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
{
"resourceType" : "Bundle",
"id" : "5712feab-f743-41ac-b88d-81474a606255",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-as-enrollment-bundle"
]
},
"identifier" : {
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "RI",
"display" : "Resource identifier"
}
]
},
"system" : "http://vendor.com/ab",
"value" : "5712feab-f743-41ac-b88d-81474a606255",
"assigner" : {
"display" : "Alpha Beta"
}
},
"type" : "message",
"timestamp" : "2020-03-11T08:10:13-05:00",
"entry" : [
{
"fullUrl" : "urn:uuid:eb5eb40b-78e8-4a52-903a-0348c1eac387",
"resource" : {
"resourceType" : "MessageHeader",
"id" : "eb5eb40b-78e8-4a52-903a-0348c1eac387",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-messageheader"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MessageHeader_eb5eb40b-78e8-4a52-903a-0348c1eac387\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MessageHeader eb5eb40b-78e8-4a52-903a-0348c1eac387</b></p><a name=\"eb5eb40b-78e8-4a52-903a-0348c1eac387\"> </a><a name=\"hceb5eb40b-78e8-4a52-903a-0348c1eac387\"> </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-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-01c31a2f-321d-4c6e-8349-206af8a88088\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 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>Vendor_AB</td><td><a href=\"http://vendor.com/fhir/enrollmentID/ENR-00001\">http://vendor.com/fhir/enrollmentID/ENR-00001</a></td></tr></table><p><b>focus</b>: <a href=\"Bundle-5712feab-f743-41ac-b88d-81474a606255.html#urn-uuid-7fea0055-632a-4cf8-b7f5-4ba321c7ccd3\">Bundle: identifier = Resource identifier: 5712feab-f743-41ac-b88d-81474a606255; type = message; timestamp = 2020-03-11 08:10:13-0500</a></p></div>"
},
"eventCoding" : {
"system" : "http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-event-type",
"code" : "enrollment-with-consent"
},
"destination" : [
{
"name" : "UAPI-ENR-V2.1",
"endpoint" : "https://test-us-e1.apis.roche.com/pharma-cmg-ehr-fhir-exp-test/v2/enrollment"
}
],
"sender" : {
"reference" : "urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088",
"type" : "Organization"
},
"source" : {
"name" : "Vendor_AB",
"endpoint" : "http://vendor.com/fhir/enrollmentID/ENR-00001"
},
"focus" : [
{
"reference" : "urn:uuid:7fea0055-632a-4cf8-b7f5-4ba321c7ccd3",
"type" : "List"
}
]
}
},
{
"fullUrl" : "urn:uuid:7fea0055-632a-4cf8-b7f5-4ba321c7ccd3",
"resource" : {
"resourceType" : "List",
"id" : "7fea0055-632a-4cf8-b7f5-4ba321c7ccd3",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"List_7fea0055-632a-4cf8-b7f5-4ba321c7ccd3\"> </a><p class=\"res-header-id\"><b>Generated Narrative: List 7fea0055-632a-4cf8-b7f5-4ba321c7ccd3</b></p><a name=\"7fea0055-632a-4cf8-b7f5-4ba321c7ccd3\"> </a><a name=\"hc7fea0055-632a-4cf8-b7f5-4ba321c7ccd3\"> </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-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-fc2e5a72-c363-4616-ae00-4ad25cbcb45c\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-01c31a2f-321d-4c6e-8349-206af8a88088\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-695d0991-5e03-46df-934a-85a28acd95c1\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 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-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-4db51d32-65c3-4f8c-959e-0155c6d14545\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-5712feab-f743-41ac-b88d-81474a606255.html#urn-uuid-63409e58-4319-4de3-b2ac-9f12047b3d33\">Bundle: identifier = Resource identifier: 5712feab-f743-41ac-b88d-81474a606255; type = message; timestamp = 2020-03-11 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-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-1b53bfb2-1361-4906-acd8-35294d30273b\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-19729d3a-4770-4587-b7c6-a369a878df88.html#urn-uuid-45cf0b29-8c1d-4882-91e1-00bc28c06a52\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 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-5712feab-f743-41ac-b88d-81474a606255.html#urn-uuid-898d1b25-6b42-493f-8963-8f0330f339ed\">Bundle: identifier = Resource identifier: 5712feab-f743-41ac-b88d-81474a606255; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-d3637025-883d-4678-9e0a-1d243a338f9f\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr></table></div>"
},
"status" : "current",
