom" + } + ], + "text": "Encounter for symptom" + }, + "encounter": [ + { + "reference": "urn:uuid:3879ad6c-0839-48f3-8e17-30d5637f874b" + } + ] + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:721349f8-f463-4c61-b01d-b45684f5c877", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "721349f8-f463-4c61-b01d-b45684f5c877", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "8e08fd86-4a37-4b97-9636-1f9ac77b416d" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "1967-11-11T00:54:38-05:00", + "end": "1968-11-11T00:54:38-05:00" + }, + "created": "1967-11-11T00:54:38-05:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:8e08fd86-4a37-4b97-9636-1f9ac77b416d" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185345009", + "display": "Encounter for symptom" + } + ], + "text": "Encounter for symptom" + }, + "servicedPeriod": { + "start": "1967-11-11T00:24:38-05:00", + "end": "1967-11-11T00:54:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "21", + "display": "Inpatient Hospital" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:3879ad6c-0839-48f3-8e17-30d5637f874b" + } + ] + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 0.0, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + }, + { + "fullUrl": "urn:uuid:294bdfba-55a3-44f7-b208-cb5835a67424", + "resource": { + "resourceType": "Encounter", + "id": "294bdfba-55a3-44f7-b208-cb5835a67424", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "AMB" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185345009", + "display": "Encounter for symptom" + } + ], + "text": "Encounter for symptom" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e", + "display": "Dr. Cedrick207 Lind531" + } + } + ], + "period": { + "start": "1968-11-10T00:24:38-05:00", + "end": "1968-11-24T00:24:38-05:00" + }, + "reasonCode": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "367498001", + "display": "Seasonal allergic rhinitis" + } + ] + } + ], + "serviceProvider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:54c20754-d436-4f6b-a0a5-466fd36665a9", + "resource": { + "resourceType": "Condition", + "id": "54c20754-d436-4f6b-a0a5-466fd36665a9", + "clinicalStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/condition-clinical", + "code": "active" + } + ] + }, + "verificationStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status", + "code": "confirmed" + } + ] + }, + "code": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "367498001", + "display": "Seasonal allergic rhinitis" + } + ], + "text": "Seasonal allergic rhinitis" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:294bdfba-55a3-44f7-b208-cb5835a67424" + }, + "onsetDateTime": "1968-11-10T00:24:38-05:00", + "recordedDate": "1968-11-10T00:24:38-05:00" + }, + "request": { + "method": "POST", + "url": "Condition" + } + }, + { + "fullUrl": "urn:uuid:1f14d2ae-a3bd-412b-9068-35efef091e2c", + "resource": { + "resourceType": "MedicationRequest", + "id": "1f14d2ae-a3bd-412b-9068-35efef091e2c", + "status": "active", + "intent": "order", + "medicationCodeableConcept": { + "coding": [ + { + "system": "http://www.nlm.nih.gov/research/umls/rxnorm", + "code": "477045", + "display": "Chlorpheniramine Maleate 2 MG/ML Oral Solution" + } + ], + "text": "Chlorpheniramine Maleate 2 MG/ML Oral Solution" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:294bdfba-55a3-44f7-b208-cb5835a67424" + }, + "authoredOn": "1968-11-24T00:24:38-05:00", + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e", + "display": "Dr. Cedrick207 Lind531" + }, + "dosageInstruction": [ + { + "sequence": 1, + "asNeededBoolean": true + } + ] + }, + "request": { + "method": "POST", + "url": "MedicationRequest" + } + }, + { + "fullUrl": "urn:uuid:41cdd5a1-c2b4-4c21-8490-2eefb931c958", + "resource": { + "resourceType": "Claim", + "id": "41cdd5a1-c2b4-4c21-8490-2eefb931c958", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "pharmacy" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "1968-11-10T00:24:38-05:00", + "end": "1968-11-24T00:24:38-05:00" + }, + "created": "1968-11-24T00:24:38-05:00", + "provider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "prescription": { + "reference": "urn:uuid:1f14d2ae-a3bd-412b-9068-35efef091e2c" + }, + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185345009", + "display": "Encounter for symptom" + } + ], + "text": "Encounter for symptom" + }, + "encounter": [ + { + "reference": "urn:uuid:294bdfba-55a3-44f7-b208-cb5835a67424" + } + ] + } + ], + "total": { + "value": 6.77, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:61cd342f-cd24-47d6-85d3-bf74746e5c36", + "resource": { + "resourceType": "Claim", + "id": "61cd342f-cd24-47d6-85d3-bf74746e5c36", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "1968-11-10T00:24:38-05:00", + "end": "1968-11-24T00:24:38-05:00" + }, + "created": "1968-11-24T00:24:38-05:00", + "provider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "diagnosis": [ + { + "sequence": 1, + "diagnosisReference": { + "reference": "urn:uuid:54c20754-d436-4f6b-a0a5-466fd36665a9" + } + } + ], + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185345009", + "display": "Encounter for symptom" + } + ], + "text": "Encounter for symptom" + }, + "encounter": [ + { + "reference": "urn:uuid:294bdfba-55a3-44f7-b208-cb5835a67424" + } + ] + }, + { + "sequence": 2, + "diagnosisSequence": [ + 1 + ], + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "367498001", + "display": "Seasonal allergic rhinitis" + } + ], + "text": "Seasonal allergic rhinitis" + } + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:3d193393-8532-47a2-b50f-43879ae73316", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "3d193393-8532-47a2-b50f-43879ae73316", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "61cd342f-cd24-47d6-85d3-bf74746e5c36" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "1968-11-24T00:24:38-05:00", + "end": "1969-11-24T00:24:38-05:00" + }, + "created": "1968-11-24T00:24:38-05:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:61cd342f-cd24-47d6-85d3-bf74746e5c36" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "diagnosis": [ + { + "sequence": 1, + "diagnosisReference": { + "reference": "urn:uuid:54c20754-d436-4f6b-a0a5-466fd36665a9" + }, + "type": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype", + "code": "principal" + } + ] + } + ] + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185345009", + "display": "Encounter for symptom" + } + ], + "text": "Encounter for symptom" + }, + "servicedPeriod": { + "start": "1968-11-10T00:24:38-05:00", + "end": "1968-11-24T00:24:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "21", + "display": "Inpatient Hospital" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:294bdfba-55a3-44f7-b208-cb5835a67424" + } + ] + }, + { + "sequence": 2, + "diagnosisSequence": [ + 1 + ], + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "367498001", + "display": "Seasonal allergic rhinitis" + } + ], + "text": "Seasonal allergic rhinitis" + }, + "servicedPeriod": { + "start": "1968-11-10T00:24:38-05:00", + "end": "1968-11-24T00:24:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "21", + "display": "Inpatient Hospital" + } + ] + } + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 0.0, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + }, + { + "fullUrl": "urn:uuid:81db737b-092f-469d-a898-03c15260e6a6", + "resource": { + "resourceType": "Encounter", + "id": "81db737b-092f-469d-a898-03c15260e6a6", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "AMB" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185347001", + "display": "Encounter for problem" + } + ], + "text": "Encounter for problem" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e", + "display": "Dr. Cedrick207 Lind531" + } + } + ], + "period": { + "start": "1968-11-29T00:24:38-05:00", + "end": "1968-11-29T00:39:38-05:00" + }, + "serviceProvider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:2b48d92c-5f92-46ee-9777-b42112b35cb3", + "resource": { + "resourceType": "AllergyIntolerance", + "id": "2b48d92c-5f92-46ee-9777-b42112b35cb3", + "clinicalStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical", + "code": "active" + } + ] + }, + "verificationStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification", + "code": "confirmed" + } + ] + }, + "type": "allergy", + "category": [ + "food" + ], + "criticality": "low", + "code": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "300916003", + "display": "Latex allergy" + } + ], + "text": "Latex allergy" + }, + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "recordedDate": "1968-11-29T00:24:38-05:00" + }, + "request": { + "method": "POST", + "url": "AllergyIntolerance" + } + }, + { + "fullUrl": "urn:uuid:2d6f8548-1344-4a6f-b2ea-af43b808439c", + "resource": { + "resourceType": "AllergyIntolerance", + "id": "2d6f8548-1344-4a6f-b2ea-af43b808439c", + "clinicalStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical", + "code": "active" + } + ] + }, + "verificationStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification", + "code": "confirmed" + } + ] + }, + "type": "allergy", + "category": [ + "food" + ], + "criticality": "low", + "code": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "419474003", + "display": "Allergy to mould" + } + ], + "text": "Allergy to mould" + }, + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "recordedDate": "1968-11-29T00:24:38-05:00" + }, + "request": { + "method": "POST", + "url": "AllergyIntolerance" + } + }, + { + "fullUrl": "urn:uuid:6840b5f7-e097-4ba7-b35b-0c3b0770a2b1", + "resource": { + "resourceType": "AllergyIntolerance", + "id": "6840b5f7-e097-4ba7-b35b-0c3b0770a2b1", + "clinicalStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical", + "code": "active" + } + ] + }, + "verificationStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification", + "code": "confirmed" + } + ] + }, + "type": "allergy", + "category": [ + "food" + ], + "criticality": "low", + "code": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "232350006", + "display": "House dust mite allergy" + } + ], + "text": "House dust mite allergy" + }, + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "recordedDate": "1968-11-29T00:24:38-05:00" + }, + "request": { + "method": "POST", + "url": "AllergyIntolerance" + } + }, + { + "fullUrl": "urn:uuid:72c5fe15-5835-4e6f-a645-fa8659faa1dd", + "resource": { + "resourceType": "AllergyIntolerance", + "id": "72c5fe15-5835-4e6f-a645-fa8659faa1dd", + "clinicalStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical", + "code": "active" + } + ] + }, + "verificationStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification", + "code": "confirmed" + } + ] + }, + "type": "allergy", + "category": [ + "food" + ], + "criticality": "low", + "code": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "232347008", + "display": "Dander (animal) allergy" + } + ], + "text": "Dander (animal) allergy" + }, + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "recordedDate": "1968-11-29T00:24:38-05:00" + }, + "request": { + "method": "POST", + "url": "AllergyIntolerance" + } + }, + { + "fullUrl": "urn:uuid:a62570ee-1e8d-410b-b353-786a036b4ac8", + "resource": { + "resourceType": "AllergyIntolerance", + "id": "a62570ee-1e8d-410b-b353-786a036b4ac8", + "clinicalStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical", + "code": "active" + } + ] + }, + "verificationStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification", + "code": "confirmed" + } + ] + }, + "type": "allergy", + "category": [ + "food" + ], + "criticality": "low", + "code": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "419263009", + "display": "Allergy to tree pollen" + } + ], + "text": "Allergy to tree pollen" + }, + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "recordedDate": "1968-11-29T00:24:38-05:00" + }, + "request": { + "method": "POST", + "url": "AllergyIntolerance" + } + }, + { + "fullUrl": "urn:uuid:5ffad690-a0b1-4756-a7e1-120cd880090a", + "resource": { + "resourceType": "CareTeam", + "id": "5ffad690-a0b1-4756-a7e1-120cd880090a", + "status": "active", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:81db737b-092f-469d-a898-03c15260e6a6" + }, + "period": { + "start": "1968-11-29T00:24:38-05:00" + }, + "participant": [ + { + "role": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "116153009", + "display": "Patient" + } + ], + "text": "Patient" + } + ], + "member": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + } + }, + { + "role": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "303118004", + "display": "Person in the healthcare environment (person)" + } + ], + "text": "Person in the healthcare environment (person)" + } + ], + "member": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e", + "display": "Dr. Cedrick207 Lind531" + } + }, + { + "role": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "303118004", + "display": "Healthcare related organization (qualifier value)" + } + ], + "text": "Healthcare related organization (qualifier value)" + } + ], + "member": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + } + } + ], + "managingOrganization": [ + { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + } + ] + }, + "request": { + "method": "POST", + "url": "CareTeam" + } + }, + { + "fullUrl": "urn:uuid:1154ba7a-df80-4753-aef8-61351cc1817c", + "resource": { + "resourceType": "CarePlan", + "id": "1154ba7a-df80-4753-aef8-61351cc1817c", + "text": { + "status": "generated", + "div": "
Care Plan for Self care.
Activities:
  • Self care
" + }, + "status": "active", + "intent": "order", + "category": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "326051000000105", + "display": "Self care" + } + ], + "text": "Self care" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:81db737b-092f-469d-a898-03c15260e6a6" + }, + "period": { + "start": "1968-11-29T00:24:38-05:00" + }, + "careTeam": [ + { + "reference": "urn:uuid:5ffad690-a0b1-4756-a7e1-120cd880090a" + } + ], + "activity": [ + { + "detail": { + "code": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "58332002", + "display": "Allergy education" + } + ], + "text": "Allergy education" + }, + "status": "in-progress", + "location": { + "display": "LAWRENCE GENERAL HOSPITAL" + } + } + } + ] + }, + "request": { + "method": "POST", + "url": "CarePlan" + } + }, + { + "fullUrl": "urn:uuid:6a0eef16-49a0-41a2-b3cb-322c14eaab8d", + "resource": { + "resourceType": "Claim", + "id": "6a0eef16-49a0-41a2-b3cb-322c14eaab8d", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "1968-11-29T00:24:38-05:00", + "end": "1968-11-29T00:39:38-05:00" + }, + "created": "1968-11-29T00:39:38-05:00", + "provider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185347001", + "display": "Encounter for problem" + } + ], + "text": "Encounter for problem" + }, + "encounter": [ + { + "reference": "urn:uuid:81db737b-092f-469d-a898-03c15260e6a6" + } + ] + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:aef924ce-6797-4c16-8882-9bea844e5e5b", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "aef924ce-6797-4c16-8882-9bea844e5e5b", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "6a0eef16-49a0-41a2-b3cb-322c14eaab8d" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "1968-11-29T00:39:38-05:00", + "end": "1969-11-29T00:39:38-05:00" + }, + "created": "1968-11-29T00:39:38-05:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:6a0eef16-49a0-41a2-b3cb-322c14eaab8d" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185347001", + "display": "Encounter for problem" + } + ], + "text": "Encounter for problem" + }, + "servicedPeriod": { + "start": "1968-11-29T00:24:38-05:00", + "end": "1968-11-29T00:39:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "21", + "display": "Inpatient Hospital" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:81db737b-092f-469d-a898-03c15260e6a6" + } + ] + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 0.0, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + }, + { + "fullUrl": "urn:uuid:54f6fc59-7709-310f-9249-1e92d0464b00", + "resource": { + "resourceType": "Organization", + "id": "54f6fc59-7709-310f-9249-1e92d0464b00", + "identifier": [ + { + "system": "https://github.com/synthetichealth/synthea", + "value": "54f6fc59-7709-310f-9249-1e92d0464b00" + } + ], + "active": true, + "type": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/organization-type", + "code": "prov", + "display": "Healthcare Provider" + } + ], + "text": "Healthcare Provider" + } + ], + "name": "PCP145391", + "address": [ + { + "line": [ + "21 MAIN ST" + ], + "city": "NORTH READING", + "state": "MA", + "postalCode": "01864-2270", + "country": "US" + } + ] + }, + "request": { + "method": "POST", + "url": "Organization" + } + }, + { + "fullUrl": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710", + "resource": { + "resourceType": "Practitioner", + "id": "0000016d-3a85-4cca-0000-00000000c710", + "identifier": [ + { + "system": "http://hl7.org/fhir/sid/us-npi", + "value": "50960" + } + ], + "active": true, + "name": [ + { + "family": "Cummerata161", + "given": [ + "Shantae970" + ], + "prefix": [ + "Dr." + ] + } + ], + "telecom": [ + { + "system": "email", + "value": "Shantae970.Cummerata161@example.com", + "use": "work" + } + ], + "address": [ + { + "line": [ + "21 MAIN ST" + ], + "city": "NORTH READING", + "state": "MA", + "postalCode": "01864-2270", + "country": "US" + } + ], + "gender": "female" + }, + "request": { + "method": "POST", + "url": "Practitioner" + } + }, + { + "fullUrl": "urn:uuid:51142185-4752-442c-a9ed-bb8ea0b31dd4", + "resource": { + "resourceType": "Encounter", + "id": "51142185-4752-442c-a9ed-bb8ea0b31dd4", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "AMB" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710", + "display": "Dr. Shantae970 Cummerata161" + } + } + ], + "period": { + "start": "1983-12-29T00:24:38-05:00", + "end": "1983-12-29T00:54:38-05:00" + }, + "serviceProvider": { + "reference": "urn:uuid:54f6fc59-7709-310f-9249-1e92d0464b00", + "display": "PCP145391" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:52207d7f-0b29-4fbd-a8ed-4b3f73373ef6", + "resource": { + "resourceType": "Condition", + "id": "52207d7f-0b29-4fbd-a8ed-4b3f73373ef6", + "clinicalStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/condition-clinical", + "code": "active" + } + ] + }, + "verificationStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status", + "code": "confirmed" + } + ] + }, + "code": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "59621000", + "display": "Hypertension" + } + ], + "text": "Hypertension" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:51142185-4752-442c-a9ed-bb8ea0b31dd4" + }, + "onsetDateTime": "1983-12-29T00:24:38-05:00", + "recordedDate": "1983-12-29T00:24:38-05:00" + }, + "request": { + "method": "POST", + "url": "Condition" + } + }, + { + "fullUrl": "urn:uuid:d64f4b7d-0267-4476-a83c-57b52f1c7eab", + "resource": { + "resourceType": "MedicationRequest", + "id": "d64f4b7d-0267-4476-a83c-57b52f1c7eab", + "status": "active", + "intent": "order", + "medicationCodeableConcept": { + "coding": [ + { + "system": "http://www.nlm.nih.gov/research/umls/rxnorm", + "code": "316049", + "display": "Hydrochlorothiazide 25 MG" + } + ], + "text": "Hydrochlorothiazide 25 MG" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:51142185-4752-442c-a9ed-bb8ea0b31dd4" + }, + "authoredOn": "1983-12-29T00:24:38-05:00", + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710", + "display": "Dr. Shantae970 Cummerata161" + }, + "reasonReference": [ + { + "reference": "urn:uuid:52207d7f-0b29-4fbd-a8ed-4b3f73373ef6" + } + ] + }, + "request": { + "method": "POST", + "url": "MedicationRequest" + } + }, + { + "fullUrl": "urn:uuid:244423ca-353d-4294-b3ab-37e92f6b8d61", + "resource": { + "resourceType": "Claim", + "id": "244423ca-353d-4294-b3ab-37e92f6b8d61", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "pharmacy" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "1983-12-29T00:24:38-05:00", + "end": "1983-12-29T00:54:38-05:00" + }, + "created": "1983-12-29T00:54:38-05:00", + "provider": { + "reference": "urn:uuid:54f6fc59-7709-310f-9249-1e92d0464b00", + "display": "PCP145391" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "prescription": { + "reference": "urn:uuid:d64f4b7d-0267-4476-a83c-57b52f1c7eab" + }, + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + }, + "encounter": [ + { + "reference": "urn:uuid:51142185-4752-442c-a9ed-bb8ea0b31dd4" + } + ] + } + ], + "total": { + "value": 263.49, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:ba4d5d85-c7ca-4c93-ab81-4a6bb23d6a7f", + "resource": { + "resourceType": "CareTeam", + "id": "ba4d5d85-c7ca-4c93-ab81-4a6bb23d6a7f", + "status": "active", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:51142185-4752-442c-a9ed-bb8ea0b31dd4" + }, + "period": { + "start": "1983-12-29T00:24:38-05:00" + }, + "participant": [ + { + "role": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "116153009", + "display": "Patient" + } + ], + "text": "Patient" + } + ], + "member": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + } + }, + { + "role": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "303118004", + "display": "Person in the healthcare environment (person)" + } + ], + "text": "Person in the healthcare environment (person)" + } + ], + "member": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710", + "display": "Dr. Shantae970 Cummerata161" + } + }, + { + "role": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "303118004", + "display": "Healthcare related organization (qualifier value)" + } + ], + "text": "Healthcare related organization (qualifier value)" + } + ], + "member": { + "reference": "urn:uuid:54f6fc59-7709-310f-9249-1e92d0464b00", + "display": "PCP145391" + } + } + ], + "reasonCode": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "59621000", + "display": "Hypertension" + } + ], + "text": "Hypertension" + } + ], + "managingOrganization": [ + { + "reference": "urn:uuid:54f6fc59-7709-310f-9249-1e92d0464b00", + "display": "PCP145391" + } + ] + }, + "request": { + "method": "POST", + "url": "CareTeam" + } + }, + { + "fullUrl": "urn:uuid:cf5a54a4-2ec8-4acd-871f-1a59bbe7d992", + "resource": { + "resourceType": "Goal", + "id": "cf5a54a4-2ec8-4acd-871f-1a59bbe7d992", + "lifecycleStatus": "accepted", + "achievementStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/goal-achievement", + "code": "in-progress" + } + ] + }, + "description": { + "text": "Maintain blood pressure below 140/90 mm[Hg]" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + } + }, + "request": { + "method": "POST", + "url": "Goal" + } + }, + { + "fullUrl": "urn:uuid:0271e0b9-1743-49f0-a414-84826fd63d50", + "resource": { + "resourceType": "Goal", + "id": "0271e0b9-1743-49f0-a414-84826fd63d50", + "lifecycleStatus": "accepted", + "achievementStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/goal-achievement", + "code": "in-progress" + } + ] + }, + "description": { + "text": "Reduce sodium intake to no more than 2,400 mg/day" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + } + }, + "request": { + "method": "POST", + "url": "Goal" + } + }, + { + "fullUrl": "urn:uuid:c7fc97e5-f9e4-4fec-9525-051ddd1c6262", + "resource": { + "resourceType": "CarePlan", + "id": "c7fc97e5-f9e4-4fec-9525-051ddd1c6262", + "text": { + "status": "generated", + "div": "
Care Plan for Lifestyle education regarding hypertension.
