Universal API Implementation Guide
1.1.20 - ci-build
Universal API Implementation Guide - Local Development build (v1.1.20) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
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🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-as-enrollment-bundle"
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"identifier" : {
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"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "RI",
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"system" : "http://tailormed.co",
"value" : "6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2",
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"display" : "TailorMed"
}
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"timestamp" : "2024-04-02T08:10:13-05:00",
"entry" : [
{
"fullUrl" : "urn:uuid:9e592049-0434-48f9-8498-d7cf1e80e086",
"resource" : {
"resourceType" : "MessageHeader",
"id" : "9e592049-0434-48f9-8498-d7cf1e80e086",
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🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-messageheader"
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"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MessageHeader_9e592049-0434-48f9-8498-d7cf1e80e086\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MessageHeader 9e592049-0434-48f9-8498-d7cf1e80e086</b></p><a name=\"9e592049-0434-48f9-8498-d7cf1e80e086\"> </a><a name=\"hc9e592049-0434-48f9-8498-d7cf1e80e086\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-uapi-messageheader.html\">UAPI MessageHeader</a></p></div><p><b>event</b>: uapi-event-type enrollment-with-consent: enrollment-with-consent</p><h3>Destinations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Name</b></td><td><b>Endpoint</b></td></tr><tr><td style=\"display: none\">*</td><td>UAPI-ENR-V2.1</td><td><a href=\"https://test-us-e1.apis.roche.com/pharma-cmg-ehr-fhir-exp-test/v2/enrollment\">https://test-us-e1.apis.roche.com/pharma-cmg-ehr-fhir-exp-test/v2/enrollment</a></td></tr></table><p><b>sender</b>: <a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-7e45cd4c-8c11-4205-a2b7-fce834bc3511\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></p><h3>Sources</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Name</b></td><td><b>Endpoint</b></td></tr><tr><td style=\"display: none\">*</td><td>TailorMed</td><td><a href=\"http://tailormed.co/fhir/enrollmentID/ENR-00001\">http://tailormed.co/fhir/enrollmentID/ENR-00001</a></td></tr></table><p><b>focus</b>: <a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-7cd8694a-0268-414e-b8ca-9271e7e1a242\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></p></div>"
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"eventCoding" : {
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"destination" : [
{
"name" : "UAPI-ENR-V2.1",
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],
"sender" : {
"reference" : "urn:uuid:7e45cd4c-8c11-4205-a2b7-fce834bc3511",
"type" : "Organization"
},
"source" : {
"name" : "TailorMed",
"endpoint" : "http://tailormed.co/fhir/enrollmentID/ENR-00001"
},
"focus" : [
{
"reference" : "urn:uuid:7cd8694a-0268-414e-b8ca-9271e7e1a242",
"type" : "List"
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]
}
},
{
"fullUrl" : "urn:uuid:7cd8694a-0268-414e-b8ca-9271e7e1a242",
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"id" : "7cd8694a-0268-414e-b8ca-9271e7e1a242",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"List_7cd8694a-0268-414e-b8ca-9271e7e1a242\"> </a><p class=\"res-header-id\"><b>Generated Narrative: List 7cd8694a-0268-414e-b8ca-9271e7e1a242</b></p><a name=\"7cd8694a-0268-414e-b8ca-9271e7e1a242\"> </a><a name=\"hc7cd8694a-0268-414e-b8ca-9271e7e1a242\"> </a><h2>messageContext</h2><table class=\"clstu\"><tr><td>Mode: Change List </td><td>Status: Current </td></tr><tr><td/></tr></table><table class=\"grid\"><tr style=\"backgound-color: #eeeeee\"><td><b>Items</b></td></tr><tr><td><a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-ab45810f-2057-4b15-a24d-be929071cad5\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-7e45cd4c-8c11-4205-a2b7-fce834bc3511\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-3c5298d3-2b49-4f79-b703-a46623899258\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-42b41bdb-1781-49aa-a091-78cdd92129df\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-46d09721-f04e-4059-871f-31a1dc5127cf\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-af15ccf2-4e36-400f-8e74-24fbcf29dfbd\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-bc20c5ea-f639-4221-ab61-ce75c5e64aba\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-645c7756-d1d7-4df2-a65d-e1680dbbb991\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-4f536bc9-a238-49ac-bf07-65d670f84ed3\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-1cc390ba-32b3-4c41-a805-d4b9cee64784\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-212c57ad-45cd-4882-87e7-8415ded3db05\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-f71a66c4-f747-4b46-8adc-875a45f8ee7e\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-e9d05dcd-bb02-4a08-af63-386dcab3f160\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-d1654255-0a8d-4f2c-9405-19a6794500a2\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-d1089cdf-7a5f-45b1-99b9-2c021eca5270\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></td></tr></table></div>"
},
"status" : "current",
"mode" : "changes",
"title" : "messageContext",
"entry" : [
{
"item" : {
"reference" : "urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5",
"type" : "Patient"
