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="c27869ff-b920-4aa6-9416-ff391da1aa95"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-as-enrollment-bundle"/>
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<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="RI"/>
<display value="Resource identifier"/>
</coding>
</type>
<system value="http://vendor.com/ab"/>
<value value="e0166aae-5615-455f-97f9-9fabe0be7c5d"/>
<assigner>
<display value="Alpha Beta"/>
</assigner>
</identifier>
<type value="message"/>
<timestamp value="2020-03-11T08:10:13-05:00"/>
<entry>
<fullUrl value="urn:uuid:eb5eb40b-78e8-4a52-903a-0348c1eac387"/>
<resource>
<MessageHeader>
<id value="eb5eb40b-78e8-4a52-903a-0348c1eac387"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-messageheader"/>
</meta>
<text>
<status value="generated"/>
<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-c27869ff-b920-4aa6-9416-ff391da1aa95.html#urn-uuid-3ba7dfc5-6aef-43da-9fdf-a3099fd430b9">Bundle: identifier = Resource identifier: e0166aae-5615-455f-97f9-9fabe0be7c5d; type = message; timestamp = 2020-03-11 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:01c31a2f-321d-4c6e-8349-206af8a88088"/>
<type value="Organization"/>
</sender>
<source>
<name value="Vendor_AB"/>
<endpoint value="http://vendor.com/fhir/enrollmentID/ENR-00001"/>
</source>
<focus>
<reference value="urn:uuid:3ba7dfc5-6aef-43da-9fdf-a3099fd430b9"/>
<type value="List"/>
</focus>
</MessageHeader>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:3ba7dfc5-6aef-43da-9fdf-a3099fd430b9"/>
<resource>
<List>
<id value="3ba7dfc5-6aef-43da-9fdf-a3099fd430b9"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="List_3ba7dfc5-6aef-43da-9fdf-a3099fd430b9"> </a><p class="res-header-id"><b>Generated Narrative: List 3ba7dfc5-6aef-43da-9fdf-a3099fd430b9</b></p><a name="3ba7dfc5-6aef-43da-9fdf-a3099fd430b9"> </a><a name="hc3ba7dfc5-6aef-43da-9fdf-a3099fd430b9"> </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-c27869ff-b920-4aa6-9416-ff391da1aa95.html#urn-uuid-60af2db1-1cc4-4da5-9f8b-de4799caaa03">Bundle: identifier = Resource identifier: e0166aae-5615-455f-97f9-9fabe0be7c5d; 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-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-c27869ff-b920-4aa6-9416-ff391da1aa95.html#urn-uuid-d4389544-6ff6-4019-9a3f-0a72b8562655">Bundle: identifier = Resource identifier: e0166aae-5615-455f-97f9-9fabe0be7c5d; 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>
</text>
<status value="current"/>
<mode value="changes"/>
<title value="messageContext"/>
<entry>
<item>
<reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<type value="Patient"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088"/>
<type value="Organization"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1"/>
<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:4db51d32-65c3-4f8c-959e-0155c6d14545"/>
<type value="RelatedPerson"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:60af2db1-1cc4-4da5-9f8b-de4799caaa03"/>
<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:1b53bfb2-1361-4906-acd8-35294d30273b"/>
<type value="Consent"/>
</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:d4389544-6ff6-4019-9a3f-0a72b8562655"/>
<type value="MedicationRequest"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:d3637025-883d-4678-9e0a-1d243a338f9f"/>
<type value="Organization"/>
</item>
</entry>
</List>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<resource>
<Patient>
<id value="fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<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_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 (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: 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>
</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://vendor.com/ab"/>
<value value="6bcd8467-0473-4836-9128-2e7972f23177"/>
<assigner>
<display value="AB Vendor"/>
</assigner>
</identifier>
<name>
<use value="official"/>
<family value="Michaelson"/>
<given value="Ryan"/>
</name>
<telecom>
<system value="phone"/>
<value value="1231231234"/>
<use value="home"/>
<rank value="1"/>
</telecom>
<telecom>
<system value="phone"/>
<value value="1234561234"/>
<use value="mobile"/>
<rank value="2"/>
</telecom>
<telecom>
<system value="email"/>
<value value="bobster83@example.com"/>
<use value="home"/>
<rank value="3"/>
</telecom>
<gender value="male"/>
<birthDate value="1972-10-29"/>
<address>
<line value="1234 Main St"/>
<city value="San Francisco"/>
<state value="CA"/>
<postalCode value="94105"/>
<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:695d0991-5e03-46df-934a-85a28acd95c1"/>
</generalPractitioner>
<managingOrganization>
<reference value="urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088"/>
</managingOrganization>
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088"/>
<resource>
<Organization>
<id value="01c31a2f-321d-4c6e-8349-206af8a88088"/>
<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_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 (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>: 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>
</text>
<identifier>
<use value="usual"/>
<system value="http://vendor.com/ab"/>
<value value="HOSP-12345"/>
<assigner>
<display value="AB Vendor"/>
</assigner>
</identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/organization-type"/>
<code value="prov"/>
<display value="Healthcare Provider"/>
</coding>
</type>
<name value="Mid Atlantic Retina"/>
<telecom>
<system value="email"/>
<value value="mar@example.com"/>
</telecom>
<address>
<line value="8 Ranoldo Terrace"/>
<city value="Cherry Hill"/>
<state value="NJ"/>
<postalCode value="08034"/>
<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:695d0991-5e03-46df-934a-85a28acd95c1"/>
<resource>
<Practitioner>
<id value="695d0991-5e03-46df-934a-85a28acd95c1"/>
<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_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 (use: official, ), Tax ID number/00000000 (use: official, ), National provider identifier/1639285034 (use: official, )</p><p><b>name</b>: MARISSA CRUZ (Official)</p></div>
</text>
<identifier>
<use value="official"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="PRN"/>
<display value="Provider number"/>
</coding>
</type>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="1922071448"/>
<assigner>
<display value="Centers for Medicare & Medicaid Services"/>
</assigner>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="TAX"/>
<display value="Tax ID number"/>
</coding>