"mode" : "changes",
"title" : "messageContext",
"entry" : [
{
"item" : {
"reference" : "urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c",
"type" : "Patient"
}
},
{
"item" : {
"reference" : "urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088",
"type" : "Organization"
}
},
{
"item" : {
"reference" : "urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1",
"type" : "Practitioner"
}
},
{
"item" : {
"reference" : "urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df",
"type" : "Coverage"
}
},
{
"item" : {
"reference" : "urn:uuid:4db51d32-65c3-4f8c-959e-0155c6d14545",
"type" : "RelatedPerson"
}
},
{
"item" : {
"reference" : "urn:uuid:63409e58-4319-4de3-b2ac-9f12047b3d33",
"type" : "QuestionnaireResponse"
}
},
{
"item" : {
"reference" : "urn:uuid:bc20c5ea-f639-4221-ab61-ce75c5e64aba",
"type" : "Condition"
}
},
{
"item" : {
"reference" : "urn:uuid:1b53bfb2-1361-4906-acd8-35294d30273b",
"type" : "Consent"
}
},
{
"item" : {
"reference" : "urn:uuid:45cf0b29-8c1d-4882-91e1-00bc28c06a52",
"type" : "Organization"
}
},
{
"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:898d1b25-6b42-493f-8963-8f0330f339ed",
"type" : "MedicationRequest"
}
},
{
"item" : {
"reference" : "urn:uuid:d3637025-883d-4678-9e0a-1d243a338f9f",
"type" : "Organization"
}
}
]
}
},
{
"fullUrl" : "urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c",
"resource" : {
"resourceType" : "Patient",
"id" : "fc2e5a72-c363-4616-ae00-4ad25cbcb45c",
"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_fc2e5a72-c363-4616-ae00-4ad25cbcb45c\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient fc2e5a72-c363-4616-ae00-4ad25cbcb45c</b></p><a name=\"fc2e5a72-c363-4616-ae00-4ad25cbcb45c\"> </a><a name=\"hcfc2e5a72-c363-4616-ae00-4ad25cbcb45c\"> </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;\">Ryan Michaelson (official) Male, DoB: 1972-10-29 ( Patient internal identifier: 6bcd8467-0473-4836-9128-2e7972f23177\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: 1231231234(Home)</li><li>ph: 1234561234(Mobile)</li><li><a href=\"mailto:bobster83@example.com\">bobster83@example.com</a></li><li>1234 Main St San Francisco CA 94105 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-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-695d0991-5e03-46df-934a-85a28acd95c1\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 08:10:13-0500</a></li><li>Managing Organization: <a href=\"Bundle-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-01c31a2f-321d-4c6e-8349-206af8a88088\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 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://vendor.com/ab",
"value" : "6bcd8467-0473-4836-9128-2e7972f23177",
"assigner" : {
"display" : "AB Vendor"
}
}
],
"name" : [
{
"use" : "official",
"family" : "Michaelson",
"given" : [
"Ryan"
]
}
],
"telecom" : [
{
"system" : "phone",
"value" : "1231231234",
"use" : "home",
"rank" : 1
},
{
"system" : "phone",
"value" : "1234561234",
"use" : "mobile",
"rank" : 2
},
{
"system" : "email",
"value" : "bobster83@example.com",
"use" : "home",
"rank" : 3
}
],
"gender" : "male",
"birthDate" : "1972-10-29",
"address" : [
{
"line" : [
"1234 Main St"
],
"city" : "San Francisco",
"state" : "CA",
"postalCode" : "94105",
"country" : "US"
}
],
"communication" : [
{
"language" : {
"coding" : [
{
"system" : "urn:ietf:bcp:47",
"code" : "en",
"display" : "English"
}
]
},
"preferred" : true
}
],
"generalPractitioner" : [
{
"reference" : "urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1"
}
],
"managingOrganization" : {
"reference" : "urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088"
}
}
},
{
"fullUrl" : "urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088",
"resource" : {
"resourceType" : "Organization",
"id" : "01c31a2f-321d-4c6e-8349-206af8a88088",
"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_01c31a2f-321d-4c6e-8349-206af8a88088\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization 01c31a2f-321d-4c6e-8349-206af8a88088</b></p><a name=\"01c31a2f-321d-4c6e-8349-206af8a88088\"> </a><a name=\"hc01c31a2f-321d-4c6e-8349-206af8a88088\"> </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://vendor.com/ab</code>/HOSP-12345\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>: Mid Atlantic Retina</p><p><b>telecom</b>: <a href=\"mailto:mar@example.com\">mar@example.com</a></p><p><b>address</b>: 8 Ranoldo Terrace Cherry Hill NJ 08034 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://vendor.com/ab",