}
},
{
"item" : {
"reference" : "urn:uuid:7e45cd4c-8c11-4205-a2b7-fce834bc3511",
"type" : "Organization"
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},
{
"item" : {
"reference" : "urn:uuid:3c5298d3-2b49-4f79-b703-a46623899258",
"type" : "Practitioner"
}
},
{
"item" : {
"reference" : "urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df",
"type" : "Coverage"
}
},
{
"item" : {
"reference" : "urn:uuid:46d09721-f04e-4059-871f-31a1dc5127cf",
"type" : "RelatedPerson"
}
},
{
"item" : {
"reference" : "urn:uuid:af15ccf2-4e36-400f-8e74-24fbcf29dfbd",
"type" : "QuestionnaireResponse"
}
},
{
"item" : {
"reference" : "urn:uuid:bc20c5ea-f639-4221-ab61-ce75c5e64aba",
"type" : "Condition"
}
},
{
"item" : {
"reference" : "urn:uuid:645c7756-d1d7-4df2-a65d-e1680dbbb991",
"type" : "Consent"
}
},
{
"item" : {
"reference" : "urn:uuid:4f536bc9-a238-49ac-bf07-65d670f84ed3",
"type" : "Consent"
}
},
{
"item" : {
"reference" : "urn:uuid:1cc390ba-32b3-4c41-a805-d4b9cee64784",
"type" : "Provenance"
}
},
{
"item" : {
"reference" : "urn:uuid:212c57ad-45cd-4882-87e7-8415ded3db05",
"type" : "ServiceRequest"
}
},
{
"item" : {
"reference" : "urn:uuid:f71a66c4-f747-4b46-8adc-875a45f8ee7e",
"type" : "ServiceRequest"
}
},
{
"item" : {
"reference" : "urn:uuid:e9d05dcd-bb02-4a08-af63-386dcab3f160",
"type" : "MedicationRequest"
}
},
{
"item" : {
"reference" : "urn:uuid:d1654255-0a8d-4f2c-9405-19a6794500a2",
"type" : "Organization"
}
},
{
"item" : {
"reference" : "urn:uuid:d1089cdf-7a5f-45b1-99b9-2c021eca5270",
"type" : "Organization"
}
}
]
}
},
{
"fullUrl" : "urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5",
"resource" : {
"resourceType" : "Patient",
"id" : "ab45810f-2057-4b15-a24d-be929071cad5",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-patient"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_ab45810f-2057-4b15-a24d-be929071cad5\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient ab45810f-2057-4b15-a24d-be929071cad5</b></p><a name=\"ab45810f-2057-4b15-a24d-be929071cad5\"> </a><a name=\"hcab45810f-2057-4b15-a24d-be929071cad5\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-uapi-patient.html\">UAPI Patient</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Rudy Gandoff (official) Male, DoB: 1965-10-29 ( Patient internal identifier: TM-2345\u00a0(use:\u00a0official,\u00a0))</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\"><ul><li>ph: 6501231234(Home)</li><li>ph: 6504561234(Mobile)</li><li><a href=\"mailto:rudyg@example.com\">rudyg@example.com</a></li><li>1234 Airport Blvd South San Francisco CA 94080 US </li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Language spoken\">Language:</td><td colspan=\"3\"><span title=\"Codes:{urn:ietf:bcp:47 en}\">English</span> (preferred)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Patient Links\">Links:</td><td colspan=\"3\"><ul><li>General Practitioner: <a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-3c5298d3-2b49-4f79-b703-a46623899258\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></li><li>Managing Organization: <a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-7e45cd4c-8c11-4205-a2b7-fce834bc3511\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></li></ul></td></tr></table></div>"
},
"identifier" : [
{
"use" : "official",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "PI",
"display" : "Patient internal identifier"
}
]
},
"system" : "http://tailormed.co",
"value" : "TM-2345",
"assigner" : {
"display" : "TailorMed"
}
}
],
"name" : [
{
"use" : "official",
"family" : "Gandoff",
"given" : [
"Rudy"
]
}
],
"telecom" : [
{
"system" : "phone",
"value" : "6501231234",
"use" : "home",
"rank" : 1
},
{
"system" : "phone",
"value" : "6504561234",
"use" : "mobile",
"rank" : 2
},
{
"system" : "email",
"value" : "rudyg@example.com",
"use" : "home",
"rank" : 3
}
],
"gender" : "male",
"birthDate" : "1965-10-29",
"address" : [
{
"line" : [
"1234 Airport Blvd"
],
"city" : "South San Francisco",
"state" : "CA",
"postalCode" : "94080",
"country" : "US"
}
],
"communication" : [
{
"language" : {
"coding" : [
{
"system" : "urn:ietf:bcp:47",
"code" : "en",
"display" : "English"
}
]
},
"preferred" : true
}
],
"generalPractitioner" : [
{
"reference" : "urn:uuid:3c5298d3-2b49-4f79-b703-a46623899258"
}
],
"managingOrganization" : {
"reference" : "urn:uuid:7e45cd4c-8c11-4205-a2b7-fce834bc3511"
}
}
},
{
"fullUrl" : "urn:uuid:7e45cd4c-8c11-4205-a2b7-fce834bc3511",
"resource" : {
"resourceType" : "Organization",
"id" : "7e45cd4c-8c11-4205-a2b7-fce834bc3511",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-organization"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_7e45cd4c-8c11-4205-a2b7-fce834bc3511\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization 7e45cd4c-8c11-4205-a2b7-fce834bc3511</b></p><a name=\"7e45cd4c-8c11-4205-a2b7-fce834bc3511\"> </a><a name=\"hc7e45cd4c-8c11-4205-a2b7-fce834bc3511\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-uapi-organization.html\">UAPI Organization</a></p></div><p><b>identifier</b>: <code>http://tailormed.co</code>/HCP-01\u00a0(use:\u00a0usual,\u00a0)</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: TANNER CLINIC MURRAY</p><p><b>telecom</b>: <a href=\"mailto:venus@tannerclinic.com\">venus@tannerclinic.com</a></p><p><b>address</b>: 5296 S COMMERCE DR Murray UT 84107 US </p><blockquote><p><b>contact</b></p><p><b>name</b>: Venus Yardav (Official)</p><p><b>telecom</b>: ph: 8882704882(Work), fax: 8179974042(Work)</p></blockquote></div>"
},
"identifier" : [
{
"use" : "usual",
"system" : "http://tailormed.co",
"value" : "HCP-01",
"assigner" : {
"display" : "TailorMed"
}