Activities:
  • Lifestyle education regarding hypertension
  • Lifestyle education regarding hypertension
  • Lifestyle education regarding hypertension
  • Lifestyle education regarding hypertension

Care plan is meant to treat Hypertension.
" + }, + "status": "active", + "intent": "order", + "category": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "443402002", + "display": "Lifestyle education regarding hypertension" + } + ], + "text": "Lifestyle education regarding hypertension" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:51142185-4752-442c-a9ed-bb8ea0b31dd4" + }, + "period": { + "start": "1983-12-29T00:24:38-05:00" + }, + "careTeam": [ + { + "reference": "urn:uuid:ba4d5d85-c7ca-4c93-ab81-4a6bb23d6a7f" + } + ], + "addresses": [ + { + "reference": "urn:uuid:52207d7f-0b29-4fbd-a8ed-4b3f73373ef6" + } + ], + "goal": [ + { + "reference": "urn:uuid:cf5a54a4-2ec8-4acd-871f-1a59bbe7d992" + }, + { + "reference": "urn:uuid:0271e0b9-1743-49f0-a414-84826fd63d50" + } + ], + "activity": [ + { + "detail": { + "code": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "386463000", + "display": "Prescribed activity/exercise education" + } + ], + "text": "Prescribed activity/exercise education" + }, + "status": "in-progress", + "location": { + "display": "PCP145391" + } + } + }, + { + "detail": { + "code": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "413473000", + "display": "Counseling about alcohol consumption" + } + ], + "text": "Counseling about alcohol consumption" + }, + "status": "in-progress", + "location": { + "display": "PCP145391" + } + } + }, + { + "detail": { + "code": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "1151000175103", + "display": "Dietary approaches to stop hypertension diet" + } + ], + "text": "Dietary approaches to stop hypertension diet" + }, + "status": "in-progress", + "location": { + "display": "PCP145391" + } + } + }, + { + "detail": { + "code": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "225323000", + "display": "Smoking cessation education" + } + ], + "text": "Smoking cessation education" + }, + "status": "in-progress", + "location": { + "display": "PCP145391" + } + } + } + ] + }, + "request": { + "method": "POST", + "url": "CarePlan" + } + }, + { + "fullUrl": "urn:uuid:92f51b68-9ec2-499b-a6ba-b374200d9766", + "resource": { + "resourceType": "Claim", + "id": "92f51b68-9ec2-499b-a6ba-b374200d9766", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "1983-12-29T00:24:38-05:00", + "end": "1983-12-29T00:54:38-05:00" + }, + "created": "1983-12-29T00:54:38-05:00", + "provider": { + "reference": "urn:uuid:54f6fc59-7709-310f-9249-1e92d0464b00", + "display": "PCP145391" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "diagnosis": [ + { + "sequence": 1, + "diagnosisReference": { + "reference": "urn:uuid:52207d7f-0b29-4fbd-a8ed-4b3f73373ef6" + } + } + ], + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + }, + "encounter": [ + { + "reference": "urn:uuid:51142185-4752-442c-a9ed-bb8ea0b31dd4" + } + ] + }, + { + "sequence": 2, + "diagnosisSequence": [ + 1 + ], + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "59621000", + "display": "Hypertension" + } + ], + "text": "Hypertension" + } + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:54b88b5e-69b9-4d7e-ab6a-48b23e71004a", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "54b88b5e-69b9-4d7e-ab6a-48b23e71004a", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "92f51b68-9ec2-499b-a6ba-b374200d9766" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "1983-12-29T00:54:38-05:00", + "end": "1984-12-29T00:54:38-05:00" + }, + "created": "1983-12-29T00:54:38-05:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:92f51b68-9ec2-499b-a6ba-b374200d9766" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "diagnosis": [ + { + "sequence": 1, + "diagnosisReference": { + "reference": "urn:uuid:52207d7f-0b29-4fbd-a8ed-4b3f73373ef6" + }, + "type": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype", + "code": "principal" + } + ] + } + ] + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + }, + "servicedPeriod": { + "start": "1983-12-29T00:24:38-05:00", + "end": "1983-12-29T00:54:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "19", + "display": "Off Campus-Outpatient Hospital" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:51142185-4752-442c-a9ed-bb8ea0b31dd4" + } + ] + }, + { + "sequence": 2, + "diagnosisSequence": [ + 1 + ], + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "59621000", + "display": "Hypertension" + } + ], + "text": "Hypertension" + }, + "servicedPeriod": { + "start": "1983-12-29T00:24:38-05:00", + "end": "1983-12-29T00:54:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "19", + "display": "Off Campus-Outpatient Hospital" + } + ] + } + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 0.0, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + }, + { + "fullUrl": "urn:uuid:6d846e9f-40c3-42b5-a952-4401164102f7", + "resource": { + "resourceType": "Encounter", + "id": "6d846e9f-40c3-42b5-a952-4401164102f7", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "AMB" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710", + "display": "Dr. Shantae970 Cummerata161" + } + } + ], + "period": { + "start": "2009-11-19T00:24:38-05:00", + "end": "2009-11-19T00:39:38-05:00" + }, + "serviceProvider": { + "reference": "urn:uuid:54f6fc59-7709-310f-9249-1e92d0464b00", + "display": "PCP145391" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:87e26906-c3d6-424b-a0b8-28f51e7e00de", + "resource": { + "resourceType": "Observation", + "id": "87e26906-c3d6-424b-a0b8-28f51e7e00de", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8302-2", + "display": "Body Height" + } + ], + "text": "Body Height" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:6d846e9f-40c3-42b5-a952-4401164102f7" + }, + "effectiveDateTime": "2009-11-19T00:24:38-05:00", + "issued": "2009-11-19T00:24:38.752-05:00", + "valueQuantity": { + "value": 155.01680645430415, + "unit": "cm", + "system": "http://unitsofmeasure.org", + "code": "cm" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:2231ce31-cf31-4d96-80c6-93cedad1ab82", + "resource": { + "resourceType": "Observation", + "id": "2231ce31-cf31-4d96-80c6-93cedad1ab82", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "72514-3", + "display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported" + } + ], + "text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:6d846e9f-40c3-42b5-a952-4401164102f7" + }, + "effectiveDateTime": "2009-11-19T00:24:38-05:00", + "issued": "2009-11-19T00:24:38.752-05:00", + "valueQuantity": { + "value": 3.3512054198931174, + "unit": "{score}", + "system": "http://unitsofmeasure.org", + "code": "{score}" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:b21bb015-9965-4aed-8928-8da75982cb90", + "resource": { + "resourceType": "Observation", + "id": "b21bb015-9965-4aed-8928-8da75982cb90", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "29463-7", + "display": "Body Weight" + } + ], + "text": "Body Weight" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:6d846e9f-40c3-42b5-a952-4401164102f7" + }, + "effectiveDateTime": "2009-11-19T00:24:38-05:00", + "issued": "2009-11-19T00:24:38.752-05:00", + "valueQuantity": { + "value": 65.79684973105927, + "unit": "kg", + "system": "http://unitsofmeasure.org", + "code": "kg" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:3580afa4-29dc-4706-8074-dc783b6da239", + "resource": { + "resourceType": "Observation", + "id": "3580afa4-29dc-4706-8074-dc783b6da239", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "39156-5", + "display": "Body Mass Index" + } + ], + "text": "Body Mass Index" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:6d846e9f-40c3-42b5-a952-4401164102f7" + }, + "effectiveDateTime": "2009-11-19T00:24:38-05:00", + "issued": "2009-11-19T00:24:38.752-05:00", + "valueQuantity": { + "value": 27.38088803859094, + "unit": "kg/m2", + "system": "http://unitsofmeasure.org", + "code": "kg/m2" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:3088c179-0ef9-4fe7-899e-8a941bdac6f7", + "resource": { + "resourceType": "Observation", + "id": "3088c179-0ef9-4fe7-899e-8a941bdac6f7", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "55284-4", + "display": "Blood Pressure" + } + ], + "text": "Blood Pressure" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:6d846e9f-40c3-42b5-a952-4401164102f7" + }, + "effectiveDateTime": "2009-11-19T00:24:38-05:00", + "issued": "2009-11-19T00:24:38.752-05:00", + "component": [ + { + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8462-4", + "display": "Diastolic Blood Pressure" + } + ], + "text": "Diastolic Blood Pressure" + }, + "valueQuantity": { + "value": 84.85191424756442, + "unit": "mm[Hg]", + "system": "http://unitsofmeasure.org", + "code": "mm[Hg]" + } + }, + { + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8480-6", + "display": "Systolic Blood Pressure" + } + ], + "text": "Systolic Blood Pressure" + }, + "valueQuantity": { + "value": 103.6779728677694, + "unit": "mm[Hg]", + "system": "http://unitsofmeasure.org", + "code": "mm[Hg]" + } + } + ] + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:a2bb184e-d641-4585-ae20-153e8047b476", + "resource": { + "resourceType": "Observation", + "id": "a2bb184e-d641-4585-ae20-153e8047b476", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "survey", + "display": "survey" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "72166-2", + "display": "Tobacco smoking status NHIS" + } + ], + "text": "Tobacco smoking status NHIS" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:6d846e9f-40c3-42b5-a952-4401164102f7" + }, + "effectiveDateTime": "2009-11-19T00:24:38-05:00", + "issued": "2009-11-19T00:24:38.752-05:00", + "valueCodeableConcept": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "8517006", + "display": "Former smoker" + } + ], + "text": "Former smoker" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:b0af72c9-4314-4e9b-80a4-4c5d15a16bef", + "resource": { + "resourceType": "Immunization", + "id": "b0af72c9-4314-4e9b-80a4-4c5d15a16bef", + "status": "completed", + "vaccineCode": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:6d846e9f-40c3-42b5-a952-4401164102f7" + }, + "occurrenceDateTime": "2009-11-19T00:24:38-05:00", + "primarySource": true + }, + "request": { + "method": "POST", + "url": "Immunization" + } + }, + { + "fullUrl": "urn:uuid:d11073f7-618e-4b5e-b92b-25e5ec16866d", + "resource": { + "resourceType": "Claim", + "id": "d11073f7-618e-4b5e-b92b-25e5ec16866d", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "2009-11-19T00:24:38-05:00", + "end": "2009-11-19T00:39:38-05:00" + }, + "created": "2009-11-19T00:39:38-05:00", + "provider": { + "reference": "urn:uuid:54f6fc59-7709-310f-9249-1e92d0464b00", + "display": "PCP145391" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "supportingInfo": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory", + "code": "info" + } + ] + }, + "valueReference": { + "reference": "urn:uuid:b0af72c9-4314-4e9b-80a4-4c5d15a16bef" + } + } + ], + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + }, + "encounter": [ + { + "reference": "urn:uuid:6d846e9f-40c3-42b5-a952-4401164102f7" + } + ] + }, + { + "sequence": 2, + "informationSequence": [ + 1 + ], + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "net": { + "value": 140.52, + "currency": "USD" + } + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:00d3d0bd-6866-405e-a67e-45fed5c5c57d", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "00d3d0bd-6866-405e-a67e-45fed5c5c57d", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "d11073f7-618e-4b5e-b92b-25e5ec16866d" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "2009-11-19T00:39:38-05:00", + "end": "2010-11-19T00:39:38-05:00" + }, + "created": "2009-11-19T00:39:38-05:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:d11073f7-618e-4b5e-b92b-25e5ec16866d" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + }, + "servicedPeriod": { + "start": "2009-11-19T00:24:38-05:00", + "end": "2009-11-19T00:39:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "19", + "display": "Off Campus-Outpatient Hospital" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:6d846e9f-40c3-42b5-a952-4401164102f7" + } + ] + }, + { + "sequence": 2, + "informationSequence": [ + 1 + ], + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "servicedPeriod": { + "start": "2009-11-19T00:24:38-05:00", + "end": "2009-11-19T00:39:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "19", + "display": "Off Campus-Outpatient Hospital" + } + ] + }, + "net": { + "value": 140.52, + "currency": "USD" + }, + "adjudication": [ + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt", + "display": "Line Beneficiary Coinsurance Amount" + } + ] + }, + "amount": { + "value": 28.104000000000003, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt", + "display": "Line Provider Payment Amount" + } + ] + }, + "amount": { + "value": 112.41600000000001, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt", + "display": "Line Submitted Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt", + "display": "Line Allowed Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt", + "display": "Line Beneficiary Part B Deductible Amount" + } + ] + }, + "amount": { + "value": 0, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd", + "display": "Line Processing Indicator Code" + } + ] + } + } + ] + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 112.41600000000001, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + }, + { + "fullUrl": "urn:uuid:4f761b91-7603-461e-aecd-d18f297f6632", + "resource": { + "resourceType": "Encounter", + "id": "4f761b91-7603-461e-aecd-d18f297f6632", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "AMB" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "394701000", + "display": "Asthma follow-up" + } + ], + "text": "Asthma follow-up" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e", + "display": "Dr. Cedrick207 Lind531" + } + } + ], + "period": { + "start": "2010-03-15T01:24:38-04:00", + "end": "2010-03-15T01:39:38-04:00" + }, + "reasonCode": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "195967001", + "display": "Asthma" + } + ] + } + ], + "serviceProvider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:740d7f40-2418-44c8-91dc-1000eba4dc3b", + "resource": { + "resourceType": "Claim", + "id": "740d7f40-2418-44c8-91dc-1000eba4dc3b", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "2010-03-15T01:24:38-04:00", + "end": "2010-03-15T01:39:38-04:00" + }, + "created": "2010-03-15T01:39:38-04:00", + "provider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "394701000", + "display": "Asthma follow-up" + } + ], + "text": "Asthma follow-up" + }, + "encounter": [ + { + "reference": "urn:uuid:4f761b91-7603-461e-aecd-d18f297f6632" + } + ] + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:4bdb9df2-97fe-4faa-bee4-25f2d5df7547", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "4bdb9df2-97fe-4faa-bee4-25f2d5df7547", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "740d7f40-2418-44c8-91dc-1000eba4dc3b" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "2010-03-15T01:39:38-04:00", + "end": "2011-03-15T01:39:38-04:00" + }, + "created": "2010-03-15T01:39:38-04:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:740d7f40-2418-44c8-91dc-1000eba4dc3b" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "394701000", + "display": "Asthma follow-up" + } + ], + "text": "Asthma follow-up" + }, + "servicedPeriod": { + "start": "2010-03-15T01:24:38-04:00", + "end": "2010-03-15T01:39:38-04:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "21", + "display": "Inpatient Hospital" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:4f761b91-7603-461e-aecd-d18f297f6632" + } + ] + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 0.0, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + }, + { + "fullUrl": "urn:uuid:f0dfdfb3-d42d-428c-9314-d68283fcf087", + "resource": { + "resourceType": "Encounter", + "id": "f0dfdfb3-d42d-428c-9314-d68283fcf087", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "AMB" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185345009", + "display": "Encounter for symptom" + } + ], + "text": "Encounter for symptom" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e", + "display": "Dr. Cedrick207 Lind531" + } + } + ], + "period": { + "start": "2010-03-22T01:24:38-04:00", + "end": "2010-03-22T01:54:38-04:00" + }, + "reasonCode": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "195662009", + "display": "Acute viral pharyngitis (disorder)" + } + ] + } + ], + "serviceProvider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:20ff4a63-ada1-44f4-bff7-d951b0de4a2a", + "resource": { + "resourceType": "Condition", + "id": "20ff4a63-ada1-44f4-bff7-d951b0de4a2a", + "clinicalStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/condition-clinical", + "code": "resolved" + } + ] + }, + "verificationStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status", + "code": "confirmed" + } + ] + }, + "code": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "195662009", + "display": "Acute viral pharyngitis (disorder)" + } + ], + "text": "Acute viral pharyngitis (disorder)" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:f0dfdfb3-d42d-428c-9314-d68283fcf087" + }, + "onsetDateTime": "2010-03-22T01:24:38-04:00", + "abatementDateTime": "2010-03-30T01:24:38-04:00", + "recordedDate": "2010-03-22T01:24:38-04:00" + }, + "request": { + "method": "POST", + "url": "Condition" + } + }, + { + "fullUrl": "urn:uuid:09f5c351-3462-4977-9e41-fcd493d08e18", + "resource": { + "resourceType": "Observation", + "id": "09f5c351-3462-4977-9e41-fcd493d08e18", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8331-1", + "display": "Oral temperature" + } + ], + "text": "Oral temperature" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:f0dfdfb3-d42d-428c-9314-d68283fcf087" + }, + "effectiveDateTime": "2010-03-22T01:24:38-04:00", + "issued": "2010-03-22T01:24:38.752-04:00", + "valueQuantity": { + "value": 37.165995943945376, + "unit": "Cel", + "system": "http://unitsofmeasure.org", + "code": "Cel" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:b491e8d4-248f-4069-8098-a02cf194fc41", + "resource": { + "resourceType": "Procedure", + "id": "b491e8d4-248f-4069-8098-a02cf194fc41", + "status": "completed", + "code": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "117015009", + "display": "Throat culture (procedure)" + } + ], + "text": "Throat culture (procedure)" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:f0dfdfb3-d42d-428c-9314-d68283fcf087" + }, + "performedPeriod": { + "start": "2010-03-22T01:24:38-04:00", + "end": "2010-03-22T01:39:38-04:00" + }, + "reasonReference": [ + { + "reference": "urn:uuid:20ff4a63-ada1-44f4-bff7-d951b0de4a2a", + "display": "Acute viral pharyngitis (disorder)" + } + ] + }, + "request": { + "method": "POST", + "url": "Procedure" + } + }, + { + "fullUrl": "urn:uuid:5e6e954f-8767-4479-b2fd-908554450698", + "resource": { + "resourceType": "Claim", + "id": "5e6e954f-8767-4479-b2fd-908554450698", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "2010-03-22T01:24:38-04:00", + "end": "2010-03-22T01:54:38-04:00" + }, + "created": "2010-03-22T01:54:38-04:00", + "provider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "diagnosis": [ + { + "sequence": 1, + "diagnosisReference": { + "reference": "urn:uuid:20ff4a63-ada1-44f4-bff7-d951b0de4a2a" + } + } + ], + "procedure": [ + { + "sequence": 1, + "procedureReference": { + "reference": "urn:uuid:b491e8d4-248f-4069-8098-a02cf194fc41" + } + } + ], + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185345009", + "display": "Encounter for symptom" + } + ], + "text": "Encounter for symptom" + }, + "encounter": [ + { + "reference": "urn:uuid:f0dfdfb3-d42d-428c-9314-d68283fcf087" + } + ] + }, + { + "sequence": 2, + "diagnosisSequence": [ + 1 + ], + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "195662009", + "display": "Acute viral pharyngitis (disorder)" + } + ], + "text": "Acute viral pharyngitis (disorder)" + } + }, + { + "sequence": 3, + "procedureSequence": [ + 1 + ], + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "117015009", + "display": "Throat culture (procedure)" + } + ], + "text": "Throat culture (procedure)" + }, + "net": { + "value": 1327.91, + "currency": "USD" + } + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:ce04e563-4435-4383-b2c1-536b9595f39e", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "ce04e563-4435-4383-b2c1-536b9595f39e", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "5e6e954f-8767-4479-b2fd-908554450698" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "2010-03-22T01:54:38-04:00", + "end": "2011-03-22T01:54:38-04:00" + }, + "created": "2010-03-22T01:54:38-04:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:5e6e954f-8767-4479-b2fd-908554450698" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "diagnosis": [ + { + "sequence": 1, + "diagnosisReference": { + "reference": "urn:uuid:20ff4a63-ada1-44f4-bff7-d951b0de4a2a" + }, + "type": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype", + "code": "principal" + } + ] + } + ] + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185345009", + "display": "Encounter for symptom" + } + ], + "text": "Encounter for symptom" + }, + "servicedPeriod": { + "start": "2010-03-22T01:24:38-04:00", + "end": "2010-03-22T01:54:38-04:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "21", + "display": "Inpatient Hospital" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:f0dfdfb3-d42d-428c-9314-d68283fcf087" + } + ] + }, + { + "sequence": 2, + "diagnosisSequence": [ + 1 + ], + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "195662009", + "display": "Acute viral pharyngitis (disorder)" + } + ], + "text": "Acute viral pharyngitis (disorder)" + }, + "servicedPeriod": { + "start": "2010-03-22T01:24:38-04:00", + "end": "2010-03-22T01:54:38-04:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "21", + "display": "Inpatient Hospital" + } + ] + } + }, + { + "sequence": 3, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "117015009", + "display": "Throat culture (procedure)" + } + ], + "text": "Throat culture (procedure)" + }, + "servicedPeriod": { + "start": "2010-03-22T01:24:38-04:00", + "end": "2010-03-22T01:54:38-04:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "21", + "display": "Inpatient Hospital" + } + ] + }, + "net": { + "value": 1327.91, + "currency": "USD" + }, + "adjudication": [ + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt", + "display": "Line Beneficiary Coinsurance Amount" + } + ] + }, + "amount": { + "value": 265.58200000000005, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt", + "display": "Line Provider Payment Amount" + } + ] + }, + "amount": { + "value": 1062.3280000000002, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt", + "display": "Line Submitted Charge Amount" + } + ] + }, + "amount": { + "value": 1327.91, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt", + "display": "Line Allowed Charge Amount" + } + ] + }, + "amount": { + "value": 1327.91, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt", + "display": "Line Beneficiary Part B Deductible Amount" + } + ] + }, + "amount": { + "value": 0, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd", + "display": "Line Processing Indicator Code" + } + ] + } + } + ] + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 