"value" : "HOSP-12345",
"assigner" : {
"display" : "AB Vendor"
}
}
],
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/organization-type",
"code" : "prov",
"display" : "Healthcare Provider"
}
]
}
],
"name" : "Mid Atlantic Retina",
"telecom" : [
{
"system" : "email",
"value" : "mar@example.com"
}
],
"address" : [
{
"line" : [
"8 Ranoldo Terrace"
],
"city" : "Cherry Hill",
"state" : "NJ",
"postalCode" : "08034",
"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:695d0991-5e03-46df-934a-85a28acd95c1",
"resource" : {
"resourceType" : "Practitioner",
"id" : "695d0991-5e03-46df-934a-85a28acd95c1",
"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_695d0991-5e03-46df-934a-85a28acd95c1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner 695d0991-5e03-46df-934a-85a28acd95c1</b></p><a name=\"695d0991-5e03-46df-934a-85a28acd95c1\"> </a><a name=\"hc695d0991-5e03-46df-934a-85a28acd95c1\"> </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>: Provider number/1922071448\u00a0(use:\u00a0official,\u00a0), Tax ID number/00000000\u00a0(use:\u00a0official,\u00a0), National provider identifier/1639285034\u00a0(use:\u00a0official,\u00a0)</p><p><b>name</b>: MARISSA CRUZ (Official)</p></div>"
},
"identifier" : [
{
"use" : "official",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "PRN",
"display" : "Provider number"
}
]
},
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "1922071448",
"assigner" : {
"display" : "Centers for Medicare & Medicaid Services"
}
},
{
"use" : "official",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "TAX",
"display" : "Tax ID number"
}
]
},
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "00000000"
},
{
"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" : "1639285034"
}
],
"name" : [
{
"use" : "official",
"family" : "CRUZ",
"given" : [
"MARISSA"
]
}
]
}
},
{
"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-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-4db51d32-65c3-4f8c-959e-0155c6d14545\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 08:10:13-0500</a></p><p><b>subscriberId</b>: 4353</p><p><b>beneficiary</b>: <a href=\"Bundle-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-fc2e5a72-c363-4616-ae00-4ad25cbcb45c\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 08:10:13-0500</a></p><p><b>payor</b>: <a href=\"Bundle-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-d3637025-883d-4678-9e0a-1d243a338f9f\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 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:4db51d32-65c3-4f8c-959e-0155c6d14545",
"type" : "RelatedPerson"
},
"subscriberId" : "4353",
"beneficiary" : {
"reference" : "urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c",
"type" : "Patient"
},
"payor" : [
{
"reference" : "urn:uuid:d3637025-883d-4678-9e0a-1d243a338f9f",
"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:4db51d32-65c3-4f8c-959e-0155c6d14545",
"resource" : {
"resourceType" : "RelatedPerson",
"id" : "4db51d32-65c3-4f8c-959e-0155c6d14545",
"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_4db51d32-65c3-4f8c-959e-0155c6d14545\"> </a><p class=\"res-header-id\"><b>Generated Narrative: RelatedPerson 4db51d32-65c3-4f8c-959e-0155c6d14545</b></p><a name=\"4db51d32-65c3-4f8c-959e-0155c6d14545\"> </a><a name=\"hc4db51d32-65c3-4f8c-959e-0155c6d14545\"> </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-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-fc2e5a72-c363-4616-ae00-4ad25cbcb45c\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 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>: Bob Paul Smith (Official)</p><p><b>telecom</b>: ph: 1234567890(Mobile)</p><p><b>birthDate</b>: 1972-10-29</p></div>"
},
"patient" : {
"reference" : "urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c",
"type" : "Patient"
},
"relationship" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code" : "SIGOTHR",
"display" : "significant other"
}
]
}
],
"name" : [
{
"use" : "official",
"family" : "Smith",
"given" : [
"Bob Paul"
]
}
],
"telecom" : [
{
"system" : "phone",
"value" : "1234567890",
"use" : "mobile"
}
],
"birthDate" : "1972-10-29"
}
},
{
"fullUrl" : "urn:uuid:63409e58-4319-4de3-b2ac-9f12047b3d33",
"resource" : {
"resourceType" : "QuestionnaireResponse",