}
],
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/organization-type",
"code" : "prov",
"display" : "Healthcare Provider"
}
]
}
],
"name" : "TANNER CLINIC MURRAY",
"telecom" : [
{
"system" : "email",
"value" : "venus@tannerclinic.com"
}
],
"address" : [
{
"line" : [
"5296 S COMMERCE DR"
],
"city" : "Murray",
"state" : "UT",
"postalCode" : "84107",
"country" : "US"
}
],
"contact" : [
{
"name" : {
"use" : "official",
"family" : "Yardav",
"given" : [
"Venus"
]
},
"telecom" : [
{
"system" : "phone",
"value" : "8882704882",
"use" : "work",
"rank" : 1
},
{
"system" : "fax",
"value" : "8179974042",
"use" : "work",
"rank" : 2
}
]
}
]
}
},
{
"fullUrl" : "urn:uuid:3c5298d3-2b49-4f79-b703-a46623899258",
"resource" : {
"resourceType" : "Practitioner",
"id" : "3c5298d3-2b49-4f79-b703-a46623899258",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-practitioner"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_3c5298d3-2b49-4f79-b703-a46623899258\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner 3c5298d3-2b49-4f79-b703-a46623899258</b></p><a name=\"3c5298d3-2b49-4f79-b703-a46623899258\"> </a><a name=\"hc3c5298d3-2b49-4f79-b703-a46623899258\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-uapi-practitioner.html\">UAPI Practitioner</a></p></div><p><b>identifier</b>: National provider identifier/1659533669\u00a0(use:\u00a0official,\u00a0)</p><p><b>name</b>: RAFAEL FIRSZT (Official)</p></div>"
},
"identifier" : [
{
"use" : "official",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "NPI",
"display" : "National provider identifier"
}
]
},
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "1659533669"
}
],
"name" : [
{
"use" : "official",
"family" : "FIRSZT",
"given" : [
"RAFAEL"
]
}
]
}
},
{
"fullUrl" : "urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df",
"resource" : {
"resourceType" : "Coverage",
"id" : "42b41bdb-1781-49aa-a091-78cdd92129df",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-coverage"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Coverage_42b41bdb-1781-49aa-a091-78cdd92129df\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage 42b41bdb-1781-49aa-a091-78cdd92129df</b></p><a name=\"42b41bdb-1781-49aa-a091-78cdd92129df\"> </a><a name=\"hc42b41bdb-1781-49aa-a091-78cdd92129df\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-uapi-coverage.html\">UAPI Coverage</a></p></div><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode HIP}\">health insurance plan policy</span></p><p><b>subscriber</b>: <a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-46d09721-f04e-4059-871f-31a1dc5127cf\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></p><p><b>subscriberId</b>: 4353</p><p><b>beneficiary</b>: <a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-ab45810f-2057-4b15-a24d-be929071cad5\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></p><p><b>payor</b>: <a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-d1654255-0a8d-4f2c-9405-19a6794500a2\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></p><h3>Classes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Value</b></td><td><b>Name</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class group}\">Group</span></td><td>12344frgr</td><td>Group Number</td></tr></table><p><b>order</b>: 1</p><p><b>network</b>: Dakotacare</p></div>"
},
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code" : "HIP",
"display" : "health insurance plan policy"
}
]
},
"subscriber" : {
"reference" : "urn:uuid:46d09721-f04e-4059-871f-31a1dc5127cf",
"type" : "RelatedPerson"
},
"subscriberId" : "4353",
"beneficiary" : {
"reference" : "urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5",
"type" : "Patient"
},
"payor" : [
{
"reference" : "urn:uuid:d1654255-0a8d-4f2c-9405-19a6794500a2",
"type" : "Organization"
}
],
"class" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
"code" : "group",
"display" : "Group"
}
]
},
"value" : "12344frgr",
"name" : "Group Number"
}
],
"order" : 1,
"network" : "Dakotacare"
}
},
{
"fullUrl" : "urn:uuid:46d09721-f04e-4059-871f-31a1dc5127cf",
"resource" : {
"resourceType" : "RelatedPerson",
"id" : "46d09721-f04e-4059-871f-31a1dc5127cf",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-relatedPerson"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"RelatedPerson_46d09721-f04e-4059-871f-31a1dc5127cf\"> </a><p class=\"res-header-id\"><b>Generated Narrative: RelatedPerson 46d09721-f04e-4059-871f-31a1dc5127cf</b></p><a name=\"46d09721-f04e-4059-871f-31a1dc5127cf\"> </a><a name=\"hc46d09721-f04e-4059-871f-31a1dc5127cf\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-uapi-relatedPerson.html\">UAPI RelatedPerson</a></p></div><p><b>patient</b>: <a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-ab45810f-2057-4b15-a24d-be929071cad5\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-RoleCode SIGOTHR}\">significant other</span></p><p><b>name</b>: Rebecca Gandoff (Official)</p><p><b>telecom</b>: ph: 6504567890(Mobile)</p><p><b>birthDate</b>: 1972-10-29</p></div>"
},
"patient" : {
"reference" : "urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5",
"type" : "Patient"
},
"relationship" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code" : "SIGOTHR",
"display" : "significant other"
}
]
}
],
"name" : [
{
"use" : "official",
"family" : "Gandoff",
"given" : [
"Rebecca"
]
}
],
"telecom" : [
{
"system" : "phone",
"value" : "6504567890",
"use" : "mobile"
}
],
"birthDate" : "1972-10-29"
}
},
{
"fullUrl" : "urn:uuid:af15ccf2-4e36-400f-8e74-24fbcf29dfbd",
"resource" : {
"resourceType" : "QuestionnaireResponse",
