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
<Bundle xmlns="http://hl7.org/fhir">
<id value="04afa000-48a5-4fb2-8707-6a43af045868"/>
<meta>
<profile
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<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="RI"/>
<display value="Resource identifier"/>
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<system value="http://tailormed.co"/>
<value value="6a7dbbed-6c6f-48b0-b32e-0a5d89dc72b2"/>
<assigner>
<display value="TailorMed"/>
</assigner>
</identifier>
<type value="message"/>
<timestamp value="2024-04-02T08:10:13-05:00"/>
<entry>
<fullUrl value="urn:uuid:9e592049-0434-48f9-8498-d7cf1e80e086"/>
<resource>
<MessageHeader>
<id value="9e592049-0434-48f9-8498-d7cf1e80e086"/>
<meta>
<profile
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<text>
<status value="generated"/>
<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>
</text>
<eventCoding>
<system
value="http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-event-type"/>
<code value="enrollment-with-consent"/>
</eventCoding>
<destination>
<name value="UAPI-ENR-V2.1"/>
<endpoint
value="https://test-us-e1.apis.roche.com/pharma-cmg-ehr-fhir-exp-test/v2/enrollment"/>
</destination>
<sender>
<reference value="urn:uuid:7e45cd4c-8c11-4205-a2b7-fce834bc3511"/>
<type value="Organization"/>
</sender>
<source>
<name value="TailorMed"/>
<endpoint value="http://tailormed.co/fhir/enrollmentID/ENR-00001"/>
</source>
<focus>
<reference value="urn:uuid:7cd8694a-0268-414e-b8ca-9271e7e1a242"/>
<type value="List"/>
</focus>
</MessageHeader>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:7cd8694a-0268-414e-b8ca-9271e7e1a242"/>
<resource>
<List>
<id value="7cd8694a-0268-414e-b8ca-9271e7e1a242"/>
<text>
<status value="generated"/>
<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>
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<status value="current"/>
<mode value="changes"/>
<title value="messageContext"/>
<entry>
<item>
<reference value="urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5"/>
<type value="Patient"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:7e45cd4c-8c11-4205-a2b7-fce834bc3511"/>
<type value="Organization"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:3c5298d3-2b49-4f79-b703-a46623899258"/>
<type value="Practitioner"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df"/>
<type value="Coverage"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:46d09721-f04e-4059-871f-31a1dc5127cf"/>
<type value="RelatedPerson"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:af15ccf2-4e36-400f-8e74-24fbcf29dfbd"/>
<type value="QuestionnaireResponse"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:bc20c5ea-f639-4221-ab61-ce75c5e64aba"/>
<type value="Condition"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:645c7756-d1d7-4df2-a65d-e1680dbbb991"/>
<type value="Consent"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:4f536bc9-a238-49ac-bf07-65d670f84ed3"/>
<type value="Consent"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:1cc390ba-32b3-4c41-a805-d4b9cee64784"/>
<type value="Provenance"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:212c57ad-45cd-4882-87e7-8415ded3db05"/>
<type value="ServiceRequest"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:f71a66c4-f747-4b46-8adc-875a45f8ee7e"/>
<type value="ServiceRequest"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:e9d05dcd-bb02-4a08-af63-386dcab3f160"/>
<type value="MedicationRequest"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:d1654255-0a8d-4f2c-9405-19a6794500a2"/>
<type value="Organization"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:d1089cdf-7a5f-45b1-99b9-2c021eca5270"/>
<type value="Organization"/>
</item>
</entry>
</List>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5"/>
<resource>
<Patient>
<id value="ab45810f-2057-4b15-a24d-be929071cad5"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-patient"/>
