medax_pipeline/testData/Donnell534_Koss676_5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e.json
2025-04-16 22:12:19 +02:00

35695 lines
1.1 MiB

{
"resourceType": "Bundle",
"type": "transaction",
"entry": [ {
"fullUrl": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"resource": {
"resourceType": "Patient",
"id": "5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient" ]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Generated by <a href=\"https://github.com/synthetichealth/synthea\">Synthea</a>.Version identifier: 3c23908\n . Person seed: 1761778044446332803 Population seed: 1693908535569</div>"
},
"extension": [ {
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race",
"extension": [ {
"url": "ombCategory",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2106-3",
"display": "White"
}
}, {
"url": "text",
"valueString": "White"
} ]
}, {
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity",
"extension": [ {
"url": "ombCategory",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2186-5",
"display": "Not Hispanic or Latino"
}
}, {
"url": "text",
"valueString": "Not Hispanic or Latino"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName",
"valueString": "Laure395 Beatty507"
}, {
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
"valueCode": "M"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/patient-birthPlace",
"valueAddress": {
"city": "Canton",
"state": "Massachusetts",
"country": "US"
}
}, {
"url": "http://synthetichealth.github.io/synthea/disability-adjusted-life-years",
"valueDecimal": 0.024488430436944673
}, {
"url": "http://synthetichealth.github.io/synthea/quality-adjusted-life-years",
"valueDecimal": 7.975511569563055
} ],
"identifier": [ {
"system": "https://github.com/synthetichealth/synthea",
"value": "5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
}, {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "MR",
"display": "Medical Record Number"
} ],
"text": "Medical Record Number"
},
"system": "http://hospital.smarthealthit.org",
"value": "5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
}, {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "SS",
"display": "Social Security Number"
} ],
"text": "Social Security Number"
},
"system": "http://hl7.org/fhir/sid/us-ssn",
"value": "999-77-6266"
} ],
"name": [ {
"use": "official",
"family": "Koss676",
"given": [ "Donnell534", "Ted955" ]
} ],
"telecom": [ {
"system": "phone",
"value": "555-823-5005",
"use": "home"
} ],
"gender": "male",
"birthDate": "2014-01-10",
"address": [ {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/geolocation",
"extension": [ {
"url": "latitude",
"valueDecimal": 41.54623017867348
}, {
"url": "longitude",
"valueDecimal": -70.94969217879832
} ]
} ],
"line": [ "595 Murphy Terrace Apt 73" ],
"city": "Dartmouth",
"state": "MA",
"postalCode": "00000",
"country": "US"
} ],
"maritalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
"code": "S",
"display": "Never Married"
} ],
"text": "Never Married"
},
"multipleBirthBoolean": false,
"communication": [ {
"language": {
"coding": [ {
"system": "urn:ietf:bcp:47",
"code": "en-US",
"display": "English (United States)"
} ],
"text": "English (United States)"
}
} ]
},
"request": {
"method": "POST",
"url": "Patient"
}
}, {
"fullUrl": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59",
"resource": {
"resourceType": "Encounter",
"id": "320d0b45-ec1b-c298-503c-cb537e27ae59",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "320d0b45-ec1b-c298-503c-cb537e27ae59"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2014-01-10T21:33:10+01:00",
"end": "2014-01-10T21:48:10+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
}
} ],
"period": {
"start": "2014-01-10T21:33:10+01:00",
"end": "2014-01-10T21:48:10+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:25ea0e18-3ef2-dc5d-ddbe-7902e114b8f3",
"resource": {
"resourceType": "Condition",
"id": "25ea0e18-3ef2-dc5d-ddbe-7902e114b8f3",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "resolved"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed"
} ]
},
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-category",
"code": "encounter-diagnosis",
"display": "Encounter Diagnosis"
} ]
} ],
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"onsetDateTime": "2014-01-10T21:33:10+01:00",
"abatementDateTime": "2014-01-10T21:33:10+01:00",
"recordedDate": "2014-01-10T21:33:10+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:c681dee0-096d-ce83-da51-03708d1fe063",
"resource": {
"resourceType": "Observation",
"id": "c681dee0-096d-ce83-da51-03708d1fe063",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8302-2",
"display": "Body Height"
} ],
"text": "Body Height"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"valueQuantity": {
"value": 54.2,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:ed0db3c9-da26-3097-b007-8aae43176bf2",
"resource": {
"resourceType": "Observation",
"id": "ed0db3c9-da26-3097-b007-8aae43176bf2",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72514-3",
"display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
} ],
"text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"valueQuantity": {
"value": 0,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:b0a618e8-91fd-accf-8c39-05506824ed92",
"resource": {
"resourceType": "Observation",
"id": "b0a618e8-91fd-accf-8c39-05506824ed92",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "29463-7",
"display": "Body Weight"
} ],
"text": "Body Weight"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"valueQuantity": {
"value": 4.7,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:cb47d590-00f4-c94a-9f78-3a7ca4b9dd1b",
"resource": {
"resourceType": "Observation",
"id": "cb47d590-00f4-c94a-9f78-3a7ca4b9dd1b",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-weight-for-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "77606-2",
"display": "Weight-for-length Per age and sex"
} ],
"text": "Weight-for-length Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"valueQuantity": {
"value": 69.568,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:f4cabca9-cfe8-f1a2-0be7-43fd3384e37c",
"resource": {
"resourceType": "Observation",
"id": "f4cabca9-cfe8-f1a2-0be7-43fd3384e37c",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/head-occipital-frontal-circumference-percentile" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8289-1",
"display": "Head Occipital-frontal circumference Percentile"
} ],
"text": "Head Occipital-frontal circumference Percentile"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"valueQuantity": {
"value": 74.37,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:9058a658-009c-3a52-a2f8-9c8fb4aeb01c",
"resource": {
"resourceType": "Observation",
"id": "9058a658-009c-3a52-a2f8-9c8fb4aeb01c",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-head-circumference" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9843-4",
"display": "Head Occipital-frontal circumference"
} ],
"text": "Head Occipital-frontal circumference"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"valueQuantity": {
"value": 36.97,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:217c402c-225d-af2e-c9d5-fb57f1b82ba9",
"resource": {
"resourceType": "Observation",
"id": "217c402c-225d-af2e-c9d5-fb57f1b82ba9",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "85354-9",
"display": "Blood pressure panel with all children optional"
} ],
"text": "Blood pressure panel with all children optional"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 84,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8480-6",
"display": "Systolic Blood Pressure"
} ],
"text": "Systolic Blood Pressure"
},
"valueQuantity": {
"value": 125,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:06e71611-068b-a069-80f5-c8fb418e01d8",
"resource": {
"resourceType": "Observation",
"id": "06e71611-068b-a069-80f5-c8fb418e01d8",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8867-4",
"display": "Heart rate"
} ],
"text": "Heart rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"valueQuantity": {
"value": 69,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:282f815f-df2e-e038-959e-ef84fe3574f6",
"resource": {
"resourceType": "Observation",
"id": "282f815f-df2e-e038-959e-ef84fe3574f6",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9279-1",
"display": "Respiratory rate"
} ],
"text": "Respiratory rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"valueQuantity": {
"value": 13,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:29d0837d-137f-67dc-92f0-f33c5713d3fa",
"resource": {
"resourceType": "Observation",
"id": "29d0837d-137f-67dc-92f0-f33c5713d3fa",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "6690-2",
"display": "Leukocytes [#/volume] in Blood by Automated count"
} ],
"text": "Leukocytes [#/volume] in Blood by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"valueQuantity": {
"value": 8.935,
"unit": "10*3/uL",
"system": "http://unitsofmeasure.org",
"code": "10*3/uL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:8ee4ce6d-d05a-8dcb-0ad5-f97a43eb8e25",
"resource": {
"resourceType": "Observation",
"id": "8ee4ce6d-d05a-8dcb-0ad5-f97a43eb8e25",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "789-8",
"display": "Erythrocytes [#/volume] in Blood by Automated count"
} ],
"text": "Erythrocytes [#/volume] in Blood by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"valueQuantity": {
"value": 5.229,
"unit": "10*6/uL",
"system": "http://unitsofmeasure.org",
"code": "10*6/uL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:965d3f39-6355-57bb-c2db-f9818788ef8d",
"resource": {
"resourceType": "Observation",
"id": "965d3f39-6355-57bb-c2db-f9818788ef8d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "718-7",
"display": "Hemoglobin [Mass/volume] in Blood"
} ],
"text": "Hemoglobin [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"valueQuantity": {
"value": 12.328,
"unit": "g/dL",
"system": "http://unitsofmeasure.org",
"code": "g/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:0417218d-2552-4159-2354-68b8eafabd24",
"resource": {
"resourceType": "Observation",
"id": "0417218d-2552-4159-2354-68b8eafabd24",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "4544-3",
"display": "Hematocrit [Volume Fraction] of Blood by Automated count"
} ],
"text": "Hematocrit [Volume Fraction] of Blood by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"valueQuantity": {
"value": 47.057,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:cf9a639b-33dd-4f3a-31a1-e7ba7207817c",
"resource": {
"resourceType": "Observation",
"id": "cf9a639b-33dd-4f3a-31a1-e7ba7207817c",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "787-2",
"display": "MCV [Entitic volume] by Automated count"
} ],
"text": "MCV [Entitic volume] by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"valueQuantity": {
"value": 94.139,
"unit": "fL",
"system": "http://unitsofmeasure.org",
"code": "fL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:dcf5e22e-b8c2-7533-7bb0-95bca530d65b",
"resource": {
"resourceType": "Observation",
"id": "dcf5e22e-b8c2-7533-7bb0-95bca530d65b",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "785-6",
"display": "MCH [Entitic mass] by Automated count"
} ],
"text": "MCH [Entitic mass] by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"valueQuantity": {
"value": 28.399,
"unit": "pg",
"system": "http://unitsofmeasure.org",
"code": "pg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:ed6352ec-326c-5d03-5f5b-5fdbb709acc9",
"resource": {
"resourceType": "Observation",
"id": "ed6352ec-326c-5d03-5f5b-5fdbb709acc9",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "786-4",
"display": "MCHC [Mass/volume] by Automated count"
} ],
"text": "MCHC [Mass/volume] by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"valueQuantity": {
"value": 35.201,
"unit": "g/dL",
"system": "http://unitsofmeasure.org",
"code": "g/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:5a7de3b9-ce63-f295-5af1-b51a6b15479a",
"resource": {
"resourceType": "Observation",
"id": "5a7de3b9-ce63-f295-5af1-b51a6b15479a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "21000-5",
"display": "Erythrocyte distribution width [Entitic volume] by Automated count"
} ],
"text": "Erythrocyte distribution width [Entitic volume] by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"valueQuantity": {
"value": 43.642,
"unit": "fL",
"system": "http://unitsofmeasure.org",
"code": "fL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:9d7dadc0-43ea-b148-b4db-813e4a89bcaa",
"resource": {
"resourceType": "Observation",
"id": "9d7dadc0-43ea-b148-b4db-813e4a89bcaa",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "777-3",
"display": "Platelets [#/volume] in Blood by Automated count"
} ],
"text": "Platelets [#/volume] in Blood by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"valueQuantity": {
"value": 431.72,
"unit": "10*3/uL",
"system": "http://unitsofmeasure.org",
"code": "10*3/uL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:0b5ae785-b718-91f6-95a1-ffd877b6ef41",
"resource": {
"resourceType": "Observation",
"id": "0b5ae785-b718-91f6-95a1-ffd877b6ef41",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "32207-3",
"display": "Platelet distribution width [Entitic volume] in Blood by Automated count"
} ],