1062.3280000000002, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + }, + { + "fullUrl": "urn:uuid:f1313c7d-3148-335b-adc3-337f15567b82", + "resource": { + "resourceType": "Organization", + "id": "f1313c7d-3148-335b-adc3-337f15567b82", + "identifier": [ + { + "system": "https://github.com/synthetichealth/synthea", + "value": "f1313c7d-3148-335b-adc3-337f15567b82" + } + ], + "active": true, + "type": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/organization-type", + "code": "prov", + "display": "Healthcare Provider" + } + ], + "text": "Healthcare Provider" + } + ], + "name": "WINCHESTER HOSPITAL FAMILY MEDICAL CENTER", + "telecom": [ + { + "system": "phone", + "value": "978-988-6105" + } + ], + "address": [ + { + "line": [ + "500 SALEM STREET" + ], + "city": "WILMINGTON", + "state": "MA", + "postalCode": "1887", + "country": "US" + } + ] + }, + "request": { + "method": "POST", + "url": "Organization" + } + }, + { + "fullUrl": "urn:uuid:0000016d-3a85-4cca-0000-000000016c9c", + "resource": { + "resourceType": "Practitioner", + "id": "0000016d-3a85-4cca-0000-000000016c9c", + "identifier": [ + { + "system": "http://hl7.org/fhir/sid/us-npi", + "value": "93340" + } + ], + "active": true, + "name": [ + { + "family": "Pouros728", + "given": [ + "Jacquelyn628" + ], + "prefix": [ + "Dr." + ] + } + ], + "telecom": [ + { + "system": "email", + "value": "Jacquelyn628.Pouros728@example.com", + "use": "work" + } + ], + "address": [ + { + "line": [ + "500 SALEM STREET" + ], + "city": "WILMINGTON", + "state": "MA", + "postalCode": "1887", + "country": "US" + } + ], + "gender": "female" + }, + "request": { + "method": "POST", + "url": "Practitioner" + } + }, + { + "fullUrl": "urn:uuid:31c17645-917b-4a93-8351-f8082dc5ac4e", + "resource": { + "resourceType": "Encounter", + "id": "31c17645-917b-4a93-8351-f8082dc5ac4e", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "AMB" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "702927004", + "display": "Urgent care clinic (procedure)" + } + ], + "text": "Urgent care clinic (procedure)" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-000000016c9c", + "display": "Dr. Jacquelyn628 Pouros728" + } + } + ], + "period": { + "start": "2010-04-01T01:24:38-04:00", + "end": "2010-04-01T01:39:38-04:00" + }, + "serviceProvider": { + "reference": "urn:uuid:f1313c7d-3148-335b-adc3-337f15567b82", + "display": "WINCHESTER HOSPITAL FAMILY MEDICAL CENTER" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:0005c0c0-7a46-417b-b856-fd3967e12425", + "resource": { + "resourceType": "Immunization", + "id": "0005c0c0-7a46-417b-b856-fd3967e12425", + "status": "completed", + "vaccineCode": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:31c17645-917b-4a93-8351-f8082dc5ac4e" + }, + "occurrenceDateTime": "2010-04-01T01:24:38-04:00", + "primarySource": true + }, + "request": { + "method": "POST", + "url": "Immunization" + } + }, + { + "fullUrl": "urn:uuid:bab12743-0520-479b-89d2-a1aca8c4715e", + "resource": { + "resourceType": "Claim", + "id": "bab12743-0520-479b-89d2-a1aca8c4715e", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "2010-04-01T01:24:38-04:00", + "end": "2010-04-01T01:39:38-04:00" + }, + "created": "2010-04-01T01:39:38-04:00", + "provider": { + "reference": "urn:uuid:f1313c7d-3148-335b-adc3-337f15567b82", + "display": "WINCHESTER HOSPITAL FAMILY MEDICAL CENTER" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "supportingInfo": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory", + "code": "info" + } + ] + }, + "valueReference": { + "reference": "urn:uuid:0005c0c0-7a46-417b-b856-fd3967e12425" + } + } + ], + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "702927004", + "display": "Urgent care clinic (procedure)" + } + ], + "text": "Urgent care clinic (procedure)" + }, + "encounter": [ + { + "reference": "urn:uuid:31c17645-917b-4a93-8351-f8082dc5ac4e" + } + ] + }, + { + "sequence": 2, + "informationSequence": [ + 1 + ], + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "net": { + "value": 140.52, + "currency": "USD" + } + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:d77fe71b-1ef3-4187-8b33-a264a09d9c4d", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "d77fe71b-1ef3-4187-8b33-a264a09d9c4d", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-000000016c9c" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-000000016c9c" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "bab12743-0520-479b-89d2-a1aca8c4715e" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "2010-04-01T01:39:38-04:00", + "end": "2011-04-01T01:39:38-04:00" + }, + "created": "2010-04-01T01:39:38-04:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-000000016c9c" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:bab12743-0520-479b-89d2-a1aca8c4715e" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-000000016c9c" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "702927004", + "display": "Urgent care clinic (procedure)" + } + ], + "text": "Urgent care clinic (procedure)" + }, + "servicedPeriod": { + "start": "2010-04-01T01:24:38-04:00", + "end": "2010-04-01T01:39:38-04:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "20", + "display": "Urgent Care Facility" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:31c17645-917b-4a93-8351-f8082dc5ac4e" + } + ] + }, + { + "sequence": 2, + "informationSequence": [ + 1 + ], + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "servicedPeriod": { + "start": "2010-04-01T01:24:38-04:00", + "end": "2010-04-01T01:39:38-04:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "20", + "display": "Urgent Care Facility" + } + ] + }, + "net": { + "value": 140.52, + "currency": "USD" + }, + "adjudication": [ + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt", + "display": "Line Beneficiary Coinsurance Amount" + } + ] + }, + "amount": { + "value": 28.104000000000003, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt", + "display": "Line Provider Payment Amount" + } + ] + }, + "amount": { + "value": 112.41600000000001, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt", + "display": "Line Submitted Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt", + "display": "Line Allowed Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt", + "display": "Line Beneficiary Part B Deductible Amount" + } + ] + }, + "amount": { + "value": 0, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd", + "display": "Line Processing Indicator Code" + } + ] + } + } + ] + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 112.41600000000001, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + }, + { + "fullUrl": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5", + "resource": { + "resourceType": "Encounter", + "id": "b5dbf510-069c-4db5-aa4a-6f5cca4f62f5", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "AMB" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710", + "display": "Dr. Shantae970 Cummerata161" + } + } + ], + "period": { + "start": "2011-11-24T00:24:38-05:00", + "end": "2011-11-24T00:39:38-05:00" + }, + "serviceProvider": { + "reference": "urn:uuid:54f6fc59-7709-310f-9249-1e92d0464b00", + "display": "PCP145391" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:06135771-d68c-49a3-a76c-bd67f244e9ba", + "resource": { + "resourceType": "Observation", + "id": "06135771-d68c-49a3-a76c-bd67f244e9ba", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8302-2", + "display": "Body Height" + } + ], + "text": "Body Height" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "valueQuantity": { + "value": 155.01680645430415, + "unit": "cm", + "system": "http://unitsofmeasure.org", + "code": "cm" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:9afc08b7-cced-4256-92c2-3bc88820eff5", + "resource": { + "resourceType": "Observation", + "id": "9afc08b7-cced-4256-92c2-3bc88820eff5", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "72514-3", + "display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported" + } + ], + "text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "valueQuantity": { + "value": 2.5789023713849293, + "unit": "{score}", + "system": "http://unitsofmeasure.org", + "code": "{score}" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:f5bb1c0e-cc13-40ad-8ede-31298b5f2470", + "resource": { + "resourceType": "Observation", + "id": "f5bb1c0e-cc13-40ad-8ede-31298b5f2470", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "29463-7", + "display": "Body Weight" + } + ], + "text": "Body Weight" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "valueQuantity": { + "value": 65.79684973105927, + "unit": "kg", + "system": "http://unitsofmeasure.org", + "code": "kg" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:47218695-6cf7-45f6-be1f-e9ef32f49b01", + "resource": { + "resourceType": "Observation", + "id": "47218695-6cf7-45f6-be1f-e9ef32f49b01", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "39156-5", + "display": "Body Mass Index" + } + ], + "text": "Body Mass Index" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "valueQuantity": { + "value": 27.38088803859094, + "unit": "kg/m2", + "system": "http://unitsofmeasure.org", + "code": "kg/m2" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:b30d3a05-767e-40ee-81a0-bceef6b07a34", + "resource": { + "resourceType": "Observation", + "id": "b30d3a05-767e-40ee-81a0-bceef6b07a34", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "55284-4", + "display": "Blood Pressure" + } + ], + "text": "Blood Pressure" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "component": [ + { + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8462-4", + "display": "Diastolic Blood Pressure" + } + ], + "text": "Diastolic Blood Pressure" + }, + "valueQuantity": { + "value": 72.98831814031367, + "unit": "mm[Hg]", + "system": "http://unitsofmeasure.org", + "code": "mm[Hg]" + } + }, + { + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8480-6", + "display": "Systolic Blood Pressure" + } + ], + "text": "Systolic Blood Pressure" + }, + "valueQuantity": { + "value": 131.85005905322754, + "unit": "mm[Hg]", + "system": "http://unitsofmeasure.org", + "code": "mm[Hg]" + } + } + ] + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:92d29bf9-7185-4bb8-845c-ff21daa0731c", + "resource": { + "resourceType": "Observation", + "id": "92d29bf9-7185-4bb8-845c-ff21daa0731c", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "2093-3", + "display": "Total Cholesterol" + } + ], + "text": "Total Cholesterol" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "valueQuantity": { + "value": 189.12126181004368, + "unit": "mg/dL", + "system": "http://unitsofmeasure.org", + "code": "mg/dL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:fed82905-ced9-4774-905b-2211d342dacf", + "resource": { + "resourceType": "Observation", + "id": "fed82905-ced9-4774-905b-2211d342dacf", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "2571-8", + "display": "Triglycerides" + } + ], + "text": "Triglycerides" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "valueQuantity": { + "value": 110.93157888298342, + "unit": "mg/dL", + "system": "http://unitsofmeasure.org", + "code": "mg/dL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:03ccbed2-d2da-455b-8121-fb2974759051", + "resource": { + "resourceType": "Observation", + "id": "03ccbed2-d2da-455b-8121-fb2974759051", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "18262-6", + "display": "Low Density Lipoprotein Cholesterol" + } + ], + "text": "Low Density Lipoprotein Cholesterol" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "valueQuantity": { + "value": 89.15392652380663, + "unit": "mg/dL", + "system": "http://unitsofmeasure.org", + "code": "mg/dL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:1e23261c-fa8b-4497-bcca-6110e490c0f4", + "resource": { + "resourceType": "Observation", + "id": "1e23261c-fa8b-4497-bcca-6110e490c0f4", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "2085-9", + "display": "High Density Lipoprotein Cholesterol" + } + ], + "text": "High Density Lipoprotein Cholesterol" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "valueQuantity": { + "value": 77.78101950964036, + "unit": "mg/dL", + "system": "http://unitsofmeasure.org", + "code": "mg/dL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:31d999a0-f89a-4bfd-8cf5-c1fc6054784a", + "resource": { + "resourceType": "Observation", + "id": "31d999a0-f89a-4bfd-8cf5-c1fc6054784a", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "6690-2", + "display": "Leukocytes [#/volume] in Blood by Automated count" + } + ], + "text": "Leukocytes [#/volume] in Blood by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "valueQuantity": { + "value": 9.963408128633784, + "unit": "10*3/uL", + "system": "http://unitsofmeasure.org", + "code": "10*3/uL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:3f22617b-498e-485d-9096-b195d90cbef2", + "resource": { + "resourceType": "Observation", + "id": "3f22617b-498e-485d-9096-b195d90cbef2", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "789-8", + "display": "Erythrocytes [#/volume] in Blood by Automated count" + } + ], + "text": "Erythrocytes [#/volume] in Blood by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "valueQuantity": { + "value": 3.953323310741711, + "unit": "10*6/uL", + "system": "http://unitsofmeasure.org", + "code": "10*6/uL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:1a16a45b-3f9e-43fc-91f8-85cbbb9674f1", + "resource": { + "resourceType": "Observation", + "id": "1a16a45b-3f9e-43fc-91f8-85cbbb9674f1", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "718-7", + "display": "Hemoglobin [Mass/volume] in Blood" + } + ], + "text": "Hemoglobin [Mass/volume] in Blood" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "valueQuantity": { + "value": 14.656768990520666, + "unit": "g/dL", + "system": "http://unitsofmeasure.org", + "code": "g/dL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:c4c75eae-9b86-4642-b471-a24f72480c0b", + "resource": { + "resourceType": "Observation", + "id": "c4c75eae-9b86-4642-b471-a24f72480c0b", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "4544-3", + "display": "Hematocrit [Volume Fraction] of Blood by Automated count" + } + ], + "text": "Hematocrit [Volume Fraction] of Blood by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "valueQuantity": { + "value": 48.44143477628018, + "unit": "%", + "system": "http://unitsofmeasure.org", + "code": "%" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:8b533527-2970-44a9-9516-9c6b56eb3a53", + "resource": { + "resourceType": "Observation", + "id": "8b533527-2970-44a9-9516-9c6b56eb3a53", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "787-2", + "display": "MCV [Entitic volume] by Automated count" + } + ], + "text": "MCV [Entitic volume] by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "valueQuantity": { + "value": 89.23779935011983, + "unit": "fL", + "system": "http://unitsofmeasure.org", + "code": "fL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:9c0e0441-a657-4372-ba1c-24a01ab0ffcd", + "resource": { + "resourceType": "Observation", + "id": "9c0e0441-a657-4372-ba1c-24a01ab0ffcd", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "785-6", + "display": "MCH [Entitic mass] by Automated count" + } + ], + "text": "MCH [Entitic mass] by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "valueQuantity": { + "value": 27.43081477867061, + "unit": "pg", + "system": "http://unitsofmeasure.org", + "code": "pg" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:e7c1564e-e4a8-448a-9ba3-eae24e61514f", + "resource": { + "resourceType": "Observation", + "id": "e7c1564e-e4a8-448a-9ba3-eae24e61514f", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "786-4", + "display": "MCHC [Mass/volume] by Automated count" + } + ], + "text": "MCHC [Mass/volume] by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "valueQuantity": { + "value": 33.15719128456441, + "unit": "g/dL", + "system": "http://unitsofmeasure.org", + "code": "g/dL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:0b9da397-a08a-4181-bab2-144957ce2dc3", + "resource": { + "resourceType": "Observation", + "id": "0b9da397-a08a-4181-bab2-144957ce2dc3", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "21000-5", + "display": "Erythrocyte distribution width [Entitic volume] by Automated count" + } + ], + "text": "Erythrocyte distribution width [Entitic volume] by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "valueQuantity": { + "value": 44.015084388458064, + "unit": "fL", + "system": "http://unitsofmeasure.org", + "code": "fL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:ce35a31f-e2af-4510-be31-6ecf5bcaba49", + "resource": { + "resourceType": "Observation", + "id": "ce35a31f-e2af-4510-be31-6ecf5bcaba49", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "777-3", + "display": "Platelets [#/volume] in Blood by Automated count" + } + ], + "text": "Platelets [#/volume] in Blood by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "valueQuantity": { + "value": 210.6273154244719, + "unit": "10*3/uL", + "system": "http://unitsofmeasure.org", + "code": "10*3/uL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:78fd90eb-a447-4ed8-a1c2-6335d9974d91", + "resource": { + "resourceType": "Observation", + "id": "78fd90eb-a447-4ed8-a1c2-6335d9974d91", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "32207-3", + "display": "Platelet distribution width [Entitic volume] in Blood by Automated count" + } + ], + "text": "Platelet distribution width [Entitic volume] in Blood by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "valueQuantity": { + "value": 268.67951473420686, + "unit": "fL", + "system": "http://unitsofmeasure.org", + "code": "fL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:cf37b6d7-243c-41bc-9ac1-50b62d0dbb91", + "resource": { + "resourceType": "Observation", + "id": "cf37b6d7-243c-41bc-9ac1-50b62d0dbb91", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "32623-1", + "display": "Platelet mean volume [Entitic volume] in Blood by Automated count" + } + ], + "text": "Platelet mean volume [Entitic volume] in Blood by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "valueQuantity": { + "value": 11.230019304893485, + "unit": "fL", + "system": "http://unitsofmeasure.org", + "code": "fL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:e96f044a-4cd5-4892-8c7d-aa004fdd18d2", + "resource": { + "resourceType": "Observation", + "id": "e96f044a-4cd5-4892-8c7d-aa004fdd18d2", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "survey", + "display": "survey" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "72166-2", + "display": "Tobacco smoking status NHIS" + } + ], + "text": "Tobacco smoking status NHIS" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "valueCodeableConcept": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "8517006", + "display": "Former smoker" + } + ], + "text": "Former smoker" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:91fb533f-942b-44af-8c67-5ea322a27ef6", + "resource": { + "resourceType": "Immunization", + "id": "91fb533f-942b-44af-8c67-5ea322a27ef6", + "status": "completed", + "vaccineCode": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "occurrenceDateTime": "2011-11-24T00:24:38-05:00", + "primarySource": true + }, + "request": { + "method": "POST", + "url": "Immunization" + } + }, + { + "fullUrl": "urn:uuid:cce6f3b0-ebbf-4d01-8c33-667be472ccc9", + "resource": { + "resourceType": "DiagnosticReport", + "id": "cce6f3b0-ebbf-4d01-8c33-667be472ccc9", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/v2-0074", + "code": "LAB", + "display": "Laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "57698-3", + "display": "Lipid Panel" + } + ], + "text": "Lipid Panel" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "result": [ + { + "reference": "urn:uuid:92d29bf9-7185-4bb8-845c-ff21daa0731c", + "display": "Total Cholesterol" + }, + { + "reference": "urn:uuid:fed82905-ced9-4774-905b-2211d342dacf", + "display": "Triglycerides" + }, + { + "reference": "urn:uuid:03ccbed2-d2da-455b-8121-fb2974759051", + "display": "Low Density Lipoprotein Cholesterol" + }, + { + "reference": "urn:uuid:1e23261c-fa8b-4497-bcca-6110e490c0f4", + "display": "High Density Lipoprotein Cholesterol" + } + ] + }, + "request": { + "method": "POST", + "url": "DiagnosticReport" + } + }, + { + "fullUrl": "urn:uuid:9f007049-35c6-4b31-8084-022d11181a05", + "resource": { + "resourceType": "DiagnosticReport", + "id": "9f007049-35c6-4b31-8084-022d11181a05", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/v2-0074", + "code": "LAB", + "display": "Laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "58410-2", + "display": "Complete blood count (hemogram) panel - Blood by Automated count" + } + ], + "text": "Complete blood count (hemogram) panel - Blood by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + }, + "effectiveDateTime": "2011-11-24T00:24:38-05:00", + "issued": "2011-11-24T00:24:38.752-05:00", + "result": [ + { + "reference": "urn:uuid:31d999a0-f89a-4bfd-8cf5-c1fc6054784a", + "display": "Leukocytes [#/volume] in Blood by Automated count" + }, + { + "reference": "urn:uuid:3f22617b-498e-485d-9096-b195d90cbef2", + "display": "Erythrocytes [#/volume] in Blood by Automated count" + }, + { + "reference": "urn:uuid:1a16a45b-3f9e-43fc-91f8-85cbbb9674f1", + "display": "Hemoglobin [Mass/volume] in Blood" + }, + { + "reference": "urn:uuid:c4c75eae-9b86-4642-b471-a24f72480c0b", + "display": "Hematocrit [Volume Fraction] of Blood by Automated count" + }, + { + "reference": "urn:uuid:8b533527-2970-44a9-9516-9c6b56eb3a53", + "display": "MCV [Entitic volume] by Automated count" + }, + { + "reference": "urn:uuid:9c0e0441-a657-4372-ba1c-24a01ab0ffcd", + "display": "MCH [Entitic mass] by Automated count" + }, + { + "reference": "urn:uuid:e7c1564e-e4a8-448a-9ba3-eae24e61514f", + "display": "MCHC [Mass/volume] by Automated count" + }, + { + "reference": "urn:uuid:0b9da397-a08a-4181-bab2-144957ce2dc3", + "display": "Erythrocyte distribution width [Entitic volume] by Automated count" + }, + { + "reference": "urn:uuid:ce35a31f-e2af-4510-be31-6ecf5bcaba49", + "display": "Platelets [#/volume] in Blood by Automated count" + }, + { + "reference": "urn:uuid:78fd90eb-a447-4ed8-a1c2-6335d9974d91", + "display": "Platelet distribution width [Entitic volume] in Blood by Automated count" + }, + { + "reference": "urn:uuid:cf37b6d7-243c-41bc-9ac1-50b62d0dbb91", + "display": "Platelet mean volume [Entitic volume] in Blood by Automated count" + } + ] + }, + "request": { + "method": "POST", + "url": "DiagnosticReport" + } + }, + { + "fullUrl": "urn:uuid:7e580db2-ee89-4bef-a510-12f2ac002519", + "resource": { + "resourceType": "Claim", + "id": "7e580db2-ee89-4bef-a510-12f2ac002519", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "2011-11-24T00:24:38-05:00", + "end": "2011-11-24T00:39:38-05:00" + }, + "created": "2011-11-24T00:39:38-05:00", + "provider": { + "reference": "urn:uuid:54f6fc59-7709-310f-9249-1e92d0464b00", + "display": "PCP145391" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "supportingInfo": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory", + "code": "info" + } + ] + }, + "valueReference": { + "reference": "urn:uuid:91fb533f-942b-44af-8c67-5ea322a27ef6" + } + } + ], + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + }, + "encounter": [ + { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + } + ] + }, + { + "sequence": 2, + "informationSequence": [ + 1 + ], + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "net": { + "value": 