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Packageodilab.evo
Resource TypeBundle
IdBundle-HiMiBundle.json
FHIR VersionR4

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Source1

{
  "resourceType": "Bundle",
  "id": "HiMiBundle",
  "meta": {
    "profile": [
      "http://fhir.odilab.de/StructureDefinition/ERPBundleHiMi"
    ]
  },
  "identifier": {
    "system": "https://gematik.de/fhir/NamingSystem/PrescriptionID",
    "value": "162.240.219.130.055.90"
  },
  "entry": [
    {
      "fullUrl": "Composition/416b7bc3-7483-46ba-bc67-306bf671c569",
      "resource": {
        "resourceType": "Composition",
        "id": "416b7bc3-7483-46ba-bc67-306bf671c569",
        "meta": {
          "profile": [
            "http://fhir.odilab.de/StructureDefinition/CompositionHiMi"
          ]
        },
        "extension": [
          {
            "valueCoding": {
              "system": "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_STATUSKENNZEICHEN",
              "code": "00"
            },
            "url": "https://fhir.kbv.de/StructureDefinition/KBV_EX_FOR_Legal_basis"
          }
        ],
        "type": {
          "coding": [
            {
              "system": "https://fhir.odilab.de/ValueSet/VS_HIMI_HEIMI_KBV_FORMULAR_ART",
              "code": "e15H"
            }
          ]
        },
        "subject": {
          "reference": "Patient/416b7bc3-7483-46ba-bc67-306bf671c569"
        },
        "author": [
          {
            "type": "Practitioner",
            "reference": "Practitioner/416b7bc3-7483-46ba-bc67-306bf671c569"
          },
          {
            "identifier": {
              "system": "https://fhir.kbv.de/NamingSystem/KBV_NS_FOR_Pruefnummer",
              "value": "Y/400/2107/36/999"
            },
            "type": "Device"
          }
        ],
        "custodian": {
          "reference": "Organization/416b7bc3-7483-46ba-bc67-306bf671c569"
        },
        "section": [
          {
            "entry": [
              {
                "reference": "DeviceRequest/416b7bc3-7483-46ba-bc67-306bf671c569"
              }
            ],
            "code": {
              "coding": [
                {
                  "system": "https://fhir.kbv.de/CodeSystem/KBV_CS_ERP_Section_Type",
                  "code": "PrescriptionHilfsmittel"
                }
              ]
            }
          },
          {
            "entry": [
              {
                "reference": "Coverage/416b7bc3-7483-46ba-bc67-306bf671c569"
              }
            ],
            "code": {
              "coding": [
                {
                  "system": "https://fhir.kbv.de/CodeSystem/KBV_CS_ERP_Section_Type",
                  "code": "Coverage"
                }
              ]
            }
          }
        ],
        "status": "final",
        "title": "elektronische Arznei- Heil- Hilfsmittelverordnung",
        "date": "2021-01-01"
      }
    },
    {
      "fullUrl": "PrescriptionDevice/416b7bc3-7483-46ba-bc67-306bf671c569",
      "resource": {
        "resourceType": "DeviceRequest",
        "id": "416b7bc3-7483-46ba-bc67-306bf671c569",
        "meta": {
          "profile": [
            "http://fhir.odilab.de/StructureDefinition/PrescriptionDevice"
          ]
        },
        "extension": [
          {
            "url": "http://fhir.odilab.de/StructureDefinition/Folgeversorgung",
            "valueBoolean": false
          },
          {
            "url": "https://fhir.kbv.de/StructureDefinition/KBV_EX_ERP_BVG",
            "valueBoolean": false
          }
        ],
        "reasonCode": [
          {
            "coding": [
              {
                "code": "H91.9",
                "display": "Hörverlust"
              }
            ]
          }
        ],
        "codeCodeableConcept": {
          "coding": [
            {
              "display": "Hörhilfe"
            }
          ],
          "text": "Hörhilfe"
        },
        "parameter": [
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "99915-2",
                  "display": "Status Gehörgang Rechts"
                }
              ],
              "text": "Normal"
            }
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "99916-2",
                  "display": "Status Trommelfell Rechts"
                }
              ],
              "text": "Intakt"
            }
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "99917-2",
                  "display": "Hörhilfe notwendig Rechts"
