Universal API Implementation Guide
1.1.20 - ci-build
Universal API Implementation Guide - Local Development build (v1.1.20) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MessageHeader_67379338-7852-425e-aa9b-f68d03699943\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MessageHeader 67379338-7852-425e-aa9b-f68d03699943</b></p><a name=\"67379338-7852-425e-aa9b-f68d03699943\"> </a><a name=\"hc67379338-7852-425e-aa9b-f68d03699943\"> </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-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-e69e5e73-0723-4f42-bfdd-b69f181160bf\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; 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-df929183-0365-4f13-b558-0c455b47e544.html#urn-uuid-34768fee-4578-46fc-b51e-540e9685d65f\">Bundle: identifier = Resource identifier: df929183-0365-4f13-b558-0c455b47e544; type = message; timestamp = 2020-03-11 08:10:13-0500</a></p></div>"
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"List_34768fee-4578-46fc-b51e-540e9685d65f\"> </a><p class=\"res-header-id\"><b>Generated Narrative: List 34768fee-4578-46fc-b51e-540e9685d65f</b></p><a name=\"34768fee-4578-46fc-b51e-540e9685d65f\"> </a><a name=\"hc34768fee-4578-46fc-b51e-540e9685d65f\"> </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-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-1b315218-49b7-4264-816e-05d4b92ecbaa\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-e69e5e73-0723-4f42-bfdd-b69f181160bf\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-78ef1b71-b14a-44a1-a1e8-c9c9efcc157c\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-df929183-0365-4f13-b558-0c455b47e544.html#urn-uuid-28d3f8af-7f77-43ed-9d84-ed67eaa2e674\">Bundle: identifier = Resource identifier: df929183-0365-4f13-b558-0c455b47e544; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-df929183-0365-4f13-b558-0c455b47e544.html#urn-uuid-694ce192-7b69-4d75-8f91-0031bb2b0811\">Bundle: identifier = Resource identifier: df929183-0365-4f13-b558-0c455b47e544; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-090e5caf-fdbd-4a67-8535-2983a3868f41\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-e551b51b-0646-4b23-b1ac-9ec623756ec6\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-2722d5ae-1658-4d7f-8f64-de1299a1fb7f\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-7ec5069e-799f-413a-a0d2-d107acdfad3d\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-3f640e58-2f13-4d07-9356-8bc2ee64054d\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-ccd28c58-83e7-4657-b06a-53c8cc4ac94f\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-0ec0f18c-5869-4d10-9752-79ea39e1f7ac\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-4fd42cc9-559c-463e-8968-3e291ba91066.html#urn-uuid-94a59676-0e1f-42d6-b046-3c456758b90b\">Bundle: identifier = Resource identifier: 4fd42cc9-559c-463e-8968-3e291ba91066; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr><tr><td><a href=\"Bundle-4fd42cc9-559c-463e-8968-3e291ba91066.html#urn-uuid-b83bae44-3e47-4d5c-807e-41944016dc79\">Bundle: identifier = Resource identifier: 4fd42cc9-559c-463e-8968-3e291ba91066; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr></table></div>"
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{
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{
"item" : {
"reference" : "urn:uuid:e69e5e73-0723-4f42-bfdd-b69f181160bf",
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{
"item" : {
"reference" : "urn:uuid:78ef1b71-b14a-44a1-a1e8-c9c9efcc157c",
"type" : "Practitioner"
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},
{
"item" : {
"reference" : "urn:uuid:28d3f8af-7f77-43ed-9d84-ed67eaa2e674",
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{
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{
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"reference" : "urn:uuid:7ec5069e-799f-413a-a0d2-d107acdfad3d",
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{
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"reference" : "urn:uuid:3f640e58-2f13-4d07-9356-8bc2ee64054d",
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{
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"reference" : "urn:uuid:ccd28c58-83e7-4657-b06a-53c8cc4ac94f",
