FHIR IG analytics| Package | hl7.fhir.us.davinci-pct |
| Resource Type | Bundle |
| Id | Bundle-PCT-GFE-Information-Bundle-1.json |
| FHIR Version | R4 |
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No resources found
No narrative content found in resource
FHIR
FHIRsmith{
"resourceType": "Bundle",
"id": "PCT-GFE-Information-Bundle-1",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-information-bundle"
]
},
"identifier": {
"system": "http://example.com/identifiers/bundle",
"value": "59688475-2324-3242-2347384711"
},
"type": "collection",
"timestamp": "2024-03-27T11:01:00+05:00",
"entry": [
{
"fullUrl": "http://example.org/fhir/Patient/patient1001",
"resource": {
"resourceType": "Patient",
"id": "patient1001",
"meta": {
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|7.0.0"
]
},
"text": {
"status": "additional",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_patient1001\"> </a><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\"><b>Eve Betterhalf</b> female, DoB: 1955-07-23 ( <code>http://example.com/identifiers/patient</code>/1001)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Known Marital status of Patient\">Marital Status:</td><td colspan=\"3\"><span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus U}\">unmarried</span></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Details:</td><td colspan=\"3\"><ul><li>ph: 781-949-4949(MOBILE)</li><li>222 Burlington Road, Bedford MA 01730</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Languages spoken\">Language:</td><td colspan=\"3\"><span title=\"Codes: {urn:ietf:bcp:47 en-US}\">English (United States)</span> (preferred)</td></tr></table></div>"
},
"identifier": [
{
"system": "http://example.com/identifiers/patient",
"value": "1001"
}
],
"name": [
{
"text": "Eve Betterhalf",
"family": "Betterhalf",
"given": [
"Eve"
]
}
],
"telecom": [
{
"system": "phone",
"value": "781-949-4949",
"use": "mobile"
}
],
"gender": "female",
"birthDate": "1955-07-23",
"address": [
{
"text": "222 Burlington Road, Bedford MA 01730"
}
],
"maritalStatus": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
"code": "U",
"display": "unmarried"
}
]
},
"communication": [
{
"language": {
"coding": [
{
"system": "urn:ietf:bcp:47",
"code": "en-US",
"display": "English (United States)"
}
]
},
"preferred": true
}
]
}
},
{
"fullUrl": "http://example.org/fhir/Coverage/coverage1001",
"resource": {
"resourceType": "Coverage",
"id": "coverage1001",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage"
]
},
"text": {
"status": "extensions",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Coverage_coverage1001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage coverage1001</b></p><a name=\"coverage1001\"> </a><a name=\"hccoverage1001\"> </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-davinci-pct-coverage.html\">PCT Coverage</a></p></div><p><b>Extension Definition for Coverage.kind for Version 5.0</b>: insurance</p><p><b>status</b>: Active</p><p><b>subscriberId</b>: PFP123450000</p><p><b>beneficiary</b>: <a href=\"Patient-patient1001.html\">Eve Betterhalf Female, DoB: 1955-07-23 ( http://example.com/identifiers/patient#1001)</a></p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}\">Self</span></p><p><b>period</b>: 2021-01-01 --> 2022-01-01</p><p><b>payor</b>: <a href=\"Organization-org1001.html\">Organization Umbrella Insurance Company</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 plan}\">Plan</span></td><td>Premim Family Plus</td><td>Premim Family Plus Plan</td></tr></table><h3>CostToBeneficiaries</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-copay-type copaypct}\">Copay Percentage</span></td><td>20</td></tr></table></div>"
},
"extension": [
{
"url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Coverage.kind",
"valueCode": "insurance"
}
],
"status": "active",
"subscriberId": "PFP123450000",
"beneficiary": {
"reference": "Patient/patient1001"
},
"relationship": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
"code": "self",
"display": "Self"
}
]
},
"period": {
"start": "2021-01-01",
"end": "2022-01-01"
},
"payor": [
{
"reference": "Organization/org1001"
}
],
"class": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "plan",
"display": "Plan"
}
]
},
"value": "Premim Family Plus",
"name": "Premim Family Plus Plan"
}
],
"costToBeneficiary": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-copay-type",
"code": "copaypct",
"display": "Copay Percentage"
}
]
},
"valueQuantity": {
"value": 20
}
}
]
}
},
{
"fullUrl": "http://example.org/fhir/Organization/org1001",
"resource": {
"resourceType": "Organization",