"id" : "af15ccf2-4e36-400f-8e74-24fbcf29dfbd",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"QuestionnaireResponse_af15ccf2-4e36-400f-8e74-24fbcf29dfbd\"> </a><p class=\"res-header-id\"><b>Generated Narrative: QuestionnaireResponse af15ccf2-4e36-400f-8e74-24fbcf29dfbd</b></p><a name=\"af15ccf2-4e36-400f-8e74-24fbcf29dfbd\"> </a><a name=\"hcaf15ccf2-4e36-400f-8e74-24fbcf29dfbd\"> </a><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4B/formats.html#table\" title=\"The linkID for the item\">LinkID</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4B/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4B/formats.html#table\" title=\"Minimum and Maximum # of times the item can appear in the instance\">Definition</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4B/formats.html#table\" title=\"The type of the item\">Answer</a><span style=\"float: right\"><a href=\"https://hl7.org/fhir/R4B/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireResponseRoot\" class=\"hierarchy\"/> af15ccf2-4e36-400f-8e74-24fbcf29dfbd</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire:https://dev.gene.com/fhir/uapi/fhirapi/Questionnaire/1234</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> authorization</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Authorization #</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">3333333333</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> xolair-prescription-type</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">What is the Prescription Type?</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Naive/new start</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> xolair-have-moderate-to-severe-persistent-aa</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Does the patient have moderate to severe persistent allergic asthma?</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Yes</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> xolair-positive-skin-or-rast-test-to-a-perennial-aeroallergen</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Does the patient have a history of positive skin or RAST test to a perennial aeroallergen?</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Yes</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> xolair-have-symptoms-inadequately-controlled-with-ics</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Does the patient have symptoms inadequately controlled with ICS?</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Yes</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> xolair-ige-mediated-fa</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Does the Patient have a clinical history consistent with IgE-mediated food allergy?</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">No</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> site-of-treatment</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Site of Treatment</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-d1089cdf-7a5f-45b1-99b9-2c021eca5270\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> contact-patient</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Do not contact patient</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Yes</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> xolair-ige-level-iuml</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">What is the patient's IgE level (IU/mL)?</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">200</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> adot</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Anticipated Date of Treatment (Optional)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">2024-04-30</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> dispensing-through</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Dispensing Through:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Specialty Pharmacy</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> dispense</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Dispense:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Prefilled Syringe</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> ship-to-2</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">C&R Ship To</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Site of Treatment</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> detailed-message</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Ok to leave a detailed message?</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Yes</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> has-treatment-started</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Has treatment started?</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Yes</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> pos</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Place of Service</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Infusion Center</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> preferred-sp-optional</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Preferred Specialty Pharmacy (Optional)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">RX Crossroads</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> pa-in-place</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Is prior authorization in place?</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Yes</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> prescription-plan</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Is this a Prescription plan?</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">No</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> re-verify-benefits-at-pa-expiration</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Re-verify benefits at PA expiration</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Yes</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> xolair-weight-kg</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Weight (kg)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">50</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> tcpa-consent</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">TCPA Consent Provided?</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">No</td></tr>\r\n<tr><td colspan=\"4\" class=\"hierarchy\"><br/><a href=\"https://hl7.org/fhir/R4B/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"