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{
"item" : {
"reference" : "urn:uuid:0ec0f18c-5869-4d10-9752-79ea39e1f7ac",
"type" : "RelatedPerson"
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{
"item" : {
"reference" : "urn:uuid:94a59676-0e1f-42d6-b046-3c456758b90b",
"type" : "Consent"
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},
{
"item" : {
"reference" : "urn:uuid:b83bae44-3e47-4d5c-807e-41944016dc79",
"type" : "Provenance"
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}
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{
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"resource" : {
"resourceType" : "Patient",
"id" : "1b315218-49b7-4264-816e-05d4b92ecbaa",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-patient"
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"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_1b315218-49b7-4264-816e-05d4b92ecbaa\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient 1b315218-49b7-4264-816e-05d4b92ecbaa</b></p><a name=\"1b315218-49b7-4264-816e-05d4b92ecbaa\"> </a><a name=\"hc1b315218-49b7-4264-816e-05d4b92ecbaa\"> </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-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-78ef1b71-b14a-44a1-a1e8-c9c9efcc157c\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500</a></li><li>Managing Organization: <a href=\"Bundle-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-e69e5e73-0723-4f42-bfdd-b69f181160bf\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500</a></li></ul></td></tr></table></div>"
},
"identifier" : [
{
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"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:78ef1b71-b14a-44a1-a1e8-c9c9efcc157c"
}
],
"managingOrganization" : {
"reference" : "urn:uuid:e69e5e73-0723-4f42-bfdd-b69f181160bf"
}
}
},
{
"fullUrl" : "urn:uuid:e69e5e73-0723-4f42-bfdd-b69f181160bf",
"resource" : {
"resourceType" : "Organization",
"id" : "e69e5e73-0723-4f42-bfdd-b69f181160bf",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-organization"
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"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_e69e5e73-0723-4f42-bfdd-b69f181160bf\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization e69e5e73-0723-4f42-bfdd-b69f181160bf</b></p><a name=\"e69e5e73-0723-4f42-bfdd-b69f181160bf\"> </a><a name=\"hce69e5e73-0723-4f42-bfdd-b69f181160bf\"> </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:78ef1b71-b14a-44a1-a1e8-c9c9efcc157c",
"resource" : {
"resourceType" : "Practitioner",
"id" : "78ef1b71-b14a-44a1-a1e8-c9c9efcc157c",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-practitioner"
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"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_78ef1b71-b14a-44a1-a1e8-c9c9efcc157c\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner 78ef1b71-b14a-44a1-a1e8-c9c9efcc157c</b></p><a name=\"78ef1b71-b14a-44a1-a1e8-c9c9efcc157c\"> </a><a name=\"hc78ef1b71-b14a-44a1-a1e8-c9c9efcc157c\"> </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:2722d5ae-1658-4d7f-8f64-de1299a1fb7f",
"resource" : {
"resourceType" : "Coverage",
"id" : "2722d5ae-1658-4d7f-8f64-de1299a1fb7f",
"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_2722d5ae-1658-4d7f-8f64-de1299a1fb7f\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage 2722d5ae-1658-4d7f-8f64-de1299a1fb7f</b></p><a name=\"2722d5ae-1658-4d7f-8f64-de1299a1fb7f\"> </a><a name=\"hc2722d5ae-1658-4d7f-8f64-de1299a1fb7f\"> </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-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-0ec0f18c-5869-4d10-9752-79ea39e1f7ac\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; 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-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-1b315218-49b7-4264-816e-05d4b92ecbaa\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500</a></p><p><b>payor</b>: <a href=\"Bundle-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-e551b51b-0646-4b23-b1ac-9ec623756ec6\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; 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:0ec0f18c-5869-4d10-9752-79ea39e1f7ac",