</meta>
<text>
<status value="generated"/>
<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 (use: official, ))</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>
</text>
<identifier>
<use value="official"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="PI"/>
<display value="Patient internal identifier"/>
</coding>
</type>
<system value="http://tailormed.co"/>
<value value="TM-2345"/>
<assigner>
<display value="TailorMed"/>
</assigner>
</identifier>
<name>
<use value="official"/>
<family value="Gandoff"/>
<given value="Rudy"/>
</name>
<telecom>
<system value="phone"/>
<value value="6501231234"/>
<use value="home"/>
<rank value="1"/>
</telecom>
<telecom>
<system value="phone"/>
<value value="6504561234"/>
<use value="mobile"/>
<rank value="2"/>
</telecom>
<telecom>
<system value="email"/>
<value value="rudyg@example.com"/>
<use value="home"/>
<rank value="3"/>
</telecom>
<gender value="male"/>
<birthDate value="1965-10-29"/>
<address>
<line value="1234 Airport Blvd"/>
<city value="South San Francisco"/>
<state value="CA"/>
<postalCode value="94080"/>
<country value="US"/>
</address>
<communication>
<language>
<coding>
<system value="urn:ietf:bcp:47"/>
<code value="en"/>
<display value="English"/>
</coding>
</language>
<preferred value="true"/>
</communication>
<generalPractitioner>
<reference value="urn:uuid:3c5298d3-2b49-4f79-b703-a46623899258"/>
</generalPractitioner>
<managingOrganization>
<reference value="urn:uuid:7e45cd4c-8c11-4205-a2b7-fce834bc3511"/>
</managingOrganization>
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:7e45cd4c-8c11-4205-a2b7-fce834bc3511"/>
<resource>
<Organization>
<id value="7e45cd4c-8c11-4205-a2b7-fce834bc3511"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-organization"/>
</meta>
<text>
<status value="generated"/>
<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 (use: usual, )</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>
</text>
<identifier>
<use value="usual"/>
<system value="http://tailormed.co"/>
<value value="HCP-01"/>
<assigner>
<display value="TailorMed"/>
</assigner>
</identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/organization-type"/>
<code value="prov"/>
<display value="Healthcare Provider"/>
</coding>
</type>
<name value="TANNER CLINIC MURRAY"/>
<telecom>
<system value="email"/>
<value value="venus@tannerclinic.com"/>
</telecom>
<address>
<line value="5296 S COMMERCE DR"/>
<city value="Murray"/>
<state value="UT"/>
<postalCode value="84107"/>
<country value="US"/>
</address>
<contact>
<name>
<use value="official"/>
<family value="Yardav"/>
<given value="Venus"/>
</name>
<telecom>
<system value="phone"/>
<value value="8882704882"/>
<use value="work"/>
<rank value="1"/>
</telecom>
<telecom>
<system value="fax"/>
<value value="8179974042"/>
<use value="work"/>
<rank value="2"/>
</telecom>
</contact>
</Organization>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:3c5298d3-2b49-4f79-b703-a46623899258"/>
<resource>
<Practitioner>
<id value="3c5298d3-2b49-4f79-b703-a46623899258"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-practitioner"/>
</meta>
<text>
<status value="generated"/>
<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 (use: official, )</p><p><b>name</b>: RAFAEL FIRSZT (Official)</p></div>
</text>
<identifier>
<use value="official"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="NPI"/>
<display value="National provider identifier"/>
</coding>
</type>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="1659533669"/>
</identifier>
<name>
<use value="official"/>
<family value="FIRSZT"/>
<given value="RAFAEL"/>
</name>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df"/>
<resource>
<Coverage>
<id value="42b41bdb-1781-49aa-a091-78cdd92129df"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-coverage"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="HIP"/>
