FHIR IG analytics| Package | surescripts.specialty |
| Resource Type | Bundle |
| Id | example-SRxDataRequest-Bundle.json |
| FHIR Version | R4 |
No resources found
No resources found
No narrative content found in resource
FHIR
FHIRsmith{
"resourceType": "Bundle",
"id": "example-SRxDataRequest-Bundle",
"language": "en-US",
"type": "message",
"timestamp": "2022-02-03T08:01:48.794+00:00",
"entry": [
{
"resource": {
"resourceType": "MessageHeader",
"id": "620b9e7f5fd54adda8d161becce5a536",
"eventCoding": {
"system": "http://fhirdocs.surescripts.net/message-events",
"code": "specialty-data-request"
},
"destination": [
{
"name": "Acme Message Gateway",
"target": {
"reference": "Device/example"
},
"endpoint": "llp:10.11.12.14:5432"
}
],
"sender": {
"reference": "urn:uuid:a716f94a-2e39-447d-bd00-4bed52f37184"
},
"source": {
"name": "Surescripts, LLC (Staging)",
"software": "Workbench Specialty Testing Tools",
"endpoint": "B3C4BFEE81A64EA3ADC0FF33D386EED1"
},
"focus": [
{
"reference": "urn:uuid:4f2743cb-b5b5-43a5-9f92-93d13e331633"
}
]
}
},
{
"fullUrl": "urn:uuid:4f2743cb-b5b5-43a5-9f92-93d13e331633",
"resource": {
"resourceType": "MedicationRequest",
"id": "4f2743cb-b5b5-43a5-9f92-93d13e331633",
"identifier": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "PLAC",
"display": "Placer Identifier"
}
],
"text": "Prescriber Order Number"
},
"value": "PON7777777",
"assigner": {
"display": "MyEHR-777"
}
},
{
"system": "urn://myehr.com/namespace/hl7/1",
"value": "9941339108"
},
{
"system": "urn://myehr.com/namespace/hl7/20",
"value": "abc"
}
],
"status": "active",
"intent": "filler-order",
"medicationCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/sid/ndc",
"code": "68788729801"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1741049"
}
],
"text": "CHIDEBETINOL 3 MCG"
},
"subject": {
"reference": "urn:uuid:7dfed5cc-99b5-48be-829b-3ea749fa963a",
"type": "Patient"
},
"authoredOn": "2023-05-09T20:59:49.5019483Z",
"requester": {
"reference": "urn:uuid:a716f94a-2e39-447d-bd00-4bed52f37184",
"type": "Practitioner"
},
"performer": {
"reference": "urn:uuid:0b4ddfe8-c96f-45e7-b0de-e66dc375d5b8",
"type": "Organization"
},
"reasonCode": [
{
"coding": [
{
"system": "http://hl7.org/fhir/sid/icd-10",
"code": "D10.2"
}
],
"text": "Mysotaesis poisoning"
}
],
"reasonReference": [
{
"reference": "urn:uuid:9e95ceeb-a029-4956-8b13-6c346e63fe10",
"type": "Condition"
}
],
"groupIdentifier": {
"value": "1664224781150",
"assigner": {
"display": "MyEHR-123"
}
},
"dosageInstruction": [
{
"text": "1 PO QD"
}
],
"dispenseRequest": {
"quantity": {
"value": 30,
"unit": "tablets",
"system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
"code": "tablets"
},
"expectedSupplyDuration": {
"value": 30,
"unit": "days",
"system": "http://unitsofmeasure.org",
"code": "d"
}
}
}
},
{
"fullUrl": "urn:uuid:7dfed5cc-99b5-48be-829b-3ea749fa963a",
"resource": {
"resourceType": "Patient",
"id": "7dfed5cc-99b5-48be-829b-3ea749fa963a",
"identifier": [
{
"use": "official",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "MR",
"display": "Medical Record Number"
}
],
"text": "Medical Record Number"
},
"system": "urn://myehr.com/namespace/hl7/3",
"value": "7dfed5cc-99b5-48be-829b-3ea749fa963a"
},
{
"system": "urn://myehr.com/namespace/hl7/3",
"value": "999-99-9999"
}
],
"active": true,
"name": [
{
"use": "official",
"text": "Jane Doe",
"family": "Doe",
"given": [
"Jane"
]
}
],
"telecom": [
{
"system": "email",
"value": "d.h@bom.com",
"rank": 1
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/contactpoint-extension",
"valueString": "123"
}
],
"system": "phone",
"value": "9715551111",
"rank": 1
},
{
"system": "fax",
"value": "8005551312",
"rank": 1
},
{
"system": "phone",
"value": "4155552222",
"use": "home"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/contactpoint-extension",
"valueString": "124"
}
],
"system": "phone",
"value": "8775553333",
"use": "work"
},
{
"system": "phone",
"value": "8665554444",
"use": "mobile"
}
],
"gender": "female",
"birthDate": "2000-02-20",