"type" : "RelatedPerson"
},
"subscriberId" : "4353",
"beneficiary" : {
"reference" : "urn:uuid:1b315218-49b7-4264-816e-05d4b92ecbaa",
"type" : "Patient"
},
"payor" : [
{
"reference" : "urn:uuid:e551b51b-0646-4b23-b1ac-9ec623756ec6",
"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:0ec0f18c-5869-4d10-9752-79ea39e1f7ac",
"resource" : {
"resourceType" : "RelatedPerson",
"id" : "0ec0f18c-5869-4d10-9752-79ea39e1f7ac",
"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_0ec0f18c-5869-4d10-9752-79ea39e1f7ac\"> </a><p class=\"res-header-id\"><b>Generated Narrative: RelatedPerson 0ec0f18c-5869-4d10-9752-79ea39e1f7ac</b></p><a name=\"0ec0f18c-5869-4d10-9752-79ea39e1f7ac\"> </a><a name=\"hc0ec0f18c-5869-4d10-9752-79ea39e1f7ac\"> </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-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-1b315218-49b7-4264-816e-05d4b92ecbaa\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; 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>"
},
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"reference" : "urn:uuid:1b315218-49b7-4264-816e-05d4b92ecbaa",
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},
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{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code" : "SIGOTHR",
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}
]
}
],
"name" : [
{
"use" : "official",
"family" : "Smith",
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"Bob Paul"
]
}
],
"telecom" : [
{
"system" : "phone",
"value" : "1234567890",
"use" : "mobile"
}
],
"birthDate" : "1972-10-29"
}
},
{
"fullUrl" : "urn:uuid:090e5caf-fdbd-4a67-8535-2983a3868f41",
"resource" : {
"resourceType" : "Condition",
"id" : "090e5caf-fdbd-4a67-8535-2983a3868f41",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Condition_090e5caf-fdbd-4a67-8535-2983a3868f41\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Condition 090e5caf-fdbd-4a67-8535-2983a3868f41</b></p><a name=\"090e5caf-fdbd-4a67-8535-2983a3868f41\"> </a><a name=\"hc090e5caf-fdbd-4a67-8535-2983a3868f41\"> </a><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/sid/icd-10-cm C91.10}\">Chronic lymphocytic leuk of B-cell type not achieve remis</span></p><p><b>subject</b>: <a href=\"Bundle-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-1b315218-49b7-4264-816e-05d4b92ecbaa\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; 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" : "C91.10"
}
]
},
"subject" : {
"reference" : "urn:uuid:1b315218-49b7-4264-816e-05d4b92ecbaa",
"type" : "Patient"
}
}
},
{
"fullUrl" : "urn:uuid:7ec5069e-799f-413a-a0d2-d107acdfad3d",
"resource" : {
"resourceType" : "Consent",
"id" : "7ec5069e-799f-413a-a0d2-d107acdfad3d",
"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_7ec5069e-799f-413a-a0d2-d107acdfad3d\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Consent 7ec5069e-799f-413a-a0d2-d107acdfad3d</b></p><a name=\"7ec5069e-799f-413a-a0d2-d107acdfad3d\"> </a><a name=\"hc7ec5069e-799f-413a-a0d2-d107acdfad3d\"> </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-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-1b315218-49b7-4264-816e-05d4b92ecbaa\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; 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-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-1b315218-49b7-4264-816e-05d4b92ecbaa\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; 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:1b315218-49b7-4264-816e-05d4b92ecbaa",
"type" : "Patient"
},
"dateTime" : "2016-06-16T16:24:45Z",
"performer" : [
{
"reference" : "urn:uuid:1b315218-49b7-4264-816e-05d4b92ecbaa",
"type" : "Patient"
}
],
"policyRule" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/consentpolicycodes",
"code" : "hipaa-auth",
"display" : "HIPAA Authorization"
}
]
},
"provision" : {
"type" : "permit"
}
}
},
{
"fullUrl" : "urn:uuid:b83bae44-3e47-4d5c-807e-41944016dc79",
"resource" : {
"resourceType" : "Provenance",