<display value="health insurance plan policy"/>
</coding>
</type>
<subscriber>
<reference value="urn:uuid:46d09721-f04e-4059-871f-31a1dc5127cf"/>
<type value="RelatedPerson"/>
</subscriber>
<subscriberId value="4353"/>
<beneficiary>
<reference value="urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5"/>
<type value="Patient"/>
</beneficiary>
<payor>
<reference value="urn:uuid:d1654255-0a8d-4f2c-9405-19a6794500a2"/>
<type value="Organization"/>
</payor>
<class>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="group"/>
<display value="Group"/>
</coding>
</type>
<value value="12344frgr"/>
<name value="Group Number"/>
</class>
<order value="1"/>
<network value="Dakotacare"/>
</Coverage>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:46d09721-f04e-4059-871f-31a1dc5127cf"/>
<resource>
<RelatedPerson>
<id value="46d09721-f04e-4059-871f-31a1dc5127cf"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-relatedPerson"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<patient>
<reference value="urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5"/>
<type value="Patient"/>
</patient>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="SIGOTHR"/>
<display value="significant other"/>
</coding>
</relationship>
<name>
<use value="official"/>
<family value="Gandoff"/>
<given value="Rebecca"/>
</name>
<telecom>
<system value="phone"/>
<value value="6504567890"/>
<use value="mobile"/>
</telecom>
<birthDate value="1972-10-29"/>
</RelatedPerson>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:af15ccf2-4e36-400f-8e74-24fbcf29dfbd"/>
<resource>
<QuestionnaireResponse>
<id value="af15ccf2-4e36-400f-8e74-24fbcf29dfbd"/>
<text>
<status value="generated"/>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
</text>
<questionnaire
value="https://dev.gene.com/fhir/uapi/fhirapi/Questionnaire/1234"/>
<status value="completed"/>
<subject>
<reference value="urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5"/>
<type value="Patient"/>
</subject>
<item>
<linkId value="authorization"/>
<text value="Authorization #"/>
<answer>
<valueString value="3333333333"/>
</answer>
</item>
<item>
<linkId value="xolair-prescription-type"/>
<text value="What is the Prescription Type?"/>
<answer>
<valueString value="Naive/new start"/>
</answer>
</item>
<item>
<linkId value="xolair-have-moderate-to-severe-persistent-aa"/>
<text
value="Does the patient have moderate to severe persistent allergic asthma?"/>
<answer>
<valueString value="Yes"/>
</answer>
</item>
<item>
<linkId
value="xolair-positive-skin-or-rast-test-to-a-perennial-aeroallergen"/>
<text
value="Does the patient have a history of positive skin or RAST test to a perennial aeroallergen?"/>
<answer>
<valueString value="Yes"/>
</answer>
</item>
<item>
<linkId
value="xolair-have-symptoms-inadequately-controlled-with-ics"/>
<text
value="Does the patient have symptoms inadequately controlled with ICS?"/>
<answer>
<valueString value="Yes"/>
</answer>
</item>
<item>
<linkId value="xolair-ige-mediated-fa"/>
<text
value="Does the Patient have a clinical history consistent with IgE-mediated food allergy?"/>
<answer>
<valueString value="No"/>
</answer>
</item>
<item>
<linkId value="site-of-treatment"/>
<text value="Site of Treatment"/>
<answer>
<valueReference>
<reference
value="urn:uuid:d1089cdf-7a5f-45b1-99b9-2c021eca5270"/>
<type value="Organization"/>
</valueReference>
</answer>
</item>
<item>
<linkId value="contact-patient"/>
<text value="Do not contact patient"/>
<answer>
<valueString value="Yes"/>
</answer>
</item>
<item>
<linkId value="xolair-ige-level-iuml"/>
<text value="What is the patient's IgE level (IU/mL)?"/>
<answer>
<valueDecimal value="200"/>
</answer>
</item>
<item>
<linkId value="adot"/>
<text value="Anticipated Date of Treatment (Optional)"/>
<answer>
<valueDate value="2024-04-30"/>
</answer>
</item>
<item>
<linkId value="dispensing-through"/>
