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Packagehl7.fhir.us.davinci-pcde
Resource TypeBundle
IdBundle-pcde-document.json
FHIR VersionR4

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Resources that this resource uses

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Narrative

No narrative content found in resource


Source1

{
  "resourceType": "Bundle",
  "id": "pcde-document",
  "meta": {
    "lastUpdated": "2019-07-21T11:01:00+05:00"
  },
  "identifier": {
    "system": "http://originalinsuranceinc.com/documentIDs",
    "value": "A12345"
  },
  "type": "document",
  "timestamp": "2019-07-21T11:01:00+05:00",
  "entry": [
    {
      "fullUrl": "http://originalinsuranceinc.com/fhir/Composition/1",
      "resource": {
        "resourceType": "Composition",
        "id": "1",
        "meta": {
          "profile": [
            "http://hl7.org/fhir/us/davinci-pcde/StructureDefinition/profile-composition"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Composition</b></p><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\">Resource Composition \"1\" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-composition.html\">PCDE Coverage Transition Composition Profile</a></p></div><p><b>status</b>: final</p><p><b>type</b>: Coverage Transition Document <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-PCDEtempCodes.html\">PCDE Temporary Codes</a>#pcde)</span></p><p><b>date</b>: 2019-07-21 11:09:00+0700</p><p><b>author</b>: <a href=\"#Practitioner_1\">See above (Practitioner/1)</a></p><p><b>title</b>: Coverage Decision Exchange Document (Joe Smith, 2019-07-21)</p><h3>Events</h3><table class=\"grid\"><tr><td>-</td><td><b>Detail</b></td></tr><tr><td>*</td><td><a href=\"#Coverage_1\">See above (Coverage/1)</a></td></tr></table></div>"
        },
        "status": "final",
        "type": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/us/davinci-pcde/CodeSystem/PCDEtempCodes",
              "code": "pcde"
            }
          ]
        },
        "subject": {
          "reference": "Patient/1"
        },
        "date": "2019-07-21T23:09:00+07:00",
        "author": [
          {
            "reference": "Practitioner/1"
          }
        ],
        "title": "Coverage Decision Exchange Document (Joe Smith, 2019-07-21)",
        "event": [
          {
            "detail": [
              {
                "reference": "Coverage/1"
              }
            ]
          }
        ],
        "section": [
          {
            "title": "Active Treatments",
            "code": {
              "coding": [
                {
                  "system": "http://hl7.org/fhir/us/davinci-pcde/CodeSystem/PCDEtempCodes",
                  "code": "activeTreatment"
                }
              ]
            },
            "section": [
              {
                "title": "Consulation re: MCI",
                "code": {
                  "coding": [
                    {
                      "system": "http://hl7.org/fhir/us/davinci-pcde/CodeSystem/PCDEtempCodes",
                      "code": "treatment"
                    }
                  ]
                },
                "entry": [
                  {
                    "reference": "CarePlan/1"
                  }
                ]
              },
              {
                "title": "Prior coverage",
                "code": {
                  "coding": [
                    {
                      "system": "http://hl7.org/fhir/us/davinci-pcde/CodeSystem/PCDEtempCodes",
                      "code": "priorCoverage"
                    }
                  ]
                },
                "entry": [
                  {
                    "reference": "Claim/1"
                  },
                  {
                    "reference": "ClaimResponse/1"
                  }
                ]
              },
              {
                "title": "Supporting information",
                "code": {
                  "coding": [
                    {
                      "system": "http://hl7.org/fhir/us/davinci-pcde/CodeSystem/PCDEtempCodes",
                      "code": "supportingInfo"
                    }
                  ]
                },
                "text": {
                  "status": "generated",
                  "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n                                Joe Smith is a subscriber to Maryland Capital Insurance Company. During a regular physical, Dr. James Gardener, Joe’s primary care physician, diagnosed a potential heart problem, acute myocardial infarction; unspecified site. \n                                Dr. Gardener had referred Joe to Dr. Susan Watson, a cardiologist for a consultation.\n                                During the consultation examination, Dr. Watson determined that Joe’s diagnosis requires hospitalization and a surgical procedure, a triple bypass venous graft. \n                                The operation and recovery was at Montgomery Hospital.\n                            </div>"
                },
                "entry": [