"text": "Platelet distribution width [Entitic volume] in Blood by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"valueQuantity": {
"value": 503.63,
"unit": "fL",
"system": "http://unitsofmeasure.org",
"code": "fL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:a8982511-0fe8-3bb5-7ee9-2e0f76222257",
"resource": {
"resourceType": "Observation",
"id": "a8982511-0fe8-3bb5-7ee9-2e0f76222257",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "32623-1",
"display": "Platelet mean volume [Entitic volume] in Blood by Automated count"
} ],
"text": "Platelet mean volume [Entitic volume] in Blood by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"valueQuantity": {
"value": 12.094,
"unit": "fL",
"system": "http://unitsofmeasure.org",
"code": "fL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:b9332d0c-6b86-0bb1-f357-10fa23c971b8",
"resource": {
"resourceType": "Observation",
"id": "b9332d0c-6b86-0bb1-f357-10fa23c971b8",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social history"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72166-2",
"display": "Tobacco smoking status"
} ],
"text": "Tobacco smoking status"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "266919005",
"display": "Never smoked tobacco (finding)"
} ],
"text": "Never smoked tobacco (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:50123d03-1782-d07d-9f54-d1360fb03aec",
"resource": {
"resourceType": "Procedure",
"id": "50123d03-1782-d07d-9f54-d1360fb03aec",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"performedPeriod": {
"start": "2014-01-10T21:33:10+01:00",
"end": "2014-01-10T21:48:10+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:f14d0a3e-e502-b976-e51e-9baffd63c4cd",
"resource": {
"resourceType": "Immunization",
"id": "f14d0a3e-e502-b976-e51e-9baffd63c4cd",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "08",
"display": "Hep B, adolescent or pediatric"
} ],
"text": "Hep B, adolescent or pediatric"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"occurrenceDateTime": "2014-01-10T21:33:10+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:d02e5263-4a43-f180-50ce-3e174749c98e",
"resource": {
"resourceType": "DiagnosticReport",
"id": "d02e5263-4a43-f180-50ce-3e174749c98e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v2-0074",
"code": "LAB",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "58410-2",
"display": "CBC panel - Blood by Automated count"
} ],
"text": "CBC panel - Blood by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"performer": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
} ],
"result": [ {
"reference": "urn:uuid:29d0837d-137f-67dc-92f0-f33c5713d3fa",
"display": "Leukocytes [#/volume] in Blood by Automated count"
}, {
"reference": "urn:uuid:8ee4ce6d-d05a-8dcb-0ad5-f97a43eb8e25",
"display": "Erythrocytes [#/volume] in Blood by Automated count"
}, {
"reference": "urn:uuid:965d3f39-6355-57bb-c2db-f9818788ef8d",
"display": "Hemoglobin [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:0417218d-2552-4159-2354-68b8eafabd24",
"display": "Hematocrit [Volume Fraction] of Blood by Automated count"
}, {
"reference": "urn:uuid:cf9a639b-33dd-4f3a-31a1-e7ba7207817c",
"display": "MCV [Entitic volume] by Automated count"
}, {
"reference": "urn:uuid:dcf5e22e-b8c2-7533-7bb0-95bca530d65b",
"display": "MCH [Entitic mass] by Automated count"
}, {
"reference": "urn:uuid:ed6352ec-326c-5d03-5f5b-5fdbb709acc9",
"display": "MCHC [Mass/volume] by Automated count"
}, {
"reference": "urn:uuid:5a7de3b9-ce63-f295-5af1-b51a6b15479a",
"display": "Erythrocyte distribution width [Entitic volume] by Automated count"
}, {
"reference": "urn:uuid:9d7dadc0-43ea-b148-b4db-813e4a89bcaa",
"display": "Platelets [#/volume] in Blood by Automated count"
}, {
"reference": "urn:uuid:0b5ae785-b718-91f6-95a1-ffd877b6ef41",
"display": "Platelet distribution width [Entitic volume] in Blood by Automated count"
}, {
"reference": "urn:uuid:a8982511-0fe8-3bb5-7ee9-2e0f76222257",
"display": "Platelet mean volume [Entitic volume] in Blood by Automated count"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:c43c23c4-142c-fdda-2e5b-5da74e39f9c7",
"resource": {
"resourceType": "DiagnosticReport",
"id": "c43c23c4-142c-fdda-2e5b-5da74e39f9c7",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
},
"effectiveDateTime": "2014-01-10T21:33:10+01:00",
"issued": "2014-01-10T21:33:10.614+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:1fa49cde-b768-b630-8784-002fb137d000",
"resource": {
"resourceType": "DocumentReference",
"id": "1fa49cde-b768-b630-8784-002fb137d000",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:c43c23c4-142c-fdda-2e5b-5da74e39f9c7"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2014-01-10T21:33:10.614+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
} ],
"period": {
"start": "2014-01-10T21:33:10+01:00",
"end": "2014-01-10T21:48:10+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:aab6bb49-3365-d6d4-9287-1669eeddd48b",
"resource": {
"resourceType": "Claim",
"id": "aab6bb49-3365-d6d4-9287-1669eeddd48b",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2014-01-10T21:33:10+01:00",
"end": "2014-01-10T21:48:10+01:00"
},
"created": "2014-01-10T21:48:10+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:f14d0a3e-e502-b976-e51e-9baffd63c4cd"
}
}, {
"sequence": 2,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:25ea0e18-3ef2-dc5d-ddbe-7902e114b8f3"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:50123d03-1782-d07d-9f54-d1360fb03aec"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "08",
"display": "Hep B, adolescent or pediatric"
} ],
"text": "Hep B, adolescent or pediatric"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 3,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
}
}, {
"sequence": 4,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"net": {
"value": 396.45,
"currency": "USD"
}
}, {
"sequence": 5,
"informationSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "58410-2",
"display": "CBC panel - Blood by Automated count"
} ],
"text": "CBC panel - Blood by Automated count"
},
"net": {
"value": 74.58,
"currency": "USD"
}
} ],
"total": {
"value": 743.83,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:10d1969c-61a7-253a-ba1d-34d00784db6f",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "10d1969c-61a7-253a-ba1d-34d00784db6f",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "aab6bb49-3365-d6d4-9287-1669eeddd48b"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2014-01-10T21:48:10+01:00",
"end": "2015-01-10T21:48:10+01:00"
},
"created": "2014-01-10T21:48:10+01:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"claim": {
"reference": "urn:uuid:aab6bb49-3365-d6d4-9287-1669eeddd48b"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:25ea0e18-3ef2-dc5d-ddbe-7902e114b8f3"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"servicedPeriod": {
"start": "2014-01-10T21:33:10+01:00",
"end": "2014-01-10T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "08",
"display": "Hep B, adolescent or pediatric"
} ],
"text": "Hep B, adolescent or pediatric"
},
"servicedPeriod": {
"start": "2014-01-10T21:33:10+01:00",
"end": "2014-01-10T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 3,
"diagnosisSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"servicedPeriod": {
"start": "2014-01-10T21:33:10+01:00",
"end": "2014-01-10T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 4,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"servicedPeriod": {
"start": "2014-01-10T21:33:10+01:00",
"end": "2014-01-10T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 396.45,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 79.29,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 317.16,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 396.45,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 396.45,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 5,
"informationSequence": [ 2 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "58410-2",
"display": "CBC panel - Blood by Automated count"
} ],
"text": "CBC panel - Blood by Automated count"
},
"servicedPeriod": {
"start": "2014-01-10T21:33:10+01:00",
"end": "2014-01-10T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 74.58,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 14.916,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 59.664,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 74.58,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 74.58,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 743.83,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 485.624,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:b62a8951-86ff-c9d1-99bd-3562067a87f5",
"resource": {
"resourceType": "Encounter",
"id": "b62a8951-86ff-c9d1-99bd-3562067a87f5",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "b62a8951-86ff-c9d1-99bd-3562067a87f5"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2014-02-14T21:33:10+01:00",
"end": "2014-02-14T21:48:10+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
}
} ],
"period": {
"start": "2014-02-14T21:33:10+01:00",
"end": "2014-02-14T21:48:10+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:1636332d-b9d1-4c6b-5f0e-fd8164049df1",
"resource": {
"resourceType": "Condition",
"id": "1636332d-b9d1-4c6b-5f0e-fd8164049df1",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "resolved"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed"
} ]
},
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-category",
"code": "encounter-diagnosis",
"display": "Encounter Diagnosis"
} ]
} ],
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b62a8951-86ff-c9d1-99bd-3562067a87f5"
},
"onsetDateTime": "2014-02-14T21:33:10+01:00",
"abatementDateTime": "2014-02-14T21:33:10+01:00",
"recordedDate": "2014-02-14T21:33:10+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:c49c76fc-01e8-cc06-655e-647dc31f6a16",
"resource": {
"resourceType": "Observation",
"id": "c49c76fc-01e8-cc06-655e-647dc31f6a16",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8302-2",
"display": "Body Height"
} ],
"text": "Body Height"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b62a8951-86ff-c9d1-99bd-3562067a87f5"
},
"effectiveDateTime": "2014-02-14T21:33:10+01:00",
"issued": "2014-02-14T21:33:10.614+01:00",
"valueQuantity": {
"value": 58.1,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:721048db-d168-4c92-0fab-2b60b0e88945",
"resource": {
"resourceType": "Observation",
"id": "721048db-d168-4c92-0fab-2b60b0e88945",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72514-3",
"display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
} ],
"text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b62a8951-86ff-c9d1-99bd-3562067a87f5"
},
"effectiveDateTime": "2014-02-14T21:33:10+01:00",
"issued": "2014-02-14T21:33:10.614+01:00",
"valueQuantity": {
"value": 4,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:8b6b22b5-97ec-574e-b4cc-5faf6396f78f",
"resource": {
"resourceType": "Observation",
"id": "8b6b22b5-97ec-574e-b4cc-5faf6396f78f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "29463-7",
"display": "Body Weight"
} ],
"text": "Body Weight"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b62a8951-86ff-c9d1-99bd-3562067a87f5"
},
"effectiveDateTime": "2014-02-14T21:33:10+01:00",
"issued": "2014-02-14T21:33:10.614+01:00",
"valueQuantity": {
"value": 5.7,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:dab814fd-65bd-1141-7a21-6abd37d92300",
"resource": {
"resourceType": "Observation",
"id": "dab814fd-65bd-1141-7a21-6abd37d92300",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-weight-for-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "77606-2",
"display": "Weight-for-length Per age and sex"
} ],
"text": "Weight-for-length Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b62a8951-86ff-c9d1-99bd-3562067a87f5"
},
"effectiveDateTime": "2014-02-14T21:33:10+01:00",
"issued": "2014-02-14T21:33:10.614+01:00",
"valueQuantity": {
"value": 65.443,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e784ebcf-6d24-646e-b76d-c09f32e7a6f1",
"resource": {
"resourceType": "Observation",
"id": "e784ebcf-6d24-646e-b76d-c09f32e7a6f1",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/head-occipital-frontal-circumference-percentile" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8289-1",
"display": "Head Occipital-frontal circumference Percentile"
} ],
"text": "Head Occipital-frontal circumference Percentile"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b62a8951-86ff-c9d1-99bd-3562067a87f5"
},
"effectiveDateTime": "2014-02-14T21:33:10+01:00",
"issued": "2014-02-14T21:33:10.614+01:00",
"valueQuantity": {
"value": 74.37,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:38c29740-e49a-fb58-9c1e-1f188d650b6b",
"resource": {
"resourceType": "Observation",
"id": "38c29740-e49a-fb58-9c1e-1f188d650b6b",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-head-circumference" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9843-4",
"display": "Head Occipital-frontal circumference"
} ],
"text": "Head Occipital-frontal circumference"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b62a8951-86ff-c9d1-99bd-3562067a87f5"
},
"effectiveDateTime": "2014-02-14T21:33:10+01:00",
"issued": "2014-02-14T21:33:10.614+01:00",
"valueQuantity": {
"value": 40.22,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:885eea7c-a5c3-ac93-f512-fa1fd92275fa",