},
"questionnaire" : "https://dev.gene.com/fhir/uapi/fhirapi/Questionnaire/1234",
"status" : "completed",
"subject" : {
"reference" : "urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5",
"type" : "Patient"
},
"item" : [
{
"linkId" : "authorization",
"text" : "Authorization #",
"answer" : [
{
"valueString" : "3333333333"
}
]
},
{
"linkId" : "xolair-prescription-type",
"text" : "What is the Prescription Type?",
"answer" : [
{
"valueString" : "Naive/new start"
}
]
},
{
"linkId" : "xolair-have-moderate-to-severe-persistent-aa",
"text" : "Does the patient have moderate to severe persistent allergic asthma?",
"answer" : [
{
"valueString" : "Yes"
}
]
},
{
"linkId" : "xolair-positive-skin-or-rast-test-to-a-perennial-aeroallergen",
"text" : "Does the patient have a history of positive skin or RAST test to a perennial aeroallergen?",
"answer" : [
{
"valueString" : "Yes"
}
]
},
{
"linkId" : "xolair-have-symptoms-inadequately-controlled-with-ics",
"text" : "Does the patient have symptoms inadequately controlled with ICS?",
"answer" : [
{
"valueString" : "Yes"
}
]
},
{
"linkId" : "xolair-ige-mediated-fa",
"text" : "Does the Patient have a clinical history consistent with IgE-mediated food allergy?",
"answer" : [
{
"valueString" : "No"
}
]
},
{
"linkId" : "site-of-treatment",
"text" : "Site of Treatment",
"answer" : [
{
"valueReference" : {
"reference" : "urn:uuid:d1089cdf-7a5f-45b1-99b9-2c021eca5270",
"type" : "Organization"
}
}
]
},
{
"linkId" : "contact-patient",
"text" : "Do not contact patient",
"answer" : [
{
"valueString" : "Yes"
}
]
},
{
"linkId" : "xolair-ige-level-iuml",
"text" : "What is the patient's IgE level (IU/mL)?",
"answer" : [
{
"valueDecimal" : 200
}
]
},
{
"linkId" : "adot",
"text" : "Anticipated Date of Treatment (Optional)",
"answer" : [
{
"valueDate" : "2024-04-30"
}
]
},
{
"linkId" : "dispensing-through",
"text" : "Dispensing Through:",
"answer" : [
{
"valueString" : "Specialty Pharmacy"
}
]
},
{
"linkId" : "dispense",
"text" : "Dispense:",
"answer" : [
{
"valueString" : "Prefilled Syringe"
}
]
},
{
"linkId" : "ship-to-2",
"text" : "C&R Ship To",
"answer" : [
{
"valueString" : "Site of Treatment"
}
]
},
{
"linkId" : "detailed-message",
"text" : "Ok to leave a detailed message?",
"answer" : [
{
"valueString" : "Yes"
}
]
},
{
"linkId" : "has-treatment-started",
"text" : "Has treatment started?",
"answer" : [
{
"valueString" : "Yes"
}
]
},
{
"linkId" : "pos",
"text" : "Place of Service",
"answer" : [
{
"valueString" : "Infusion Center"
}
]
},
{
"linkId" : "preferred-sp-optional",
"text" : "Preferred Specialty Pharmacy (Optional)",
"answer" : [
{
"valueString" : "RX Crossroads"
}
]
},
{
"linkId" : "pa-in-place",
"text" : "Is prior authorization in place?",
"answer" : [
{
"valueString" : "Yes"
}
]
},
{
"linkId" : "prescription-plan",
"text" : "Is this a Prescription plan?",
"answer" : [
{
"valueString" : "No"
}
]
},
{
"linkId" : "re-verify-benefits-at-pa-expiration",
"text" : "Re-verify benefits at PA expiration",
"answer" : [
{
"valueString" : "Yes"
}
]
},
{
"linkId" : "xolair-weight-kg",
"text" : "Weight (kg)",
"answer" : [
{
"valueDecimal" : 50
}
]
},
{
"linkId" : "tcpa-consent",
"text" : "TCPA Consent Provided?",
"answer" : [
{
"valueString" : "No"
}
]
}
]
}
},
{
"fullUrl" : "urn:uuid:bc20c5ea-f639-4221-ab61-ce75c5e64aba",
"resource" : {
"resourceType" : "Condition",
"id" : "bc20c5ea-f639-4221-ab61-ce75c5e64aba",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Condition_bc20c5ea-f639-4221-ab61-ce75c5e64aba\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Condition bc20c5ea-f639-4221-ab61-ce75c5e64aba</b></p><a name=\"bc20c5ea-f639-4221-ab61-ce75c5e64aba\"> </a><a name=\"hcbc20c5ea-f639-4221-ab61-ce75c5e64aba\"> </a><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/sid/icd-10-cm J45.50}\">Severe persistent asthma, uncomplicated</span></p><p><b>subject</b>: <a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-ab45810f-2057-4b15-a24d-be929071cad5\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></p></div>"
},
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "J45.50"
}
]
},
"subject" : {
"reference" : "urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5",
"type" : "Patient"
}
}
},
{
"fullUrl" : "urn:uuid:645c7756-d1d7-4df2-a65d-e1680dbbb991",
"resource" : {
"resourceType" : "Consent",