"deceasedBoolean": false,
"address": [
{
"type": "postal",
"line": [
"1877 189th"
],
"city": "Beaverton",
"state": "OR",
"postalCode": "97006",
"country": "US"
}
],
"contact": [
{
"relationship": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0131",
"code": "N"
}
]
}
],
"name": {
"family": "du Marche",
"_family": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/humanname-own-prefix",
"valueString": "VV"
}
]
},
"given": [
"Benedicte"
]
},
"telecom": [
{
"system": "phone",
"value": "+33 (237) 998327"
}
],
"address": {
"use": "home",
"type": "both",
"line": [
"534 Erewhon St"
],
"city": "PleasantVille",
"district": "Rainbow",
"state": "Vic",
"postalCode": "3999",
"period": {
"start": "1974-12-25"
}
},
"gender": "female",
"period": {
"start": "2012"
}
}
],
"communication": [
{
"language": {
"coding": [
{
"system": "urn:ietf:bcp:47",
"code": "en",
"display": "English"
}
]
}
}
]
}
},
{
"fullUrl": "urn:uuid:0b4ddfe8-c96f-45e7-b0de-e66dc375d5b8",
"resource": {
"resourceType": "Organization",
"id": "0b4ddfe8-c96f-45e7-b0de-e66dc375d5b8",
"identifier": [
{
"use": "official",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "PRN",
"display": "Provider Number"
}
],
"text": "Provider Number"
},
"system": "http://ncpdp.org/provider-id",
"value": "9876546",
"assigner": {
"identifier": {
"system": "urn:ietf:rfc:3986",
"value": "urn:oid:2.16.840.1.113883.3.79"
}
}
},
{
"use": "official",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "PRN",
"display": "Provider Number"
}
],
"text": "Provider Number"
},
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "1093759540"
}
],
"active": true,
"type": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/organization-type",
"code": "prov",
"display": "Healthcare Provider"
}
],
"text": "Pharmacy"
}
],
"name": "T12.Dev.RLE.Electronic",
"telecom": [
{
"system": "email",
"value": "manager@smart.com",
"rank": 1
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/contactpoint-extension",
"valueString": "123"
}
],
"system": "phone",
"value": "8005432121",
"rank": 1
},
{
"system": "fax",
"value": "5034567890",
"rank": 1
}
],
"address": [
{
"type": "postal",
"line": [
"123 Fake St"
],
"city": "Timber",
"state": "OR",
"postalCode": "97008",
"country": "US"
}
]
}
},
{
"fullUrl": "urn:uuid:a716f94a-2e39-447d-bd00-4bed52f37184",
"resource": {
"resourceType": "Practitioner",
"id": "a716f94a-2e39-447d-bd00-4bed52f37184",
"identifier": [
{
"use": "secondary",
"type": {
"coding": [
{
"system": "Surescripts",
"code": "SPI"
}
]
},
"system": "http://fhirdocs.surescripts.net/spi",
"value": "4725438108001"
},
{
"use": "official",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "PRN",
"display": "Provider Number"
}
],
"text": "Provider Number"
},
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "1257237549"
},
{
"use": "official",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "PRN",
"display": "Provider Number"
}
],
"text": "Provider Number"
},
"system": "http://hl7.org/fhir/sid/us-medicare",
"value": "G12345"
},
{
"use": "official",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "PRN",
"display": "Provider Number"
}
],
"text": "Provider Number"
},
"system": "urn:oid:2.16.840.1.113883.4.290",
"value": "123456789"
},
{
"use": "official",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "PRN",
"display": "Provider Number"
}
],
"text": "Provider Number"
},
"system": "urn:oid:2.16.840.1.113883.4.814",
"value": "CS2121212"
}
],
"active": true,
"name": [
{
"use": "official",
"text": "Dr. Rufus B.",
"family": "Provider",
"given": [
"Specialty"
],
"prefix": [
"Dr."
],
"suffix": [
"Jr."
]
}
],
"telecom": [
{
"system": "email",
"value": "barleyr@procto.com",
"rank": 1
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/contactpoint-extension",
"valueString": "44"
}
],
"system": "phone",
"value": "5595551212",
"rank": 1
},
{
"system": "fax",
"value": "4565551212",
"rank": 1
}
],
"address": [
{
"type": "postal",
"line": [
"66 Tat Ave"
],
"city": "Timber",
"state": "OR",
"postalCode": "97008",
"country": "US"
}
]
}
}
]
}