"resource": {
"resourceType": "Observation",
"id": "885eea7c-a5c3-ac93-f512-fa1fd92275fa",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "85354-9",
"display": "Blood pressure panel with all children optional"
} ],
"text": "Blood pressure panel with all children optional"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b62a8951-86ff-c9d1-99bd-3562067a87f5"
},
"effectiveDateTime": "2014-02-14T21:33:10+01:00",
"issued": "2014-02-14T21:33:10.614+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 85,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8480-6",
"display": "Systolic Blood Pressure"
} ],
"text": "Systolic Blood Pressure"
},
"valueQuantity": {
"value": 126,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:48a51e48-a91f-e233-8f52-357197c95afd",
"resource": {
"resourceType": "Observation",
"id": "48a51e48-a91f-e233-8f52-357197c95afd",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8867-4",
"display": "Heart rate"
} ],
"text": "Heart rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b62a8951-86ff-c9d1-99bd-3562067a87f5"
},
"effectiveDateTime": "2014-02-14T21:33:10+01:00",
"issued": "2014-02-14T21:33:10.614+01:00",
"valueQuantity": {
"value": 92,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:da2027fc-c95e-022b-43ab-e2d6e8025617",
"resource": {
"resourceType": "Observation",
"id": "da2027fc-c95e-022b-43ab-e2d6e8025617",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9279-1",
"display": "Respiratory rate"
} ],
"text": "Respiratory rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b62a8951-86ff-c9d1-99bd-3562067a87f5"
},
"effectiveDateTime": "2014-02-14T21:33:10+01:00",
"issued": "2014-02-14T21:33:10.614+01:00",
"valueQuantity": {
"value": 14,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:f37bc261-acfe-e1ec-e0c8-e98a9b410c71",
"resource": {
"resourceType": "Observation",
"id": "f37bc261-acfe-e1ec-e0c8-e98a9b410c71",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social history"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72166-2",
"display": "Tobacco smoking status"
} ],
"text": "Tobacco smoking status"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b62a8951-86ff-c9d1-99bd-3562067a87f5"
},
"effectiveDateTime": "2014-02-14T21:33:10+01:00",
"issued": "2014-02-14T21:33:10.614+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "266919005",
"display": "Never smoked tobacco (finding)"
} ],
"text": "Never smoked tobacco (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:c8b58af2-71a2-7167-d100-f1967375bab4",
"resource": {
"resourceType": "Procedure",
"id": "c8b58af2-71a2-7167-d100-f1967375bab4",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b62a8951-86ff-c9d1-99bd-3562067a87f5"
},
"performedPeriod": {
"start": "2014-02-14T21:33:10+01:00",
"end": "2014-02-14T21:48:10+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:9ccff10f-6261-d068-8e2a-f76ffcee90d3",
"resource": {
"resourceType": "Immunization",
"id": "9ccff10f-6261-d068-8e2a-f76ffcee90d3",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "08",
"display": "Hep B, adolescent or pediatric"
} ],
"text": "Hep B, adolescent or pediatric"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b62a8951-86ff-c9d1-99bd-3562067a87f5"
},
"occurrenceDateTime": "2014-02-14T21:33:10+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:5446ca22-f79d-5347-f3c4-5766ded9ba88",
"resource": {
"resourceType": "DiagnosticReport",
"id": "5446ca22-f79d-5347-f3c4-5766ded9ba88",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b62a8951-86ff-c9d1-99bd-3562067a87f5"
},
"effectiveDateTime": "2014-02-14T21:33:10+01:00",
"issued": "2014-02-14T21:33:10.614+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:d163a598-ef28-b25e-b49d-b294db92d198",
"resource": {
"resourceType": "DocumentReference",
"id": "d163a598-ef28-b25e-b49d-b294db92d198",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:5446ca22-f79d-5347-f3c4-5766ded9ba88"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2014-02-14T21:33:10.614+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:b62a8951-86ff-c9d1-99bd-3562067a87f5"
} ],
"period": {
"start": "2014-02-14T21:33:10+01:00",
"end": "2014-02-14T21:48:10+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:1d4f1d82-40ae-3f0d-d7d7-09d3b6677f36",
"resource": {
"resourceType": "Claim",
"id": "1d4f1d82-40ae-3f0d-d7d7-09d3b6677f36",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2014-02-14T21:33:10+01:00",
"end": "2014-02-14T21:48:10+01:00"
},
"created": "2014-02-14T21:48:10+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:9ccff10f-6261-d068-8e2a-f76ffcee90d3"
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:1636332d-b9d1-4c6b-5f0e-fd8164049df1"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:c8b58af2-71a2-7167-d100-f1967375bab4"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:b62a8951-86ff-c9d1-99bd-3562067a87f5"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "08",
"display": "Hep B, adolescent or pediatric"
} ],
"text": "Hep B, adolescent or pediatric"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 3,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
}
}, {
"sequence": 4,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"net": {
"value": 372.97,
"currency": "USD"
}
} ],
"total": {
"value": 645.77,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:f6b830a8-2452-5847-ff2b-303cde3592a5",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "f6b830a8-2452-5847-ff2b-303cde3592a5",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "1d4f1d82-40ae-3f0d-d7d7-09d3b6677f36"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2014-02-14T21:48:10+01:00",
"end": "2015-02-14T21:48:10+01:00"
},
"created": "2014-02-14T21:48:10+01:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"claim": {
"reference": "urn:uuid:1d4f1d82-40ae-3f0d-d7d7-09d3b6677f36"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:1636332d-b9d1-4c6b-5f0e-fd8164049df1"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"servicedPeriod": {
"start": "2014-02-14T21:33:10+01:00",
"end": "2014-02-14T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:b62a8951-86ff-c9d1-99bd-3562067a87f5"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "08",
"display": "Hep B, adolescent or pediatric"
} ],
"text": "Hep B, adolescent or pediatric"
},
"servicedPeriod": {
"start": "2014-02-14T21:33:10+01:00",
"end": "2014-02-14T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 3,
"diagnosisSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"servicedPeriod": {
"start": "2014-02-14T21:33:10+01:00",
"end": "2014-02-14T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 4,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"servicedPeriod": {
"start": "2014-02-14T21:33:10+01:00",
"end": "2014-02-14T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 372.97,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 74.59400000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 298.37600000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 372.97,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 372.97,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 645.77,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 407.17600000000004,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b",
"resource": {
"resourceType": "Encounter",
"id": "e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2014-04-18T22:33:10+02:00",
"end": "2014-04-18T22:48:10+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
}
} ],
"period": {
"start": "2014-04-18T22:33:10+02:00",
"end": "2014-04-18T22:48:10+02:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:b6b2cc04-80cb-a8a4-4ef4-e89c9807b2a1",
"resource": {
"resourceType": "Condition",
"id": "b6b2cc04-80cb-a8a4-4ef4-e89c9807b2a1",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "resolved"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed"
} ]
},
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-category",
"code": "encounter-diagnosis",
"display": "Encounter Diagnosis"
} ]
} ],
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
},
"onsetDateTime": "2014-04-18T22:33:10+02:00",
"abatementDateTime": "2014-04-18T22:33:10+02:00",
"recordedDate": "2014-04-18T22:33:10+02:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:9cb1d257-31ed-a1ea-f9b7-2579154b99b6",
"resource": {
"resourceType": "Observation",
"id": "9cb1d257-31ed-a1ea-f9b7-2579154b99b6",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8302-2",
"display": "Body Height"
} ],
"text": "Body Height"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
},
"effectiveDateTime": "2014-04-18T22:33:10+02:00",
"issued": "2014-04-18T22:33:10.614+02:00",
"valueQuantity": {
"value": 63.6,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:ba675a8c-6be0-30bc-138e-3c100400c343",
"resource": {
"resourceType": "Observation",
"id": "ba675a8c-6be0-30bc-138e-3c100400c343",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72514-3",
"display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
} ],
"text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
},
"effectiveDateTime": "2014-04-18T22:33:10+02:00",
"issued": "2014-04-18T22:33:10.614+02:00",
"valueQuantity": {
"value": 3,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:716a8e8d-40d9-4dd5-319c-ce5e7c299874",
"resource": {
"resourceType": "Observation",
"id": "716a8e8d-40d9-4dd5-319c-ce5e7c299874",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "29463-7",
"display": "Body Weight"
} ],
"text": "Body Weight"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
},
"effectiveDateTime": "2014-04-18T22:33:10+02:00",
"issued": "2014-04-18T22:33:10.614+02:00",
"valueQuantity": {
"value": 7.4,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:44d9bc28-362d-1970-0234-8108c406675e",
"resource": {
"resourceType": "Observation",
"id": "44d9bc28-362d-1970-0234-8108c406675e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-weight-for-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "77606-2",
"display": "Weight-for-length Per age and sex"
} ],
"text": "Weight-for-length Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
},
"effectiveDateTime": "2014-04-18T22:33:10+02:00",
"issued": "2014-04-18T22:33:10.614+02:00",
"valueQuantity": {
"value": 71.421,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:015d4855-3140-9985-379b-e57cceffde97",
"resource": {
"resourceType": "Observation",
"id": "015d4855-3140-9985-379b-e57cceffde97",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/head-occipital-frontal-circumference-percentile" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8289-1",
"display": "Head Occipital-frontal circumference Percentile"
} ],
"text": "Head Occipital-frontal circumference Percentile"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
},
"effectiveDateTime": "2014-04-18T22:33:10+02:00",
"issued": "2014-04-18T22:33:10.614+02:00",
"valueQuantity": {
"value": 74.37,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:bb4493c9-cd8e-d7fb-4e24-47171a0597f1",
"resource": {
"resourceType": "Observation",
"id": "bb4493c9-cd8e-d7fb-4e24-47171a0597f1",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-head-circumference" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9843-4",
"display": "Head Occipital-frontal circumference"
} ],
"text": "Head Occipital-frontal circumference"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
},
"effectiveDateTime": "2014-04-18T22:33:10+02:00",
"issued": "2014-04-18T22:33:10.614+02:00",
"valueQuantity": {
"value": 42.69,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:dc2d22b3-523c-6ce0-b6d6-e0bf291a057b",
"resource": {
"resourceType": "Observation",
"id": "dc2d22b3-523c-6ce0-b6d6-e0bf291a057b",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "85354-9",
"display": "Blood pressure panel with all children optional"
} ],
"text": "Blood pressure panel with all children optional"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
},
"effectiveDateTime": "2014-04-18T22:33:10+02:00",
"issued": "2014-04-18T22:33:10.614+02:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 86,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8480-6",
"display": "Systolic Blood Pressure"
} ],
"text": "Systolic Blood Pressure"
},
"valueQuantity": {
"value": 115,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e4457322-03c8-838c-cfaf-e17c8e958fd6",
"resource": {
"resourceType": "Observation",
"id": "e4457322-03c8-838c-cfaf-e17c8e958fd6",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8867-4",
"display": "Heart rate"
} ],
"text": "Heart rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
},
"effectiveDateTime": "2014-04-18T22:33:10+02:00",
"issued": "2014-04-18T22:33:10.614+02:00",
"valueQuantity": {
"value": 73,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:a39bad2c-e228-08a0-bf63-c94c4b90f344",
"resource": {
"resourceType": "Observation",
"id": "a39bad2c-e228-08a0-bf63-c94c4b90f344",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9279-1",
"display": "Respiratory rate"
} ],
"text": "Respiratory rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
},
"effectiveDateTime": "2014-04-18T22:33:10+02:00",
"issued": "2014-04-18T22:33:10.614+02:00",
"valueQuantity": {
"value": 14,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:726628f8-40f2-60c9-8a17-6342a3569179",