"id" : "b83bae44-3e47-4d5c-807e-41944016dc79",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-provenance"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Provenance_b83bae44-3e47-4d5c-807e-41944016dc79\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Provenance b83bae44-3e47-4d5c-807e-41944016dc79</b></p><a name=\"b83bae44-3e47-4d5c-807e-41944016dc79\"> </a><a name=\"hcb83bae44-3e47-4d5c-807e-41944016dc79\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-uapi-provenance.html\">UAPI Provenance</a></p></div><p>Provenance for <a href=\"Bundle-4fd42cc9-559c-463e-8968-3e291ba91066.html#urn-uuid-94a59676-0e1f-42d6-b046-3c456758b90b\">Bundle: identifier = Resource identifier: 4fd42cc9-559c-463e-8968-3e291ba91066; type = message; timestamp = 2020-03-11 08:10:13-0500</a></p><p>Summary</p><table class=\"grid\"><tr><td>Recorded</td><td>2022-02-07 09:49:39+0000</td></tr></table><p><b>Agents</b></p><table class=\"grid\"><tr><td><b>who</b></td></tr><tr><td><a href=\"Bundle-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-78ef1b71-b14a-44a1-a1e8-c9c9efcc157c\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500</a></td></tr></table></div>"
},
"target" : [
{
"reference" : "urn:uuid:94a59676-0e1f-42d6-b046-3c456758b90b",
"type" : "Consent"
}
],
"recorded" : "2022-02-07T09:49:39.382941+00:00",
"agent" : [
{
"who" : {
"reference" : "urn:uuid:78ef1b71-b14a-44a1-a1e8-c9c9efcc157c",
"type" : "Practitioner"
}
}
],
"signature" : [
{
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{
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"code" : "1.2.840.10065.1.12.1.7",
"display" : "Consent Signature"
}
],
"when" : "2022-02-07T09:49:39.382897+00:00",
"who" : {
"reference" : "urn:uuid:78ef1b71-b14a-44a1-a1e8-c9c9efcc157c",
"type" : "Practitioner"
},
"sigFormat" : "image/*",
"data" : "bQ=="
}
]
}
},
{
"fullUrl" : "urn:uuid:94a59676-0e1f-42d6-b046-3c456758b90b",
"resource" : {
"resourceType" : "Consent",
"id" : "94a59676-0e1f-42d6-b046-3c456758b90b",
"meta" : {
"profile" : [
🔗 "https://fhir.developer.gene.com/StructureDefinition/uapi-consent"
]
},
"text" : {
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Consent_94a59676-0e1f-42d6-b046-3c456758b90b\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Consent 94a59676-0e1f-42d6-b046-3c456758b90b</b></p><a name=\"94a59676-0e1f-42d6-b046-3c456758b90b\"> </a><a name=\"hc94a59676-0e1f-42d6-b046-3c456758b90b\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-uapi-consent.html\">UAPI Consent</a></p></div><p><b>status</b>: Active</p><p><b>scope</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/consentscope patient-privacy}\">Privacy Consent</span></p><p><b>category</b>: <span title=\"Codes:{http://loinc.org 59284-0}\">Prescriber Signature</span></p><p><b>patient</b>: <a href=\"Bundle-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-1b315218-49b7-4264-816e-05d4b92ecbaa\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; 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></div>"
},
"status" : "active",
"scope" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/consentscope",
"code" : "patient-privacy",
"display" : "Privacy Consent"
}
]
},
"category" : [
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "59284-0",
"display" : "Prescriber Signature"
}
]
}
],
"patient" : {
"reference" : "urn:uuid:1b315218-49b7-4264-816e-05d4b92ecbaa",
"type" : "Patient"
},
"policyRule" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/consentpolicycodes",
"code" : "hipaa-auth",
"display" : "HIPAA Authorization"
}
]
}
}
},
{
"fullUrl" : "urn:uuid:3f640e58-2f13-4d07-9356-8bc2ee64054d",
"resource" : {
"resourceType" : "ServiceRequest",
"id" : "3f640e58-2f13-4d07-9356-8bc2ee64054d",
"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_3f640e58-2f13-4d07-9356-8bc2ee64054d\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ServiceRequest 3f640e58-2f13-4d07-9356-8bc2ee64054d</b></p><a name=\"3f640e58-2f13-4d07-9356-8bc2ee64054d\"> </a><a name=\"hc3f640e58-2f13-4d07-9356-8bc2ee64054d\"> </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-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-1b315218-49b7-4264-816e-05d4b92ecbaa\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; 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:1b315218-49b7-4264-816e-05d4b92ecbaa",
"type" : "Patient"
}
}
},
{
"fullUrl" : "urn:uuid:ccd28c58-83e7-4657-b06a-53c8cc4ac94f",
"resource" : {