                  {
                    "reference": "DocumentReference/1"
                  }
                ]
              }
            ]
          }
        ]
      }
    },
    {
      "fullUrl": "http://originalinsuranceinc.com/fhir/Patient/1",
      "resource": {
        "resourceType": "Patient",
        "id": "1",
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Patient</b></p><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\">Resource Patient \"1\" </p></div><p><b>identifier</b>: id: 444222222</p><p><b>name</b>: JOE SMITH </p><p><b>gender</b>: male</p></div>"
        },
        "identifier": [
          {
            "system": "http://originalinsuranceinc.com/fhir/NamingSystem/client-ids",
            "value": "444222222"
          }
        ],
        "name": [
          {
            "family": "SMITH",
            "given": [
              "JOE"
            ]
          }
        ],
        "gender": "male"
      }
    },
    {
      "fullUrl": "http://originalinsuranceinc.com/fhir/Coverage/1",
      "resource": {
        "resourceType": "Coverage",
        "id": "1",
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Coverage</b></p><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\">Resource Coverage \"1\" </p></div><p><b>status</b>: active</p><p><b>subscriberId</b>: 12345678</p><p><b>beneficiary</b>: <a href=\"#Patient_1\">See above (Patient/1)</a></p><p><b>payor</b>: <a href=\"#Organization_1\">See above (Organization/1)</a></p></div>"
        },
        "status": "active",
        "subscriberId": "12345678",
        "beneficiary": {
          "reference": "Patient/1"
        },
        "payor": [
          {
            "reference": "Organization/1"
          }
        ]
      }
    },
    {
      "fullUrl": "http://originalinsuranceinc.com/fhir/Organization/1",
      "resource": {
        "resourceType": "Organization",
        "id": "1",
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b></p><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\">Resource Organization \"1\" </p></div><p><b>identifier</b>: id: 789312</p><p><b>active</b>: true</p><p><b>name</b>: MARYLAND CAPITAL INSURANCE COMPANY</p></div>"
        },
        "identifier": [
          {
            "system": "http://originalinsuranceinc.com/fhir/NamingSystem/ETIN",
            "value": "789312"
          }
        ],
        "active": true,
        "name": "MARYLAND CAPITAL INSURANCE COMPANY"
      }
    },
    {
      "fullUrl": "http://originalinsuranceinc.com/fhir/CarePlan/1",
      "resource": {
        "resourceType": "CarePlan",
        "id": "1",
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: CarePlan</b></p><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\">Resource CarePlan \"1\" </p></div><p><b>instantiatesUri</b>: <a href=\"http://originalinsuranceinc.com/consultReviewURI\">http://originalinsuranceinc.com/consultReviewURI</a></p><p><b>status</b>: active</p><p><b>intent</b>: plan</p><p><b>category</b>: Assessment and Plan of Treatment <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-careplan-category.html\">US Core CarePlan Category Extension Codes</a>#assess-plan)</span></p><p><b>subject</b>: <a href=\"#Patient_1\">See above (Patient/1)</a></p><blockquote><p><b>activity</b></p><h3>Details</h3><table class=\"grid\"><tr><td>-</td><td><b>Code</b></td><td><b>ReasonReference</b></td><td><b>Status</b></td></tr><tr><td>*</td><td>Consultation <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (SERVICE_TYPE_CODE#3)</span></td><td><a href=\"#Condition_1\">See above (Condition/1)</a></td><td>in-progress</td></tr></table></blockquote></div>"
        },
        "instantiatesUri": [
          "http://originalinsuranceinc.com/consultReviewURI"
        ],
        "status": "active",
        "intent": "plan",
        "category": [
          {
            "coding": [
              {
                "system": "http://hl7.org/fhir/us/core/CodeSystem/careplan-category",
                "code": "assess-plan"
              }
            ]
          }
        ],
        "subject": {
          "reference": "Patient/1"
        },
        "activity": [
          {
            "detail": {
              "code": {
                "coding": [
                  {
                    "system": "http://example.org/SERVICE_TYPE_CODE",
                    "code": "3",
                    "display": "Consultation"
                  }
                ]
              },
              "reasonReference": [
                {
                  "reference": "Condition/1"
                }
              ],
              "status": "in-progress"
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://originalinsuranceinc.com/fhir/Claim/1",
      "resource": {
        "resourceType": "Claim",
        "id": "1",