"id" : "645c7756-d1d7-4df2-a65d-e1680dbbb991",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-consent"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Consent_645c7756-d1d7-4df2-a65d-e1680dbbb991\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Consent 645c7756-d1d7-4df2-a65d-e1680dbbb991</b></p><a name=\"645c7756-d1d7-4df2-a65d-e1680dbbb991\"> </a><a name=\"hc645c7756-d1d7-4df2-a65d-e1680dbbb991\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-uapi-consent.html\">UAPI Consent</a></p></div><p><b>status</b>: Active</p><p><b>scope</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/consentscope patient-privacy}\">Privacy Consent</span></p><p><b>category</b>: <span title=\"Codes:{http://loinc.org 59284-0}\">Patient Authorization Signature</span></p><p><b>patient</b>: <a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-ab45810f-2057-4b15-a24d-be929071cad5\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></p><p><b>dateTime</b>: 2024-04-02 16:24:45+0000</p><p><b>performer</b>: <a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-ab45810f-2057-4b15-a24d-be929071cad5\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></p><p><b>policyRule</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/consentpolicycodes hipaa-auth}\">HIPAA Authorization</span></p><h3>Provisions</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>Opt In</td></tr></table></div>"
},
"status" : "active",
"scope" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/consentscope",
"code" : "patient-privacy",
"display" : "Privacy Consent"
}
]
},
"category" : [
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "59284-0",
"display" : "Patient Authorization Signature"
}
]
}
],
"patient" : {
"reference" : "urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5",
"type" : "Patient"
},
"dateTime" : "2024-04-02T16:24:45Z",
"performer" : [
{
"reference" : "urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5",
"type" : "Patient"
}
],
"policyRule" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/consentpolicycodes",
"code" : "hipaa-auth",
"display" : "HIPAA Authorization"
}
]
},
"provision" : {
"type" : "permit"
}
}
},
{
"fullUrl" : "urn:uuid:4f536bc9-a238-49ac-bf07-65d670f84ed3",
"resource" : {
"resourceType" : "Consent",
"id" : "4f536bc9-a238-49ac-bf07-65d670f84ed3",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-consent"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Consent_4f536bc9-a238-49ac-bf07-65d670f84ed3\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Consent 4f536bc9-a238-49ac-bf07-65d670f84ed3</b></p><a name=\"4f536bc9-a238-49ac-bf07-65d670f84ed3\"> </a><a name=\"hc4f536bc9-a238-49ac-bf07-65d670f84ed3\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-uapi-consent.html\">UAPI Consent</a></p></div><p><b>status</b>: Active</p><p><b>scope</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/consentscope patient-privacy}\">Privacy Consent</span></p><p><b>category</b>: <span title=\"Codes:{http://loinc.org 59284-0}\">Prescriber Signature</span></p><p><b>patient</b>: <a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-ab45810f-2057-4b15-a24d-be929071cad5\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></p><p><b>dateTime</b>: 2024-04-02 16:24:45+0000</p><p><b>performer</b>: <a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-ab45810f-2057-4b15-a24d-be929071cad5\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></p><p><b>policyRule</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/consentpolicycodes hipaa-auth}\">HIPAA Authorization</span></p><h3>Provisions</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>Opt In</td></tr></table></div>"
},
"status" : "active",
"scope" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/consentscope",
"code" : "patient-privacy",
"display" : "Privacy Consent"
}
]
},
"category" : [
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "59284-0",
"display" : "Prescriber Signature"
}
]
}
],
"patient" : {
"reference" : "urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5",
"type" : "Patient"
},
"dateTime" : "2024-04-02T16:24:45Z",
"performer" : [
{
"reference" : "urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5",
"type" : "Patient"
}
],
"policyRule" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/consentpolicycodes",
"code" : "hipaa-auth",
"display" : "HIPAA Authorization"
}
]
},
"provision" : {
"type" : "permit"
}
}
},
{
"fullUrl" : "urn:uuid:1cc390ba-32b3-4c41-a805-d4b9cee64784",
"resource" : {
"resourceType" : "Provenance",
"id" : "1cc390ba-32b3-4c41-a805-d4b9cee64784",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-provenance"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Provenance_1cc390ba-32b3-4c41-a805-d4b9cee64784\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Provenance 1cc390ba-32b3-4c41-a805-d4b9cee64784</b></p><a name=\"1cc390ba-32b3-4c41-a805-d4b9cee64784\"> </a><a name=\"hc1cc390ba-32b3-4c41-a805-d4b9cee64784\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-uapi-provenance.html\">UAPI Provenance</a></p></div><p>Provenance for <a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-4f536bc9-a238-49ac-bf07-65d670f84ed3\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></p><p>Summary</p><table class=\"grid\"><tr><td>Recorded</td><td>2024-04-02 09:49:39+0000</td></tr></table><p><b>Agents</b></p><table class=\"grid\"><tr><td><b>who</b></td></tr><tr><td><a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-3c5298d3-2b49-4f79-b703-a46623899258\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></td></tr></table></div>"
},
"target" : [
{
"reference" : "urn:uuid:4f536bc9-a238-49ac-bf07-65d670f84ed3",
"type" : "Consent"
}
],
"recorded" : "2024-04-02T09:49:39.382941+00:00",
"agent" : [
{
"who" : {
"reference" : "urn:uuid:3c5298d3-2b49-4f79-b703-a46623899258",
"type" : "Practitioner"
}
}
],
"signature" : [
{
"type" : [
{
"system" : "urn:iso-astm:E1762-95:2013",
"code" : "1.2.840.10065.1.12.1.7",
"display" : "Consent Signature"
}
],
"when" : "2024-04-02T09:49:39.382897+00:00",
"who" : {
"reference" : "urn:uuid:3c5298d3-2b49-4f79-b703-a46623899258",
"type" : "Practitioner"
},
"sigFormat" : "image/*",
"data" : "bQ=="
}
]
}