"resourceType" : "ServiceRequest",
"id" : "ccd28c58-83e7-4657-b06a-53c8cc4ac94f",
"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_ccd28c58-83e7-4657-b06a-53c8cc4ac94f\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ServiceRequest ccd28c58-83e7-4657-b06a-53c8cc4ac94f</b></p><a name=\"ccd28c58-83e7-4657-b06a-53c8cc4ac94f\"> </a><a name=\"hcccd28c58-83e7-4657-b06a-53c8cc4ac94f\"> </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-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-1b315218-49b7-4264-816e-05d4b92ecbaa\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; 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:1b315218-49b7-4264-816e-05d4b92ecbaa",
"type" : "Patient"
}
}
},
{
"fullUrl" : "urn:uuid:28d3f8af-7f77-43ed-9d84-ed67eaa2e674",
"resource" : {
"resourceType" : "MedicationRequest",
"id" : "28d3f8af-7f77-43ed-9d84-ed67eaa2e674",
"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_28d3f8af-7f77-43ed-9d84-ed67eaa2e674\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MedicationRequest 28d3f8af-7f77-43ed-9d84-ed67eaa2e674</b></p><a name=\"28d3f8af-7f77-43ed-9d84-ed67eaa2e674\"> </a><a name=\"hc28d3f8af-7f77-43ed-9d84-ed67eaa2e674\"> </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 venclexta}\">Venclexta</span></p><p><b>subject</b>: <a href=\"Bundle-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-1b315218-49b7-4264-816e-05d4b92ecbaa\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500</a></p><p><b>requester</b>: <a href=\"Bundle-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-78ef1b71-b14a-44a1-a1e8-c9c9efcc157c\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500</a></p><p><b>courseOfTherapyType</b>: <span title=\"Codes:\">CLL/SLL (Maint)</span></p><p><b>insurance</b>: <a href=\"Bundle-05c47586-a4e8-4ab2-9dff-51f73ff6bda3.html#urn-uuid-2722d5ae-1658-4d7f-8f64-de1299a1fb7f\">Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500</a></p><p><b>note</b>: </p><blockquote><div><p>Maintenance</p>\n</div></blockquote><blockquote><p><b>dosageInstruction</b></p><p><b>timing</b>: Once per 1 day</p><h3>DoseAndRates</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Dose[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>200 mg</td></tr></table></blockquote><blockquote><p><b>dispenseRequest</b></p><p><b>numberOfRepeatsAllowed</b>: 1</p><h3>ExpectedSupplyDurations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Unit</b></td><td><b>System</b></td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>mo</td><td><a href=\"http://terminology.hl7.org/6.4.0/CodeSystem-v3-ucum.html\">http://unitsofmeasure.org</a></td><td>mo</td></tr></table></blockquote></div>"
},
"status" : "active",
"intent" : "order",
"medicationCodeableConcept" : {
"coding" : [
{
"system" : "https://fhir.developer.gene.com/CodeSystem/uapi-product-name",
"code" : "venclexta",
"display" : "Venclexta"
}
]
},
"subject" : {
"reference" : "urn:uuid:1b315218-49b7-4264-816e-05d4b92ecbaa",
"type" : "Patient"
},
"requester" : {
"reference" : "urn:uuid:78ef1b71-b14a-44a1-a1e8-c9c9efcc157c",
"type" : "Practitioner"
},
"courseOfTherapyType" : {
"text" : "CLL/SLL (Maint)"
},
"insurance" : [
{
"reference" : "urn:uuid:2722d5ae-1658-4d7f-8f64-de1299a1fb7f",
"type" : "Coverage"
}
],
"note" : [
{
"text" : "Maintenance"
}
],
"dosageInstruction" : [
{
"timing" : {
"repeat" : {
"frequency" : 1,
"period" : 1,
"periodUnit" : "d"
}
},
"doseAndRate" : [
{
"doseQuantity" : {
"value" : 200,
"unit" : "mg"
}
}
]
}
],
"dispenseRequest" : {
"numberOfRepeatsAllowed" : 1,
"expectedSupplyDuration" : {
"value" : 1,
"unit" : "mo",
"system" : "http://unitsofmeasure.org",
"code" : "mo"
}
}
}
},
{
"fullUrl" : "urn:uuid:e551b51b-0646-4b23-b1ac-9ec623756ec6",
"resource" : {
"resourceType" : "Organization",
"id" : "e551b51b-0646-4b23-b1ac-9ec623756ec6",
"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_e551b51b-0646-4b23-b1ac-9ec623756ec6\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization e551b51b-0646-4b23-b1ac-9ec623756ec6</b></p><a name=\"e551b51b-0646-4b23-b1ac-9ec623756ec6\"> </a><a name=\"hce551b51b-0646-4b23-b1ac-9ec623756ec6\"> </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
}
]
}
},
{