"id": "org1001",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_org1001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization org1001</b></p><a name=\"org1001\"> </a><a name=\"hcorg1001\"> </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-davinci-pct-organization.html\">PCT Organization</a></p></div><p><b>identifier</b>: Electronic Transmitter Identification Number/ETIN-3200002</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type pay}\">Payer</span></p><p><b>name</b>: Umbrella Insurance Company</p><p><b>telecom</b>: ph: 860-547-5001(Work)</p><p><b>address</b>: 680 Asylum Street Hartford CT 06155 US </p></div>"
},
"identifier": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "ETIN"
}
]
},
"value": "ETIN-3200002"
}
],
"active": true,
"type": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/organization-type",
"code": "pay",
"display": "Payer"
}
]
}
],
"name": "Umbrella Insurance Company",
"telecom": [
{
"system": "phone",
"value": "860-547-5001",
"use": "work"
}
],
"address": [
{
"line": [
"680 Asylum Street"
],
"city": "Hartford",
"state": "CT",
"postalCode": "06155",
"country": "US"
}
]
}
},
{
"id": "PCT-ServiceLocation-1",
"fullUrl": "http://example.org/fhir/Location/PCT-ServiceLocation-1",
"resource": {
"resourceType": "Location",
"id": "PCT-ServiceLocation-1",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-service-location"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Location_PCT-ServiceLocation-1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Location PCT-ServiceLocation-1</b></p><a name=\"PCT-ServiceLocation-1\"> </a><a name=\"hcPCT-ServiceLocation-1\"> </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-davinci-pct-service-location.html\">PCT Service Location</a></p></div><p><b>status</b>: Active</p><p><b>name</b>: Hospital</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-RoleCode HOSP}\">Hospital</span></p></div>"
},
"status": "active",
"name": "Hospital",
"type": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code": "HOSP",
"display": "Hospital"
}
]
}
]
}
},
{
"id": "PCT-ServiceRequest-1",
"fullUrl": "http://example.org/fhir/ServiceRequest/PCT-ServiceRequest-1",
"resource": {
"resourceType": "ServiceRequest",
"id": "PCT-ServiceRequest-1",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-servicerequest"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ServiceRequest_PCT-ServiceRequest-1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ServiceRequest PCT-ServiceRequest-1</b></p><a name=\"PCT-ServiceRequest-1\"> </a><a name=\"hcPCT-ServiceRequest-1\"> </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-davinci-pct-servicerequest.html\">PCT GFE ServiceRequest</a></p></div><p><b>status</b>: Active</p><p><b>intent</b>: Proposal</p><p><b>code</b>: <span title=\"Codes:{http://www.ama-assn.org/go/cpt 73722}\">Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)</span></p><p><b>subject</b>: <a href=\"Patient-patient1001.html\">Eve Betterhalf Female, DoB: 1955-07-23 ( http://example.com/identifiers/patient#1001)</a></p></div>"
},
"status": "active",
"intent": "proposal",
"code": {
"coding": [
{
"system": "http://www.ama-assn.org/go/cpt",
"code": "73722",
"display": "Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)"
}
]
},
"subject": {
"reference": "Patient/patient1001"
}
}
},
{
"id": "PCT-DeviceRequest-1",
"fullUrl": "http://example.org/fhir/DeviceRequest/PCT-DeviceRequest-1",
"resource": {
"resourceType": "DeviceRequest",
"id": "PCT-DeviceRequest-1",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-devicerequest"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"DeviceRequest_PCT-DeviceRequest-1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: DeviceRequest PCT-DeviceRequest-1</b></p><a name=\"PCT-DeviceRequest-1\"> </a><a name=\"hcPCT-DeviceRequest-1\"> </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-davinci-pct-devicerequest.html\">PCT GFE DeviceRequest</a></p></div><p><b>status</b>: Active</p><p><b>intent</b>: Proposal</p><p><b>code</b>: <span title=\"Codes:{http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets L1820}\">KNEE ORTHOSIS, ELASTIC WITH CONDYLAR PADS AND JOINTS, WITH OR WITHOUT PATELLAR CONTROL, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT</span></p><p><b>subject</b>: <a href=\"Patient-patient1001.html\">Eve Betterhalf Female, DoB: 1955-07-23 ( http://example.com/identifiers/patient#1001)</a></p></div>"
},
"status": "active",
"intent": "proposal",
"codeCodeableConcept": {
"coding": [
{
"system": "http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets",
"code": "L1820",
"display": "KNEE ORTHOSIS, ELASTIC WITH CONDYLAR PADS AND JOINTS, WITH OR WITHOUT PATELLAR CONTROL, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT"
}
]
},
"subject": {
"reference": "Patient/patient1001"
}
}
}
]
}