"id" : "63409e58-4319-4de3-b2ac-9f12047b3d33",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"QuestionnaireResponse_63409e58-4319-4de3-b2ac-9f12047b3d33\"> </a><p class=\"res-header-id\"><b>Generated Narrative: QuestionnaireResponse 63409e58-4319-4de3-b2ac-9f12047b3d33</b></p><a name=\"63409e58-4319-4de3-b2ac-9f12047b3d33\"> </a><a name=\"hc63409e58-4319-4de3-b2ac-9f12047b3d33\"> </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\"/> 63409e58-4319-4de3-b2ac-9f12047b3d33</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\">11111111199</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\"/> dot</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\">Date of Treatment</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\">2022-02-02</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\"/> opn-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\">Onsite Pharmacy Name (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\">Onsite Phy</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\"/> preferred-sp-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\">Preferred Specialty Pharmacy (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\">Pref SP</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\"/> contact-patient</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\">Do not contact patient</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\"/> 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\"/> line-of-therapy</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\">Line of therapy?</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\">Second</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\"/> onsite-pharmacy</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\">Onsite Pharmacy?</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\"/> 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\"/> pos</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\">Place of Service</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\">Infusion Center</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\"/> prescription-plan</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 this a Prescription plan?</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\"/> re-verify-benefits-at-pa-expiration</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\">Re-verify benefits at PA expiration</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\"/> site-of-treatment</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\">Site of Treatment</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\"><span><span><a href=\"Bundle-19729d3a-4770-4587-b7c6-a369a878df88.html#urn-uuid-45cf0b29-8c1d-4882-91e1-00bc28c06a52\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 08:10:13-0500</a></span></span></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\"/> specialty-pharmacy</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\">Specialty Pharmacy?</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\"/> 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\">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\"/> polivy-metastatic-disease</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\">Metastatic Disease?</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\"/> certify-patient-for-copay-program</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\">Co-pay program Commercial Insurance</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_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: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> polivy-clinical-trial-participant</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\">Was the patient a clinical trial participant for this medicine?</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><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:fc2e5a72-c363-4616-ae00-4ad25cbcb45c",
"type" : "Patient"
},
"item" : [
{
"linkId" : "authorization",
"text" : "Authorization #",
"answer" : [
{
"valueString" : "11111111199"
}
]
},
{
"linkId" : "dot",
"text" : "Date of Treatment",
"answer" : [
{
"valueDate" : "2022-02-02"
}
]
},
{
"linkId" : "opn-optional",
"text" : "Onsite Pharmacy Name (Optional)",
"answer" : [
{
"valueString" : "Onsite Phy"
}
]
},
{
"linkId" : "preferred-sp-optional",
"text" : "Preferred Specialty Pharmacy (Optional)",
"answer" : [
{
"valueString" : "Pref SP"