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Claim</b></p><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\">Resource Claim \"1\" </p></div><p><b>identifier</b>: id: 111099</p><p><b>status</b>: active</p><p><b>type</b>: Professional <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-claim-type.html\">Claim Type Codes</a>#professional)</span></p><p><b>use</b>: preauthorization</p><p><b>patient</b>: <a href=\"#Patient_1\">See above (Patient/1)</a></p><p><b>created</b>: 2019-07-20</p><p><b>insurer</b>: <a href=\"#Organization_1\">See above (Organization/1)</a></p><p><b>provider</b>: <a href=\"http://example.org/fhir/Organization/provider\">http://example.org/fhir/Organization/provider</a></p><p><b>priority</b>: Normal <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-processpriority.html\">Process Priority Codes</a>#normal)</span></p><h3>CareTeams</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Provider</b></td></tr><tr><td>*</td><td>1</td><td><a href=\"http://example.org/fhir/Organization/provider\">http://example.org/fhir/Organization/provider</a></td></tr></table><h3>Diagnoses</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td>*</td><td>1</td><td>Chronic pain syndrome <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-icd10CM.html\">International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)</a>#G89.4)</span></td></tr></table><h3>Insurances</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td>*</td><td>1</td><td>true</td><td><a href=\"#Coverage_1\">See above (Coverage/1)</a></td></tr></table><h3>Items</h3><table class=\"grid\"><tr><td>-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>CareTeamSequence</b></td><td><b>DiagnosisSequence</b></td><td><b>ProductOrService</b></td><td><b>Location[x]</b></td></tr><tr><td>*</td><td>, , </td><td>1</td><td>1</td><td>1</td><td>Consultation <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (1365#3)</span></td><td>11 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-CMSPlaceofServiceCodes.html\">CMS Place of Service Codes (POS)</a>#11)</span></td></tr></table></div>"
        },
        "identifier": [
          {
            "system": "http://example.org/PATIENT_EVENT_TRACE_NUMBER",
            "value": "111099",
            "assigner": {
              "identifier": {
                "system": "http://example.org/USER_ASSIGNED",
                "value": "9012345678"
              }
            }
          }
        ],
        "status": "active",
        "type": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/claim-type",
              "code": "professional"
            }
          ]
        },
        "use": "preauthorization",
        "patient": {
          "reference": "Patient/1"
        },
        "created": "2019-07-20",
        "insurer": {
          "reference": "Organization/1"
        },
        "provider": {
          "reference": "http://example.org/fhir/Organization/provider"
        },
        "priority": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/processpriority",
              "code": "normal",
              "display": "Normal"
            }
          ]
        },
        "careTeam": [
          {
            "sequence": 1,
            "provider": {
              "reference": "http://example.org/fhir/Organization/provider"
            }
          }
        ],
        "diagnosis": [
          {
            "sequence": 1,
            "diagnosisCodeableConcept": {
              "coding": [
                {
                  "system": "http://hl7.org/fhir/sid/icd-10-cm",
                  "code": "G89.4"
                }
              ]
            }
          }
        ],
        "insurance": [
          {
            "sequence": 1,
            "focal": true,
            "coverage": {
              "reference": "Coverage/1"
            }
          }
        ],
        "item": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType",
                "valueCodeableConcept": {
                  "coding": [
                    {
                      "system": "http://codesystem.x12.org/005010/1525",
                      "code": "SC",
                      "display": "Specialty Care Review"
                    }
                  ]
                }
              },
              {
                "url": "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType",
                "valueCodeableConcept": {
                  "coding": [
                    {
                      "system": "http://codesystem.x12.org/005010/1322",
                      "code": "I",
                      "display": "Initial"
                    }
                  ]
                }
              },
              {
                "url": "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService",
                "valueReference": {
                  "reference": "ServiceRequest/1"
                }
              }
            ],
            "sequence": 1,
            "careTeamSequence": [
              1
            ],
            "diagnosisSequence": [
              1
            ],
            "productOrService": {
              "coding": [
                {
                  "system": "http://codesystem.x12.org/005010/1365",
                  "code": "3",
                  "display": "Consultation"
                }
              ]
            },
            "locationCodeableConcept": {
              "coding": [
                {