"resource": {
"resourceType": "Observation",
"id": "726628f8-40f2-60c9-8a17-6342a3569179",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social history"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72166-2",
"display": "Tobacco smoking status"
} ],
"text": "Tobacco smoking status"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
},
"effectiveDateTime": "2014-04-18T22:33:10+02:00",
"issued": "2014-04-18T22:33:10.614+02:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "266919005",
"display": "Never smoked tobacco (finding)"
} ],
"text": "Never smoked tobacco (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:12cbd6d5-8577-f6c8-f79c-3cbff9b6f5ba",
"resource": {
"resourceType": "Procedure",
"id": "12cbd6d5-8577-f6c8-f79c-3cbff9b6f5ba",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
},
"performedPeriod": {
"start": "2014-04-18T22:33:10+02:00",
"end": "2014-04-18T22:48:10+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:c31299ba-60a9-562a-2345-daa49a7102e8",
"resource": {
"resourceType": "Immunization",
"id": "c31299ba-60a9-562a-2345-daa49a7102e8",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "49",
"display": "Hib (PRP-OMP)"
} ],
"text": "Hib (PRP-OMP)"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
},
"occurrenceDateTime": "2014-04-18T22:33:10+02:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:a7426a22-7d97-5108-e3c1-3f56696aa2f4",
"resource": {
"resourceType": "Immunization",
"id": "a7426a22-7d97-5108-e3c1-3f56696aa2f4",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "119",
"display": "rotavirus, monovalent"
} ],
"text": "rotavirus, monovalent"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
},
"occurrenceDateTime": "2014-04-18T22:33:10+02:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:aeb15fa7-c53f-f191-6abf-b544087e3db0",
"resource": {
"resourceType": "Immunization",
"id": "aeb15fa7-c53f-f191-6abf-b544087e3db0",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "10",
"display": "IPV"
} ],
"text": "IPV"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
},
"occurrenceDateTime": "2014-04-18T22:33:10+02:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:5cdb3ef7-cbba-68aa-3997-35ea5bf54a19",
"resource": {
"resourceType": "Immunization",
"id": "5cdb3ef7-cbba-68aa-3997-35ea5bf54a19",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "20",
"display": "DTaP"
} ],
"text": "DTaP"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
},
"occurrenceDateTime": "2014-04-18T22:33:10+02:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:df11acf0-81a7-ced4-1fd0-86a3c00d6d90",
"resource": {
"resourceType": "Immunization",
"id": "df11acf0-81a7-ced4-1fd0-86a3c00d6d90",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "133",
"display": "Pneumococcal conjugate PCV 13"
} ],
"text": "Pneumococcal conjugate PCV 13"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
},
"occurrenceDateTime": "2014-04-18T22:33:10+02:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:0322519b-b73c-525f-e65c-5e97a3a67198",
"resource": {
"resourceType": "DiagnosticReport",
"id": "0322519b-b73c-525f-e65c-5e97a3a67198",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
},
"effectiveDateTime": "2014-04-18T22:33:10+02:00",
"issued": "2014-04-18T22:33:10.614+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:9f694925-4cd0-9380-f063-183f1d3872e3",
"resource": {
"resourceType": "DocumentReference",
"id": "9f694925-4cd0-9380-f063-183f1d3872e3",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:0322519b-b73c-525f-e65c-5e97a3a67198"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2014-04-18T22:33:10.614+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
} ],
"period": {
"start": "2014-04-18T22:33:10+02:00",
"end": "2014-04-18T22:48:10+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:1c2fbb2a-87f0-117b-7727-b64ce98cea03",
"resource": {
"resourceType": "Claim",
"id": "1c2fbb2a-87f0-117b-7727-b64ce98cea03",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2014-04-18T22:33:10+02:00",
"end": "2014-04-18T22:48:10+02:00"
},
"created": "2014-04-18T22:48:10+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:c31299ba-60a9-562a-2345-daa49a7102e8"
}
}, {
"sequence": 2,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:a7426a22-7d97-5108-e3c1-3f56696aa2f4"
}
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:aeb15fa7-c53f-f191-6abf-b544087e3db0"
}
}, {
"sequence": 4,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:5cdb3ef7-cbba-68aa-3997-35ea5bf54a19"
}
}, {
"sequence": 5,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:df11acf0-81a7-ced4-1fd0-86a3c00d6d90"
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:b6b2cc04-80cb-a8a4-4ef4-e89c9807b2a1"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:12cbd6d5-8577-f6c8-f79c-3cbff9b6f5ba"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "49",
"display": "Hib (PRP-OMP)"
} ],
"text": "Hib (PRP-OMP)"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 3,
"informationSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "119",
"display": "rotavirus, monovalent"
} ],
"text": "rotavirus, monovalent"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 4,
"informationSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "10",
"display": "IPV"
} ],
"text": "IPV"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 5,
"informationSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "20",
"display": "DTaP"
} ],
"text": "DTaP"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 6,
"informationSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "133",
"display": "Pneumococcal conjugate PCV 13"
} ],
"text": "Pneumococcal conjugate PCV 13"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 7,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
}
}, {
"sequence": 8,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"net": {
"value": 637.60,
"currency": "USD"
}
} ],
"total": {
"value": 1454.40,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:e0d31490-88ff-812c-93f1-65ba7cc5f5e9",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "e0d31490-88ff-812c-93f1-65ba7cc5f5e9",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "1c2fbb2a-87f0-117b-7727-b64ce98cea03"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2014-04-18T22:48:10+02:00",
"end": "2015-04-18T22:48:10+02:00"
},
"created": "2014-04-18T22:48:10+02:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"claim": {
"reference": "urn:uuid:1c2fbb2a-87f0-117b-7727-b64ce98cea03"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:b6b2cc04-80cb-a8a4-4ef4-e89c9807b2a1"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"servicedPeriod": {
"start": "2014-04-18T22:33:10+02:00",
"end": "2014-04-18T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "49",
"display": "Hib (PRP-OMP)"
} ],
"text": "Hib (PRP-OMP)"
},
"servicedPeriod": {
"start": "2014-04-18T22:33:10+02:00",
"end": "2014-04-18T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 3,
"informationSequence": [ 2 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "119",
"display": "rotavirus, monovalent"
} ],
"text": "rotavirus, monovalent"
},
"servicedPeriod": {
"start": "2014-04-18T22:33:10+02:00",
"end": "2014-04-18T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 4,
"informationSequence": [ 3 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "10",
"display": "IPV"
} ],
"text": "IPV"
},
"servicedPeriod": {
"start": "2014-04-18T22:33:10+02:00",
"end": "2014-04-18T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 5,
"informationSequence": [ 4 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "20",
"display": "DTaP"
} ],
"text": "DTaP"
},
"servicedPeriod": {
"start": "2014-04-18T22:33:10+02:00",
"end": "2014-04-18T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 6,
"informationSequence": [ 5 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "133",
"display": "Pneumococcal conjugate PCV 13"
} ],
"text": "Pneumococcal conjugate PCV 13"
},
"servicedPeriod": {
"start": "2014-04-18T22:33:10+02:00",
"end": "2014-04-18T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 7,
"diagnosisSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"servicedPeriod": {
"start": "2014-04-18T22:33:10+02:00",
"end": "2014-04-18T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 8,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"servicedPeriod": {
"start": "2014-04-18T22:33:10+02:00",
"end": "2014-04-18T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 637.60,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 127.52000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 510.08000000000004,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 637.60,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 637.60,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 1454.40,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 1054.08,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493",
"resource": {
"resourceType": "Encounter",
"id": "5a6d9a68-8a4a-b46c-20a9-5b870a0d0493",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2014-06-20T22:33:10+02:00",
"end": "2014-06-20T22:48:10+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
}
} ],
"period": {
"start": "2014-06-20T22:33:10+02:00",
"end": "2014-06-20T22:48:10+02:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:b4361fcc-3313-98f3-50b1-ea121f9a45ba",
"resource": {
"resourceType": "Condition",
"id": "b4361fcc-3313-98f3-50b1-ea121f9a45ba",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "resolved"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed"
} ]
},
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-category",
"code": "encounter-diagnosis",
"display": "Encounter Diagnosis"
} ]
} ],
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
},
"onsetDateTime": "2014-06-20T22:33:10+02:00",
"abatementDateTime": "2014-06-20T22:33:10+02:00",
"recordedDate": "2014-06-20T22:33:10+02:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:c2cad048-b297-64b1-fd81-d96288a571c3",
"resource": {
"resourceType": "Observation",
"id": "c2cad048-b297-64b1-fd81-d96288a571c3",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8302-2",
"display": "Body Height"
} ],
"text": "Body Height"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
},
"effectiveDateTime": "2014-06-20T22:33:10+02:00",
"issued": "2014-06-20T22:33:10.614+02:00",
"valueQuantity": {
"value": 67.7,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e2ad57cd-56dd-1848-0673-1208e73bfca8",
"resource": {
"resourceType": "Observation",
"id": "e2ad57cd-56dd-1848-0673-1208e73bfca8",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72514-3",
"display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
} ],
"text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
},
"effectiveDateTime": "2014-06-20T22:33:10+02:00",
"issued": "2014-06-20T22:33:10.614+02:00",
"valueQuantity": {
"value": 2,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:8081c706-205c-ccba-5d60-4a2d2ffca870",
"resource": {
"resourceType": "Observation",
"id": "8081c706-205c-ccba-5d60-4a2d2ffca870",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "29463-7",
"display": "Body Weight"
} ],
"text": "Body Weight"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
},
"effectiveDateTime": "2014-06-20T22:33:10+02:00",
"issued": "2014-06-20T22:33:10.614+02:00",
"valueQuantity": {
"value": 8.8,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:2b4ad797-c665-d31c-3ed2-0a0a9b0f4e0d",
"resource": {
"resourceType": "Observation",
"id": "2b4ad797-c665-d31c-3ed2-0a0a9b0f4e0d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-weight-for-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "77606-2",
"display": "Weight-for-length Per age and sex"
} ],
"text": "Weight-for-length Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
},
"effectiveDateTime": "2014-06-20T22:33:10+02:00",
"issued": "2014-06-20T22:33:10.614+02:00",
"valueQuantity": {
"value": 84.866,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:1b65742e-cf29-5bd4-b844-b96f7c4c3487",
"resource": {
"resourceType": "Observation",
"id": "1b65742e-cf29-5bd4-b844-b96f7c4c3487",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/head-occipital-frontal-circumference-percentile" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8289-1",
"display": "Head Occipital-frontal circumference Percentile"
} ],
"text": "Head Occipital-frontal circumference Percentile"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
},
"effectiveDateTime": "2014-06-20T22:33:10+02:00",
"issued": "2014-06-20T22:33:10.614+02:00",
"valueQuantity": {
"value": 74.37,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:dfd79d36-52f6-607a-bb40-435024973e3f",
"resource": {
"resourceType": "Observation",
"id": "dfd79d36-52f6-607a-bb40-435024973e3f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-head-circumference" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9843-4",
"display": "Head Occipital-frontal circumference"
} ],
"text": "Head Occipital-frontal circumference"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
},
"effectiveDateTime": "2014-06-20T22:33:10+02:00",
"issued": "2014-06-20T22:33:10.614+02:00",
"valueQuantity": {
"value": 44.28,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:c0f08104-e8ff-208d-8f8d-1fb2ee3471ba",
"resource": {
"resourceType": "Observation",