},
{
"fullUrl" : "urn:uuid:212c57ad-45cd-4882-87e7-8415ded3db05",
"resource" : {
"resourceType" : "ServiceRequest",
"id" : "212c57ad-45cd-4882-87e7-8415ded3db05",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-servicerequest"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ServiceRequest_212c57ad-45cd-4882-87e7-8415ded3db05\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ServiceRequest 212c57ad-45cd-4882-87e7-8415ded3db05</b></p><a name=\"212c57ad-45cd-4882-87e7-8415ded3db05\"> </a><a name=\"hc212c57ad-45cd-4882-87e7-8415ded3db05\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-uapi-servicerequest.html\">UAPI ServiceRequest</a></p></div><p><b>status</b>: Active</p><p><b>intent</b>: Order</p><p><b>code</b>: <span title=\"Codes:{https://fhir.developer.gene.com/CodeSystem/uapi-sr-type bipa}\">Benefit Investigation / Prior Authorization</span></p><p><b>subject</b>: <a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-ab45810f-2057-4b15-a24d-be929071cad5\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></p></div>"
},
"status" : "active",
"intent" : "order",
"code" : {
"coding" : [
{
"system" : "https://fhir.developer.gene.com/CodeSystem/uapi-sr-type",
"code" : "bipa"
}
]
},
"subject" : {
"reference" : "urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5",
"type" : "Patient"
}
}
},
{
"fullUrl" : "urn:uuid:f71a66c4-f747-4b46-8adc-875a45f8ee7e",
"resource" : {
"resourceType" : "ServiceRequest",
"id" : "f71a66c4-f747-4b46-8adc-875a45f8ee7e",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-servicerequest"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ServiceRequest_f71a66c4-f747-4b46-8adc-875a45f8ee7e\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ServiceRequest f71a66c4-f747-4b46-8adc-875a45f8ee7e</b></p><a name=\"f71a66c4-f747-4b46-8adc-875a45f8ee7e\"> </a><a name=\"hcf71a66c4-f747-4b46-8adc-875a45f8ee7e\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-uapi-servicerequest.html\">UAPI ServiceRequest</a></p></div><p><b>status</b>: Active</p><p><b>intent</b>: Order</p><p><b>code</b>: <span title=\"Codes:{https://fhir.developer.gene.com/CodeSystem/uapi-sr-type starter}\">Starter</span></p><p><b>subject</b>: <a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-ab45810f-2057-4b15-a24d-be929071cad5\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></p></div>"
},
"status" : "active",
"intent" : "order",
"code" : {
"coding" : [
{
"system" : "https://fhir.developer.gene.com/CodeSystem/uapi-sr-type",
"code" : "starter"
}
]
},
"subject" : {
"reference" : "urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5",
"type" : "Patient"
}
}
},
{
"fullUrl" : "urn:uuid:e9d05dcd-bb02-4a08-af63-386dcab3f160",
"resource" : {
"resourceType" : "MedicationRequest",
"id" : "e9d05dcd-bb02-4a08-af63-386dcab3f160",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-medicationrequest"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MedicationRequest_e9d05dcd-bb02-4a08-af63-386dcab3f160\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MedicationRequest e9d05dcd-bb02-4a08-af63-386dcab3f160</b></p><a name=\"e9d05dcd-bb02-4a08-af63-386dcab3f160\"> </a><a name=\"hce9d05dcd-bb02-4a08-af63-386dcab3f160\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-uapi-medicationrequest.html\">UAPI MedicationRequest</a></p></div><p><b>status</b>: Active</p><p><b>intent</b>: Order</p><p><b>medication</b>: <span title=\"Codes:{https://fhir.developer.gene.com/CodeSystem/uapi-product-name xolair}\">Xolair</span></p><p><b>subject</b>: <a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-ab45810f-2057-4b15-a24d-be929071cad5\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></p><p><b>requester</b>: <a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-3c5298d3-2b49-4f79-b703-a46623899258\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></p><p><b>courseOfTherapyType</b>: <span title=\"Codes:\">Starter (Pre filled Syringe)</span></p><p><b>insurance</b>: <a href=\"Bundle-04afa000-48a5-4fb2-8707-6a43af045868.html#urn-uuid-42b41bdb-1781-49aa-a091-78cdd92129df\">Bundle: identifier = Resource identifier: 6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2; type = message; timestamp = 2024-04-02 08:10:13-0500</a></p><p><b>note</b>: </p><blockquote><div><p>Allergic Asthma - 300mg/dose every 2 weeks</p>\n</div></blockquote><blockquote><p><b>dosageInstruction</b></p><p><b>timing</b>: Once per 2 weeks</p><h3>DoseAndRates</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Dose[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>300 mg</td></tr></table></blockquote><blockquote><p><b>dispenseRequest</b></p><p><b>UAPI MedicationRequest Dispenser Instructions</b>: </p><blockquote><div><p>Dispense Instruction: Quantity 5 of 300mg prefilled syringe(s), Quantity 2 of 75 mg prefilled syringe(s) and Quantity 1 of 150 mg prefilled syringe(s)</p>\n</div></blockquote><blockquote><p><b>UAPI MedicationRequest Dispense Quantity Detailed Breakdown</b></p><ul><li>dispenseQuantity: 5</li><li>dispenseUnit: 300mg prefilled syringe(s)</li></ul></blockquote><blockquote><p><b>UAPI MedicationRequest Dispense Quantity Detailed Breakdown</b></p><ul><li>dispenseQuantity: 2</li><li>dispenseUnit: 75mg prefilled syringe(s)</li></ul></blockquote><blockquote><p><b>UAPI MedicationRequest Dispense Quantity Detailed Breakdown</b></p><ul><li>dispenseQuantity: 1</li><li>dispenseUnit: 150 mg prefilled syringe(s)</li></ul></blockquote><p><b>numberOfRepeatsAllowed</b>: 1</p><h3>ExpectedSupplyDurations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Unit</b></td><td><b>System</b></td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td>90</td><td>d</td><td><a href=\"http://terminology.hl7.org/6.4.0/CodeSystem-v3-ucum.html\">http://unitsofmeasure.org</a></td><td>d</td></tr></table></blockquote></div>"