140.52, + "currency": "USD" + } + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:a34c786d-48aa-4f06-b6ea-f043b45176ba", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "a34c786d-48aa-4f06-b6ea-f043b45176ba", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "7e580db2-ee89-4bef-a510-12f2ac002519" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "2011-11-24T00:39:38-05:00", + "end": "2012-11-24T00:39:38-05:00" + }, + "created": "2011-11-24T00:39:38-05:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:7e580db2-ee89-4bef-a510-12f2ac002519" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + }, + "servicedPeriod": { + "start": "2011-11-24T00:24:38-05:00", + "end": "2011-11-24T00:39:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "19", + "display": "Off Campus-Outpatient Hospital" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:b5dbf510-069c-4db5-aa4a-6f5cca4f62f5" + } + ] + }, + { + "sequence": 2, + "informationSequence": [ + 1 + ], + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "servicedPeriod": { + "start": "2011-11-24T00:24:38-05:00", + "end": "2011-11-24T00:39:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "19", + "display": "Off Campus-Outpatient Hospital" + } + ] + }, + "net": { + "value": 140.52, + "currency": "USD" + }, + "adjudication": [ + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt", + "display": "Line Beneficiary Coinsurance Amount" + } + ] + }, + "amount": { + "value": 28.104000000000003, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt", + "display": "Line Provider Payment Amount" + } + ] + }, + "amount": { + "value": 112.41600000000001, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt", + "display": "Line Submitted Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt", + "display": "Line Allowed Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt", + "display": "Line Beneficiary Part B Deductible Amount" + } + ] + }, + "amount": { + "value": 0, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd", + "display": "Line Processing Indicator Code" + } + ] + } + } + ] + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 112.41600000000001, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + }, + { + "fullUrl": "urn:uuid:8c31170c-62fc-4eb6-88a9-c92cb1966350", + "resource": { + "resourceType": "Encounter", + "id": "8c31170c-62fc-4eb6-88a9-c92cb1966350", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "AMB" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185349003", + "display": "Encounter for check up (procedure)" + } + ], + "text": "Encounter for check up (procedure)" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e", + "display": "Dr. Cedrick207 Lind531" + } + } + ], + "period": { + "start": "2012-05-10T01:24:38-04:00", + "end": "2012-05-10T01:39:38-04:00" + }, + "serviceProvider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:229dc440-7417-4bd3-902c-e626972aa508", + "resource": { + "resourceType": "Immunization", + "id": "229dc440-7417-4bd3-902c-e626972aa508", + "status": "completed", + "vaccineCode": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:8c31170c-62fc-4eb6-88a9-c92cb1966350" + }, + "occurrenceDateTime": "2012-05-10T01:24:38-04:00", + "primarySource": true + }, + "request": { + "method": "POST", + "url": "Immunization" + } + }, + { + "fullUrl": "urn:uuid:d088c2b8-6235-46cc-99fa-595a2099b302", + "resource": { + "resourceType": "Claim", + "id": "d088c2b8-6235-46cc-99fa-595a2099b302", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "2012-05-10T01:24:38-04:00", + "end": "2012-05-10T01:39:38-04:00" + }, + "created": "2012-05-10T01:39:38-04:00", + "provider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "supportingInfo": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory", + "code": "info" + } + ] + }, + "valueReference": { + "reference": "urn:uuid:229dc440-7417-4bd3-902c-e626972aa508" + } + } + ], + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185349003", + "display": "Encounter for check up (procedure)" + } + ], + "text": "Encounter for check up (procedure)" + }, + "encounter": [ + { + "reference": "urn:uuid:8c31170c-62fc-4eb6-88a9-c92cb1966350" + } + ] + }, + { + "sequence": 2, + "informationSequence": [ + 1 + ], + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "net": { + "value": 140.52, + "currency": "USD" + } + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:1c1e10f9-aa1b-4b8f-8cda-fc941def3e69", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "1c1e10f9-aa1b-4b8f-8cda-fc941def3e69", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "d088c2b8-6235-46cc-99fa-595a2099b302" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "2012-05-10T01:39:38-04:00", + "end": "2013-05-10T01:39:38-04:00" + }, + "created": "2012-05-10T01:39:38-04:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:d088c2b8-6235-46cc-99fa-595a2099b302" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185349003", + "display": "Encounter for check up (procedure)" + } + ], + "text": "Encounter for check up (procedure)" + }, + "servicedPeriod": { + "start": "2012-05-10T01:24:38-04:00", + "end": "2012-05-10T01:39:38-04:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "21", + "display": "Inpatient Hospital" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:8c31170c-62fc-4eb6-88a9-c92cb1966350" + } + ] + }, + { + "sequence": 2, + "informationSequence": [ + 1 + ], + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "servicedPeriod": { + "start": "2012-05-10T01:24:38-04:00", + "end": "2012-05-10T01:39:38-04:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "21", + "display": "Inpatient Hospital" + } + ] + }, + "net": { + "value": 140.52, + "currency": "USD" + }, + "adjudication": [ + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt", + "display": "Line Beneficiary Coinsurance Amount" + } + ] + }, + "amount": { + "value": 28.104000000000003, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt", + "display": "Line Provider Payment Amount" + } + ] + }, + "amount": { + "value": 112.41600000000001, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt", + "display": "Line Submitted Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt", + "display": "Line Allowed Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt", + "display": "Line Beneficiary Part B Deductible Amount" + } + ] + }, + "amount": { + "value": 0, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd", + "display": "Line Processing Indicator Code" + } + ] + } + } + ] + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 112.41600000000001, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + }, + { + "fullUrl": "urn:uuid:443b45e3-bac2-47f4-b169-c47a1844a91d", + "resource": { + "resourceType": "Encounter", + "id": "443b45e3-bac2-47f4-b169-c47a1844a91d", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "AMB" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185345009", + "display": "Encounter for symptom" + } + ], + "text": "Encounter for symptom" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e", + "display": "Dr. Cedrick207 Lind531" + } + } + ], + "period": { + "start": "2012-05-06T01:24:38-04:00", + "end": "2012-05-06T01:39:38-04:00" + }, + "reasonCode": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "444814009", + "display": "Viral sinusitis (disorder)" + } + ] + } + ], + "serviceProvider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:df427f8b-43f3-48e6-8c0c-16c7a369cad4", + "resource": { + "resourceType": "Condition", + "id": "df427f8b-43f3-48e6-8c0c-16c7a369cad4", + "clinicalStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/condition-clinical", + "code": "resolved" + } + ] + }, + "verificationStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status", + "code": "confirmed" + } + ] + }, + "code": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "444814009", + "display": "Viral sinusitis (disorder)" + } + ], + "text": "Viral sinusitis (disorder)" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:443b45e3-bac2-47f4-b169-c47a1844a91d" + }, + "onsetDateTime": "2012-05-06T01:24:38-04:00", + "abatementDateTime": "2012-05-20T01:24:38-04:00", + "recordedDate": "2012-05-06T01:24:38-04:00" + }, + "request": { + "method": "POST", + "url": "Condition" + } + }, + { + "fullUrl": "urn:uuid:b1637edf-bd6f-448a-b545-7f964cb05039", + "resource": { + "resourceType": "Observation", + "id": "b1637edf-bd6f-448a-b545-7f964cb05039", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8302-2", + "display": "Body Height" + } + ], + "text": "Body Height" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:443b45e3-bac2-47f4-b169-c47a1844a91d" + }, + "effectiveDateTime": "2012-05-10T01:24:38-04:00", + "issued": "2012-05-10T01:24:38.752-04:00", + "valueQuantity": { + "value": 155.01680645430415, + "unit": "cm", + "system": "http://unitsofmeasure.org", + "code": "cm" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:8972edca-cd45-444c-841f-e57e31bfc436", + "resource": { + "resourceType": "Observation", + "id": "8972edca-cd45-444c-841f-e57e31bfc436", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "72514-3", + "display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported" + } + ], + "text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:443b45e3-bac2-47f4-b169-c47a1844a91d" + }, + "effectiveDateTime": "2012-05-10T01:24:38-04:00", + "issued": "2012-05-10T01:24:38.752-04:00", + "valueQuantity": { + "value": 1.3611606013389705, + "unit": "{score}", + "system": "http://unitsofmeasure.org", + "code": "{score}" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:3b2b3fac-c1f4-4ef4-b924-ddea599ececb", + "resource": { + "resourceType": "Observation", + "id": "3b2b3fac-c1f4-4ef4-b924-ddea599ececb", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "29463-7", + "display": "Body Weight" + } + ], + "text": "Body Weight" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:443b45e3-bac2-47f4-b169-c47a1844a91d" + }, + "effectiveDateTime": "2012-05-10T01:24:38-04:00", + "issued": "2012-05-10T01:24:38.752-04:00", + "valueQuantity": { + "value": 65.79684973105927, + "unit": "kg", + "system": "http://unitsofmeasure.org", + "code": "kg" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:24bbf580-0dda-4cae-b31a-7c090af87860", + "resource": { + "resourceType": "Observation", + "id": "24bbf580-0dda-4cae-b31a-7c090af87860", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "39156-5", + "display": "Body Mass Index" + } + ], + "text": "Body Mass Index" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:443b45e3-bac2-47f4-b169-c47a1844a91d" + }, + "effectiveDateTime": "2012-05-10T01:24:38-04:00", + "issued": "2012-05-10T01:24:38.752-04:00", + "valueQuantity": { + "value": 27.38088803859094, + "unit": "kg/m2", + "system": "http://unitsofmeasure.org", + "code": "kg/m2" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:53ed9ffd-5c35-4bfc-8076-e2fef2e3c47d", + "resource": { + "resourceType": "Observation", + "id": "53ed9ffd-5c35-4bfc-8076-e2fef2e3c47d", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "55284-4", + "display": "Blood Pressure" + } + ], + "text": "Blood Pressure" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:443b45e3-bac2-47f4-b169-c47a1844a91d" + }, + "effectiveDateTime": "2012-05-10T01:24:38-04:00", + "issued": "2012-05-10T01:24:38.752-04:00", + "component": [ + { + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8462-4", + "display": "Diastolic Blood Pressure" + } + ], + "text": "Diastolic Blood Pressure" + }, + "valueQuantity": { + "value": 73.43063713020616, + "unit": "mm[Hg]", + "system": "http://unitsofmeasure.org", + "code": "mm[Hg]" + } + }, + { + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8480-6", + "display": "Systolic Blood Pressure" + } + ], + "text": "Systolic Blood Pressure" + }, + "valueQuantity": { + "value": 124.97982289550339, + "unit": "mm[Hg]", + "system": "http://unitsofmeasure.org", + "code": "mm[Hg]" + } + } + ] + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:c797848a-46b5-43cd-89ca-b4551f1ac8e1", + "resource": { + "resourceType": "Observation", + "id": "c797848a-46b5-43cd-89ca-b4551f1ac8e1", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "survey", + "display": "survey" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "72166-2", + "display": "Tobacco smoking status NHIS" + } + ], + "text": "Tobacco smoking status NHIS" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:443b45e3-bac2-47f4-b169-c47a1844a91d" + }, + "effectiveDateTime": "2012-05-10T01:24:38-04:00", + "issued": "2012-05-10T01:24:38.752-04:00", + "valueCodeableConcept": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "8517006", + "display": "Former smoker" + } + ], + "text": "Former smoker" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:6031e4eb-32ee-4cd4-86db-05ef0b14992f", + "resource": { + "resourceType": "Claim", + "id": "6031e4eb-32ee-4cd4-86db-05ef0b14992f", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "2012-05-06T01:24:38-04:00", + "end": "2012-05-06T01:39:38-04:00" + }, + "created": "2012-05-06T01:39:38-04:00", + "provider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "diagnosis": [ + { + "sequence": 1, + "diagnosisReference": { + "reference": "urn:uuid:df427f8b-43f3-48e6-8c0c-16c7a369cad4" + } + } + ], + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185345009", + "display": "Encounter for symptom" + } + ], + "text": "Encounter for symptom" + }, + "encounter": [ + { + "reference": "urn:uuid:443b45e3-bac2-47f4-b169-c47a1844a91d" + } + ] + }, + { + "sequence": 2, + "diagnosisSequence": [ + 1 + ], + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "444814009", + "display": "Viral sinusitis (disorder)" + } + ], + "text": "Viral sinusitis (disorder)" + } + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:059b2ec8-794c-4d39-ad71-5faf4b2f7d2f", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "059b2ec8-794c-4d39-ad71-5faf4b2f7d2f", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "6031e4eb-32ee-4cd4-86db-05ef0b14992f" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "2012-05-06T01:39:38-04:00", + "end": "2013-05-06T01:39:38-04:00" + }, + "created": "2012-05-06T01:39:38-04:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:6031e4eb-32ee-4cd4-86db-05ef0b14992f" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "diagnosis": [ + { + "sequence": 1, + "diagnosisReference": { + "reference": "urn:uuid:df427f8b-43f3-48e6-8c0c-16c7a369cad4" + }, + "type": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype", + "code": "principal" + } + ] + } + ] + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185345009", + "display": "Encounter for symptom" + } + ], + "text": "Encounter for symptom" + }, + "servicedPeriod": { + "start": "2012-05-06T01:24:38-04:00", + "end": "2012-05-06T01:39:38-04:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "21", + "display": "Inpatient Hospital" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:443b45e3-bac2-47f4-b169-c47a1844a91d" + } + ] + }, + { + "sequence": 2, + "diagnosisSequence": [ + 1 + ], + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "444814009", + "display": "Viral sinusitis (disorder)" + } + ], + "text": "Viral sinusitis (disorder)" + }, + "servicedPeriod": { + "start": "2012-05-06T01:24:38-04:00", + "end": "2012-05-06T01:39:38-04:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "21", + "display": "Inpatient Hospital" + } + ] + } + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 0.0, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + }, + { + "fullUrl": "urn:uuid:bbaa1361-3f33-4afe-83bb-5ed614b14dc5", + "resource": { + "resourceType": "Encounter", + "id": "bbaa1361-3f33-4afe-83bb-5ed614b14dc5", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "AMB" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710", + "display": "Dr. Shantae970 Cummerata161" + } + } + ], + "period": { + "start": "2013-11-28T00:24:38-05:00", + "end": "2013-11-28T00:39:38-05:00" + }, + "serviceProvider": { + "reference": "urn:uuid:54f6fc59-7709-310f-9249-1e92d0464b00", + "display": "PCP145391" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:ecd55c0b-fa06-472c-b30b-42d758f6b1bf", + "resource": { + "resourceType": "Observation", + "id": "ecd55c0b-fa06-472c-b30b-42d758f6b1bf", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8302-2", + "display": "Body Height" + } + ], + "text": "Body Height" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:bbaa1361-3f33-4afe-83bb-5ed614b14dc5" + }, + "effectiveDateTime": "2013-11-28T00:24:38-05:00", + "issued": "2013-11-28T00:24:38.752-05:00", + "valueQuantity": { + "value": 155.01680645430415, + "unit": "cm", + "system": "http://unitsofmeasure.org", + "code": "cm" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:89656b69-eb88-4520-b251-5e7f7ac1d73b", + "resource": { + "resourceType": "Observation", + "id": "89656b69-eb88-4520-b251-5e7f7ac1d73b", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "72514-3", + "display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported" + } + ], + "text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:bbaa1361-3f33-4afe-83bb-5ed614b14dc5" + }, + "effectiveDateTime": "2013-11-28T00:24:38-05:00", + "issued": "2013-11-28T00:24:38.752-05:00", + "valueQuantity": { + "value": 3.542390063459913, + "unit": "{score}", + "system": "http://unitsofmeasure.org", + "code": "{score}" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:cde549fa-9827-470f-b942-d619d6c50b0f", + "resource": { + "resourceType": "Observation", + "id": "cde549fa-9827-470f-b942-d619d6c50b0f", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "29463-7", + "display": "Body Weight" + } + ], + "text": "Body Weight" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:bbaa1361-3f33-4afe-83bb-5ed614b14dc5" + }, + "effectiveDateTime": "2013-11-28T00:24:38-05:00", + "issued": "2013-11-28T00:24:38.752-05:00", + "valueQuantity": { + "value": 65.79684973105927, + "unit": "kg", + "system": "http://unitsofmeasure.org", + "code": "kg" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:e439cc95-b372-40ea-95af-2e7b3734fbc3", + "resource": { + "resourceType": "Observation", + "id": "e439cc95-b372-40ea-95af-2e7b3734fbc3", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "39156-5", + "display": "Body Mass Index" + } + ], + "text": "Body Mass Index" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:bbaa1361-3f33-4afe-83bb-5ed614b14dc5" + }, + "effectiveDateTime": "2013-11-28T00:24:38-05:00", + "issued": "2013-11-28T00:24:38.752-05:00", + "valueQuantity": { + "value": 27.38088803859094, + "unit": "kg/m2", + "system": "http://unitsofmeasure.org", + "code": "kg/m2" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:5a56ee21-6689-453e-b435-fcaaef055385", + "resource": { + "resourceType": "Observation", + "id": "5a56ee21-6689-453e-b435-fcaaef055385", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "55284-4", + "display": "Blood Pressure" + } + ], + "text": "Blood Pressure" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:bbaa1361-3f33-4afe-83bb-5ed614b14dc5" + }, + "effectiveDateTime": "2013-11-28T00:24:38-05:00", + "issued": "2013-11-28T00:24:38.752-05:00", + "component": [ + { + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8462-4", + "display": "Diastolic Blood Pressure" + } + ], + "text": "Diastolic Blood Pressure" + }, + "valueQuantity": { + "value": 80.1030955878793, + "unit": "mm[Hg]", + "system": "http://unitsofmeasure.org", + "code": "mm[Hg]" + } + }, + { + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8480-6", + "display": "Systolic Blood Pressure" + } + ], + "text": "Systolic Blood Pressure" + }, + "valueQuantity": { + "value": 119.84972065684128, + "unit": "mm[Hg]", + "system": "http://unitsofmeasure.org", + "code": "mm[Hg]" + } + } + ] + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:c4973e7c-2f78-46e5-9287-745b2b9bb870", + "resource": { + "resourceType": "Observation", + "id": "c4973e7c-2f78-46e5-9287-745b2b9bb870", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "survey", + "display": "survey" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "72166-2", + "display": "Tobacco smoking status NHIS" + } + ], + "text": "Tobacco smoking status NHIS" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:bbaa1361-3f33-4afe-83bb-5ed614b14dc5" + }, + "effectiveDateTime": "2013-11-28T00:24:38-05:00", + "issued": "2013-11-28T00:24:38.752-05:00", + "valueCodeableConcept": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "8517006", + "display": "Former smoker" + } + ], + "text": "Former smoker" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:533f0cdf-6c30-4eee-9785-1f9be49027ba", + "resource": { + "resourceType": "Immunization", + "id": "533f0cdf-6c30-4eee-9785-1f9be49027ba", + "status": "completed", + "vaccineCode": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:bbaa1361-3f33-4afe-83bb-5ed614b14dc5" + }, + "occurrenceDateTime": "2013-11-28T00:24:38-05:00", + "primarySource": true + }, + "request": { + "method": "POST", + "url": "Immunization" + } + }, + { + "fullUrl": "urn:uuid:3693fb32-090d-4897-8e2e-a1f66df31a89", + "resource": { + "resourceType": "Claim", + "id": "3693fb32-090d-4897-8e2e-a1f66df31a89", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "2013-11-28T00:24:38-05:00", + "end": "2013-11-28T00:39:38-05:00" + }, + "created": "2013-11-28T00:39:38-05:00", + "provider": { + "reference": "urn:uuid:54f6fc59-7709-310f-9249-1e92d0464b00", + "display": "PCP145391" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "supportingInfo": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory", + "code": "info" + } + ] + }, + "valueReference": { + "reference": "urn:uuid:533f0cdf-6c30-4eee-9785-1f9be49027ba" + } + } + ], + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + }, + "encounter": [ + { + "reference": "urn:uuid:bbaa1361-3f33-4afe-83bb-5ed614b14dc5" + } + ] + }, + { + "sequence": 2, + "informationSequence": [ + 1 + ], + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "net": { + "value": 140.52, + "currency": "USD" + } + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:182d280b-56bb-49b3-9d2f-0d7475811af3", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "182d280b-56bb-49b3-9d2f-0d7475811af3", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "3693fb32-090d-4897-8e2e-a1f66df31a89" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "2013-11-28T00:39:38-05:00", + "end": "2014-11-28T00:39:38-05:00" + }, + "created": "2013-11-28T00:39:38-05:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:3693fb32-090d-4897-8e2e-a1f66df31a89" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + }, + "servicedPeriod": { + "start": "2013-11-28T00:24:38-05:00", + "end": "2013-11-28T00:39:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "19", + "display": "Off Campus-Outpatient Hospital" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:bbaa1361-3f33-4afe-83bb-5ed614b14dc5" + } + ] + }, + { + "sequence": 2, + "informationSequence": [ + 1 + ], + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "servicedPeriod": { + "start": "2013-11-28T00:24:38-05:00", + "end": "2013-11-28T00:39:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "19", + "display": "Off Campus-Outpatient Hospital" + } + ] + }, + "net": { + "value": 140.52, + "currency": "USD" + }, + "adjudication": [ + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt", + "display": "Line Beneficiary Coinsurance Amount" + } + ] + }, + "amount": { + "value": 28.104000000000003, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt", + "display": "Line Provider Payment Amount" + } + ] + }, + "amount": { + "value": 