"id": "c0f08104-e8ff-208d-8f8d-1fb2ee3471ba",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "85354-9",
"display": "Blood pressure panel with all children optional"
} ],
"text": "Blood pressure panel with all children optional"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
},
"effectiveDateTime": "2014-06-20T22:33:10+02:00",
"issued": "2014-06-20T22:33:10.614+02:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 84,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8480-6",
"display": "Systolic Blood Pressure"
} ],
"text": "Systolic Blood Pressure"
},
"valueQuantity": {
"value": 115,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:85eb2225-dcf4-a62c-013d-79e1f091eb07",
"resource": {
"resourceType": "Observation",
"id": "85eb2225-dcf4-a62c-013d-79e1f091eb07",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8867-4",
"display": "Heart rate"
} ],
"text": "Heart rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
},
"effectiveDateTime": "2014-06-20T22:33:10+02:00",
"issued": "2014-06-20T22:33:10.614+02:00",
"valueQuantity": {
"value": 70,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:7800eaf2-4e0e-0309-cec5-c71e4186943e",
"resource": {
"resourceType": "Observation",
"id": "7800eaf2-4e0e-0309-cec5-c71e4186943e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9279-1",
"display": "Respiratory rate"
} ],
"text": "Respiratory rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
},
"effectiveDateTime": "2014-06-20T22:33:10+02:00",
"issued": "2014-06-20T22:33:10.614+02:00",
"valueQuantity": {
"value": 15,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e8fbe6b5-8a8c-cced-d870-073f8b06b16d",
"resource": {
"resourceType": "Observation",
"id": "e8fbe6b5-8a8c-cced-d870-073f8b06b16d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social history"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72166-2",
"display": "Tobacco smoking status"
} ],
"text": "Tobacco smoking status"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
},
"effectiveDateTime": "2014-06-20T22:33:10+02:00",
"issued": "2014-06-20T22:33:10.614+02:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "266919005",
"display": "Never smoked tobacco (finding)"
} ],
"text": "Never smoked tobacco (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:1885dfd0-fc99-70d0-354b-abf43b6e09f6",
"resource": {
"resourceType": "Procedure",
"id": "1885dfd0-fc99-70d0-354b-abf43b6e09f6",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
},
"performedPeriod": {
"start": "2014-06-20T22:33:10+02:00",
"end": "2014-06-20T22:48:10+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:cef5a8ec-46c1-3047-7846-9fef57c08a48",
"resource": {
"resourceType": "Immunization",
"id": "cef5a8ec-46c1-3047-7846-9fef57c08a48",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "49",
"display": "Hib (PRP-OMP)"
} ],
"text": "Hib (PRP-OMP)"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
},
"occurrenceDateTime": "2014-06-20T22:33:10+02:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:573e5fff-054e-a104-8240-9b60ea1f85c1",
"resource": {
"resourceType": "Immunization",
"id": "573e5fff-054e-a104-8240-9b60ea1f85c1",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "119",
"display": "rotavirus, monovalent"
} ],
"text": "rotavirus, monovalent"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
},
"occurrenceDateTime": "2014-06-20T22:33:10+02:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:d972a2eb-9f0c-b0a2-7432-dd29225aefd8",
"resource": {
"resourceType": "Immunization",
"id": "d972a2eb-9f0c-b0a2-7432-dd29225aefd8",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "10",
"display": "IPV"
} ],
"text": "IPV"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
},
"occurrenceDateTime": "2014-06-20T22:33:10+02:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:08bc276b-e00d-7873-d54f-94ca4acbe298",
"resource": {
"resourceType": "Immunization",
"id": "08bc276b-e00d-7873-d54f-94ca4acbe298",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "20",
"display": "DTaP"
} ],
"text": "DTaP"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
},
"occurrenceDateTime": "2014-06-20T22:33:10+02:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:ae852503-c81c-a41c-84a8-3de52417a7e1",
"resource": {
"resourceType": "Immunization",
"id": "ae852503-c81c-a41c-84a8-3de52417a7e1",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "133",
"display": "Pneumococcal conjugate PCV 13"
} ],
"text": "Pneumococcal conjugate PCV 13"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
},
"occurrenceDateTime": "2014-06-20T22:33:10+02:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:233ac195-7e34-63aa-e201-63891c680479",
"resource": {
"resourceType": "DiagnosticReport",
"id": "233ac195-7e34-63aa-e201-63891c680479",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
},
"effectiveDateTime": "2014-06-20T22:33:10+02:00",
"issued": "2014-06-20T22:33:10.614+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:1bd2cc76-41da-196c-b8d9-4a6c76e9b65d",
"resource": {
"resourceType": "DocumentReference",
"id": "1bd2cc76-41da-196c-b8d9-4a6c76e9b65d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:233ac195-7e34-63aa-e201-63891c680479"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2014-06-20T22:33:10.614+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
} ],
"period": {
"start": "2014-06-20T22:33:10+02:00",
"end": "2014-06-20T22:48:10+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:4c7f6922-71ee-0568-341f-e0d73c811260",
"resource": {
"resourceType": "Claim",
"id": "4c7f6922-71ee-0568-341f-e0d73c811260",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2014-06-20T22:33:10+02:00",
"end": "2014-06-20T22:48:10+02:00"
},
"created": "2014-06-20T22:48:10+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:cef5a8ec-46c1-3047-7846-9fef57c08a48"
}
}, {
"sequence": 2,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:573e5fff-054e-a104-8240-9b60ea1f85c1"
}
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:d972a2eb-9f0c-b0a2-7432-dd29225aefd8"
}
}, {
"sequence": 4,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:08bc276b-e00d-7873-d54f-94ca4acbe298"
}
}, {
"sequence": 5,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:ae852503-c81c-a41c-84a8-3de52417a7e1"
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:b4361fcc-3313-98f3-50b1-ea121f9a45ba"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:1885dfd0-fc99-70d0-354b-abf43b6e09f6"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "49",
"display": "Hib (PRP-OMP)"
} ],
"text": "Hib (PRP-OMP)"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 3,
"informationSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "119",
"display": "rotavirus, monovalent"
} ],
"text": "rotavirus, monovalent"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 4,
"informationSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "10",
"display": "IPV"
} ],
"text": "IPV"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 5,
"informationSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "20",
"display": "DTaP"
} ],
"text": "DTaP"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 6,
"informationSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "133",
"display": "Pneumococcal conjugate PCV 13"
} ],
"text": "Pneumococcal conjugate PCV 13"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 7,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
}
}, {
"sequence": 8,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"net": {
"value": 489.11,
"currency": "USD"
}
} ],
"total": {
"value": 1305.91,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:7ca67a1f-ad4f-5df9-27f8-0ed99089bca4",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "7ca67a1f-ad4f-5df9-27f8-0ed99089bca4",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "4c7f6922-71ee-0568-341f-e0d73c811260"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2014-06-20T22:48:10+02:00",
"end": "2015-06-20T22:48:10+02:00"
},
"created": "2014-06-20T22:48:10+02:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"claim": {
"reference": "urn:uuid:4c7f6922-71ee-0568-341f-e0d73c811260"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:b4361fcc-3313-98f3-50b1-ea121f9a45ba"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"servicedPeriod": {
"start": "2014-06-20T22:33:10+02:00",
"end": "2014-06-20T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "49",
"display": "Hib (PRP-OMP)"
} ],
"text": "Hib (PRP-OMP)"
},
"servicedPeriod": {
"start": "2014-06-20T22:33:10+02:00",
"end": "2014-06-20T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 3,
"informationSequence": [ 2 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "119",
"display": "rotavirus, monovalent"
} ],
"text": "rotavirus, monovalent"
},
"servicedPeriod": {
"start": "2014-06-20T22:33:10+02:00",
"end": "2014-06-20T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 4,
"informationSequence": [ 3 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "10",
"display": "IPV"
} ],
"text": "IPV"
},
"servicedPeriod": {
"start": "2014-06-20T22:33:10+02:00",
"end": "2014-06-20T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 5,
"informationSequence": [ 4 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "20",
"display": "DTaP"
} ],
"text": "DTaP"
},
"servicedPeriod": {
"start": "2014-06-20T22:33:10+02:00",
"end": "2014-06-20T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 6,
"informationSequence": [ 5 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "133",
"display": "Pneumococcal conjugate PCV 13"
} ],
"text": "Pneumococcal conjugate PCV 13"
},
"servicedPeriod": {
"start": "2014-06-20T22:33:10+02:00",
"end": "2014-06-20T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 7,
"diagnosisSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"servicedPeriod": {
"start": "2014-06-20T22:33:10+02:00",
"end": "2014-06-20T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 8,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"servicedPeriod": {
"start": "2014-06-20T22:33:10+02:00",
"end": "2014-06-20T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 489.11,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 97.822,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 391.288,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 489.11,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 489.11,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 1305.91,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 935.288,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5",
"resource": {
"resourceType": "Encounter",
"id": "18cfb879-6c94-f4b7-18b1-f79c5104d0f5",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2014-09-19T22:33:10+02:00",
"end": "2014-09-19T22:48:10+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
}
} ],
"period": {
"start": "2014-09-19T22:33:10+02:00",
"end": "2014-09-19T22:48:10+02:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:4fee0291-8872-f64a-16d9-c02bba20eb76",
"resource": {
"resourceType": "Condition",
"id": "4fee0291-8872-f64a-16d9-c02bba20eb76",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "resolved"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed"
} ]
},
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-category",
"code": "encounter-diagnosis",
"display": "Encounter Diagnosis"
} ]
} ],
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
},
"onsetDateTime": "2014-09-19T22:33:10+02:00",
"abatementDateTime": "2014-09-19T22:33:10+02:00",
"recordedDate": "2014-09-19T22:33:10+02:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:238920fa-ee95-23fb-109a-1cb85fb6fa1b",
"resource": {
"resourceType": "Observation",
"id": "238920fa-ee95-23fb-109a-1cb85fb6fa1b",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8302-2",
"display": "Body Height"
} ],
"text": "Body Height"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
},
"effectiveDateTime": "2014-09-19T22:33:10+02:00",
"issued": "2014-09-19T22:33:10.614+02:00",
"valueQuantity": {
"value": 72.6,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:da7185d4-3672-1109-8a59-8e1b8e406323",
"resource": {
"resourceType": "Observation",
"id": "da7185d4-3672-1109-8a59-8e1b8e406323",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72514-3",
"display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
} ],
"text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
},
"effectiveDateTime": "2014-09-19T22:33:10+02:00",
"issued": "2014-09-19T22:33:10.614+02:00",
"valueQuantity": {
"value": 1,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:bd3c663a-0b26-dc62-f45a-7518e1ad18e0",
"resource": {
"resourceType": "Observation",
"id": "bd3c663a-0b26-dc62-f45a-7518e1ad18e0",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "29463-7",
"display": "Body Weight"
} ],
"text": "Body Weight"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
},
"effectiveDateTime": "2014-09-19T22:33:10+02:00",
"issued": "2014-09-19T22:33:10.614+02:00",
"valueQuantity": {
"value": 10.4,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:10574e7a-07e3-a1dd-3857-cd35f6951e33",
"resource": {
"resourceType": "Observation",
"id": "10574e7a-07e3-a1dd-3857-cd35f6951e33",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-weight-for-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "77606-2",
"display": "Weight-for-length Per age and sex"