}
]
},
{
"linkId" : "contact-patient",
"text" : "Do not contact patient",
"answer" : [
{
"valueString" : "Yes"
}
]
},
{
"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" : "line-of-therapy",
"text" : "Line of therapy?",
"answer" : [
{
"valueString" : "Second"
}
]
},
{
"linkId" : "onsite-pharmacy",
"text" : "Onsite Pharmacy?",
"answer" : [
{
"valueString" : "Yes"
}
]
},
{
"linkId" : "pa-in-place",
"text" : "Is prior authorization in place?",
"answer" : [
{
"valueString" : "Yes"
}
]
},
{
"linkId" : "pos",
"text" : "Place of Service",
"answer" : [
{
"valueString" : "Infusion Center"
}
]
},
{
"linkId" : "prescription-plan",
"text" : "Is this a Prescription plan?",
"answer" : [
{
"valueString" : "Yes"
}
]
},
{
"linkId" : "re-verify-benefits-at-pa-expiration",
"text" : "Re-verify benefits at PA expiration",
"answer" : [
{
"valueString" : "Yes"
}
]
},
{
"linkId" : "site-of-treatment",
"text" : "Site of Treatment",
"answer" : [
{
"valueReference" : {
"reference" : "urn:uuid:45cf0b29-8c1d-4882-91e1-00bc28c06a52",
"type" : "Organization"
}
}
]
},
{
"linkId" : "specialty-pharmacy",
"text" : "Specialty Pharmacy?",
"answer" : [
{
"valueString" : "Yes"
}
]
},
{
"linkId" : "tcpa-consent",
"text" : "TCPA Consent Provided?",
"answer" : [
{
"valueString" : "Yes"
}
]
},
{
"linkId" : "polivy-metastatic-disease",
"text" : "Metastatic Disease?",
"answer" : [
{
"valueString" : "Yes"
}
]
},
{
"linkId" : "certify-patient-for-copay-program",
"text" : "Co-pay program Commercial Insurance",
"answer" : [
{
"valueString" : "No"
}
]
},
{
"linkId" : "polivy-clinical-trial-participant",
"text" : "Was the patient a clinical trial participant for this medicine?",
"answer" : [
{
"valueString" : "Yes"
}
]
}
]
}
},
{
"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 C83.30}\">Diffuse large B-cell lymphoma, unspecified site</span></p><p><b>subject</b>: <a href=\"Bundle-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-fc2e5a72-c363-4616-ae00-4ad25cbcb45c\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 08:10:13-0500</a></p></div>"
},
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "C83.30"
}
]
},
"subject" : {
"reference" : "urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c",
"type" : "Patient"
}
}
},
{
"fullUrl" : "urn:uuid:1b53bfb2-1361-4906-acd8-35294d30273b",
"resource" : {
"resourceType" : "Consent",
"id" : "1b53bfb2-1361-4906-acd8-35294d30273b",
"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_1b53bfb2-1361-4906-acd8-35294d30273b\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Consent 1b53bfb2-1361-4906-acd8-35294d30273b</b></p><a name=\"1b53bfb2-1361-4906-acd8-35294d30273b\"> </a><a name=\"hc1b53bfb2-1361-4906-acd8-35294d30273b\"> </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-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-fc2e5a72-c363-4616-ae00-4ad25cbcb45c\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 08:10:13-0500</a></p><p><b>dateTime</b>: 2016-06-16 16:24:45+0000</p><p><b>performer</b>: <a href=\"Bundle-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-fc2e5a72-c363-4616-ae00-4ad25cbcb45c\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 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:fc2e5a72-c363-4616-ae00-4ad25cbcb45c",
"type" : "Patient"
},
"dateTime" : "2016-06-16T16:24:45Z",
"performer" : [
{
"reference" : "urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c",
"type" : "Patient"
}
],
"policyRule" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/consentpolicycodes",
"code" : "hipaa-auth",
"display" : "HIPAA Authorization"
}
]
},
"provision" : {
"type" : "permit"
}
}
},
{
"fullUrl" : "urn:uuid:45cf0b29-8c1d-4882-91e1-00bc28c06a52",
"resource" : {
"resourceType" : "Organization",
"id" : "45cf0b29-8c1d-4882-91e1-00bc28c06a52",
"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_45cf0b29-8c1d-4882-91e1-00bc28c06a52\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization 45cf0b29-8c1d-4882-91e1-00bc28c06a52</b></p><a name=\"45cf0b29-8c1d-4882-91e1-00bc28c06a52\"> </a><a name=\"hc45cf0b29-8c1d-4882-91e1-00bc28c06a52\"> </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>/Infusion Site Id\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>: Infusion Centre</p><p><b>telecom</b>: ph: 8882704882(Work), fax: 8179974042(Work)</p><p><b>address</b>: 8 Ranoldo Terrace Cherry Hill NJ 08034 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>Venus Yardav (Official)</td><td>ph: -unknown-</td></tr></table></div>"