                  "system": "https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set",
                  "code": "11"
                }
              ]
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://originalinsuranceinc.com/fhir/ClaimResponse/1",
      "resource": {
        "resourceType": "ClaimResponse",
        "id": "1",
        "text": {
          "status": "extensions",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: ClaimResponse</b></p><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\">Resource ClaimResponse \"1\" </p></div><p><b>identifier</b>: id: 111099</p><p><b>status</b>: active</p><p><b>type</b>: Professional <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-claim-type.html\">Claim Type Codes</a>#professional)</span></p><p><b>use</b>: preauthorization</p><p><b>patient</b>: <a href=\"#Patient_1\">See above (Patient/1)</a></p><p><b>created</b>: 2019-07-20</p><p><b>insurer</b>: <a href=\"#Organization_1\">See above (Organization/1)</a></p><p><b>requestor</b>: <a href=\"http://example.org/fhir/Organization/provider\">http://example.org/fhir/Organization/provider</a></p><p><b>outcome</b>: complete</p><blockquote><p><b>item</b></p><blockquote><p><b>ReviewAction</b></p><p><b>value</b>: AUTH0001</p><p><b>value</b>: Certified in total <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (306#A1)</span></p></blockquote><p><b>AuthorizedDate</b>: 2005-05-02 --&gt; 2005-06-02</p><p><b>itemSequence</b>: 1</p><h3>Adjudications</h3><table class=\"grid\"><tr><td>-</td><td><b>Category</b></td></tr><tr><td>*</td><td>Submitted Amount <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-adjudication.html\">Adjudication Value Codes</a>#submitted)</span></td></tr></table></blockquote></div>"
        },
        "identifier": [
          {
            "system": "http://example.org/PATIENT_EVENT_TRACE_NUMBER",
            "value": "111099",
            "assigner": {
              "identifier": {
                "system": "http://example.org/USER_ASSIGNED",
                "value": "9012345678"
              }
            }
          }
        ],
        "status": "active",
        "type": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/claim-type",
              "code": "professional"
            }
          ]
        },
        "use": "preauthorization",
        "patient": {
          "reference": "Patient/1"
        },
        "created": "2019-07-20",
        "insurer": {
          "reference": "Organization/1"
        },
        "requestor": {
          "reference": "http://example.org/fhir/Organization/provider"
        },
        "outcome": "complete",
        "item": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction",
                "extension": [
                  {
                    "url": "number",
                    "valueString": "AUTH0001"
                  },
                  {
                    "url": "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewActionCode",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://codesystem.x12.org/005010/306",
                          "code": "A1",
                          "display": "Certified in total"
                        }
                      ]
                    }
                  }
                ]
              },
              {
                "url": "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDate",
                "valuePeriod": {
                  "start": "2005-05-02",
                  "end": "2005-06-02"
                }
              }
            ],
            "itemSequence": 1,
            "adjudication": [
              {
                "category": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                      "code": "submitted"
                    }
                  ]
                }
              }
            ]
          }
        ]
      }
    },
    {
      "fullUrl": "http://originalinsuranceinc.com/fhir/Practitioner/1",
      "resource": {
        "resourceType": "Practitioner",
        "id": "1",
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Practitioner</b></p><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\">Resource Practitioner \"1\" </p></div><p><b>identifier</b>: id: 8189991234</p><p><b>name</b>: JAMES GARDENER </p></div>"
        },
        "identifier": [
          {
            "system": "http://originalinsuranceinc.com/fhir/NamingSystem/ETIN",
            "value": "8189991234"
          }
        ],
        "name": [
          {
            "family": "GARDENER",
            "given": [
              "JAMES"
            ]
          }
        ]
      }
    },
    {
      "fullUrl": "http://originalinsuranceinc.com/fhir/ServiceRequest/1",
      "resource": {
        "resourceType": "ServiceRequest",
        "id": "1",
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: ServiceRequest</b></p><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\">Resource ServiceRequest \"1\" </p></div><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>code</b>: Consultation <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (1365#3)</span></p><p><b>quantity</b>: 1 VS</p><p><b>subject</b>: <a href=\"#Patient_1\">See above (Patient/1)</a></p><p><b>performer</b>: <a href=\"#PractitionerRole_1\">See above (PractitionerRole/1)</a></p></div>"