},
"status" : "active",
"intent" : "order",
"medicationCodeableConcept" : {
"coding" : [
{
"system" : "https://fhir.developer.gene.com/CodeSystem/uapi-product-name",
"code" : "xolair",
"display" : "Xolair"
}
]
},
"subject" : {
"reference" : "urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5",
"type" : "Patient"
},
"requester" : {
"reference" : "urn:uuid:3c5298d3-2b49-4f79-b703-a46623899258",
"type" : "Practitioner"
},
"courseOfTherapyType" : {
"text" : "Starter (Pre filled Syringe)"
},
"insurance" : [
{
"reference" : "urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df",
"type" : "Coverage"
}
],
"note" : [
{
"text" : "Allergic Asthma - 300mg/dose every 2 weeks"
}
],
"dosageInstruction" : [
{
"timing" : {
"repeat" : {
"frequency" : 1,
"period" : 2,
"periodUnit" : "wk"
}
},
"doseAndRate" : [
{
"doseQuantity" : {
"value" : 300,
"unit" : "mg"
}
}
]
}
],
"dispenseRequest" : {
"extension" : [
{
"url" : "https://fhir.developer.gene.com/StructureDefinition/dispenser-instruction",
"valueAnnotation" : {
"text" : "Dispense Instruction: Quantity 5 of 300mg prefilled syringe(s), Quantity 2 of 75 mg prefilled syringe(s) and Quantity 1 of 150 mg prefilled syringe(s)"
}
},
{
"extension" : [
{
"url" : "dispenseQuantity",
"valueQuantity" : {
"value" : 5
}
},
{
"url" : "dispenseUnit",
"valueString" : "300mg prefilled syringe(s)"
}
],
"url" : "https://fhir.developer.gene.com/StructureDefinition/dispense-quantity-detail"
},
{
"extension" : [
{
"url" : "dispenseQuantity",
"valueQuantity" : {
"value" : 2
}
},
{
"url" : "dispenseUnit",
"valueString" : "75mg prefilled syringe(s)"
}
],
"url" : "https://fhir.developer.gene.com/StructureDefinition/dispense-quantity-detail"
},
{
"extension" : [
{
"url" : "dispenseQuantity",
"valueQuantity" : {
"value" : 1
}
},
{
"url" : "dispenseUnit",
"valueString" : "150 mg prefilled syringe(s)"
}
],
"url" : "https://fhir.developer.gene.com/StructureDefinition/dispense-quantity-detail"
}
],
"numberOfRepeatsAllowed" : 1,
"expectedSupplyDuration" : {
"value" : 90,
"unit" : "d",
"system" : "http://unitsofmeasure.org",
"code" : "d"
}
}
}
},
{
"fullUrl" : "urn:uuid:d1654255-0a8d-4f2c-9405-19a6794500a2",
"resource" : {
"resourceType" : "Organization",
"id" : "d1654255-0a8d-4f2c-9405-19a6794500a2",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-organization"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_d1654255-0a8d-4f2c-9405-19a6794500a2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization d1654255-0a8d-4f2c-9405-19a6794500a2</b></p><a name=\"d1654255-0a8d-4f2c-9405-19a6794500a2\"> </a><a name=\"hcd1654255-0a8d-4f2c-9405-19a6794500a2\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-uapi-organization.html\">UAPI Organization</a></p></div><p><b>identifier</b>: <code>http://tailormed.co</code>/PAY-200\u00a0(use:\u00a0usual,\u00a0)</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type ins}\">Insurance Company</span></p><p><b>name</b>: Dakotacare</p><p><b>telecom</b>: ph: 8778472862(Work)</p></div>"
},
"identifier" : [
{
"use" : "usual",
"system" : "http://tailormed.co",
"value" : "PAY-200",
"assigner" : {
"display" : "TailorMed"
}
}
],
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/organization-type",
"code" : "ins"
}
]
}
],
"name" : "Dakotacare",
"telecom" : [
{
"system" : "phone",
"value" : "8778472862",
"use" : "work",
"rank" : 1
}
]
}
},
{
"fullUrl" : "urn:uuid:d1089cdf-7a5f-45b1-99b9-2c021eca5270",
"resource" : {
"resourceType" : "Organization",
"id" : "d1089cdf-7a5f-45b1-99b9-2c021eca5270",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-organization"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_d1089cdf-7a5f-45b1-99b9-2c021eca5270\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization d1089cdf-7a5f-45b1-99b9-2c021eca5270</b></p><a name=\"d1089cdf-7a5f-45b1-99b9-2c021eca5270\"> </a><a name=\"hcd1089cdf-7a5f-45b1-99b9-2c021eca5270\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-uapi-organization.html\">UAPI Organization</a></p></div><p><b>identifier</b>: <code>http://SOT.com/ab</code>/SOT-001\u00a0(use:\u00a0usual,\u00a0)</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type other}\">Site of Treatment</span></p><p><b>name</b>: FLORIDA HOSPITAL ORLANDO INFUSION CNTR</p><p><b>telecom</b>: ph: 4012704882(Work), fax: 4019974042(Work)</p><p><b>address</b>: 2501 N ORANGE AVE, STE 481 Orlando FL 32804 US </p><h3>Contacts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Name</b></td><td><b>Telecom</b></td></tr><tr><td style=\"display: none\">*</td><td>Vince Davis (Official)</td><td>ph: -unknown-</td></tr></table></div>"
},
"identifier" : [
{
"use" : "usual",
"system" : "http://SOT.com/ab",
"value" : "SOT-001",
"assigner" : {
"display" : "Florida Hospital Orlando Infusion Center"
}
}
],
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/organization-type",
"code" : "other",
"display" : "Site of Treatment"
}
],
"text" : "Site of Treatment"
}
],
"name" : "FLORIDA HOSPITAL ORLANDO INFUSION CNTR",
"telecom" : [
{
"system" : "phone",
"value" : "4012704882",
"use" : "work",
"rank" : 1
},
{
"system" : "fax",
"value" : "4019974042",
"use" : "work",
"rank" : 2
}
],
"address" : [
{
"line" : [
"2501 N ORANGE AVE, STE 481"
],
"city" : "Orlando",
"state" : "FL",
"postalCode" : "32804",
"country" : "US"
}
],
"contact" : [
{
"name" : {
"use" : "official",
"family" : "Davis",
"given" : [
"Vince"
]
},
"telecom" : [
{
"system" : "phone"
}
]
}
]
}
}
]
}