                }
              ]
            },
            "valueBoolean": false
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "99918-2",
                  "display": "Hörweite Fl.Spr. Rechts"
                }
              ],
              "text": "4-6 (gering)"
            }
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "99919-2",
                  "display": "Hörweite Um.Spr. Rechts"
                }
              ],
              "text": "4-X (gering)"
            }
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "99924-2",
                  "display": "Tinnitushilfe notwendig Rechts"
                }
              ]
            },
            "valueBoolean": false
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "99915-1",
                  "display": "Status Gehörgang Links"
                }
              ],
              "text": "Normal"
            }
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "99916-1",
                  "display": "Status Trommelfell Links"
                }
              ],
              "text": "Intakt"
            }
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "99917-1",
                  "display": "Hörhilfe notwendig Links"
                }
              ]
            },
            "valueBoolean": false
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "99918-1",
                  "display": "Hörweite Fl.Spr. Links"
                }
              ],
              "text": "4-6 (gering)"
            }
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "99919-1",
                  "display": "Hörweite Um.Spr. Links"
                }
              ],
              "text": "4-X (gering)"
            }
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "99924-1",
                  "display": "Tinnitushilfe notwendig Links"
                }
              ]
            },
            "valueBoolean": false
          }
        ],
        "subject": {
          "reference": "Patient/416b7bc3-7483-46ba-bc67-306bf671c569"
        },
        "requester": {
          "reference": "Practitioner/416b7bc3-7483-46ba-bc67-306bf671c569"
        },
        "insurance": [
          {
            "reference": "Coverage/416b7bc3-7483-46ba-bc67-306bf671c569"
          }
        ],
        "status": "active",
        "intent": "order",
        "authoredOn": "2021-01-01"
      }
    },
    {
      "fullUrl": "Patient/416b7bc3-7483-46ba-bc67-306bf671c569",
      "resource": {
        "resourceType": "Patient",
        "id": "416b7bc3-7483-46ba-bc67-306bf671c569",
        "meta": {
          "profile": [
            "https://fhir.kbv.de/StructureDefinition/KBV_PR_FOR_Patient|1.1.0"
          ]
        },
        "identifier": [
          {
            "type": {
              "coding": [
                {
                  "system": "http://fhir.de/CodeSystem/identifier-type-de-basis",
                  "code": "GKV"
                }
              ]
            },
            "system": "http://fhir.de/sid/gkv/kvid-10",
            "value": "X123456789"
          }
        ],
        "name": [
          {
            "given": [
              "Erika"
            ],
            "use": "official",
            "family": "Musterfrau",
            "_family": {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/humanname-own-name",
                  "valueString": "Musterfrau"
                }
              ]
            }
          }
        ],
        "address": [
          {
            "line": [
              "Musterstrasse 1"
            ],
            "_line": [
              {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName",
                    "valueString": "Musterstrasse"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber",
                    "valueString": "1"
                  }
                ]
              }
            ],
            "type": "both",
            "city": "Musterstadt",
            "postalCode": "12345",
            "country": "D"
          }
        ],
        "birthDate": "2002-02-02"
      }
    },
    {
      "fullUrl": "Practitioner/416b7bc3-7483-46ba-bc67-306bf671c569",
      "resource": {
        "resourceType": "Practitioner",
        "id": "416b7bc3-7483-46ba-bc67-306bf671c569",
        "meta": {
          "profile": [
            "https://fhir.kbv.de/StructureDefinition/KBV_PR_FOR_Practitioner|1.1.0"
          ]
        },
        "identifier": [
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "LANR"
                }