        },
        "status": "active",
        "intent": "order",
        "code": {
          "coding": [
            {
              "system": "http://codesystem.x12.org/005010/1365",
              "code": "3",
              "display": "Consultation"
            }
          ]
        },
        "quantityQuantity": {
          "value": 1,
          "unit": "VS"
        },
        "subject": {
          "reference": "Patient/1"
        },
        "performer": [
          {
            "reference": "PractitionerRole/1"
          }
        ]
      }
    },
    {
      "fullUrl": "http://originalinsuranceinc.com/fhir/Condition/1",
      "resource": {
        "resourceType": "Condition",
        "id": "1",
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Condition</b></p><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\">Resource Condition \"1\" </p></div><p><b>category</b>: Encounter Diagnosis <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-condition-category.html\">Condition Category Codes</a>#encounter-diagnosis)</span></p><p><b>code</b>: Acute myocardial infarction of unspecified site, episode of care unspecified <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (icd-9-cm#410.90)</span></p><p><b>subject</b>: <a href=\"#Patient_1\">See above (Patient/1)</a></p><p><b>recordedDate</b>: 2005-04-30</p></div>"
        },
        "category": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/condition-category",
                "code": "encounter-diagnosis"
              }
            ]
          }
        ],
        "code": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/sid/icd-9-cm",
              "code": "410.90"
            }
          ]
        },
        "subject": {
          "reference": "Patient/1"
        },
        "recordedDate": "2005-04-30"
      }
    },
    {
      "fullUrl": "http://originalinsuranceinc.com/fhir/PractitionerRole/1",
      "resource": {
        "resourceType": "PractitionerRole",
        "id": "1",
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: PractitionerRole</b></p><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\">Resource PractitionerRole \"1\" </p></div><p><b>practitioner</b>: <a href=\"#Practitioner_2\">See above (Practitioner/2)</a></p><p><b>code</b>: Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (ENTITY_IDENTIFIER_CODE#1P)</span></p></div>"
        },
        "practitioner": {
          "reference": "Practitioner/2"
        },
        "code": [
          {
            "coding": [
              {
                "system": "http://example.org/fhir/NamingSystem/ENTITY_IDENTIFIER_CODE",
                "code": "1P",
                "display": "Provider"
              }
            ]
          }
        ]
      }
    },
    {
      "fullUrl": "http://originalinsuranceinc.com/fhir/Practitioner/2",
      "resource": {
        "resourceType": "Practitioner",
        "id": "2",
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Practitioner</b></p><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\">Resource Practitioner \"2\" </p></div><p><b>identifier</b>: id: 987654321</p><p><b>name</b>: SUSAN WATSON </p><p><b>telecom</b>: ph: 4029993456</p></div>"
        },
        "identifier": [
          {
            "system": "http://originalinsuranceinc.com/fhir/NamingSystem/practitioner-id",
            "value": "987654321"
          }
        ],
        "name": [
          {
            "family": "WATSON",
            "given": [
              "SUSAN"
            ]
          }
        ],
        "telecom": [
          {
            "system": "phone",
            "value": "4029993456"
          }
        ]
      }
    },
    {
      "fullUrl": "http://originalinsuranceinc.com/fhir/DocumentReference/1",
      "resource": {
        "resourceType": "DocumentReference",
        "id": "1",
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: DocumentReference</b></p><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\">Resource DocumentReference \"1\" </p></div><p><b>status</b>: current</p><p><b>docStatus</b>: final</p><p><b>type</b>: Discharge summary <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#18842-5)</span></p><p><b>subject</b>: <a href=\"#Patient_1\">See above (Patient/1)</a></p><p><b>author</b>: <a href=\"#Practitioner_1\">See above (Practitioner/1)</a></p><blockquote><p><b>content</b></p></blockquote></div>"
        },
        "status": "current",
        "docStatus": "final",
        "type": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "18842-5"
            }
          ]
        },
        "subject": {
          "reference": "Patient/1"
        },
        "author": [
          {
            "reference": "Practitioner/1"
          }
        ],
        "content": [
          {
            "attachment": {
              "url": "http://originalinsuranceinc.com/fhir/Binary/DischargeSummaryDocument"
            }
          }
        ]
      }
    }
  ]
}