<text value="Dispensing Through:"/>
<answer>
<valueString value="Specialty Pharmacy"/>
</answer>
</item>
<item>
<linkId value="dispense"/>
<text value="Dispense:"/>
<answer>
<valueString value="Prefilled Syringe"/>
</answer>
</item>
<item>
<linkId value="ship-to-2"/>
<text value="C&R Ship To"/>
<answer>
<valueString value="Site of Treatment"/>
</answer>
</item>
<item>
<linkId value="detailed-message"/>
<text value="Ok to leave a detailed message?"/>
<answer>
<valueString value="Yes"/>
</answer>
</item>
<item>
<linkId value="has-treatment-started"/>
<text value="Has treatment started?"/>
<answer>
<valueString value="Yes"/>
</answer>
</item>
<item>
<linkId value="pos"/>
<text value="Place of Service"/>
<answer>
<valueString value="Infusion Center"/>
</answer>
</item>
<item>
<linkId value="preferred-sp-optional"/>
<text value="Preferred Specialty Pharmacy (Optional)"/>
<answer>
<valueString value="RX Crossroads"/>
</answer>
</item>
<item>
<linkId value="pa-in-place"/>
<text value="Is prior authorization in place?"/>
<answer>
<valueString value="Yes"/>
</answer>
</item>
<item>
<linkId value="prescription-plan"/>
<text value="Is this a Prescription plan?"/>
<answer>
<valueString value="No"/>
</answer>
</item>
<item>
<linkId value="re-verify-benefits-at-pa-expiration"/>
<text value="Re-verify benefits at PA expiration"/>
<answer>
<valueString value="Yes"/>
</answer>
</item>
<item>
<linkId value="xolair-weight-kg"/>
<text value="Weight (kg)"/>
<answer>
<valueDecimal value="50"/>
</answer>
</item>
<item>
<linkId value="tcpa-consent"/>
<text value="TCPA Consent Provided?"/>
<answer>
<valueString value="No"/>
</answer>
</item>
</QuestionnaireResponse>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:bc20c5ea-f639-4221-ab61-ce75c5e64aba"/>
<resource>
<Condition>
<id value="bc20c5ea-f639-4221-ab61-ce75c5e64aba"/>
<text>
<status value="generated"/>
<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>
</text>
<code>
<coding>
<system value="http://hl7.org/fhir/sid/icd-10-cm"/>
<code value="J45.50"/>
</coding>
</code>
<subject>
<reference value="urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5"/>
<type value="Patient"/>
</subject>
</Condition>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:645c7756-d1d7-4df2-a65d-e1680dbbb991"/>
<resource>
<Consent>
<id value="645c7756-d1d7-4df2-a65d-e1680dbbb991"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-consent"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<scope>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/consentscope"/>
<code value="patient-privacy"/>
<display value="Privacy Consent"/>
</coding>
</scope>
<category>
<coding>
<system value="http://loinc.org"/>
<code value="59284-0"/>
<display value="Patient Authorization Signature"/>
</coding>
</category>
<patient>
<reference value="urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5"/>
<type value="Patient"/>
</patient>
<dateTime value="2024-04-02T16:24:45Z"/>
<performer>
<reference value="urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5"/>
<type value="Patient"/>
</performer>
<policyRule>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/consentpolicycodes"/>
<code value="hipaa-auth"/>
<display value="HIPAA Authorization"/>
</coding>
</policyRule>
<provision>
<type value="permit"/>
</provision>
</Consent>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:4f536bc9-a238-49ac-bf07-65d670f84ed3"/>
<resource>
<Consent>
<id value="4f536bc9-a238-49ac-bf07-65d670f84ed3"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-consent"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<scope>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/consentscope"/>
<code value="patient-privacy"/>
<display value="Privacy Consent"/>
</coding>
</scope>
<category>
<coding>
<system value="http://loinc.org"/>
<code value="59284-0"/>
<display value="Prescriber Signature"/>
</coding>