              ]
            },
            "system": "https://fhir.kbv.de/NamingSystem/KBV_NS_Base_ANR",
            "value": "123456789"
          }
        ],
        "name": [
          {
            "given": [
              "Albert"
            ],
            "use": "official",
            "family": "Arztmann",
            "_family": {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/humanname-own-name",
                  "valueString": "Arztmann"
                }
              ]
            }
          }
        ],
        "qualification": [
          {
            "code": {
              "coding": [
                {
                  "system": "https://fhir.kbv.de/CodeSystem/KBV_CS_FOR_Qualification_Type",
                  "code": "00"
                }
              ]
            }
          },
          {
            "code": {
              "coding": [
                {
                  "system": "https://fhir.kbv.de/CodeSystem/KBV_CS_FOR_Berufsbezeichnung",
                  "code": "Berufsbezeichnung"
                }
              ],
              "text": "Arzt"
            }
          }
        ]
      }
    },
    {
      "fullUrl": "Organization/416b7bc3-7483-46ba-bc67-306bf671c569",
      "resource": {
        "resourceType": "Organization",
        "id": "416b7bc3-7483-46ba-bc67-306bf671c569",
        "meta": {
          "profile": [
            "https://fhir.kbv.de/StructureDefinition/KBV_PR_FOR_Organization|1.1.0"
          ]
        },
        "identifier": [
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "BSNR"
                }
              ]
            },
            "system": "https://fhir.kbv.de/NamingSystem/KBV_NS_Base_BSNR",
            "value": "123456789"
          }
        ],
        "telecom": [
          {
            "system": "phone",
            "value": "0201-123456789"
          }
        ],
        "address": [
          {
            "line": [
              "Musterstrasse 1"
            ],
            "_line": [
              {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName",
                    "valueString": "Musterstrasse"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber",
                    "valueString": "1"
                  }
                ]
              }
            ],
            "type": "both",
            "city": "Musterstadt",
            "postalCode": "12345",
            "country": "D"
          }
        ]
      }
    },
    {
      "fullUrl": "Coverage/416b7bc3-7483-46ba-bc67-306bf671c569",
      "resource": {
        "resourceType": "Coverage",
        "id": "416b7bc3-7483-46ba-bc67-306bf671c569",
        "meta": {
          "profile": [
            "https://fhir.kbv.de/StructureDefinition/KBV_PR_FOR_Coverage|1.1.0"
          ]
        },
        "extension": [
          {
            "valueCoding": {
              "system": "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_PERSONENGRUPPE",
              "code": "00"
            },
            "url": "http://fhir.de/StructureDefinition/gkv/besondere-personengruppe"
          },
          {
            "valueCoding": {
              "system": "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DMP",
              "code": "00"
            },
            "url": "http://fhir.de/StructureDefinition/gkv/dmp-kennzeichen"
          },
          {
            "valueCoding": {
              "system": "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_VERSICHERTENSTATUS",
              "code": "1"
            },
            "url": "http://fhir.de/StructureDefinition/gkv/versichertenart"
          },
          {
            "valueCoding": {
              "system": "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_ITA_WOP",
              "code": "00"
            },
            "url": "http://fhir.de/StructureDefinition/gkv/wop"
          }
        ],
        "type": {
          "coding": [
            {
              "system": "http://fhir.de/CodeSystem/versicherungsart-de-basis",
              "code": "GKV"
            }
          ]
        },
        "beneficiary": {
          "reference": "Patient/416b7bc3-7483-46ba-bc67-306bf671c569"
        },
        "payor": [
          {
            "identifier": {
              "system": "http://fhir.de/sid/arge-ik/iknr",
              "value": "123456789"
            },
            "display": "KN Knappschaft"
          }
        ],
        "status": "active"
      }
    }
  ],
  "type": "document",
  "timestamp": "2021-01-01T00:00:00Z"
}