} ],
"text": "Weight-for-length Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
},
"effectiveDateTime": "2014-09-19T22:33:10+02:00",
"issued": "2014-09-19T22:33:10.614+02:00",
"valueQuantity": {
"value": 91.467,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:754d6336-38d3-fee7-5fc5-82a1b6afb8aa",
"resource": {
"resourceType": "Observation",
"id": "754d6336-38d3-fee7-5fc5-82a1b6afb8aa",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/head-occipital-frontal-circumference-percentile" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8289-1",
"display": "Head Occipital-frontal circumference Percentile"
} ],
"text": "Head Occipital-frontal circumference Percentile"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
},
"effectiveDateTime": "2014-09-19T22:33:10+02:00",
"issued": "2014-09-19T22:33:10.614+02:00",
"valueQuantity": {
"value": 74.37,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e9c3c31c-4004-8981-1a3b-57022c0801f4",
"resource": {
"resourceType": "Observation",
"id": "e9c3c31c-4004-8981-1a3b-57022c0801f4",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-head-circumference" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9843-4",
"display": "Head Occipital-frontal circumference"
} ],
"text": "Head Occipital-frontal circumference"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
},
"effectiveDateTime": "2014-09-19T22:33:10+02:00",
"issued": "2014-09-19T22:33:10.614+02:00",
"valueQuantity": {
"value": 45.91,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:a51d76dc-298f-d94a-665d-82182f0cd04a",
"resource": {
"resourceType": "Observation",
"id": "a51d76dc-298f-d94a-665d-82182f0cd04a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "85354-9",
"display": "Blood pressure panel with all children optional"
} ],
"text": "Blood pressure panel with all children optional"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
},
"effectiveDateTime": "2014-09-19T22:33:10+02:00",
"issued": "2014-09-19T22:33:10.614+02:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 74,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8480-6",
"display": "Systolic Blood Pressure"
} ],
"text": "Systolic Blood Pressure"
},
"valueQuantity": {
"value": 119,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:074161e5-af83-5e10-1aa9-5c67d65865e2",
"resource": {
"resourceType": "Observation",
"id": "074161e5-af83-5e10-1aa9-5c67d65865e2",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8867-4",
"display": "Heart rate"
} ],
"text": "Heart rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
},
"effectiveDateTime": "2014-09-19T22:33:10+02:00",
"issued": "2014-09-19T22:33:10.614+02:00",
"valueQuantity": {
"value": 85,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:4f8295e2-3fdd-1c18-a968-461f0c308dc7",
"resource": {
"resourceType": "Observation",
"id": "4f8295e2-3fdd-1c18-a968-461f0c308dc7",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9279-1",
"display": "Respiratory rate"
} ],
"text": "Respiratory rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
},
"effectiveDateTime": "2014-09-19T22:33:10+02:00",
"issued": "2014-09-19T22:33:10.614+02:00",
"valueQuantity": {
"value": 14,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:8cfb914b-ea1e-1b2c-b73c-c446ef854bad",
"resource": {
"resourceType": "Observation",
"id": "8cfb914b-ea1e-1b2c-b73c-c446ef854bad",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social history"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72166-2",
"display": "Tobacco smoking status"
} ],
"text": "Tobacco smoking status"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
},
"effectiveDateTime": "2014-09-19T22:33:10+02:00",
"issued": "2014-09-19T22:33:10.614+02:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "266919005",
"display": "Never smoked tobacco (finding)"
} ],
"text": "Never smoked tobacco (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:f1a30666-4379-6fb1-101c-7fb312458eeb",
"resource": {
"resourceType": "Procedure",
"id": "f1a30666-4379-6fb1-101c-7fb312458eeb",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
},
"performedPeriod": {
"start": "2014-09-19T22:33:10+02:00",
"end": "2014-09-19T22:48:10+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:2023f0d0-2e09-517c-a46a-27741db80c30",
"resource": {
"resourceType": "Immunization",
"id": "2023f0d0-2e09-517c-a46a-27741db80c30",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "10",
"display": "IPV"
} ],
"text": "IPV"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
},
"occurrenceDateTime": "2014-09-19T22:33:10+02:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:e1e8fbd3-0211-026f-e090-0b80a8ac41ed",
"resource": {
"resourceType": "Immunization",
"id": "e1e8fbd3-0211-026f-e090-0b80a8ac41ed",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
},
"occurrenceDateTime": "2014-09-19T22:33:10+02:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:dcc3fd8e-8cf5-d5b8-50c4-a4ce82c7c543",
"resource": {
"resourceType": "Immunization",
"id": "dcc3fd8e-8cf5-d5b8-50c4-a4ce82c7c543",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "20",
"display": "DTaP"
} ],
"text": "DTaP"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
},
"occurrenceDateTime": "2014-09-19T22:33:10+02:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:aa13d63e-6746-052d-240f-94a452981a36",
"resource": {
"resourceType": "Immunization",
"id": "aa13d63e-6746-052d-240f-94a452981a36",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "133",
"display": "Pneumococcal conjugate PCV 13"
} ],
"text": "Pneumococcal conjugate PCV 13"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
},
"occurrenceDateTime": "2014-09-19T22:33:10+02:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:7acded99-f0e6-6902-b1b9-319c5d399197",
"resource": {
"resourceType": "Immunization",
"id": "7acded99-f0e6-6902-b1b9-319c5d399197",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "08",
"display": "Hep B, adolescent or pediatric"
} ],
"text": "Hep B, adolescent or pediatric"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
},
"occurrenceDateTime": "2014-09-19T22:33:10+02:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:581699d6-3764-792e-bff5-fd27313392fe",
"resource": {
"resourceType": "DiagnosticReport",
"id": "581699d6-3764-792e-bff5-fd27313392fe",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
},
"effectiveDateTime": "2014-09-19T22:33:10+02:00",
"issued": "2014-09-19T22:33:10.614+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:8c29f77e-6304-9863-04f8-7abd5e1f2032",
"resource": {
"resourceType": "DocumentReference",
"id": "8c29f77e-6304-9863-04f8-7abd5e1f2032",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:581699d6-3764-792e-bff5-fd27313392fe"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2014-09-19T22:33:10.614+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
} ],
"period": {
"start": "2014-09-19T22:33:10+02:00",
"end": "2014-09-19T22:48:10+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:f753a40e-44e9-7e21-4b8e-01ca23d5ade3",
"resource": {
"resourceType": "Claim",
"id": "f753a40e-44e9-7e21-4b8e-01ca23d5ade3",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2014-09-19T22:33:10+02:00",
"end": "2014-09-19T22:48:10+02:00"
},
"created": "2014-09-19T22:48:10+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:2023f0d0-2e09-517c-a46a-27741db80c30"
}
}, {
"sequence": 2,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:e1e8fbd3-0211-026f-e090-0b80a8ac41ed"
}
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:dcc3fd8e-8cf5-d5b8-50c4-a4ce82c7c543"
}
}, {
"sequence": 4,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:aa13d63e-6746-052d-240f-94a452981a36"
}
}, {
"sequence": 5,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:7acded99-f0e6-6902-b1b9-319c5d399197"
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:4fee0291-8872-f64a-16d9-c02bba20eb76"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:f1a30666-4379-6fb1-101c-7fb312458eeb"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "10",
"display": "IPV"
} ],
"text": "IPV"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 3,
"informationSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 4,
"informationSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "20",
"display": "DTaP"
} ],
"text": "DTaP"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 5,
"informationSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "133",
"display": "Pneumococcal conjugate PCV 13"
} ],
"text": "Pneumococcal conjugate PCV 13"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 6,
"informationSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "08",
"display": "Hep B, adolescent or pediatric"
} ],
"text": "Hep B, adolescent or pediatric"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 7,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
}
}, {
"sequence": 8,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"net": {
"value": 434.57,
"currency": "USD"
}
} ],
"total": {
"value": 1251.37,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:3e97c72e-f7c1-cdad-3917-99c634291991",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "3e97c72e-f7c1-cdad-3917-99c634291991",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "f753a40e-44e9-7e21-4b8e-01ca23d5ade3"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2014-09-19T22:48:10+02:00",
"end": "2015-09-19T22:48:10+02:00"
},
"created": "2014-09-19T22:48:10+02:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"claim": {
"reference": "urn:uuid:f753a40e-44e9-7e21-4b8e-01ca23d5ade3"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:4fee0291-8872-f64a-16d9-c02bba20eb76"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"servicedPeriod": {
"start": "2014-09-19T22:33:10+02:00",
"end": "2014-09-19T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "10",
"display": "IPV"
} ],
"text": "IPV"
},
"servicedPeriod": {
"start": "2014-09-19T22:33:10+02:00",
"end": "2014-09-19T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 3,
"informationSequence": [ 2 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"servicedPeriod": {
"start": "2014-09-19T22:33:10+02:00",
"end": "2014-09-19T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 4,
"informationSequence": [ 3 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "20",
"display": "DTaP"
} ],
"text": "DTaP"
},
"servicedPeriod": {
"start": "2014-09-19T22:33:10+02:00",
"end": "2014-09-19T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 5,
"informationSequence": [ 4 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "133",
"display": "Pneumococcal conjugate PCV 13"
} ],
"text": "Pneumococcal conjugate PCV 13"
},
"servicedPeriod": {
"start": "2014-09-19T22:33:10+02:00",
"end": "2014-09-19T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 6,
"informationSequence": [ 5 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "08",
"display": "Hep B, adolescent or pediatric"
} ],
"text": "Hep B, adolescent or pediatric"
},
"servicedPeriod": {
"start": "2014-09-19T22:33:10+02:00",
"end": "2014-09-19T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 7,
"diagnosisSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"servicedPeriod": {
"start": "2014-09-19T22:33:10+02:00",
"end": "2014-09-19T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 8,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"servicedPeriod": {
"start": "2014-09-19T22:33:10+02:00",
"end": "2014-09-19T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 434.57,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 86.914,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 347.656,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 434.57,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 434.57,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 1251.37,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 891.656,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:00df02e9-e4e6-adec-6b74-c2c355ec727f",
"resource": {
"resourceType": "Encounter",
"id": "00df02e9-e4e6-adec-6b74-c2c355ec727f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "00df02e9-e4e6-adec-6b74-c2c355ec727f"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "EMER"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "50849002",
"display": "Emergency room admission (procedure)"
} ],
"text": "Emergency room admission (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2014-11-16T21:33:10+01:00",
"end": "2014-11-16T22:33:10+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996",
"display": "Dr. Orpha286 Marks830"
}
} ],
"period": {
"start": "2014-11-16T21:33:10+01:00",
"end": "2014-11-16T22:33:10+01:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "125605004",
"display": "Fracture of bone (disorder)"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|d9dfd791-2798-33ee-b149-c9bf3b11c8cd",
"display": "HATHAWAY MANOR EXTENDED CARE"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|d140ed3f-2696-3e78-bd77-1c959ec4fc4d",
"display": "HATHAWAY MANOR EXTENDED CARE"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:2e745d68-2c9a-e1f8-19c7-ea9bc43d5b12",
"resource": {
"resourceType": "Condition",
"id": "2e745d68-2c9a-e1f8-19c7-ea9bc43d5b12",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "resolved"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed"
} ]
},