112.41600000000001, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt", + "display": "Line Submitted Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt", + "display": "Line Allowed Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt", + "display": "Line Beneficiary Part B Deductible Amount" + } + ] + }, + "amount": { + "value": 0, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd", + "display": "Line Processing Indicator Code" + } + ] + } + } + ] + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 112.41600000000001, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + }, + { + "fullUrl": "urn:uuid:1659ef44-7978-42b5-8414-4fc908f847e4", + "resource": { + "resourceType": "Encounter", + "id": "1659ef44-7978-42b5-8414-4fc908f847e4", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "AMB" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710", + "display": "Dr. Shantae970 Cummerata161" + } + } + ], + "period": { + "start": "2015-11-05T00:24:38-05:00", + "end": "2015-11-05T00:39:38-05:00" + }, + "serviceProvider": { + "reference": "urn:uuid:54f6fc59-7709-310f-9249-1e92d0464b00", + "display": "PCP145391" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:b55d9784-444e-44a7-9e79-6bc11caad74e", + "resource": { + "resourceType": "Observation", + "id": "b55d9784-444e-44a7-9e79-6bc11caad74e", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8302-2", + "display": "Body Height" + } + ], + "text": "Body Height" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:1659ef44-7978-42b5-8414-4fc908f847e4" + }, + "effectiveDateTime": "2015-11-05T00:24:38-05:00", + "issued": "2015-11-05T00:24:38.752-05:00", + "valueQuantity": { + "value": 155.01680645430415, + "unit": "cm", + "system": "http://unitsofmeasure.org", + "code": "cm" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:ca5491d9-d70b-4081-8dd2-e1ddc9990d8b", + "resource": { + "resourceType": "Observation", + "id": "ca5491d9-d70b-4081-8dd2-e1ddc9990d8b", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "72514-3", + "display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported" + } + ], + "text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:1659ef44-7978-42b5-8414-4fc908f847e4" + }, + "effectiveDateTime": "2015-11-05T00:24:38-05:00", + "issued": "2015-11-05T00:24:38.752-05:00", + "valueQuantity": { + "value": 2.072250263933972, + "unit": "{score}", + "system": "http://unitsofmeasure.org", + "code": "{score}" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:2ca83951-ecfb-4219-bd43-ae90b456e40e", + "resource": { + "resourceType": "Observation", + "id": "2ca83951-ecfb-4219-bd43-ae90b456e40e", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "29463-7", + "display": "Body Weight" + } + ], + "text": "Body Weight" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:1659ef44-7978-42b5-8414-4fc908f847e4" + }, + "effectiveDateTime": "2015-11-05T00:24:38-05:00", + "issued": "2015-11-05T00:24:38.752-05:00", + "valueQuantity": { + "value": 65.79684973105927, + "unit": "kg", + "system": "http://unitsofmeasure.org", + "code": "kg" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:7219d461-04a0-4992-ac65-2b19444f906f", + "resource": { + "resourceType": "Observation", + "id": "7219d461-04a0-4992-ac65-2b19444f906f", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "39156-5", + "display": "Body Mass Index" + } + ], + "text": "Body Mass Index" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:1659ef44-7978-42b5-8414-4fc908f847e4" + }, + "effectiveDateTime": "2015-11-05T00:24:38-05:00", + "issued": "2015-11-05T00:24:38.752-05:00", + "valueQuantity": { + "value": 27.38088803859094, + "unit": "kg/m2", + "system": "http://unitsofmeasure.org", + "code": "kg/m2" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:ffce4c2f-a5eb-4455-9e1d-3ce884744fd4", + "resource": { + "resourceType": "Observation", + "id": "ffce4c2f-a5eb-4455-9e1d-3ce884744fd4", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "55284-4", + "display": "Blood Pressure" + } + ], + "text": "Blood Pressure" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:1659ef44-7978-42b5-8414-4fc908f847e4" + }, + "effectiveDateTime": "2015-11-05T00:24:38-05:00", + "issued": "2015-11-05T00:24:38.752-05:00", + "component": [ + { + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8462-4", + "display": "Diastolic Blood Pressure" + } + ], + "text": "Diastolic Blood Pressure" + }, + "valueQuantity": { + "value": 72.84370330219258, + "unit": "mm[Hg]", + "system": "http://unitsofmeasure.org", + "code": "mm[Hg]" + } + }, + { + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8480-6", + "display": "Systolic Blood Pressure" + } + ], + "text": "Systolic Blood Pressure" + }, + "valueQuantity": { + "value": 116.58483903330045, + "unit": "mm[Hg]", + "system": "http://unitsofmeasure.org", + "code": "mm[Hg]" + } + } + ] + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:800f8564-59a5-49c3-b2fe-f84e231b0e31", + "resource": { + "resourceType": "Observation", + "id": "800f8564-59a5-49c3-b2fe-f84e231b0e31", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "2093-3", + "display": "Total Cholesterol" + } + ], + "text": "Total Cholesterol" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:1659ef44-7978-42b5-8414-4fc908f847e4" + }, + "effectiveDateTime": "2015-11-05T00:24:38-05:00", + "issued": "2015-11-05T00:24:38.752-05:00", + "valueQuantity": { + "value": 194.70322634025746, + "unit": "mg/dL", + "system": "http://unitsofmeasure.org", + "code": "mg/dL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:0dae0e54-ddd1-49ba-900b-6c0eaef0c23e", + "resource": { + "resourceType": "Observation", + "id": "0dae0e54-ddd1-49ba-900b-6c0eaef0c23e", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "2571-8", + "display": "Triglycerides" + } + ], + "text": "Triglycerides" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:1659ef44-7978-42b5-8414-4fc908f847e4" + }, + "effectiveDateTime": "2015-11-05T00:24:38-05:00", + "issued": "2015-11-05T00:24:38.752-05:00", + "valueQuantity": { + "value": 116.72101146761173, + "unit": "mg/dL", + "system": "http://unitsofmeasure.org", + "code": "mg/dL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:e2a74651-b2a1-4124-bd2c-047cae6b9c72", + "resource": { + "resourceType": "Observation", + "id": "e2a74651-b2a1-4124-bd2c-047cae6b9c72", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "18262-6", + "display": "Low Density Lipoprotein Cholesterol" + } + ], + "text": "Low Density Lipoprotein Cholesterol" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:1659ef44-7978-42b5-8414-4fc908f847e4" + }, + "effectiveDateTime": "2015-11-05T00:24:38-05:00", + "issued": "2015-11-05T00:24:38.752-05:00", + "valueQuantity": { + "value": 107.52292666005265, + "unit": "mg/dL", + "system": "http://unitsofmeasure.org", + "code": "mg/dL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:d0451c95-db66-464f-beb2-bf1a0b95323f", + "resource": { + "resourceType": "Observation", + "id": "d0451c95-db66-464f-beb2-bf1a0b95323f", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "2085-9", + "display": "High Density Lipoprotein Cholesterol" + } + ], + "text": "High Density Lipoprotein Cholesterol" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:1659ef44-7978-42b5-8414-4fc908f847e4" + }, + "effectiveDateTime": "2015-11-05T00:24:38-05:00", + "issued": "2015-11-05T00:24:38.752-05:00", + "valueQuantity": { + "value": 63.83609738668246, + "unit": "mg/dL", + "system": "http://unitsofmeasure.org", + "code": "mg/dL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:18f296a3-56db-417d-8cc3-b3ef9edb0adc", + "resource": { + "resourceType": "Observation", + "id": "18f296a3-56db-417d-8cc3-b3ef9edb0adc", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "survey", + "display": "survey" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "72166-2", + "display": "Tobacco smoking status NHIS" + } + ], + "text": "Tobacco smoking status NHIS" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:1659ef44-7978-42b5-8414-4fc908f847e4" + }, + "effectiveDateTime": "2015-11-05T00:24:38-05:00", + "issued": "2015-11-05T00:24:38.752-05:00", + "valueCodeableConcept": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "8517006", + "display": "Former smoker" + } + ], + "text": "Former smoker" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:e8237a76-c44f-4dfd-ac58-5d92d7dc5d3a", + "resource": { + "resourceType": "Immunization", + "id": "e8237a76-c44f-4dfd-ac58-5d92d7dc5d3a", + "status": "completed", + "vaccineCode": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "121", + "display": "zoster" + } + ], + "text": "zoster" + }, + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:1659ef44-7978-42b5-8414-4fc908f847e4" + }, + "occurrenceDateTime": "2015-11-05T00:24:38-05:00", + "primarySource": true + }, + "request": { + "method": "POST", + "url": "Immunization" + } + }, + { + "fullUrl": "urn:uuid:a33e2a40-fa20-4edc-bb07-a47ce42d89cf", + "resource": { + "resourceType": "Immunization", + "id": "a33e2a40-fa20-4edc-bb07-a47ce42d89cf", + "status": "completed", + "vaccineCode": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:1659ef44-7978-42b5-8414-4fc908f847e4" + }, + "occurrenceDateTime": "2015-11-05T00:24:38-05:00", + "primarySource": true + }, + "request": { + "method": "POST", + "url": "Immunization" + } + }, + { + "fullUrl": "urn:uuid:39ca57f8-aa5c-4df4-8732-025f6808ad94", + "resource": { + "resourceType": "DiagnosticReport", + "id": "39ca57f8-aa5c-4df4-8732-025f6808ad94", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/v2-0074", + "code": "LAB", + "display": "Laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "57698-3", + "display": "Lipid Panel" + } + ], + "text": "Lipid Panel" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:1659ef44-7978-42b5-8414-4fc908f847e4" + }, + "effectiveDateTime": "2015-11-05T00:24:38-05:00", + "issued": "2015-11-05T00:24:38.752-05:00", + "result": [ + { + "reference": "urn:uuid:800f8564-59a5-49c3-b2fe-f84e231b0e31", + "display": "Total Cholesterol" + }, + { + "reference": "urn:uuid:0dae0e54-ddd1-49ba-900b-6c0eaef0c23e", + "display": "Triglycerides" + }, + { + "reference": "urn:uuid:e2a74651-b2a1-4124-bd2c-047cae6b9c72", + "display": "Low Density Lipoprotein Cholesterol" + }, + { + "reference": "urn:uuid:d0451c95-db66-464f-beb2-bf1a0b95323f", + "display": "High Density Lipoprotein Cholesterol" + } + ] + }, + "request": { + "method": "POST", + "url": "DiagnosticReport" + } + }, + { + "fullUrl": "urn:uuid:22a2e60b-39ad-4fad-8d5a-a158b7d162dc", + "resource": { + "resourceType": "Claim", + "id": "22a2e60b-39ad-4fad-8d5a-a158b7d162dc", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "2015-11-05T00:24:38-05:00", + "end": "2015-11-05T00:39:38-05:00" + }, + "created": "2015-11-05T00:39:38-05:00", + "provider": { + "reference": "urn:uuid:54f6fc59-7709-310f-9249-1e92d0464b00", + "display": "PCP145391" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "supportingInfo": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory", + "code": "info" + } + ] + }, + "valueReference": { + "reference": "urn:uuid:e8237a76-c44f-4dfd-ac58-5d92d7dc5d3a" + } + }, + { + "sequence": 2, + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory", + "code": "info" + } + ] + }, + "valueReference": { + "reference": "urn:uuid:a33e2a40-fa20-4edc-bb07-a47ce42d89cf" + } + } + ], + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + }, + "encounter": [ + { + "reference": "urn:uuid:1659ef44-7978-42b5-8414-4fc908f847e4" + } + ] + }, + { + "sequence": 2, + "informationSequence": [ + 1 + ], + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "121", + "display": "zoster" + } + ], + "text": "zoster" + }, + "net": { + "value": 140.52, + "currency": "USD" + } + }, + { + "sequence": 3, + "informationSequence": [ + 2 + ], + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "net": { + "value": 140.52, + "currency": "USD" + } + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:e88abc17-9e44-41fe-8080-4167c143060c", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "e88abc17-9e44-41fe-8080-4167c143060c", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "22a2e60b-39ad-4fad-8d5a-a158b7d162dc" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "2015-11-05T00:39:38-05:00", + "end": "2016-11-05T00:39:38-04:00" + }, + "created": "2015-11-05T00:39:38-05:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:22a2e60b-39ad-4fad-8d5a-a158b7d162dc" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + }, + "servicedPeriod": { + "start": "2015-11-05T00:24:38-05:00", + "end": "2015-11-05T00:39:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "19", + "display": "Off Campus-Outpatient Hospital" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:1659ef44-7978-42b5-8414-4fc908f847e4" + } + ] + }, + { + "sequence": 2, + "informationSequence": [ + 1 + ], + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "121", + "display": "zoster" + } + ], + "text": "zoster" + }, + "servicedPeriod": { + "start": "2015-11-05T00:24:38-05:00", + "end": "2015-11-05T00:39:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "19", + "display": "Off Campus-Outpatient Hospital" + } + ] + }, + "net": { + "value": 140.52, + "currency": "USD" + }, + "adjudication": [ + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt", + "display": "Line Beneficiary Coinsurance Amount" + } + ] + }, + "amount": { + "value": 28.104000000000003, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt", + "display": "Line Provider Payment Amount" + } + ] + }, + "amount": { + "value": 112.41600000000001, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt", + "display": "Line Submitted Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt", + "display": "Line Allowed Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt", + "display": "Line Beneficiary Part B Deductible Amount" + } + ] + }, + "amount": { + "value": 0, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd", + "display": "Line Processing Indicator Code" + } + ] + } + } + ] + }, + { + "sequence": 3, + "informationSequence": [ + 2 + ], + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "servicedPeriod": { + "start": "2015-11-05T00:24:38-05:00", + "end": "2015-11-05T00:39:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "19", + "display": "Off Campus-Outpatient Hospital" + } + ] + }, + "net": { + "value": 140.52, + "currency": "USD" + }, + "adjudication": [ + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt", + "display": "Line Beneficiary Coinsurance Amount" + } + ] + }, + "amount": { + "value": 28.104000000000003, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt", + "display": "Line Provider Payment Amount" + } + ] + }, + "amount": { + "value": 112.41600000000001, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt", + "display": "Line Submitted Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt", + "display": "Line Allowed Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt", + "display": "Line Beneficiary Part B Deductible Amount" + } + ] + }, + "amount": { + "value": 0, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd", + "display": "Line Processing Indicator Code" + } + ] + } + } + ] + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 224.83200000000002, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + }, + { + "fullUrl": "urn:uuid:ff36b67d-69de-4f37-8691-e8ceb607a5ec", + "resource": { + "resourceType": "Encounter", + "id": "ff36b67d-69de-4f37-8691-e8ceb607a5ec", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "EMER" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "183478001", + "display": "Emergency hospital admission for asthma" + } + ], + "text": "Emergency hospital admission for asthma" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e", + "display": "Dr. Cedrick207 Lind531" + } + } + ], + "period": { + "start": "2016-02-12T00:24:38-05:00", + "end": "2016-02-12T01:24:38-05:00" + }, + "reasonCode": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "195967001", + "display": "Asthma" + } + ] + } + ], + "serviceProvider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:713d6566-ffc3-4c2e-8aef-73456cb0da76", + "resource": { + "resourceType": "Claim", + "id": "713d6566-ffc3-4c2e-8aef-73456cb0da76", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "2016-02-12T00:24:38-05:00", + "end": "2016-02-12T01:24:38-05:00" + }, + "created": "2016-02-12T01:24:38-05:00", + "provider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "183478001", + "display": "Emergency hospital admission for asthma" + } + ], + "text": "Emergency hospital admission for asthma" + }, + "encounter": [ + { + "reference": "urn:uuid:ff36b67d-69de-4f37-8691-e8ceb607a5ec" + } + ] + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:81e5aae4-1689-4698-938d-382ec3204a98", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "81e5aae4-1689-4698-938d-382ec3204a98", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "713d6566-ffc3-4c2e-8aef-73456cb0da76" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "2016-02-12T01:24:38-05:00", + "end": "2017-02-12T01:24:38-05:00" + }, + "created": "2016-02-12T01:24:38-05:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:713d6566-ffc3-4c2e-8aef-73456cb0da76" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "183478001", + "display": "Emergency hospital admission for asthma" + } + ], + "text": "Emergency hospital admission for asthma" + }, + "servicedPeriod": { + "start": "2016-02-12T00:24:38-05:00", + "end": "2016-02-12T01:24:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "20", + "display": "Urgent Care Facility" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:ff36b67d-69de-4f37-8691-e8ceb607a5ec" + } + ] + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 0.0, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + }, + { + "fullUrl": "urn:uuid:bc6f1a2e-44c9-488a-8034-68bac412bbe9", + "resource": { + "resourceType": "Encounter", + "id": "bc6f1a2e-44c9-488a-8034-68bac412bbe9", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "AMB" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "394701000", + "display": "Asthma follow-up" + } + ], + "text": "Asthma follow-up" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e", + "display": "Dr. Cedrick207 Lind531" + } + } + ], + "period": { + "start": "2016-02-14T00:24:38-05:00", + "end": "2016-02-14T00:39:38-05:00" + }, + "reasonCode": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "195967001", + "display": "Asthma" + } + ] + } + ], + "serviceProvider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:d51f5212-baba-42f3-b965-a6d6dc8cee6f", + "resource": { + "resourceType": "Claim", + "id": "d51f5212-baba-42f3-b965-a6d6dc8cee6f", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "2016-02-14T00:24:38-05:00", + "end": "2016-02-14T00:39:38-05:00" + }, + "created": "2016-02-14T00:39:38-05:00", + "provider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "394701000", + "display": "Asthma follow-up" + } + ], + "text": "Asthma follow-up" + }, + "encounter": [ + { + "reference": "urn:uuid:bc6f1a2e-44c9-488a-8034-68bac412bbe9" + } + ] + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:a926aad6-9213-4fb4-aba5-7e2d8a22af1c", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "a926aad6-9213-4fb4-aba5-7e2d8a22af1c", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "d51f5212-baba-42f3-b965-a6d6dc8cee6f" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "2016-02-14T00:39:38-05:00", + "end": "2017-02-14T00:39:38-05:00" + }, + "created": "2016-02-14T00:39:38-05:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:d51f5212-baba-42f3-b965-a6d6dc8cee6f" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "394701000", + "display": "Asthma follow-up" + } + ], + "text": "Asthma follow-up" + }, + "servicedPeriod": { + "start": "2016-02-14T00:24:38-05:00", + "end": "2016-02-14T00:39:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "21", + "display": "Inpatient Hospital" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:bc6f1a2e-44c9-488a-8034-68bac412bbe9" + } + ] + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 0.0, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + }, + { + "fullUrl": "urn:uuid:094603d6-cc36-4ba5-8c27-3604aff7a089", + "resource": { + "resourceType": "Encounter", + "id": "094603d6-cc36-4ba5-8c27-3604aff7a089", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "AMB" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185345009", + "display": "Encounter for symptom" + } + ], + "text": "Encounter for symptom" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e", + "display": "Dr. Cedrick207 Lind531" + } + } + ], + "period": { + "start": "2016-03-29T01:24:38-04:00", + "end": "2016-03-29T01:39:38-04:00" + }, + "reasonCode": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "195662009", + "display": "Acute viral pharyngitis (disorder)" + } + ] + } + ], + "serviceProvider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:f3a2e527-f76b-497f-bb87-a33d441936db", + "resource": { + "resourceType": "Condition", + "id": "f3a2e527-f76b-497f-bb87-a33d441936db", + "clinicalStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/condition-clinical", + "code": "resolved" + } + ] + }, + "verificationStatus": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status", + "code": "confirmed" + } + ] + }, + "code": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "195662009", + "display": "Acute viral pharyngitis (disorder)" + } + ], + "text": "Acute viral pharyngitis (disorder)" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:094603d6-cc36-4ba5-8c27-3604aff7a089" + }, + "onsetDateTime": "2016-03-29T01:24:38-04:00", + "abatementDateTime": "2016-04-10T01:24:38-04:00", + "recordedDate": "2016-03-29T01:24:38-04:00" + }, + "request": { + "method": "POST", + "url": "Condition" + } + }, + { + "fullUrl": "urn:uuid:97363fc2-301e-48c1-8745-b1a33ea7aca6", + "resource": { + "resourceType": "Observation", + "id": "97363fc2-301e-48c1-8745-b1a33ea7aca6", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8331-1", + "display": "Oral temperature" + } + ], + "text": "Oral temperature" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:094603d6-cc36-4ba5-8c27-3604aff7a089" + }, + "effectiveDateTime": "2016-03-29T01:24:38-04:00", + "issued": "2016-03-29T01:24:38.752-04:00", + "valueQuantity": { + "value": 37.25583508874942, + "unit": "Cel", + "system": "http://unitsofmeasure.org", + "code": "Cel" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:245e62dc-91e5-4247-93cc-4c00092134ae", + "resource": { + "resourceType": "Claim", + "id": "245e62dc-91e5-4247-93cc-4c00092134ae", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "2016-03-29T01:24:38-04:00", + "end": "2016-03-29T01:39:38-04:00" + }, + "created": "2016-03-29T01:39:38-04:00", + "provider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "diagnosis": [ + { + "sequence": 1, + "diagnosisReference": { + "reference": "urn:uuid:f3a2e527-f76b-497f-bb87-a33d441936db" + } + } + ], + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185345009", + "display": "Encounter for symptom" + } + ], + "text": "Encounter for symptom" + }, + "encounter": [ + { + "reference": "urn:uuid:094603d6-cc36-4ba5-8c27-3604aff7a089" + } + ] + }, + { + "sequence": 2, + "diagnosisSequence": [ + 1 + ], + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "195662009", + "display": "Acute viral pharyngitis (disorder)" + } + ], + "text": "Acute viral pharyngitis (disorder)" + } + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:bf97f5fd-8886-4587-bfa1-bda0ffd7072e", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "bf97f5fd-8886-4587-bfa1-bda0ffd7072e", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "245e62dc-91e5-4247-93cc-4c00092134ae" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "2016-03-29T01:39:38-04:00", + "end": "2017-03-29T01:39:38-04:00" + }, + "created": "2016-03-29T01:39:38-04:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:245e62dc-91e5-4247-93cc-4c00092134ae" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "diagnosis": [ + { + "sequence": 1, + "diagnosisReference": { + "reference": "urn:uuid:f3a2e527-f76b-497f-bb87-a33d441936db" + }, + "type": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype", + "code": "principal" + } + ] + } + ] + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185345009", + "display": "Encounter for symptom" + } + ], + "text": "Encounter for symptom" + }, + "servicedPeriod": { + "start": "2016-03-29T01:24:38-04:00", + "end": "2016-03-29T01:39:38-04:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "21", + "display": "Inpatient Hospital" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:094603d6-cc36-4ba5-8c27-3604aff7a089" + } + ] + }, + { + "sequence": 2, + "diagnosisSequence": [ + 1 + ], + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "195662009", + "display": "Acute viral pharyngitis (disorder)" + } + ], + "text": "Acute viral pharyngitis (disorder)" + }, + "servicedPeriod": { + "start": "2016-03-29T01:24:38-04:00", + "end": "2016-03-29T01:39:38-04:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "21", + "display": "Inpatient Hospital" + } + ] + } + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 0.0, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + }, + { + "fullUrl": "urn:uuid:e9e51b72-0f7c-4f19-96de-943b0bcf0ce0", + "resource": { + "resourceType": "Encounter", + "id": "e9e51b72-0f7c-4f19-96de-943b0bcf0ce0", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "AMB" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "702927004", + "display": "Urgent care clinic (procedure)" + } + ], + "text": "Urgent care clinic (procedure)" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-000000016c9c", + "display": "Dr. Jacquelyn628 Pouros728" + } + } + ], + "period": { + "start": "2016-04-07T01:24:38-04:00", + "end": "2016-04-07T01:39:38-04:00" + }, + "serviceProvider": { + "reference": "urn:uuid:f1313c7d-3148-335b-adc3-337f15567b82", + "display": "WINCHESTER HOSPITAL FAMILY MEDICAL CENTER" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:d9d54428-d2bd-4e6e-8489-6079bc8567f9", + "resource": { + "resourceType": "Immunization", + "id": "d9d54428-d2bd-4e6e-8489-6079bc8567f9", + "status": "completed", + "vaccineCode": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e9e51b72-0f7c-4f19-96de-943b0bcf0ce0" + }, + "occurrenceDateTime": "2016-04-07T01:24:38-04:00", + "primarySource": true + }, + "request": { + "method": "POST", + "url": "Immunization" + } + }, + { + "fullUrl": "urn:uuid:37231dc2-e734-4236-bd6b-40af79bd012d", + "resource": { + "resourceType": "Claim", + "id": "37231dc2-e734-4236-bd6b-40af79bd012d", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "2016-04-07T01:24:38-04:00", + "end": "2016-04-07T01:39:38-04:00" + }, + "created": "2016-04-07T01:39:38-04:00", + "provider": { + "reference": "urn:uuid:f1313c7d-3148-335b-adc3-337f15567b82", + "display": "WINCHESTER HOSPITAL FAMILY MEDICAL CENTER" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "supportingInfo": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory", + "code": "info" + } + ] + }, + "valueReference": { + "reference": "urn:uuid:d9d54428-d2bd-4e6e-8489-6079bc8567f9" + } + } + ], + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "702927004", + "display": "Urgent care clinic (procedure)" + } + ], + "text": "Urgent care clinic (procedure)" + }, + "encounter": [ + { + "reference": "urn:uuid:e9e51b72-0f7c-4f19-96de-943b0bcf0ce0" + } + ] + }, + { + "sequence": 2, + "informationSequence": [ + 1 + ], + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "net": { + "value": 140.52, + "currency": "USD" + } + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:667510c2-4aaf-408b-a8c5-bb1f6febd5a7", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "667510c2-4aaf-408b-a8c5-bb1f6febd5a7", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-000000016c9c" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-000000016c9c" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "37231dc2-e734-4236-bd6b-40af79bd012d" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "2016-04-07T01:39:38-04:00", + "end": "2017-04-07T01:39:38-04:00" + }, + "created": "2016-04-07T01:39:38-04:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-000000016c9c" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:37231dc2-e734-4236-bd6b-40af79bd012d" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-000000016c9c" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "702927004", + "display": "Urgent care clinic (procedure)" + } + ], + "text": "Urgent care clinic (procedure)" + }, + "servicedPeriod": { + "start": "2016-04-07T01:24:38-04:00", + "end": "2016-04-07T01:39:38-04:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "20", + "display": "Urgent Care Facility" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:e9e51b72-0f7c-4f19-96de-943b0bcf0ce0" + } + ] + }, + { + "sequence": 2, + "informationSequence": [ + 1 + ], + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "servicedPeriod": { + "start": "2016-04-07T01:24:38-04:00", + "end": "2016-04-07T01:39:38-04:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "20", + "display": "Urgent Care Facility" + } + ] + }, + "net": { + "value": 140.52, + "currency": "USD" + }, + "adjudication": [ + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt", + "display": "Line Beneficiary Coinsurance Amount" + } + ] + }, + "amount": { + "value": 28.104000000000003, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt", + "display": "Line Provider Payment Amount" + } + ] + }, + "amount": { + "value": 112.41600000000001, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt", + "display": "Line Submitted Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt", + "display": "Line Allowed Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt", + "display": "Line Beneficiary Part B Deductible Amount" + } + ] + }, + "amount": { + "value": 0, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd", + "display": "Line Processing Indicator Code" + } + ] + } + } + ] + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 112.41600000000001, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + }, + { + "fullUrl": "urn:uuid:8e8eed13-baa1-4060-9996-1970a3f26f43", + "resource": { + "resourceType": "Encounter", + "id": "8e8eed13-baa1-4060-9996-1970a3f26f43", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "AMB" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185349003", + "display": "Encounter for check up (procedure)" + } + ], + "text": "Encounter for check up (procedure)" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e", + "display": "Dr. Cedrick207 Lind531" + } + } + ], + "period": { + "start": "2016-04-14T01:24:38-04:00", + "end": "2016-04-14T01:39:38-04:00" + }, + "serviceProvider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:8a950bf2-f0d6-4a63-a55e-23299ed6add6", + "resource": { + "resourceType": "Observation", + "id": "8a950bf2-f0d6-4a63-a55e-23299ed6add6", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8302-2", + "display": "Body Height" + } + ], + "text": "Body Height" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:8e8eed13-baa1-4060-9996-1970a3f26f43" + }, + "effectiveDateTime": "2016-04-14T01:24:38-04:00", + "issued": "2016-04-14T01:24:38.752-04:00", + "valueQuantity": { + "value": 155.01680645430415, + "unit": "cm", + "system": "http://unitsofmeasure.org", + "code": "cm" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:24fad327-95b7-40b7-b710-54d593746870", + "resource": { + "resourceType": "Observation", + "id": "24fad327-95b7-40b7-b710-54d593746870", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "72514-3", + "display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported" + } + ], + "text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:8e8eed13-baa1-4060-9996-1970a3f26f43" + }, + "effectiveDateTime": "2016-04-14T01:24:38-04:00", + "issued": "2016-04-14T01:24:38.752-04:00", + "valueQuantity": { + "value": 3.7099253661720883, + "unit": "{score}", + "system": "http://unitsofmeasure.org", + "code": "{score}" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:6d8b787f-3b14-4d7b-b39c-cb0d7bb5d6bf", + "resource": { + "resourceType": "Observation", + "id": "6d8b787f-3b14-4d7b-b39c-cb0d7bb5d6bf", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "29463-7", + "display": "Body Weight" + } + ], + "text": "Body Weight" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:8e8eed13-baa1-4060-9996-1970a3f26f43" + }, + "effectiveDateTime": "2016-04-14T01:24:38-04:00", + "issued": "2016-04-14T01:24:38.752-04:00", + "valueQuantity": { + "value": 65.79684973105927, + "unit": "kg", + "system": "http://unitsofmeasure.org", + "code": "kg" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:b8c136a2-4029-4ccc-a501-c80921d31493", + "resource": { + "resourceType": "Observation", + "id": "b8c136a2-4029-4ccc-a501-c80921d31493", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "39156-5", + "display": "Body Mass Index" + } + ], + "text": "Body Mass Index" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:8e8eed13-baa1-4060-9996-1970a3f26f43" + }, + "effectiveDateTime": "2016-04-14T01:24:38-04:00", + "issued": "2016-04-14T01:24:38.752-04:00", + "valueQuantity": { + "value": 27.38088803859094, + "unit": "kg/m2", + "system": "http://unitsofmeasure.org", + "code": "kg/m2" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:a71ecd18-3f86-4ed3-b692-6ee552b2086d", + "resource": { + "resourceType": "Observation", + "id": "a71ecd18-3f86-4ed3-b692-6ee552b2086d", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "55284-4", + "display": "Blood Pressure" + } + ], + "text": "Blood Pressure" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:8e8eed13-baa1-4060-9996-1970a3f26f43" + }, + "effectiveDateTime": "2016-04-14T01:24:38-04:00", + "issued": "2016-04-14T01:24:38.752-04:00", + "component": [ + { + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8462-4", + "display": "Diastolic Blood Pressure" + } + ], + "text": "Diastolic Blood Pressure" + }, + "valueQuantity": { + "value": 82.22722074638124, + "unit": "mm[Hg]", + "system": "http://unitsofmeasure.org", + "code": "mm[Hg]" + } + }, + { + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8480-6", + "display": "Systolic Blood Pressure" + } + ], + "text": "Systolic Blood Pressure" + }, + "valueQuantity": { + "value": 104.96520788119946, + "unit": "mm[Hg]", + "system": "http://unitsofmeasure.org", + "code": "mm[Hg]" + } + } + ] + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:b10e8169-b19b-4fb0-92e4-cb8f546dcf1f", + "resource": { + "resourceType": "Observation", + "id": "b10e8169-b19b-4fb0-92e4-cb8f546dcf1f", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "survey", + "display": "survey" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "72166-2", + "display": "Tobacco smoking status NHIS" + } + ], + "text": "Tobacco smoking status NHIS" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:8e8eed13-baa1-4060-9996-1970a3f26f43" + }, + "effectiveDateTime": "2016-04-14T01:24:38-04:00", + "issued": "2016-04-14T01:24:38.752-04:00", + "valueCodeableConcept": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "8517006", + "display": "Former smoker" + } + ], + "text": "Former smoker" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:162816af-04f2-488e-b5e4-621e41f527b9", + "resource": { + "resourceType": "Claim", + "id": "162816af-04f2-488e-b5e4-621e41f527b9", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "2016-04-14T01:24:38-04:00", + "end": "2016-04-14T01:39:38-04:00" + }, + "created": "2016-04-14T01:39:38-04:00", + "provider": { + "reference": "urn:uuid:f1fbcbfb-fcfa-3bd2-b7f4-df20f1b3c3a4", + "display": "LAWRENCE GENERAL HOSPITAL" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185349003", + "display": "Encounter for check up (procedure)" + } + ], + "text": "Encounter for check up (procedure)" + }, + "encounter": [ + { + "reference": "urn:uuid:8e8eed13-baa1-4060-9996-1970a3f26f43" + } + ] + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:6feb342c-38e9-4398-b648-f0dc2c3be985", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "6feb342c-38e9-4398-b648-f0dc2c3be985", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "162816af-04f2-488e-b5e4-621e41f527b9" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "2016-04-14T01:39:38-04:00", + "end": "2017-04-14T01:39:38-04:00" + }, + "created": "2016-04-14T01:39:38-04:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:162816af-04f2-488e-b5e4-621e41f527b9" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000001e" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "185349003", + "display": "Encounter for check up (procedure)" + } + ], + "text": "Encounter for check up (procedure)" + }, + "servicedPeriod": { + "start": "2016-04-14T01:24:38-04:00", + "end": "2016-04-14T01:39:38-04:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "21", + "display": "Inpatient Hospital" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:8e8eed13-baa1-4060-9996-1970a3f26f43" + } + ] + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 0.0, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + }, + { + "fullUrl": "urn:uuid:f91eb13c-7f69-4d94-adf3-0b8739ab981f", + "resource": { + "resourceType": "Encounter", + "id": "f91eb13c-7f69-4d94-adf3-0b8739ab981f", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "AMB" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710", + "display": "Dr. Shantae970 Cummerata161" + } + } + ], + "period": { + "start": "2016-11-10T00:24:38-05:00", + "end": "2016-11-10T00:39:38-05:00" + }, + "serviceProvider": { + "reference": "urn:uuid:54f6fc59-7709-310f-9249-1e92d0464b00", + "display": "PCP145391" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:a0437fb1-36f1-4631-8bc2-1af03c66f7e6", + "resource": { + "resourceType": "Observation", + "id": "a0437fb1-36f1-4631-8bc2-1af03c66f7e6", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8302-2", + "display": "Body Height" + } + ], + "text": "Body Height" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:f91eb13c-7f69-4d94-adf3-0b8739ab981f" + }, + "effectiveDateTime": "2016-11-10T00:24:38-05:00", + "issued": "2016-11-10T00:24:38.752-05:00", + "valueQuantity": { + "value": 155.01680645430415, + "unit": "cm", + "system": "http://unitsofmeasure.org", + "code": "cm" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:a5dbb235-0be1-4a89-a7fe-1f47387b35b9", + "resource": { + "resourceType": "Observation", + "id": "a5dbb235-0be1-4a89-a7fe-1f47387b35b9", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "72514-3", + "display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported" + } + ], + "text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:f91eb13c-7f69-4d94-adf3-0b8739ab981f" + }, + "effectiveDateTime": "2016-11-10T00:24:38-05:00", + "issued": "2016-11-10T00:24:38.752-05:00", + "valueQuantity": { + "value": 2.9070699112198977, + "unit": "{score}", + "system": "http://unitsofmeasure.org", + "code": "{score}" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:6b0457cc-3542-4640-9b47-dee818155d4c", + "resource": { + "resourceType": "Observation", + "id": "6b0457cc-3542-4640-9b47-dee818155d4c", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "29463-7", + "display": "Body Weight" + } + ], + "text": "Body Weight" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:f91eb13c-7f69-4d94-adf3-0b8739ab981f" + }, + "effectiveDateTime": "2016-11-10T00:24:38-05:00", + "issued": "2016-11-10T00:24:38.752-05:00", + "valueQuantity": { + "value": 65.79684973105927, + "unit": "kg", + "system": "http://unitsofmeasure.org", + "code": "kg" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:6db34aae-f20a-4321-92a3-98312cfb81f9", + "resource": { + "resourceType": "Observation", + "id": "6db34aae-f20a-4321-92a3-98312cfb81f9", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "39156-5", + "display": "Body Mass Index" + } + ], + "text": "Body Mass Index" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:f91eb13c-7f69-4d94-adf3-0b8739ab981f" + }, + "effectiveDateTime": "2016-11-10T00:24:38-05:00", + "issued": "2016-11-10T00:24:38.752-05:00", + "valueQuantity": { + "value": 27.38088803859094, + "unit": "kg/m2", + "system": "http://unitsofmeasure.org", + "code": "kg/m2" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:b3fff94c-541b-42a5-8990-44293b5b584a", + "resource": { + "resourceType": "Observation", + "id": "b3fff94c-541b-42a5-8990-44293b5b584a", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "55284-4", + "display": "Blood Pressure" + } + ], + "text": "Blood Pressure" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:f91eb13c-7f69-4d94-adf3-0b8739ab981f" + }, + "effectiveDateTime": "2016-11-10T00:24:38-05:00", + "issued": "2016-11-10T00:24:38.752-05:00", + "component": [ + { + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8462-4", + "display": "Diastolic Blood Pressure" + } + ], + "text": "Diastolic Blood Pressure" + }, + "valueQuantity": { + "value": 75.42960548136595, + "unit": "mm[Hg]", + "system": "http://unitsofmeasure.org", + "code": "mm[Hg]" + } + }, + { + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8480-6", + "display": "Systolic Blood Pressure" + } + ], + "text": "Systolic Blood Pressure" + }, + "valueQuantity": { + "value": 122.12981598307161, + "unit": "mm[Hg]", + "system": "http://unitsofmeasure.org", + "code": "mm[Hg]" + } + } + ] + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:c06c907b-76ab-4739-bdee-08898e209f1f", + "resource": { + "resourceType": "Observation", + "id": "c06c907b-76ab-4739-bdee-08898e209f1f", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "survey", + "display": "survey" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "72166-2", + "display": "Tobacco smoking status NHIS" + } + ], + "text": "Tobacco smoking status NHIS" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:f91eb13c-7f69-4d94-adf3-0b8739ab981f" + }, + "effectiveDateTime": "2016-11-10T00:24:38-05:00", + "issued": "2016-11-10T00:24:38.752-05:00", + "valueCodeableConcept": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "8517006", + "display": "Former smoker" + } + ], + "text": "Former smoker" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:202468e4-5a03-4a44-ba69-d943886c7b15", + "resource": { + "resourceType": "Immunization", + "id": "202468e4-5a03-4a44-ba69-d943886c7b15", + "status": "completed", + "vaccineCode": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "121", + "display": "zoster" + } + ], + "text": "zoster" + }, + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:f91eb13c-7f69-4d94-adf3-0b8739ab981f" + }, + "occurrenceDateTime": "2016-11-10T00:24:38-05:00", + "primarySource": true + }, + "request": { + "method": "POST", + "url": "Immunization" + } + }, + { + "fullUrl": "urn:uuid:23780537-c98c-401a-bfce-78f888e756c3", + "resource": { + "resourceType": "Immunization", + "id": "23780537-c98c-401a-bfce-78f888e756c3", + "status": "completed", + "vaccineCode": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:f91eb13c-7f69-4d94-adf3-0b8739ab981f" + }, + "occurrenceDateTime": "2016-11-10T00:24:38-05:00", + "primarySource": true + }, + "request": { + "method": "POST", + "url": "Immunization" + } + }, + { + "fullUrl": "urn:uuid:a29c0494-706e-4a1e-b607-e190d1229de0", + "resource": { + "resourceType": "Immunization", + "id": "a29c0494-706e-4a1e-b607-e190d1229de0", + "status": "completed", + "vaccineCode": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "113", + "display": "Td (adult) preservative free" + } + ], + "text": "Td (adult) preservative free" + }, + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:f91eb13c-7f69-4d94-adf3-0b8739ab981f" + }, + "occurrenceDateTime": "2016-11-10T00:24:38-05:00", + "primarySource": true + }, + "request": { + "method": "POST", + "url": "Immunization" + } + }, + { + "fullUrl": "urn:uuid:76cdad55-7e37-4f8b-82fd-fabbe1b84d86", + "resource": { + "resourceType": "Claim", + "id": "76cdad55-7e37-4f8b-82fd-fabbe1b84d86", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "2016-11-10T00:24:38-05:00", + "end": "2016-11-10T00:39:38-05:00" + }, + "created": "2016-11-10T00:39:38-05:00", + "provider": { + "reference": "urn:uuid:54f6fc59-7709-310f-9249-1e92d0464b00", + "display": "PCP145391" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "supportingInfo": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory", + "code": "info" + } + ] + }, + "valueReference": { + "reference": "urn:uuid:202468e4-5a03-4a44-ba69-d943886c7b15" + } + }, + { + "sequence": 2, + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory", + "code": "info" + } + ] + }, + "valueReference": { + "reference": "urn:uuid:23780537-c98c-401a-bfce-78f888e756c3" + } + }, + { + "sequence": 3, + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory", + "code": "info" + } + ] + }, + "valueReference": { + "reference": "urn:uuid:a29c0494-706e-4a1e-b607-e190d1229de0" + } + } + ], + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + }, + "encounter": [ + { + "reference": "urn:uuid:f91eb13c-7f69-4d94-adf3-0b8739ab981f" + } + ] + }, + { + "sequence": 2, + "informationSequence": [ + 1 + ], + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "121", + "display": "zoster" + } + ], + "text": "zoster" + }, + "net": { + "value": 140.52, + "currency": "USD" + } + }, + { + "sequence": 3, + "informationSequence": [ + 2 + ], + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "net": { + "value": 140.52, + "currency": "USD" + } + }, + { + "sequence": 4, + "informationSequence": [ + 3 + ], + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "113", + "display": "Td (adult) preservative free" + } + ], + "text": "Td (adult) preservative free" + }, + "net": { + "value": 140.52, + "currency": "USD" + } + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:f3ece524-256a-453d-9fef-9d38421bc553", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "f3ece524-256a-453d-9fef-9d38421bc553", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "76cdad55-7e37-4f8b-82fd-fabbe1b84d86" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "2016-11-10T00:39:38-05:00", + "end": "2017-11-10T00:39:38-05:00" + }, + "created": "2016-11-10T00:39:38-05:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:76cdad55-7e37-4f8b-82fd-fabbe1b84d86" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + }, + "servicedPeriod": { + "start": "2016-11-10T00:24:38-05:00", + "end": "2016-11-10T00:39:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "19", + "display": "Off Campus-Outpatient Hospital" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:f91eb13c-7f69-4d94-adf3-0b8739ab981f" + } + ] + }, + { + "sequence": 2, + "informationSequence": [ + 1 + ], + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "121", + "display": "zoster" + } + ], + "text": "zoster" + }, + "servicedPeriod": { + "start": "2016-11-10T00:24:38-05:00", + "end": "2016-11-10T00:39:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "19", + "display": "Off Campus-Outpatient Hospital" + } + ] + }, + "net": { + "value": 140.52, + "currency": "USD" + }, + "adjudication": [ + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt", + "display": "Line Beneficiary Coinsurance Amount" + } + ] + }, + "amount": { + "value": 28.104000000000003, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt", + "display": "Line Provider Payment Amount" + } + ] + }, + "amount": { + "value": 112.41600000000001, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt", + "display": "Line Submitted Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt", + "display": "Line Allowed Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt", + "display": "Line Beneficiary Part B Deductible Amount" + } + ] + }, + "amount": { + "value": 0, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd", + "display": "Line Processing Indicator Code" + } + ] + } + } + ] + }, + { + "sequence": 3, + "informationSequence": [ + 2 + ], + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "servicedPeriod": { + "start": "2016-11-10T00:24:38-05:00", + "end": "2016-11-10T00:39:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "19", + "display": "Off Campus-Outpatient Hospital" + } + ] + }, + "net": { + "value": 140.52, + "currency": "USD" + }, + "adjudication": [ + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt", + "display": "Line Beneficiary Coinsurance Amount" + } + ] + }, + "amount": { + "value": 28.104000000000003, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt", + "display": "Line Provider Payment Amount" + } + ] + }, + "amount": { + "value": 112.41600000000001, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt", + "display": "Line Submitted Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt", + "display": "Line Allowed Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt", + "display": "Line Beneficiary Part B Deductible Amount" + } + ] + }, + "amount": { + "value": 0, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd", + "display": "Line Processing Indicator Code" + } + ] + } + } + ] + }, + { + "sequence": 4, + "informationSequence": [ + 3 + ], + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "113", + "display": "Td (adult) preservative free" + } + ], + "text": "Td (adult) preservative free" + }, + "servicedPeriod": { + "start": "2016-11-10T00:24:38-05:00", + "end": "2016-11-10T00:39:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "19", + "display": "Off Campus-Outpatient Hospital" + } + ] + }, + "net": { + "value": 140.52, + "currency": "USD" + }, + "adjudication": [ + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt", + "display": "Line Beneficiary Coinsurance Amount" + } + ] + }, + "amount": { + "value": 28.104000000000003, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt", + "display": "Line Provider Payment Amount" + } + ] + }, + "amount": { + "value": 112.41600000000001, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt", + "display": "Line Submitted Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt", + "display": "Line Allowed Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt", + "display": "Line Beneficiary Part B Deductible Amount" + } + ] + }, + "amount": { + "value": 0, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd", + "display": "Line Processing Indicator Code" + } + ] + } + } + ] + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 337.24800000000005, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + }, + { + "fullUrl": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837", + "resource": { + "resourceType": "Encounter", + "id": "e4e9898a-8b74-4140-b477-8833a119f837", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "AMB" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710", + "display": "Dr. Shantae970 Cummerata161" + } + } + ], + "period": { + "start": "2017-11-16T00:24:38-05:00", + "end": "2017-11-16T00:54:38-05:00" + }, + "serviceProvider": { + "reference": "urn:uuid:54f6fc59-7709-310f-9249-1e92d0464b00", + "display": "PCP145391" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:301a8211-48d6-40b6-b353-dde369bdb61c", + "resource": { + "resourceType": "Observation", + "id": "301a8211-48d6-40b6-b353-dde369bdb61c", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8302-2", + "display": "Body Height" + } + ], + "text": "Body Height" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + }, + "effectiveDateTime": "2017-11-16T00:24:38-05:00", + "issued": "2017-11-16T00:24:38.752-05:00", + "valueQuantity": { + "value": 155.01680645430415, + "unit": "cm", + "system": "http://unitsofmeasure.org", + "code": "cm" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:5cbc32a6-2296-4fc9-9cc0-73edd0ab84de", + "resource": { + "resourceType": "Observation", + "id": "5cbc32a6-2296-4fc9-9cc0-73edd0ab84de", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "72514-3", + "display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported" + } + ], + "text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + }, + "effectiveDateTime": "2017-11-16T00:24:38-05:00", + "issued": "2017-11-16T00:24:38.752-05:00", + "valueQuantity": { + "value": 2.481255645341747, + "unit": "{score}", + "system": "http://unitsofmeasure.org", + "code": "{score}" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:2dc94d37-acee-4de2-8bed-9cc290183679", + "resource": { + "resourceType": "Observation", + "id": "2dc94d37-acee-4de2-8bed-9cc290183679", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "29463-7", + "display": "Body Weight" + } + ], + "text": "Body Weight" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + }, + "effectiveDateTime": "2017-11-16T00:24:38-05:00", + "issued": "2017-11-16T00:24:38.752-05:00", + "valueQuantity": { + "value": 65.79684973105927, + "unit": "kg", + "system": "http://unitsofmeasure.org", + "code": "kg" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:c3b3d836-7fdf-40f6-a1f2-906485ca0840", + "resource": { + "resourceType": "Observation", + "id": "c3b3d836-7fdf-40f6-a1f2-906485ca0840", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "39156-5", + "display": "Body Mass Index" + } + ], + "text": "Body Mass Index" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + }, + "effectiveDateTime": "2017-11-16T00:24:38-05:00", + "issued": "2017-11-16T00:24:38.752-05:00", + "valueQuantity": { + "value": 27.38088803859094, + "unit": "kg/m2", + "system": "http://unitsofmeasure.org", + "code": "kg/m2" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:42f61715-b8a6-4427-bb33-784d317aebc0", + "resource": { + "resourceType": "Observation", + "id": "42f61715-b8a6-4427-bb33-784d317aebc0", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "55284-4", + "display": "Blood Pressure" + } + ], + "text": "Blood Pressure" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + }, + "effectiveDateTime": "2017-11-16T00:24:38-05:00", + "issued": "2017-11-16T00:24:38.752-05:00", + "component": [ + { + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8462-4", + "display": "Diastolic Blood Pressure" + } + ], + "text": "Diastolic Blood Pressure" + }, + "valueQuantity": { + "value": 79.17286180026619, + "unit": "mm[Hg]", + "system": "http://unitsofmeasure.org", + "code": "mm[Hg]" + } + }, + { + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8480-6", + "display": "Systolic Blood Pressure" + } + ], + "text": "Systolic Blood Pressure" + }, + "valueQuantity": { + "value": 115.02102510870571, + "unit": "mm[Hg]", + "system": "http://unitsofmeasure.org", + "code": "mm[Hg]" + } + } + ] + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:502adfed-d94e-487f-8e53-de1942d02a48", + "resource": { + "resourceType": "Observation", + "id": "502adfed-d94e-487f-8e53-de1942d02a48", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "6690-2", + "display": "Leukocytes [#/volume] in Blood by Automated count" + } + ], + "text": "Leukocytes [#/volume] in Blood by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + }, + "effectiveDateTime": "2017-11-16T00:24:38-05:00", + "issued": "2017-11-16T00:24:38.752-05:00", + "valueQuantity": { + "value": 4.8536148008758175, + "unit": "10*3/uL", + "system": "http://unitsofmeasure.org", + "code": "10*3/uL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:25bae0ad-d855-417d-b139-a17de67820c1", + "resource": { + "resourceType": "Observation", + "id": "25bae0ad-d855-417d-b139-a17de67820c1", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "789-8", + "display": "Erythrocytes [#/volume] in Blood by Automated count" + } + ], + "text": "Erythrocytes [#/volume] in Blood by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + }, + "effectiveDateTime": "2017-11-16T00:24:38-05:00", + "issued": "2017-11-16T00:24:38.752-05:00", + "valueQuantity": { + "value": 4.352730111870313, + "unit": "10*6/uL", + "system": "http://unitsofmeasure.org", + "code": "10*6/uL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:527a4ebf-88ce-4f9b-9c0d-7040d2e4cf88", + "resource": { + "resourceType": "Observation", + "id": "527a4ebf-88ce-4f9b-9c0d-7040d2e4cf88", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "718-7", + "display": "Hemoglobin [Mass/volume] in Blood" + } + ], + "text": "Hemoglobin [Mass/volume] in Blood" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + }, + "effectiveDateTime": "2017-11-16T00:24:38-05:00", + "issued": "2017-11-16T00:24:38.752-05:00", + "valueQuantity": { + "value": 14.430972827914175, + "unit": "g/dL", + "system": "http://unitsofmeasure.org", + "code": "g/dL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:29a835b5-89e5-4347-8a1e-d25560644a36", + "resource": { + "resourceType": "Observation", + "id": "29a835b5-89e5-4347-8a1e-d25560644a36", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "4544-3", + "display": "Hematocrit [Volume Fraction] of Blood by Automated count" + } + ], + "text": "Hematocrit [Volume Fraction] of Blood by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + }, + "effectiveDateTime": "2017-11-16T00:24:38-05:00", + "issued": "2017-11-16T00:24:38.752-05:00", + "valueQuantity": { + "value": 48.211447825793854, + "unit": "%", + "system": "http://unitsofmeasure.org", + "code": "%" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:82d6ffac-0cd8-49d1-8ba2-29782f870cb2", + "resource": { + "resourceType": "Observation", + "id": "82d6ffac-0cd8-49d1-8ba2-29782f870cb2", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "787-2", + "display": "MCV [Entitic volume] by Automated count" + } + ], + "text": "MCV [Entitic volume] by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + }, + "effectiveDateTime": "2017-11-16T00:24:38-05:00", + "issued": "2017-11-16T00:24:38.752-05:00", + "valueQuantity": { + "value": 92.14681288834502, + "unit": "fL", + "system": "http://unitsofmeasure.org", + "code": "fL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:978bb3ac-b3a8-45c7-8b36-45ec5b111d6b", + "resource": { + "resourceType": "Observation", + "id": "978bb3ac-b3a8-45c7-8b36-45ec5b111d6b", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "785-6", + "display": "MCH [Entitic mass] by Automated count" + } + ], + "text": "MCH [Entitic mass] by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + }, + "effectiveDateTime": "2017-11-16T00:24:38-05:00", + "issued": "2017-11-16T00:24:38.752-05:00", + "valueQuantity": { + "value": 32.348447496902125, + "unit": "pg", + "system": "http://unitsofmeasure.org", + "code": "pg" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:68f19561-ec1f-4f8c-b398-fc9d9bd36e0f", + "resource": { + "resourceType": "Observation", + "id": "68f19561-ec1f-4f8c-b398-fc9d9bd36e0f", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "786-4", + "display": "MCHC [Mass/volume] by Automated count" + } + ], + "text": "MCHC [Mass/volume] by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + }, + "effectiveDateTime": "2017-11-16T00:24:38-05:00", + "issued": "2017-11-16T00:24:38.752-05:00", + "valueQuantity": { + "value": 35.287986999768975, + "unit": "g/dL", + "system": "http://unitsofmeasure.org", + "code": "g/dL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:f276bb9b-35c3-470d-8984-c5a4bf5bbea7", + "resource": { + "resourceType": "Observation", + "id": "f276bb9b-35c3-470d-8984-c5a4bf5bbea7", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "21000-5", + "display": "Erythrocyte distribution width [Entitic volume] by Automated count" + } + ], + "text": "Erythrocyte distribution width [Entitic volume] by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + }, + "effectiveDateTime": "2017-11-16T00:24:38-05:00", + "issued": "2017-11-16T00:24:38.752-05:00", + "valueQuantity": { + "value": 39.44326306635944, + "unit": "fL", + "system": "http://unitsofmeasure.org", + "code": "fL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:b5a8cfa8-bed5-46ae-9f9f-7d9c38da21e8", + "resource": { + "resourceType": "Observation", + "id": "b5a8cfa8-bed5-46ae-9f9f-7d9c38da21e8", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "777-3", + "display": "Platelets [#/volume] in Blood by Automated count" + } + ], + "text": "Platelets [#/volume] in Blood by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + }, + "effectiveDateTime": "2017-11-16T00:24:38-05:00", + "issued": "2017-11-16T00:24:38.752-05:00", + "valueQuantity": { + "value": 418.0016492722819, + "unit": "10*3/uL", + "system": "http://unitsofmeasure.org", + "code": "10*3/uL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:619114d1-e141-4eee-b69a-47f4e54f7408", + "resource": { + "resourceType": "Observation", + "id": "619114d1-e141-4eee-b69a-47f4e54f7408", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "32207-3", + "display": "Platelet distribution width [Entitic volume] in Blood by Automated count" + } + ], + "text": "Platelet distribution width [Entitic volume] in Blood by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + }, + "effectiveDateTime": "2017-11-16T00:24:38-05:00", + "issued": "2017-11-16T00:24:38.752-05:00", + "valueQuantity": { + "value": 318.2642148107422, + "unit": "fL", + "system": "http://unitsofmeasure.org", + "code": "fL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:8254a7c0-7d2d-4f9c-9cd3-4a2d3a7aebaf", + "resource": { + "resourceType": "Observation", + "id": "8254a7c0-7d2d-4f9c-9cd3-4a2d3a7aebaf", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "32623-1", + "display": "Platelet mean volume [Entitic volume] in Blood by Automated count" + } + ], + "text": "Platelet mean volume [Entitic volume] in Blood by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + }, + "effectiveDateTime": "2017-11-16T00:24:38-05:00", + "issued": "2017-11-16T00:24:38.752-05:00", + "valueQuantity": { + "value": 10.58609485122474, + "unit": "fL", + "system": "http://unitsofmeasure.org", + "code": "fL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:95fb6e40-82bc-4a14-8a5f-b8983d47b828", + "resource": { + "resourceType": "Observation", + "id": "95fb6e40-82bc-4a14-8a5f-b8983d47b828", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "survey", + "display": "survey" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "72166-2", + "display": "Tobacco smoking status NHIS" + } + ], + "text": "Tobacco smoking status NHIS" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + }, + "effectiveDateTime": "2017-11-16T00:24:38-05:00", + "issued": "2017-11-16T00:24:38.752-05:00", + "valueCodeableConcept": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "8517006", + "display": "Former smoker" + } + ], + "text": "Former smoker" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:74bbd7ed-5a74-4c5c-80b3-ab0bdf0c52e2", + "resource": { + "resourceType": "Procedure", + "id": "74bbd7ed-5a74-4c5c-80b3-ab0bdf0c52e2", + "status": "completed", + "code": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "430193006", + "display": "Medication Reconciliation (procedure)" + } + ], + "text": "Medication Reconciliation (procedure)" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + }, + "performedPeriod": { + "start": "2017-11-16T00:24:38-05:00", + "end": "2017-11-16T00:39:38-05:00" + } + }, + "request": { + "method": "POST", + "url": "Procedure" + } + }, + { + "fullUrl": "urn:uuid:c5e95b03-3c3f-41f8-9b12-996b3c0b4bdf", + "resource": { + "resourceType": "Immunization", + "id": "c5e95b03-3c3f-41f8-9b12-996b3c0b4bdf", + "status": "completed", + "vaccineCode": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + }, + "occurrenceDateTime": "2017-11-16T00:24:38-05:00", + "primarySource": true + }, + "request": { + "method": "POST", + "url": "Immunization" + } + }, + { + "fullUrl": "urn:uuid:1475ea5d-a585-43ce-a16e-530084063ee6", + "resource": { + "resourceType": "DiagnosticReport", + "id": "1475ea5d-a585-43ce-a16e-530084063ee6", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/v2-0074", + "code": "LAB", + "display": "Laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "58410-2", + "display": "Complete blood count (hemogram) panel - Blood by Automated count" + } + ], + "text": "Complete blood count (hemogram) panel - Blood by Automated count" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + }, + "effectiveDateTime": "2017-11-16T00:24:38-05:00", + "issued": "2017-11-16T00:24:38.752-05:00", + "result": [ + { + "reference": "urn:uuid:502adfed-d94e-487f-8e53-de1942d02a48", + "display": "Leukocytes [#/volume] in Blood by Automated count" + }, + { + "reference": "urn:uuid:25bae0ad-d855-417d-b139-a17de67820c1", + "display": "Erythrocytes [#/volume] in Blood by Automated count" + }, + { + "reference": "urn:uuid:527a4ebf-88ce-4f9b-9c0d-7040d2e4cf88", + "display": "Hemoglobin [Mass/volume] in Blood" + }, + { + "reference": "urn:uuid:29a835b5-89e5-4347-8a1e-d25560644a36", + "display": "Hematocrit [Volume Fraction] of Blood by Automated count" + }, + { + "reference": "urn:uuid:82d6ffac-0cd8-49d1-8ba2-29782f870cb2", + "display": "MCV [Entitic volume] by Automated count" + }, + { + "reference": "urn:uuid:978bb3ac-b3a8-45c7-8b36-45ec5b111d6b", + "display": "MCH [Entitic mass] by Automated count" + }, + { + "reference": "urn:uuid:68f19561-ec1f-4f8c-b398-fc9d9bd36e0f", + "display": "MCHC [Mass/volume] by Automated count" + }, + { + "reference": "urn:uuid:f276bb9b-35c3-470d-8984-c5a4bf5bbea7", + "display": "Erythrocyte distribution width [Entitic volume] by Automated count" + }, + { + "reference": "urn:uuid:b5a8cfa8-bed5-46ae-9f9f-7d9c38da21e8", + "display": "Platelets [#/volume] in Blood by Automated count" + }, + { + "reference": "urn:uuid:619114d1-e141-4eee-b69a-47f4e54f7408", + "display": "Platelet distribution width [Entitic volume] in Blood by Automated count" + }, + { + "reference": "urn:uuid:8254a7c0-7d2d-4f9c-9cd3-4a2d3a7aebaf", + "display": "Platelet mean volume [Entitic volume] in Blood by Automated count" + } + ] + }, + "request": { + "method": "POST", + "url": "DiagnosticReport" + } + }, + { + "fullUrl": "urn:uuid:e31bf98d-2e5d-4d5f-8585-c5d809e025e6", + "resource": { + "resourceType": "Claim", + "id": "e31bf98d-2e5d-4d5f-8585-c5d809e025e6", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "2017-11-16T00:24:38-05:00", + "end": "2017-11-16T00:54:38-05:00" + }, + "created": "2017-11-16T00:54:38-05:00", + "provider": { + "reference": "urn:uuid:54f6fc59-7709-310f-9249-1e92d0464b00", + "display": "PCP145391" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "supportingInfo": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory", + "code": "info" + } + ] + }, + "valueReference": { + "reference": "urn:uuid:c5e95b03-3c3f-41f8-9b12-996b3c0b4bdf" + } + } + ], + "procedure": [ + { + "sequence": 1, + "procedureReference": { + "reference": "urn:uuid:74bbd7ed-5a74-4c5c-80b3-ab0bdf0c52e2" + } + } + ], + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + }, + "encounter": [ + { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + } + ] + }, + { + "sequence": 2, + "informationSequence": [ + 1 + ], + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "net": { + "value": 140.52, + "currency": "USD" + } + }, + { + "sequence": 3, + "procedureSequence": [ + 1 + ], + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "430193006", + "display": "Medication Reconciliation (procedure)" + } + ], + "text": "Medication Reconciliation (procedure)" + }, + "net": { + "value": 511.82, + "currency": "USD" + } + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:c189c230-f45e-4855-9488-5ab17801322a", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "c189c230-f45e-4855-9488-5ab17801322a", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "e31bf98d-2e5d-4d5f-8585-c5d809e025e6" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "2017-11-16T00:54:38-05:00", + "end": "2018-11-16T00:54:38-05:00" + }, + "created": "2017-11-16T00:54:38-05:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:e31bf98d-2e5d-4d5f-8585-c5d809e025e6" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + }, + "servicedPeriod": { + "start": "2017-11-16T00:24:38-05:00", + "end": "2017-11-16T00:54:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "19", + "display": "Off Campus-Outpatient Hospital" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:e4e9898a-8b74-4140-b477-8833a119f837" + } + ] + }, + { + "sequence": 2, + "informationSequence": [ + 1 + ], + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "servicedPeriod": { + "start": "2017-11-16T00:24:38-05:00", + "end": "2017-11-16T00:54:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "19", + "display": "Off Campus-Outpatient Hospital" + } + ] + }, + "net": { + "value": 140.52, + "currency": "USD" + }, + "adjudication": [ + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt", + "display": "Line Beneficiary Coinsurance Amount" + } + ] + }, + "amount": { + "value": 28.104000000000003, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt", + "display": "Line Provider Payment Amount" + } + ] + }, + "amount": { + "value": 112.41600000000001, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt", + "display": "Line Submitted Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt", + "display": "Line Allowed Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt", + "display": "Line Beneficiary Part B Deductible Amount" + } + ] + }, + "amount": { + "value": 0, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd", + "display": "Line Processing Indicator Code" + } + ] + } + } + ] + }, + { + "sequence": 3, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "430193006", + "display": "Medication Reconciliation (procedure)" + } + ], + "text": "Medication Reconciliation (procedure)" + }, + "servicedPeriod": { + "start": "2017-11-16T00:24:38-05:00", + "end": "2017-11-16T00:54:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "19", + "display": "Off Campus-Outpatient Hospital" + } + ] + }, + "net": { + "value": 511.82, + "currency": "USD" + }, + "adjudication": [ + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt", + "display": "Line Beneficiary Coinsurance Amount" + } + ] + }, + "amount": { + "value": 102.364, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt", + "display": "Line Provider Payment Amount" + } + ] + }, + "amount": { + "value": 409.456, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt", + "display": "Line Submitted Charge Amount" + } + ] + }, + "amount": { + "value": 511.82, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt", + "display": "Line Allowed Charge Amount" + } + ] + }, + "amount": { + "value": 511.82, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt", + "display": "Line Beneficiary Part B Deductible Amount" + } + ] + }, + "amount": { + "value": 0, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd", + "display": "Line Processing Indicator Code" + } + ] + } + } + ] + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 