</type>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="00000000"/>
</identifier>
<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="1639285034"/>
</identifier>
<name>
<use value="official"/>
<family value="CRUZ"/>
<given value="MARISSA"/>
</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-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>
</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:4db51d32-65c3-4f8c-959e-0155c6d14545"/>
<type value="RelatedPerson"/>
</subscriber>
<subscriberId value="4353"/>
<beneficiary>
<reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<type value="Patient"/>
</beneficiary>
<payor>
<reference value="urn:uuid:d3637025-883d-4678-9e0a-1d243a338f9f"/>
<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:4db51d32-65c3-4f8c-959e-0155c6d14545"/>
<resource>
<RelatedPerson>
<id value="4db51d32-65c3-4f8c-959e-0155c6d14545"/>
<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_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>
</text>
<patient>
<reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<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="Smith"/>
<given value="Bob Paul"/>
</name>
<telecom>
<system value="phone"/>
<value value="1234567890"/>
<use value="mobile"/>
</telecom>
<birthDate value="1972-10-29"/>
</RelatedPerson>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:60af2db1-1cc4-4da5-9f8b-de4799caaa03"/>
<resource>
<QuestionnaireResponse>
<id value="60af2db1-1cc4-4da5-9f8b-de4799caaa03"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="QuestionnaireResponse_60af2db1-1cc4-4da5-9f8b-de4799caaa03"> </a><p class="res-header-id"><b>Generated Narrative: QuestionnaireResponse 60af2db1-1cc4-4da5-9f8b-de4799caaa03</b></p><a name="60af2db1-1cc4-4da5-9f8b-de4799caaa03"> </a><a name="hc60af2db1-1cc4-4da5-9f8b-de4799caaa03"> </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"/> 60af2db1-1cc4-4da5-9f8b-de4799caaa03</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"/> adot</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">Anticipated Date of Treatment (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">2022-10-22</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"/> 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"/> 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">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_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"/> certify-patient-for-ophthalmology-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">Yes</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:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<type value="Patient"/>
</subject>
<item>
<linkId value="adot"/>
<text value="Anticipated Date of Treatment (Optional)"/>
<answer>
<valueDate value="2022-10-22"/>
</answer>
</item>
<item>
<linkId value="contact-patient"/>
<text value="Do not contact patient"/>
<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="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="No"/>
</answer>
</item>
<item>
<linkId value="certify-patient-for-ophthalmology-copay-program"/>
<text value="Co-pay program Commercial Insurance"/>
<answer>
<valueString value="Yes"/>
</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 E10.3211}">Type 1 diab with mild nonp rtnop with macular edema, r eye</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>
</text>
<code>
<coding>
<system value="http://hl7.org/fhir/sid/icd-10-cm"/>
<code value="E10.3211"/>
</coding>
</code>
<subject>
<reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<type value="Patient"/>
</subject>
</Condition>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:1b53bfb2-1361-4906-acd8-35294d30273b"/>
<resource>
<Consent>
<id value="1b53bfb2-1361-4906-acd8-35294d30273b"/>
<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_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>
</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:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<type value="Patient"/>
</patient>
<dateTime value="2016-06-16T16:24:45Z"/>
<performer>
<reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<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: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-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>
</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:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<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 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>
</text>
<status value="active"/>
<intent value="order"/>
<code>
<coding>
<system
value="https://fhir.developer.gene.com/CodeSystem/uapi-sr-type"/>
<code value="copay"/>
</coding>
</code>
<subject>
<reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<type value="Patient"/>
</subject>
</ServiceRequest>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:d4389544-6ff6-4019-9a3f-0a72b8562655"/>
<resource>
<MedicationRequest>
<id value="d4389544-6ff6-4019-9a3f-0a72b8562655"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-medicationrequest"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="MedicationRequest_d4389544-6ff6-4019-9a3f-0a72b8562655"> </a><p class="res-header-id"><b>Generated Narrative: MedicationRequest d4389544-6ff6-4019-9a3f-0a72b8562655</b></p><a name="d4389544-6ff6-4019-9a3f-0a72b8562655"> </a><a name="hcd4389544-6ff6-4019-9a3f-0a72b8562655"> </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 lucentis}">Lucentis</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>
</text>
<status value="active"/>
<intent value="order"/>
<medicationCodeableConcept>
<coding>
<system
value="https://fhir.developer.gene.com/CodeSystem/uapi-product-name"/>
<code value="lucentis"/>
<display value="Lucentis"/>
</coding>
</medicationCodeableConcept>
<subject>
<reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<type value="Patient"/>
</subject>
<requester>
<reference value="urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1"/>
<type value="Practitioner"/>
</requester>
<insurance>
<reference value="urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df"/>
<type value="Coverage"/>
</insurance>
</MedicationRequest>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:d3637025-883d-4678-9e0a-1d243a338f9f"/>
<resource>
<Organization>
<id value="d3637025-883d-4678-9e0a-1d243a338f9f"/>
<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_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 (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://vendor.com/ab"/>
<value value="PAY-111"/>
<assigner>
<display value="AB Vendor"/>
</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>
</Bundle>