</category>
<patient>
<reference value="urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5"/>
<type value="Patient"/>
</patient>
<dateTime value="2024-04-02T16:24:45Z"/>
<performer>
<reference value="urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5"/>
<type value="Patient"/>
</performer>
<policyRule>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/consentpolicycodes"/>
<code value="hipaa-auth"/>
<display value="HIPAA Authorization"/>
</coding>
</policyRule>
<provision>
<type value="permit"/>
</provision>
</Consent>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:1cc390ba-32b3-4c41-a805-d4b9cee64784"/>
<resource>
<Provenance>
<id value="1cc390ba-32b3-4c41-a805-d4b9cee64784"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-provenance"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<target>
<reference value="urn:uuid:4f536bc9-a238-49ac-bf07-65d670f84ed3"/>
<type value="Consent"/>
</target>
<recorded value="2024-04-02T09:49:39.382941+00:00"/>
<agent>
<who>
<reference value="urn:uuid:3c5298d3-2b49-4f79-b703-a46623899258"/>
<type value="Practitioner"/>
</who>
</agent>
<signature>
<type>
<system value="urn:iso-astm:E1762-95:2013"/>
<code value="1.2.840.10065.1.12.1.7"/>
<display value="Consent Signature"/>
</type>
<when value="2024-04-02T09:49:39.382897+00:00"/>
<who>
<reference value="urn:uuid:3c5298d3-2b49-4f79-b703-a46623899258"/>
<type value="Practitioner"/>
</who>
<sigFormat value="image/*"/>
<data value="bQ=="/>
</signature>
</Provenance>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:212c57ad-45cd-4882-87e7-8415ded3db05"/>
<resource>
<ServiceRequest>
<id value="212c57ad-45cd-4882-87e7-8415ded3db05"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-servicerequest"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<intent value="order"/>
<code>
<coding>
<system
value="https://fhir.developer.gene.com/CodeSystem/uapi-sr-type"/>
<code value="bipa"/>
</coding>
</code>
<subject>
<reference value="urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5"/>
<type value="Patient"/>
</subject>
</ServiceRequest>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:f71a66c4-f747-4b46-8adc-875a45f8ee7e"/>
<resource>
<ServiceRequest>
<id value="f71a66c4-f747-4b46-8adc-875a45f8ee7e"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-servicerequest"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<intent value="order"/>
<code>
<coding>
<system
value="https://fhir.developer.gene.com/CodeSystem/uapi-sr-type"/>
<code value="starter"/>
</coding>
</code>
<subject>
<reference value="urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5"/>
<type value="Patient"/>
</subject>
</ServiceRequest>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:e9d05dcd-bb02-4a08-af63-386dcab3f160"/>
<resource>
<MedicationRequest>
<id value="e9d05dcd-bb02-4a08-af63-386dcab3f160"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-medicationrequest"/>
</meta>
<text>
<status value="extensions"/>
<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>
</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>
</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>
</text>
<status value="active"/>
<intent value="order"/>
<medicationCodeableConcept>
<coding>
<system
value="https://fhir.developer.gene.com/CodeSystem/uapi-product-name"/>
<code value="xolair"/>
<display value="Xolair"/>
</coding>
</medicationCodeableConcept>
<subject>
<reference value="urn:uuid:ab45810f-2057-4b15-a24d-be929071cad5"/>
<type value="Patient"/>
</subject>
<requester>
<reference value="urn:uuid:3c5298d3-2b49-4f79-b703-a46623899258"/>
<type value="Practitioner"/>
</requester>
<courseOfTherapyType>
<text value="Starter (Pre filled Syringe)"/>
</courseOfTherapyType>
<insurance>
<reference value="urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df"/>
<type value="Coverage"/>
</insurance>
<note>
<text value="Allergic Asthma - 300mg/dose every 2 weeks"/>