521.8720000000001, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + }, + { + "fullUrl": "urn:uuid:ddce7eb9-3b5e-484b-961e-f47914854bd2", + "resource": { + "resourceType": "Encounter", + "id": "ddce7eb9-3b5e-484b-961e-f47914854bd2", + "status": "finished", + "class": { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "AMB" + }, + "type": [ + { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + } + ], + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Ms. Alesha810 Marks830" + }, + "participant": [ + { + "individual": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710", + "display": "Dr. Shantae970 Cummerata161" + } + } + ], + "period": { + "start": "2018-11-22T00:24:38-05:00", + "end": "2018-11-22T00:39:38-05:00" + }, + "serviceProvider": { + "reference": "urn:uuid:54f6fc59-7709-310f-9249-1e92d0464b00", + "display": "PCP145391" + } + }, + "request": { + "method": "POST", + "url": "Encounter" + } + }, + { + "fullUrl": "urn:uuid:c0c77f66-bc64-460f-8d7e-bf6c7c8d044d", + "resource": { + "resourceType": "Observation", + "id": "c0c77f66-bc64-460f-8d7e-bf6c7c8d044d", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8302-2", + "display": "Body Height" + } + ], + "text": "Body Height" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:ddce7eb9-3b5e-484b-961e-f47914854bd2" + }, + "effectiveDateTime": "2018-11-22T00:24:38-05:00", + "issued": "2018-11-22T00:24:38.752-05:00", + "valueQuantity": { + "value": 155.01680645430415, + "unit": "cm", + "system": "http://unitsofmeasure.org", + "code": "cm" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:66daa3de-187c-4c78-a1d0-262f65afea48", + "resource": { + "resourceType": "Observation", + "id": "66daa3de-187c-4c78-a1d0-262f65afea48", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "72514-3", + "display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported" + } + ], + "text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:ddce7eb9-3b5e-484b-961e-f47914854bd2" + }, + "effectiveDateTime": "2018-11-22T00:24:38-05:00", + "issued": "2018-11-22T00:24:38.752-05:00", + "valueQuantity": { + "value": 0.43073343370131845, + "unit": "{score}", + "system": "http://unitsofmeasure.org", + "code": "{score}" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:ded6f5a5-6079-4d7e-9b6d-2098853be4c6", + "resource": { + "resourceType": "Observation", + "id": "ded6f5a5-6079-4d7e-9b6d-2098853be4c6", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "29463-7", + "display": "Body Weight" + } + ], + "text": "Body Weight" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:ddce7eb9-3b5e-484b-961e-f47914854bd2" + }, + "effectiveDateTime": "2018-11-22T00:24:38-05:00", + "issued": "2018-11-22T00:24:38.752-05:00", + "valueQuantity": { + "value": 65.79684973105927, + "unit": "kg", + "system": "http://unitsofmeasure.org", + "code": "kg" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:c245c731-c53d-43d3-85a2-7999ab359899", + "resource": { + "resourceType": "Observation", + "id": "c245c731-c53d-43d3-85a2-7999ab359899", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "39156-5", + "display": "Body Mass Index" + } + ], + "text": "Body Mass Index" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:ddce7eb9-3b5e-484b-961e-f47914854bd2" + }, + "effectiveDateTime": "2018-11-22T00:24:38-05:00", + "issued": "2018-11-22T00:24:38.752-05:00", + "valueQuantity": { + "value": 27.38088803859094, + "unit": "kg/m2", + "system": "http://unitsofmeasure.org", + "code": "kg/m2" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:475b8086-234d-4d13-b1cc-b56001514008", + "resource": { + "resourceType": "Observation", + "id": "475b8086-234d-4d13-b1cc-b56001514008", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "vital-signs", + "display": "vital-signs" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "55284-4", + "display": "Blood Pressure" + } + ], + "text": "Blood Pressure" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:ddce7eb9-3b5e-484b-961e-f47914854bd2" + }, + "effectiveDateTime": "2018-11-22T00:24:38-05:00", + "issued": "2018-11-22T00:24:38.752-05:00", + "component": [ + { + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8462-4", + "display": "Diastolic Blood Pressure" + } + ], + "text": "Diastolic Blood Pressure" + }, + "valueQuantity": { + "value": 76.15928475258472, + "unit": "mm[Hg]", + "system": "http://unitsofmeasure.org", + "code": "mm[Hg]" + } + }, + { + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "8480-6", + "display": "Systolic Blood Pressure" + } + ], + "text": "Systolic Blood Pressure" + }, + "valueQuantity": { + "value": 109.29940925015008, + "unit": "mm[Hg]", + "system": "http://unitsofmeasure.org", + "code": "mm[Hg]" + } + } + ] + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:b779ba4a-353b-48ac-934b-70b27835b1ad", + "resource": { + "resourceType": "Observation", + "id": "b779ba4a-353b-48ac-934b-70b27835b1ad", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "2093-3", + "display": "Total Cholesterol" + } + ], + "text": "Total Cholesterol" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:ddce7eb9-3b5e-484b-961e-f47914854bd2" + }, + "effectiveDateTime": "2018-11-22T00:24:38-05:00", + "issued": "2018-11-22T00:24:38.752-05:00", + "valueQuantity": { + "value": 189.5461446255375, + "unit": "mg/dL", + "system": "http://unitsofmeasure.org", + "code": "mg/dL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:c2955df2-1363-40e2-a6a9-7ed6bb5a07e3", + "resource": { + "resourceType": "Observation", + "id": "c2955df2-1363-40e2-a6a9-7ed6bb5a07e3", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "2571-8", + "display": "Triglycerides" + } + ], + "text": "Triglycerides" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:ddce7eb9-3b5e-484b-961e-f47914854bd2" + }, + "effectiveDateTime": "2018-11-22T00:24:38-05:00", + "issued": "2018-11-22T00:24:38.752-05:00", + "valueQuantity": { + "value": 147.2569551323221, + "unit": "mg/dL", + "system": "http://unitsofmeasure.org", + "code": "mg/dL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:419d6cfc-0652-4f5b-ace0-ce7e29245ea1", + "resource": { + "resourceType": "Observation", + "id": "419d6cfc-0652-4f5b-ace0-ce7e29245ea1", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "18262-6", + "display": "Low Density Lipoprotein Cholesterol" + } + ], + "text": "Low Density Lipoprotein Cholesterol" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:ddce7eb9-3b5e-484b-961e-f47914854bd2" + }, + "effectiveDateTime": "2018-11-22T00:24:38-05:00", + "issued": "2018-11-22T00:24:38.752-05:00", + "valueQuantity": { + "value": 99.45316057404943, + "unit": "mg/dL", + "system": "http://unitsofmeasure.org", + "code": "mg/dL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:7fb19f5c-fcc5-452d-9bec-10ea25352db4", + "resource": { + "resourceType": "Observation", + "id": "7fb19f5c-fcc5-452d-9bec-10ea25352db4", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "laboratory", + "display": "laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "2085-9", + "display": "High Density Lipoprotein Cholesterol" + } + ], + "text": "High Density Lipoprotein Cholesterol" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:ddce7eb9-3b5e-484b-961e-f47914854bd2" + }, + "effectiveDateTime": "2018-11-22T00:24:38-05:00", + "issued": "2018-11-22T00:24:38.752-05:00", + "valueQuantity": { + "value": 60.64159302502363, + "unit": "mg/dL", + "system": "http://unitsofmeasure.org", + "code": "mg/dL" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:952d932f-2cc7-4853-9634-27c01dc2f13f", + "resource": { + "resourceType": "Observation", + "id": "952d932f-2cc7-4853-9634-27c01dc2f13f", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/observation-category", + "code": "survey", + "display": "survey" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "72166-2", + "display": "Tobacco smoking status NHIS" + } + ], + "text": "Tobacco smoking status NHIS" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:ddce7eb9-3b5e-484b-961e-f47914854bd2" + }, + "effectiveDateTime": "2018-11-22T00:24:38-05:00", + "issued": "2018-11-22T00:24:38.752-05:00", + "valueCodeableConcept": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "8517006", + "display": "Former smoker" + } + ], + "text": "Former smoker" + } + }, + "request": { + "method": "POST", + "url": "Observation" + } + }, + { + "fullUrl": "urn:uuid:4b1647ec-57a3-4a4f-aaf7-7e90d4185ccd", + "resource": { + "resourceType": "Immunization", + "id": "4b1647ec-57a3-4a4f-aaf7-7e90d4185ccd", + "status": "completed", + "vaccineCode": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:ddce7eb9-3b5e-484b-961e-f47914854bd2" + }, + "occurrenceDateTime": "2018-11-22T00:24:38-05:00", + "primarySource": true + }, + "request": { + "method": "POST", + "url": "Immunization" + } + }, + { + "fullUrl": "urn:uuid:b461dc4f-c53b-4c18-b916-575f98cd2ad5", + "resource": { + "resourceType": "DiagnosticReport", + "id": "b461dc4f-c53b-4c18-b916-575f98cd2ad5", + "status": "final", + "category": [ + { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/v2-0074", + "code": "LAB", + "display": "Laboratory" + } + ] + } + ], + "code": { + "coding": [ + { + "system": "http://loinc.org", + "code": "57698-3", + "display": "Lipid Panel" + } + ], + "text": "Lipid Panel" + }, + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "encounter": { + "reference": "urn:uuid:ddce7eb9-3b5e-484b-961e-f47914854bd2" + }, + "effectiveDateTime": "2018-11-22T00:24:38-05:00", + "issued": "2018-11-22T00:24:38.752-05:00", + "result": [ + { + "reference": "urn:uuid:b779ba4a-353b-48ac-934b-70b27835b1ad", + "display": "Total Cholesterol" + }, + { + "reference": "urn:uuid:c2955df2-1363-40e2-a6a9-7ed6bb5a07e3", + "display": "Triglycerides" + }, + { + "reference": "urn:uuid:419d6cfc-0652-4f5b-ace0-ce7e29245ea1", + "display": "Low Density Lipoprotein Cholesterol" + }, + { + "reference": "urn:uuid:7fb19f5c-fcc5-452d-9bec-10ea25352db4", + "display": "High Density Lipoprotein Cholesterol" + } + ] + }, + "request": { + "method": "POST", + "url": "DiagnosticReport" + } + }, + { + "fullUrl": "urn:uuid:110639e9-7b4b-4e05-a7b2-26077c348977", + "resource": { + "resourceType": "Claim", + "id": "110639e9-7b4b-4e05-a7b2-26077c348977", + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9", + "display": "Alesha810 Marks830" + }, + "billablePeriod": { + "start": "2018-11-22T00:24:38-05:00", + "end": "2018-11-22T00:39:38-05:00" + }, + "created": "2018-11-22T00:39:38-05:00", + "provider": { + "reference": "urn:uuid:54f6fc59-7709-310f-9249-1e92d0464b00", + "display": "PCP145391" + }, + "priority": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/processpriority", + "code": "normal" + } + ] + }, + "supportingInfo": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory", + "code": "info" + } + ] + }, + "valueReference": { + "reference": "urn:uuid:4b1647ec-57a3-4a4f-aaf7-7e90d4185ccd" + } + } + ], + "insurance": [ + { + "sequence": 1, + "focal": true, + "coverage": { + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + }, + "encounter": [ + { + "reference": "urn:uuid:ddce7eb9-3b5e-484b-961e-f47914854bd2" + } + ] + }, + { + "sequence": 2, + "informationSequence": [ + 1 + ], + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "net": { + "value": 140.52, + "currency": "USD" + } + } + ], + "total": { + "value": 129.16, + "currency": "USD" + } + }, + "request": { + "method": "POST", + "url": "Claim" + } + }, + { + "fullUrl": "urn:uuid:d00feb8d-243d-4636-9e21-fe47c398db8a", + "resource": { + "resourceType": "ExplanationOfBenefit", + "id": "d00feb8d-243d-4636-9e21-fe47c398db8a", + "contained": [ + { + "resourceType": "ServiceRequest", + "id": "referral", + "status": "completed", + "intent": "order", + "subject": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "requester": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "performer": [ + { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + } + ] + }, + { + "resourceType": "Coverage", + "id": "coverage", + "status": "active", + "type": { + "text": "Blue Cross Blue Shield" + }, + "beneficiary": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "payor": [ + { + "display": "Blue Cross Blue Shield" + } + ] + } + ], + "identifier": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/clm_id", + "value": "110639e9-7b4b-4e05-a7b2-26077c348977" + }, + { + "system": "https://bluebutton.cms.gov/resources/identifier/claim-group", + "value": "99999999999" + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claim-type", + "code": "institutional" + } + ] + }, + "use": "claim", + "patient": { + "reference": "urn:uuid:c088b7af-fc41-43cc-ab80-4a9ab8d47cd9" + }, + "billablePeriod": { + "start": "2018-11-22T00:39:38-05:00", + "end": "2019-11-22T00:39:38-05:00" + }, + "created": "2018-11-22T00:39:38-05:00", + "insurer": { + "display": "Blue Cross Blue Shield" + }, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "referral": { + "reference": "#referral" + }, + "claim": { + "reference": "urn:uuid:110639e9-7b4b-4e05-a7b2-26077c348977" + }, + "outcome": "complete", + "careTeam": [ + { + "sequence": 1, + "provider": { + "reference": "urn:uuid:0000016d-3a85-4cca-0000-00000000c710" + }, + "role": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole", + "code": "primary", + "display": "Primary Care Practitioner" + } + ] + } + } + ], + "insurance": [ + { + "focal": true, + "coverage": { + "reference": "#coverage", + "display": "Blue Cross Blue Shield" + } + } + ], + "item": [ + { + "sequence": 1, + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://snomed.info/sct", + "code": "162673000", + "display": "General examination of patient (procedure)" + } + ], + "text": "General examination of patient (procedure)" + }, + "servicedPeriod": { + "start": "2018-11-22T00:24:38-05:00", + "end": "2018-11-22T00:39:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "19", + "display": "Off Campus-Outpatient Hospital" + } + ] + }, + "encounter": [ + { + "reference": "urn:uuid:ddce7eb9-3b5e-484b-961e-f47914854bd2" + } + ] + }, + { + "sequence": 2, + "informationSequence": [ + 1 + ], + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "1", + "display": "Medical care" + } + ] + }, + "productOrService": { + "coding": [ + { + "system": "http://hl7.org/fhir/sid/cvx", + "code": "140", + "display": "Influenza, seasonal, injectable, preservative free" + } + ], + "text": "Influenza, seasonal, injectable, preservative free" + }, + "servicedPeriod": { + "start": "2018-11-22T00:24:38-05:00", + "end": "2018-11-22T00:39:38-05:00" + }, + "locationCodeableConcept": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace", + "code": "19", + "display": "Off Campus-Outpatient Hospital" + } + ] + }, + "net": { + "value": 140.52, + "currency": "USD" + }, + "adjudication": [ + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt", + "display": "Line Beneficiary Coinsurance Amount" + } + ] + }, + "amount": { + "value": 28.104000000000003, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt", + "display": "Line Provider Payment Amount" + } + ] + }, + "amount": { + "value": 112.41600000000001, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt", + "display": "Line Submitted Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt", + "display": "Line Allowed Charge Amount" + } + ] + }, + "amount": { + "value": 140.52, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt", + "display": "Line Beneficiary Part B Deductible Amount" + } + ] + }, + "amount": { + "value": 0, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd", + "display": "Line Processing Indicator Code" + } + ] + } + } + ] + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + } + ], + "text": "Submitted Amount" + }, + "amount": { + "value": 129.16, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 112.41600000000001, + "currency": "USD" + } + } + }, + "request": { + "method": "POST", + "url": "ExplanationOfBenefit" + } + } + ] +} diff --git a/frontend/src/lib/conduit/interface.ts b/frontend/src/lib/conduit/interface.ts index 503fa9c4..ea1b6bd4 100644 --- a/frontend/src/lib/conduit/interface.ts +++ b/frontend/src/lib/conduit/interface.ts @@ -1,14 +1,45 @@ import {IDatabaseRepository} from '../database/interface'; export interface IClient { + fhirVersion: string GetRequest(resourceSubpath: string): Promise + GetFhirVersion(): Promise SyncAll(db: IDatabaseRepository): Promise //Manual client ONLY functions SyncAllBundle(db: IDatabaseRepository, bundleFile: any): Promise } -export interface IResourceInterface { +//This is the "raw" Fhir resource +export interface IResourceRaw { resourceType: string id?: string + meta?: IResourceMetaRaw +} +// This is the "raw" Fhir Bundle resource +export interface IResourceBundleRaw { + resourceType: string + id?: string + entry: IResourceBundleEntryRaw[] + total?: number + link?: IResourceBundleLinkRaw[] + meta?: IResourceMetaRaw +} + +export interface IResourceBundleLinkRaw { + id?: string + relation: string + url: string +} + +export interface IResourceBundleEntryRaw { + id?: string + fullUrl?: string + resource: IResourceRaw +} + +export interface IResourceMetaRaw { + id?: string + versionId?: string + lastUpdated: string } diff --git a/frontend/src/lib/database/constants.ts b/frontend/src/lib/database/constants.ts index 38124eaf..5d727b2d 100644 --- a/frontend/src/lib/database/constants.ts +++ b/frontend/src/lib/database/constants.ts @@ -1,3 +1,4 @@ export enum DocType { - Source= "source", + Source = "source", + ResourceFhir = "resource_fhir" } diff --git a/frontend/src/lib/database/interface.ts b/frontend/src/lib/database/interface.ts index 001e0212..fcfcb3b8 100644 --- a/frontend/src/lib/database/interface.ts +++ b/frontend/src/lib/database/interface.ts @@ -1,7 +1,11 @@ import {Source} from '../models/database/source'; +import {ResourceFhir} from '../models/database/resource_fhir'; // import {SourceSummary} from '../../app/models/fasten/source-summary'; export interface IDatabaseDocument { + _id?: string + _rev?: string + doc_type: string populateId(): void } @@ -31,4 +35,10 @@ export interface IDatabaseRepository { DeleteSource(source_id: string): Promise // GetSourceSummary(source_id: string): Promise GetSources(): Promise + + + CreateResource(resource: ResourceFhir): Promise + CreateResources(resources: ResourceFhir[]): Promise + GetResource(resource_id: string): Promise + GetResources(): Promise } diff --git a/frontend/src/lib/database/pouchdb_repository.spec.ts b/frontend/src/lib/database/pouchdb_repository.spec.ts index b24f9390..32b439fd 100644 --- a/frontend/src/lib/database/pouchdb_repository.spec.ts +++ b/frontend/src/lib/database/pouchdb_repository.spec.ts @@ -43,7 +43,7 @@ describe('PouchdbRepository', () => { const createdSource = await repository.GetSource(createdId) - expect(createdSource.docType).toEqual(DocType.Source); + expect(createdSource.doc_type).toEqual(DocType.Source); expect(createdSource.patient).toEqual('patient'); expect(createdSource.source_type).toEqual(SourceType.Aetna); expect(createdSource.access_token).toEqual('hello-world'); diff --git a/frontend/src/lib/database/pouchdb_repository.ts b/frontend/src/lib/database/pouchdb_repository.ts index 78e0a34b..261e34ab 100644 --- a/frontend/src/lib/database/pouchdb_repository.ts +++ b/frontend/src/lib/database/pouchdb_repository.ts @@ -3,6 +3,7 @@ import {IDatabasePaginatedResponse, IDatabaseDocument, IDatabaseRepository} from import * as PouchDB from 'pouchdb/dist/pouchdb'; // import * as PouchDB from 'pouchdb'; import {DocType} from './constants'; +import {ResourceFhir} from '../models/database/resource_fhir'; export function NewRepositiory(databaseName: string = 'fasten'): IDatabaseRepository { return new PouchdbRepository(databaseName) @@ -44,6 +45,32 @@ export class PouchdbRepository implements IDatabaseRepository { return this.deleteDocument(source_id) } + public async CreateResource(resource: ResourceFhir): Promise { + return this.createDocument(resource); + } + + public async CreateResources(resources: ResourceFhir[]): Promise { + return this.createBulk(resources); + } + + public async GetResource(resource_id: string): Promise { + return this.getDocument(resource_id) + .then((doc) => { + return new ResourceFhir(doc) + }) + } + + public async GetResources(): Promise { + return this.findDocumentByDocType(DocType.ResourceFhir) + .then((docWrapper) => { + + docWrapper.rows = docWrapper.rows.map((result) => { + return new ResourceFhir(result.doc) + }) + return docWrapper + }) + } + /////////////////////////////////////////////////////////////////////////////////////// // CRUD Operators @@ -73,6 +100,15 @@ export class PouchdbRepository implements IDatabaseRepository { ); } + // create multiple documents, returns a list of generated ids + private createBulk(docs: IDatabaseDocument[]): Promise { + return this.GetDB() + .bulkDocs(docs.map((doc) => { doc.populateId(); return doc })) + .then((results): string[] => { + return results.map((result) => result.id) + }) + } + private getDocument(id: string): Promise { return this.GetDB() .get(id) diff --git a/frontend/src/lib/models/database/resource_fhir.ts b/frontend/src/lib/models/database/resource_fhir.ts new file mode 100644 index 00000000..741b4a1c --- /dev/null +++ b/frontend/src/lib/models/database/resource_fhir.ts @@ -0,0 +1,32 @@ +import {DocType} from '../../database/constants'; +import {IResourceRaw} from '../../conduit/interface'; +import {Base64} from '../../utils/base64'; + +export class ResourceFhir { + _id?: string + _rev?: string + doc_type: string + + created_at?: Date + updated_at?: Date + source_id: string + source_resource_type: string + source_resource_id: string + + resource_raw: IResourceRaw + + constructor(object?: any) { + if(object){ + object.doc_type = DocType.ResourceFhir + return Object.assign(this, object) + } else{ + this.doc_type = DocType.ResourceFhir + return this + } + } + + populateId(){ + //TODO: source_id should be base64 encoded (otherwise we get nested : chars) + this._id = `${this.doc_type}:${Base64.Encode(this.source_id)}:${this.source_resource_type}:${this.source_resource_id}` + } +} diff --git a/frontend/src/lib/models/database/source.ts b/frontend/src/lib/models/database/source.ts index b5a54dfb..b4408dd5 100644 --- a/frontend/src/lib/models/database/source.ts +++ b/frontend/src/lib/models/database/source.ts @@ -5,7 +5,7 @@ import {DocType} from '../../../lib/database/constants'; export class Source extends LighthouseSourceMetadata{ _id?: string _rev?: string - docType: string + doc_type: string source_type: SourceType patient: string @@ -16,11 +16,11 @@ export class Source extends LighthouseSourceMetadata{ constructor(object: any) { super() - object.docType = DocType.Source + object.doc_type = DocType.Source return Object.assign(this, object) } populateId(){ - this._id = `source:${this.source_type}:${this.patient}` + this._id = `${this.doc_type}:${this.source_type}:${this.patient}` } } diff --git a/frontend/src/lib/utils/base64.ts b/frontend/src/lib/utils/base64.ts new file mode 100644 index 00000000..ffa0882c --- /dev/null +++ b/frontend/src/lib/utils/base64.ts @@ -0,0 +1,8 @@ +export class Base64 { + public static Encode(data: string): string { + return btoa(data) + } + public static Decode(data: string): string { + return atob(data) + } +} diff --git a/frontend/tsconfig.spec.json b/frontend/tsconfig.spec.json index 6400fde7..9d0ff75e 100644 --- a/frontend/tsconfig.spec.json +++ b/frontend/tsconfig.spec.json @@ -1,6 +1,7 @@ { "extends": "./tsconfig.json", "compilerOptions": { + "resolveJsonModule": true, "outDir": "./out-tsc/spec", "types": [ "jasmine",