},
"identifier" : [
{
"use" : "usual",
"system" : "http://SOT.com/ab",
"value" : "Infusion Site Id",
"assigner" : {
"display" : "Site of Treatment/Infusion Centre Name"
}
}
],
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/organization-type",
"code" : "other",
"display" : "Site of Treatment"
}
],
"text" : "Site of Treatment"
}
],
"name" : "Infusion Centre",
"telecom" : [
{
"system" : "phone",
"value" : "8882704882",
"use" : "work",
"rank" : 1
},
{
"system" : "fax",
"value" : "8179974042",
"use" : "work",
"rank" : 2
}
],
"address" : [
{
"line" : [
"8 Ranoldo Terrace"
],
"city" : "Cherry Hill",
"state" : "NJ",
"postalCode" : "08034",
"country" : "US"
}
],
"contact" : [
{
"name" : {
"use" : "official",
"family" : "Yardav",
"given" : [
"Venus"
]
},
"telecom" : [
{
"system" : "phone"
}
]
}
]
}
},
{
"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-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-fc2e5a72-c363-4616-ae00-4ad25cbcb45c\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 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:fc2e5a72-c363-4616-ae00-4ad25cbcb45c",
"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 copay}\">Copay</span></p><p><b>subject</b>: <a href=\"Bundle-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-fc2e5a72-c363-4616-ae00-4ad25cbcb45c\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 08:10:13-0500</a></p></div>"
},
"status" : "active",
"intent" : "order",
"code" : {
"coding" : [
{
"system" : "https://fhir.developer.gene.com/CodeSystem/uapi-sr-type",
"code" : "copay"
}
]
},
"subject" : {
"reference" : "urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c",
"type" : "Patient"
}
}
},
{
"fullUrl" : "urn:uuid:898d1b25-6b42-493f-8963-8f0330f339ed",
"resource" : {
"resourceType" : "MedicationRequest",
"id" : "898d1b25-6b42-493f-8963-8f0330f339ed",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-medicationrequest"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MedicationRequest_898d1b25-6b42-493f-8963-8f0330f339ed\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MedicationRequest 898d1b25-6b42-493f-8963-8f0330f339ed</b></p><a name=\"898d1b25-6b42-493f-8963-8f0330f339ed\"> </a><a name=\"hc898d1b25-6b42-493f-8963-8f0330f339ed\"> </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 polivy}\">Polivy</span></p><p><b>subject</b>: <a href=\"Bundle-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-fc2e5a72-c363-4616-ae00-4ad25cbcb45c\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 08:10:13-0500</a></p><p><b>requester</b>: <a href=\"Bundle-13778a5c-73de-46e4-bb5a-3781a5c93b5e.html#urn-uuid-695d0991-5e03-46df-934a-85a28acd95c1\">Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 08:10:13-0500</a></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></div>"
},
"status" : "active",
"intent" : "order",
"medicationCodeableConcept" : {
"coding" : [
{
"system" : "https://fhir.developer.gene.com/CodeSystem/uapi-product-name",
"code" : "polivy",
"display" : "Polivy"
}
]
},
"subject" : {
"reference" : "urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c",
"type" : "Patient"
},
"requester" : {
"reference" : "urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1",
"type" : "Practitioner"
},
"insurance" : [
{
"reference" : "urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df",
"type" : "Coverage"
}
]
}
},
{
"fullUrl" : "urn:uuid:d3637025-883d-4678-9e0a-1d243a338f9f",
"resource" : {
"resourceType" : "Organization",
"id" : "d3637025-883d-4678-9e0a-1d243a338f9f",
"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_d3637025-883d-4678-9e0a-1d243a338f9f\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization d3637025-883d-4678-9e0a-1d243a338f9f</b></p><a name=\"d3637025-883d-4678-9e0a-1d243a338f9f\"> </a><a name=\"hcd3637025-883d-4678-9e0a-1d243a338f9f\"> </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://vendor.com/ab</code>/PAY-111\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://vendor.com/ab",
"value" : "PAY-111",
"assigner" : {
"display" : "AB Vendor"
}
}
],
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/organization-type",
"code" : "ins"
}
]
}
],
"name" : "Dakotacare",
"telecom" : [
{
"system" : "phone",
"value" : "8778472862",
"use" : "work",
"rank" : 1
}
]
}
}
]
}