</note>
<dosageInstruction>
<timing>
<repeat>
<frequency value="1"/>
<period value="2"/>
<periodUnit value="wk"/>
</repeat>
</timing>
<doseAndRate>
<doseQuantity>
<value value="300"/>
<unit value="mg"/>
</doseQuantity>
</doseAndRate>
</dosageInstruction>
<dispenseRequest>
<extension
url="https://fhir.developer.gene.com/StructureDefinition/dispenser-instruction">
<valueAnnotation>
<text
value="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)"/>
</valueAnnotation>
</extension>
<extension
url="https://fhir.developer.gene.com/StructureDefinition/dispense-quantity-detail">
<extension url="dispenseQuantity">
<valueQuantity>
<value value="5"/>
</valueQuantity>
</extension>
<extension url="dispenseUnit">
<valueString value="300mg prefilled syringe(s)"/>
</extension>
</extension>
<extension
url="https://fhir.developer.gene.com/StructureDefinition/dispense-quantity-detail">
<extension url="dispenseQuantity">
<valueQuantity>
<value value="2"/>
</valueQuantity>
</extension>
<extension url="dispenseUnit">
<valueString value="75mg prefilled syringe(s)"/>
</extension>
</extension>
<extension
url="https://fhir.developer.gene.com/StructureDefinition/dispense-quantity-detail">
<extension url="dispenseQuantity">
<valueQuantity>
<value value="1"/>
</valueQuantity>
</extension>
<extension url="dispenseUnit">
<valueString value="150 mg prefilled syringe(s)"/>
</extension>
</extension>
<numberOfRepeatsAllowed value="1"/>
<expectedSupplyDuration>
<value value="90"/>
<unit value="d"/>
<system value="http://unitsofmeasure.org"/>
<code value="d"/>
</expectedSupplyDuration>
</dispenseRequest>
</MedicationRequest>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:d1654255-0a8d-4f2c-9405-19a6794500a2"/>
<resource>
<Organization>
<id value="d1654255-0a8d-4f2c-9405-19a6794500a2"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-organization"/>
</meta>
<text>
<status value="generated"/>
<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 (use: usual, )</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>
</text>
<identifier>
<use value="usual"/>
<system value="http://tailormed.co"/>
<value value="PAY-200"/>
<assigner>
<display value="TailorMed"/>
</assigner>
</identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/organization-type"/>
<code value="ins"/>
</coding>
</type>
<name value="Dakotacare"/>
<telecom>
<system value="phone"/>
<value value="8778472862"/>
<use value="work"/>
<rank value="1"/>
</telecom>
</Organization>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:d1089cdf-7a5f-45b1-99b9-2c021eca5270"/>
<resource>
<Organization>
<id value="d1089cdf-7a5f-45b1-99b9-2c021eca5270"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-organization"/>
</meta>
<text>
<status value="generated"/>
<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 (use: usual, )</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>
</text>
<identifier>
<use value="usual"/>
<system value="http://SOT.com/ab"/>
<value value="SOT-001"/>
<assigner>
<display value="Florida Hospital Orlando Infusion Center"/>
</assigner>
</identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/organization-type"/>
<code value="other"/>
<display value="Site of Treatment"/>
</coding>
<text value="Site of Treatment"/>
</type>
<name value="FLORIDA HOSPITAL ORLANDO INFUSION CNTR"/>
<telecom>
<system value="phone"/>
<value value="4012704882"/>
<use value="work"/>
<rank value="1"/>
</telecom>
<telecom>
<system value="fax"/>
<value value="4019974042"/>
<use value="work"/>
<rank value="2"/>
</telecom>
<address>
<line value="2501 N ORANGE AVE, STE 481"/>
<city value="Orlando"/>
<state value="FL"/>
<postalCode value="32804"/>
<country value="US"/>
</address>
<contact>
<name>
<use value="official"/>
<family value="Davis"/>
<given value="Vince"/>
</name>
<telecom>
<system value="phone"/>
</telecom>
</contact>
</Organization>
</resource>
</entry>
</Bundle>