"fullUrl" : "urn:uuid:694ce192-7b69-4d75-8f91-0031bb2b0811",
"resource" : {
"resourceType" : "QuestionnaireResponse",
"id" : "694ce192-7b69-4d75-8f91-0031bb2b0811",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"QuestionnaireResponse_694ce192-7b69-4d75-8f91-0031bb2b0811\"> </a><p class=\"res-header-id\"><b>Generated Narrative: QuestionnaireResponse 694ce192-7b69-4d75-8f91-0031bb2b0811</b></p><a name=\"694ce192-7b69-4d75-8f91-0031bb2b0811\"> </a><a name=\"hc694ce192-7b69-4d75-8f91-0031bb2b0811\"> </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\"/> 694ce192-7b69-4d75-8f91-0031bb2b0811</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\">#3456789</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\">2022-02-28</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\">OSP - name</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\"/> pharmacy-contact-person-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\">Pharmacy Contact Person (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\">Ph contact</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\"/> pharmacy-phone-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\">Pharmacy Phone (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\">222-222-2222</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\">PSP Name</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\">No</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> 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\">First</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\"/> prescription-plan</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Is this a Prescription plan?</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">No</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> re-verify-benefits-at-pa-expiration</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Re-verify benefits at PA expiration</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">No</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> 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_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\"/> certify-patient-for-copay-program</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\">Co-pay program Commercial Insurance</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">No</td></tr>\r\n<tr><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:1b315218-49b7-4264-816e-05d4b92ecbaa",
"type" : "Patient"
},
"item" : [
{
"linkId" : "authorization",
"text" : "Authorization #",
"answer" : [
{
"valueString" : "#3456789"
}
]
},
{
"linkId" : "dot",
"text" : "Date of Treatment",
"answer" : [
{
"valueDate" : "2022-02-28"
}
]
},
{
"linkId" : "opn-optional",
"text" : "Onsite Pharmacy Name (Optional)",
"answer" : [
{
"valueString" : "OSP - name"
}
]
},
{
"linkId" : "pharmacy-contact-person-optional",
"text" : "Pharmacy Contact Person (Optional)",
"answer" : [
{
"valueString" : "Ph contact"
}
]
},
{
"linkId" : "pharmacy-phone-optional",
"text" : "Pharmacy Phone (Optional)",
"answer" : [
{
"valueString" : "222-222-2222"
}
]
},
{
"linkId" : "preferred-sp-optional",
"text" : "Preferred Specialty Pharmacy (Optional)",
"answer" : [
{
"valueString" : "PSP Name"
}
]
},
{
"linkId" : "contact-patient",
"text" : "Do not contact patient",
"answer" : [
{
"valueString" : "No"
}
]
},
{
"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" : "First"
}
]
},
{
"linkId" : "onsite-pharmacy",
"text" : "Onsite Pharmacy?",
"answer" : [
{
"valueString" : "Yes"
}
]
},
{
"linkId" : "pa-in-place",
"text" : "Is prior authorization in place?",
"answer" : [
{
"valueString" : "Yes"
}
]
},
{
"linkId" : "prescription-plan",
"text" : "Is this a Prescription plan?",
"answer" : [
{
"valueString" : "No"
}
]
},
{
"linkId" : "re-verify-benefits-at-pa-expiration",
"text" : "Re-verify benefits at PA expiration",
"answer" : [
{
"valueString" : "No"
}
]
},
{
"linkId" : "specialty-pharmacy",
"text" : "Specialty Pharmacy?",
"answer" : [
{
"valueString" : "Yes"
}
]
},
{
"linkId" : "tcpa-consent",
"text" : "TCPA Consent Provided?",
"answer" : [
{
"valueString" : "Yes"
}
]
},
{
"linkId" : "certify-patient-for-copay-program",
"text" : "Co-pay program Commercial Insurance",
"answer" : [
{
"valueString" : "No"
}
]
}
]
}
}
]
}