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Packagehl7.fhir.us.davinci-pct.r4b
Resource TypeBundle
IdBundle-PCT-GFE-Missing-Bundle-1.json
FHIR VersionR4B

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Narrative

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Source1

{
  "resourceType": "Bundle",
  "id": "PCT-GFE-Missing-Bundle-1",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-missing-bundle"
    ]
  },
  "identifier": {
    "system": "http://example.com/identifiers/bundle",
    "value": "59688475-2324-3242-2347384376"
  },
  "type": "collection",
  "timestamp": "2024-03-27T11:01:00+05:00",
  "entry": [
    {
      "fullUrl": "http://example.org/fhir/Organization/org1002",
      "resource": {
        "resourceType": "Organization",
        "id": "org1002",
        "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_org1002\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization org1002</b></p><a name=\"org1002\"> </a><a name=\"hcorg1002\"> </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>: <a href=\"http://terminology.hl7.org/6.5.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/9941339100, Tax ID number/TAX-3211001</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: Boston Radiology Center</p><p><b>telecom</b>: ph: 781-232-3200(Work)</p><p><b>address</b>: 32 Fruit Street Boston MA 02114 US </p></div>"
        },
        "identifier": [
          {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9941339100"
          },
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "TAX"
                }
              ]
            },
            "system": "urn:oid:2.16.840.1.113883.4.4",
            "value": "TAX-3211001"
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "prov",
                "display": "Healthcare Provider"
              }
            ]
          }
        ],
        "name": "Boston Radiology Center",
        "telecom": [
          {
            "system": "phone",
            "value": "781-232-3200",
            "use": "work"
          }
        ],
        "address": [
          {
            "line": [
              "32 Fruit Street"
            ],
            "city": "Boston",
            "state": "MA",
            "postalCode": "02114",
            "country": "US"
          }
        ]
      }
    },
    {
      "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 --&gt; 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-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"
        }
      }
    }
  ]
}