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-category",
"code": "encounter-diagnosis",
"display": "Encounter Diagnosis"
} ]
} ],
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "125605004",
"display": "Fracture of bone (disorder)"
} ],
"text": "Fracture of bone (disorder)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:00df02e9-e4e6-adec-6b74-c2c355ec727f"
},
"onsetDateTime": "2014-11-16T21:33:10+01:00",
"abatementDateTime": "2015-02-03T21:53:59+01:00",
"recordedDate": "2014-11-16T21:33:10+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:93f93188-9945-71ad-66a2-bb4ad4b752bb",
"resource": {
"resourceType": "Condition",
"id": "93f93188-9945-71ad-66a2-bb4ad4b752bb",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "resolved"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed"
} ]
},
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-category",
"code": "encounter-diagnosis",
"display": "Encounter Diagnosis"
} ]
} ],
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "33737001",
"display": "Fracture of rib"
} ],
"text": "Fracture of rib"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:00df02e9-e4e6-adec-6b74-c2c355ec727f"
},
"onsetDateTime": "2014-11-16T21:33:10+01:00",
"abatementDateTime": "2015-02-03T21:53:59+01:00",
"recordedDate": "2014-11-16T21:33:10+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:a5dd34e8-22b5-06fc-c199-2fb2288c4a30",
"resource": {
"resourceType": "Procedure",
"id": "a5dd34e8-22b5-06fc-c199-2fb2288c4a30",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "399208008",
"display": "Chest X-ray"
} ],
"text": "Chest X-ray"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:00df02e9-e4e6-adec-6b74-c2c355ec727f"
},
"performedPeriod": {
"start": "2014-11-16T21:33:10+01:00",
"end": "2014-11-16T22:03:10+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|d9dfd791-2798-33ee-b149-c9bf3b11c8cd",
"display": "HATHAWAY MANOR EXTENDED CARE"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:0ba7e0c4-b798-3471-52a1-d8bb86543b03",
"resource": {
"resourceType": "Procedure",
"id": "0ba7e0c4-b798-3471-52a1-d8bb86543b03",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "274474001",
"display": "Bone immobilization"
} ],
"text": "Bone immobilization"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:00df02e9-e4e6-adec-6b74-c2c355ec727f"
},
"performedPeriod": {
"start": "2014-11-16T21:33:10+01:00",
"end": "2014-11-16T21:53:59+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|d9dfd791-2798-33ee-b149-c9bf3b11c8cd",
"display": "HATHAWAY MANOR EXTENDED CARE"
},
"reasonReference": [ {
"reference": "urn:uuid:93f93188-9945-71ad-66a2-bb4ad4b752bb",
"display": "Fracture of rib"
} ]
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:f5008691-173f-5021-69a8-390466a61584",
"resource": {
"resourceType": "MedicationRequest",
"id": "f5008691-173f-5021-69a8-390466a61584",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest" ]
},
"status": "stopped",
"intent": "order",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
"code": "community",
"display": "Community"
} ],
"text": "Community"
} ],
"medicationCodeableConcept": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "198405",
"display": "Ibuprofen 100 MG Oral Tablet"
} ],
"text": "Ibuprofen 100 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:00df02e9-e4e6-adec-6b74-c2c355ec727f"
},
"authoredOn": "2014-11-16T21:53:59+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996",
"display": "Dr. Orpha286 Marks830"
},
"dosageInstruction": [ {
"sequence": 1,
"text": "Take as needed.",
"asNeededBoolean": true
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:84a67f26-8293-2c74-0c13-71dc69c9c3f5",
"resource": {
"resourceType": "Claim",
"id": "84a67f26-8293-2c74-0c13-71dc69c9c3f5",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2014-11-16T21:33:10+01:00",
"end": "2014-11-16T22:33:10+01:00"
},
"created": "2014-11-16T22:33:10+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|d140ed3f-2696-3e78-bd77-1c959ec4fc4d",
"display": "HATHAWAY MANOR EXTENDED CARE"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:f5008691-173f-5021-69a8-390466a61584"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "198405",
"display": "Ibuprofen 100 MG Oral Tablet"
} ],
"text": "Ibuprofen 100 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:00df02e9-e4e6-adec-6b74-c2c355ec727f"
} ]
} ],
"total": {
"value": 534.34,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:94441d99-5b84-c25e-777e-7d03e07d1118",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "94441d99-5b84-c25e-777e-7d03e07d1118",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "84a67f26-8293-2c74-0c13-71dc69c9c3f5"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2014-11-16T22:33:10+01:00",
"end": "2015-11-16T22:33:10+01:00"
},
"created": "2014-11-16T22:33:10+01:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|d9dfd791-2798-33ee-b149-c9bf3b11c8cd",
"display": "HATHAWAY MANOR EXTENDED CARE"
},
"claim": {
"reference": "urn:uuid:84a67f26-8293-2c74-0c13-71dc69c9c3f5"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "198405",
"display": "Ibuprofen 100 MG Oral Tablet"
} ],
"text": "Ibuprofen 100 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2014-11-16T21:33:10+01:00",
"end": "2014-11-16T22:33:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
},
"encounter": [ {
"reference": "urn:uuid:00df02e9-e4e6-adec-6b74-c2c355ec727f"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 534.34,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:bf5906ab-d43e-0eab-aff6-fa7248fce3b5",
"resource": {
"resourceType": "CareTeam",
"id": "bf5906ab-d43e-0eab-aff6-fa7248fce3b5",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam" ]
},
"status": "inactive",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:00df02e9-e4e6-adec-6b74-c2c355ec727f"
},
"period": {
"start": "2014-11-16T21:53:59+01:00",
"end": "2015-02-03T21:53:59+01:00"
},
"participant": [ {
"role": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "116154003",
"display": "Patient"
} ],
"text": "Patient"
} ],
"member": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
}
}, {
"role": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "223366009",
"display": "Healthcare professional (occupation)"
} ],
"text": "Healthcare professional (occupation)"
} ],
"member": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996",
"display": "Dr. Orpha286 Marks830"
}
}, {
"role": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "224891009",
"display": "Healthcare services (qualifier value)"
} ],
"text": "Healthcare services (qualifier value)"
} ],
"member": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|d140ed3f-2696-3e78-bd77-1c959ec4fc4d",
"display": "HATHAWAY MANOR EXTENDED CARE"
}
} ],
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "33737001",
"display": "Fracture of rib"
} ],
"text": "Fracture of rib"
} ],
"managingOrganization": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|d140ed3f-2696-3e78-bd77-1c959ec4fc4d",
"display": "HATHAWAY MANOR EXTENDED CARE"
} ]
},
"request": {
"method": "POST",
"url": "CareTeam"
}
}, {
"fullUrl": "urn:uuid:52c99c0e-c1dd-6746-04d9-2de2a08cf3ca",
"resource": {
"resourceType": "CarePlan",
"id": "52c99c0e-c1dd-6746-04d9-2de2a08cf3ca",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan" ]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Care Plan for Fracture care.<br/>Care plan is meant to treat Fracture of rib.<br/>Activities: <ul><li>Fracture care</li><li>Fracture care</li></ul></div>"
},
"status": "completed",
"intent": "order",
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/careplan-category",
"code": "assess-plan"
} ]
}, {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "385691007",
"display": "Fracture care"
} ],
"text": "Fracture care"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:00df02e9-e4e6-adec-6b74-c2c355ec727f"
},
"period": {
"start": "2014-11-16T21:53:59+01:00",
"end": "2015-02-03T21:53:59+01:00"
},
"careTeam": [ {
"reference": "urn:uuid:bf5906ab-d43e-0eab-aff6-fa7248fce3b5"
} ],
"addresses": [ {
"reference": "urn:uuid:93f93188-9945-71ad-66a2-bb4ad4b752bb"
} ],
"activity": [ {
"detail": {
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "183051005",
"display": "Recommendation to rest"
} ],
"text": "Recommendation to rest"
},
"reasonReference": [ {
"reference": "urn:uuid:93f93188-9945-71ad-66a2-bb4ad4b752bb"
} ],
"status": "completed",
"location": {
"display": "HATHAWAY MANOR EXTENDED CARE"
}
}
}, {
"detail": {
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "408580007",
"display": "Physical activity target light exercise"
} ],
"text": "Physical activity target light exercise"
},
"reasonReference": [ {
"reference": "urn:uuid:93f93188-9945-71ad-66a2-bb4ad4b752bb"
} ],
"status": "completed",
"location": {
"display": "HATHAWAY MANOR EXTENDED CARE"
}
}
} ]
},
"request": {
"method": "POST",
"url": "CarePlan"
}
}, {
"fullUrl": "urn:uuid:f20c50af-7173-82ff-30d1-ec9818a909d0",
"resource": {
"resourceType": "ImagingStudy",
"id": "f20c50af-7173-82ff-30d1-ec9818a909d0",
"identifier": [ {
"use": "official",
"system": "urn:ietf:rfc:3986",
"value": "urn:oid:1.2.840.99999999.52492227.1416169990614"
} ],
"status": "available",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:00df02e9-e4e6-adec-6b74-c2c355ec727f"
},
"started": "2014-11-16T21:33:10+01:00",
"numberOfSeries": 1,
"numberOfInstances": 1,
"procedureCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "399208008",
"display": "Chest X-ray"
} ],
"text": "Chest X-ray"
} ],
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|d9dfd791-2798-33ee-b149-c9bf3b11c8cd",
"display": "HATHAWAY MANOR EXTENDED CARE"
},
"series": [ {
"uid": "1.2.840.99999999.1.76072001.1416169990614",
"number": 1,
"modality": {
"system": "http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html",
"code": "DX",
"display": "Digital Radiography"
},
"numberOfInstances": 1,
"bodySite": {
"system": "http://snomed.info/sct",
"code": "51185008",
"display": "Chest"
},
"started": "2014-11-16T21:33:10+01:00",
"instance": [ {
"uid": "1.2.840.99999999.1.1.90146190.1416169990614",
"sopClass": {
"system": "urn:ietf:rfc:3986",
"code": "urn:oid:1.2.840.10008.5.1.4.1.1.1.1"
},
"number": 1,
"title": "Image of chest"
} ]
} ]
},
"request": {
"method": "POST",
"url": "ImagingStudy"
}
}, {
"fullUrl": "urn:uuid:bd3f6271-beaf-13d8-fede-dfff0296503f",
"resource": {
"resourceType": "DiagnosticReport",
"id": "bd3f6271-beaf-13d8-fede-dfff0296503f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:00df02e9-e4e6-adec-6b74-c2c355ec727f"
},
"effectiveDateTime": "2014-11-16T21:33:10+01:00",
"issued": "2014-11-16T21:33:10.614+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996",
"display": "Dr. Orpha286 Marks830"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:257bf7ce-71cc-6590-5f5f-31db6db8cfaf",
"resource": {
"resourceType": "DocumentReference",
"id": "257bf7ce-71cc-6590-5f5f-31db6db8cfaf",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:bd3f6271-beaf-13d8-fede-dfff0296503f"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2014-11-16T21:33:10.614+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996",
"display": "Dr. Orpha286 Marks830"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|d140ed3f-2696-3e78-bd77-1c959ec4fc4d",
"display": "HATHAWAY MANOR EXTENDED CARE"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:00df02e9-e4e6-adec-6b74-c2c355ec727f"
} ],
"period": {
"start": "2014-11-16T21:33:10+01:00",
"end": "2014-11-16T22:33:10+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:82041297-6c19-d0b2-282a-86ac7d52df21",
"resource": {
"resourceType": "Claim",
"id": "82041297-6c19-d0b2-282a-86ac7d52df21",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "institutional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2014-11-16T21:33:10+01:00",
"end": "2014-11-16T22:33:10+01:00"
},
"created": "2014-11-16T22:33:10+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|d140ed3f-2696-3e78-bd77-1c959ec4fc4d",
"display": "HATHAWAY MANOR EXTENDED CARE"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|d9dfd791-2798-33ee-b149-c9bf3b11c8cd",
"display": "HATHAWAY MANOR EXTENDED CARE"
},
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:2e745d68-2c9a-e1f8-19c7-ea9bc43d5b12"
}
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:93f93188-9945-71ad-66a2-bb4ad4b752bb"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:a5dd34e8-22b5-06fc-c199-2fb2288c4a30"
}
}, {
"sequence": 2,
"procedureReference": {
"reference": "urn:uuid:0ba7e0c4-b798-3471-52a1-d8bb86543b03"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "50849002",
"display": "Emergency room admission (procedure)"
} ],
"text": "Emergency room admission (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:00df02e9-e4e6-adec-6b74-c2c355ec727f"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "125605004",
"display": "Fracture of bone (disorder)"
} ],
"text": "Fracture of bone (disorder)"
}
}, {
"sequence": 3,
"diagnosisSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "33737001",
"display": "Fracture of rib"
} ],
"text": "Fracture of rib"
}
}, {
"sequence": 4,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "399208008",
"display": "Chest X-ray"
} ],
"text": "Chest X-ray"
},
"net": {
"value": 6454.61,
"currency": "USD"
}
}, {
"sequence": 5,
"procedureSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "274474001",
"display": "Bone immobilization"
} ],
"text": "Bone immobilization"
},
"net": {
"value": 431.40,
"currency": "USD"
}
} ],
"total": {
"value": 7032.19,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:b98ad508-85c9-725e-9cc5-347305fe0718",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "b98ad508-85c9-725e-9cc5-347305fe0718",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "82041297-6c19-d0b2-282a-86ac7d52df21"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "institutional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2014-11-16T22:33:10+01:00",
"end": "2015-11-16T22:33:10+01:00"
},
"created": "2014-11-16T22:33:10+01:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|d9dfd791-2798-33ee-b149-c9bf3b11c8cd",
"display": "HATHAWAY MANOR EXTENDED CARE"
},
"claim": {
"reference": "urn:uuid:82041297-6c19-d0b2-282a-86ac7d52df21"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:2e745d68-2c9a-e1f8-19c7-ea9bc43d5b12"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:93f93188-9945-71ad-66a2-bb4ad4b752bb"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "50849002",
"display": "Emergency room admission (procedure)"
} ],
"text": "Emergency room admission (procedure)"
},
"servicedPeriod": {
"start": "2014-11-16T21:33:10+01:00",
"end": "2014-11-16T22:33:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
},
"encounter": [ {
"reference": "urn:uuid:00df02e9-e4e6-adec-6b74-c2c355ec727f"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "125605004",
"display": "Fracture of bone (disorder)"
} ],
"text": "Fracture of bone (disorder)"
},
"servicedPeriod": {
"start": "2014-11-16T21:33:10+01:00",
"end": "2014-11-16T22:33:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
}
}, {
"sequence": 3,
"diagnosisSequence": [ 2 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "33737001",
"display": "Fracture of rib"
} ],
"text": "Fracture of rib"
},
"servicedPeriod": {
"start": "2014-11-16T21:33:10+01:00",
"end": "2014-11-16T22:33:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
}
}, {
"sequence": 4,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "399208008",
"display": "Chest X-ray"
} ],
"text": "Chest X-ray"
},
"servicedPeriod": {
"start": "2014-11-16T21:33:10+01:00",
"end": "2014-11-16T22:33:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
},
"net": {
"value": 6454.61,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 1290.922,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 5163.688,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 6454.61,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 6454.61,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 5,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "274474001",
"display": "Bone immobilization"
} ],
"text": "Bone immobilization"
},
"servicedPeriod": {
"start": "2014-11-16T21:33:10+01:00",
"end": "2014-11-16T22:33:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
},
"net": {
"value": 431.40,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 86.28,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 345.12,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 431.40,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 431.40,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 7032.19,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 5508.808,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:95084245-f1bb-1c23-f9d9-85c99449babe",
"resource": {
"resourceType": "Encounter",
"id": "95084245-f1bb-1c23-f9d9-85c99449babe",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "95084245-f1bb-1c23-f9d9-85c99449babe"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2014-12-19T21:33:10+01:00",
"end": "2014-12-19T21:48:10+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
}
} ],
"period": {
"start": "2014-12-19T21:33:10+01:00",
"end": "2014-12-19T21:48:10+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:6d1e4349-525c-ac78-3139-29902bd1aa3f",
"resource": {
"resourceType": "Condition",
"id": "6d1e4349-525c-ac78-3139-29902bd1aa3f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "resolved"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed"
} ]
},
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-category",
"code": "encounter-diagnosis",
"display": "Encounter Diagnosis"
} ]
} ],
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:95084245-f1bb-1c23-f9d9-85c99449babe"
},
"onsetDateTime": "2014-12-19T21:33:10+01:00",
"abatementDateTime": "2015-03-20T21:33:10+01:00",
"recordedDate": "2014-12-19T21:33:10+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:5e60afce-5f0d-efa1-efa6-23d7ac17cd66",
"resource": {
"resourceType": "Observation",
"id": "5e60afce-5f0d-efa1-efa6-23d7ac17cd66",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8302-2",
"display": "Body Height"
} ],
"text": "Body Height"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:95084245-f1bb-1c23-f9d9-85c99449babe"
},
"effectiveDateTime": "2014-12-19T21:33:10+01:00",
"issued": "2014-12-19T21:33:10.614+01:00",
"valueQuantity": {
"value": 76.6,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:5442a7a7-d297-caef-141c-6a19555fe397",
"resource": {
"resourceType": "Observation",
"id": "5442a7a7-d297-caef-141c-6a19555fe397",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72514-3",
"display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
} ],
"text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:95084245-f1bb-1c23-f9d9-85c99449babe"
},
"effectiveDateTime": "2014-12-19T21:33:10+01:00",
"issued": "2014-12-19T21:33:10.614+01:00",
"valueQuantity": {
"value": 1,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:cc7975db-e9c5-5c11-a15d-2bc702d4b351",
"resource": {
"resourceType": "Observation",
"id": "cc7975db-e9c5-5c11-a15d-2bc702d4b351",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "29463-7",
"display": "Body Weight"
} ],
"text": "Body Weight"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:95084245-f1bb-1c23-f9d9-85c99449babe"
},
"effectiveDateTime": "2014-12-19T21:33:10+01:00",
"issued": "2014-12-19T21:33:10.614+01:00",
"valueQuantity": {
"value": 11.7,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:7a980e42-76b4-4fe9-4c02-a71419de162e",
"resource": {
"resourceType": "Observation",
"id": "7a980e42-76b4-4fe9-4c02-a71419de162e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-weight-for-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "77606-2",
"display": "Weight-for-length Per age and sex"
} ],
"text": "Weight-for-length Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:95084245-f1bb-1c23-f9d9-85c99449babe"
},
"effectiveDateTime": "2014-12-19T21:33:10+01:00",
"issued": "2014-12-19T21:33:10.614+01:00",
"valueQuantity": {
"value": 95.09,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:3e5b9ce7-00a7-b995-f751-e8fcdf459581",
"resource": {
"resourceType": "Observation",
"id": "3e5b9ce7-00a7-b995-f751-e8fcdf459581",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/head-occipital-frontal-circumference-percentile" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8289-1",
"display": "Head Occipital-frontal circumference Percentile"
} ],
"text": "Head Occipital-frontal circumference Percentile"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:95084245-f1bb-1c23-f9d9-85c99449babe"
},
"effectiveDateTime": "2014-12-19T21:33:10+01:00",
"issued": "2014-12-19T21:33:10.614+01:00",
"valueQuantity": {
"value": 74.37,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:4749d7b7-c339-a70b-df0b-62ccf645f095",
"resource": {
"resourceType": "Observation",
"id": "4749d7b7-c339-a70b-df0b-62ccf645f095",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-head-circumference" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9843-4",
"display": "Head Occipital-frontal circumference"
} ],
"text": "Head Occipital-frontal circumference"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:95084245-f1bb-1c23-f9d9-85c99449babe"
},
"effectiveDateTime": "2014-12-19T21:33:10+01:00",
"issued": "2014-12-19T21:33:10.614+01:00",
"valueQuantity": {
"value": 47.04,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:3e2f3e40-b8ac-6688-ba97-69874d0c4db5",
"resource": {
"resourceType": "Observation",
"id": "3e2f3e40-b8ac-6688-ba97-69874d0c4db5",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "85354-9",
"display": "Blood pressure panel with all children optional"
} ],
"text": "Blood pressure panel with all children optional"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:95084245-f1bb-1c23-f9d9-85c99449babe"
},
"effectiveDateTime": "2014-12-19T21:33:10+01:00",
"issued": "2014-12-19T21:33:10.614+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 80,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8480-6",
"display": "Systolic Blood Pressure"
} ],
"text": "Systolic Blood Pressure"
},
"valueQuantity": {
"value": 124,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:8c182631-abc3-3c4b-b20b-7d0bf839db5a",
"resource": {
"resourceType": "Observation",
"id": "8c182631-abc3-3c4b-b20b-7d0bf839db5a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8867-4",
"display": "Heart rate"
} ],
"text": "Heart rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:95084245-f1bb-1c23-f9d9-85c99449babe"
},
"effectiveDateTime": "2014-12-19T21:33:10+01:00",
"issued": "2014-12-19T21:33:10.614+01:00",
"valueQuantity": {
"value": 81,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:8afc0338-dad9-9bbb-23ae-28ebadf4eb94",
"resource": {
"resourceType": "Observation",
"id": "8afc0338-dad9-9bbb-23ae-28ebadf4eb94",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9279-1",
"display": "Respiratory rate"
} ],
"text": "Respiratory rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:95084245-f1bb-1c23-f9d9-85c99449babe"
},
"effectiveDateTime": "2014-12-19T21:33:10+01:00",
"issued": "2014-12-19T21:33:10.614+01:00",
"valueQuantity": {
"value": 15,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:98675277-19a8-2cfd-1026-019de4e0377e",
"resource": {
"resourceType": "Observation",
"id": "98675277-19a8-2cfd-1026-019de4e0377e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social history"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72166-2",
"display": "Tobacco smoking status"
} ],
"text": "Tobacco smoking status"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:95084245-f1bb-1c23-f9d9-85c99449babe"
},
"effectiveDateTime": "2014-12-19T21:33:10+01:00",
"issued": "2014-12-19T21:33:10.614+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "266919005",
"display": "Never smoked tobacco (finding)"
} ],
"text": "Never smoked tobacco (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:f2a8b37b-2574-3cda-75e7-ae95ad42b5a9",
"resource": {
"resourceType": "DiagnosticReport",
"id": "f2a8b37b-2574-3cda-75e7-ae95ad42b5a9",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:95084245-f1bb-1c23-f9d9-85c99449babe"
},
"effectiveDateTime": "2014-12-19T21:33:10+01:00",
"issued": "2014-12-19T21:33:10.614+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "CjIwMTQtMTItMTkKCiMgQ2hpZWYgQ29tcGxhaW50Ck5vIGNvbXBsYWludHMuCgojIEhpc3Rvcnkgb2YgUHJlc2VudCBJbGxuZXNzCkRvbm5lbGw1MzQKIGlzIGEgMTEgbW9udGgtb2xkIG5vbmhpc3BhbmljIHdoaXRlIG1hbGUuIFBhdGllbnQgaGFzIGEgaGlzdG9yeSBvZiBtZWRpY2F0aW9uIHJldmlldyBkdWUgKHNpdHVhdGlvbiksIGZyYWN0dXJlIG9mIGJvbmUgKGRpc29yZGVyKSwgZnJhY3R1cmUgb2YgcmliLgoKIyBTb2NpYWwgSGlzdG9yeQogUGF0aWVudCBoYXMgbmV2ZXIgc21va2VkLgoKClBhdGllbnQgY29tZXMgZnJvbSBhIGhpZ2ggc29jaW9lY29ub21pYyBiYWNrZ3JvdW5kLgoKUGF0aWVudCBjdXJyZW50bHkgaGFzIEFudGhlbS4KCiMgQWxsZXJnaWVzCk5vIEtub3duIEFsbGVyZ2llcy4KCiMgTWVkaWNhdGlvbnMKaWJ1cHJvZmVuIDEwMCBtZyBvcmFsIHRhYmxldAoKIyBBc3Nlc3NtZW50IGFuZCBQbGFuClBhdGllbnQgaXMgcHJlc2VudGluZyB3aXRoIG1lZGljYXRpb24gcmV2aWV3IGR1ZSAoc2l0dWF0aW9uKS4gCgojIyBQbGFuCgo="
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:0a8825bb-330d-8861-fe4e-99d52ae65c9f",
"resource": {
"resourceType": "DocumentReference",
"id": "0a8825bb-330d-8861-fe4e-99d52ae65c9f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:f2a8b37b-2574-3cda-75e7-ae95ad42b5a9"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2014-12-19T21:33:10.614+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:95084245-f1bb-1c23-f9d9-85c99449babe"
} ],
"period": {
"start": "2014-12-19T21:33:10+01:00",
"end": "2014-12-19T21:48:10+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:87b897a8-87ea-7bc5-c877-6795f7520f4c",
"resource": {
"resourceType": "Claim",
"id": "87b897a8-87ea-7bc5-c877-6795f7520f4c",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2014-12-19T21:33:10+01:00",
"end": "2014-12-19T21:48:10+01:00"
},
"created": "2014-12-19T21:48:10+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:6d1e4349-525c-ac78-3139-29902bd1aa3f"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:95084245-f1bb-1c23-f9d9-85c99449babe"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
}
} ],
"total": {
"value": 136.80,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:2360ac01-32b7-1f35-6f53-4b96a54e5b9c",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "2360ac01-32b7-1f35-6f53-4b96a54e5b9c",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "87b897a8-87ea-7bc5-c877-6795f7520f4c"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2014-12-19T21:48:10+01:00",
"end": "2015-12-19T21:48:10+01:00"
},
"created": "2014-12-19T21:48:10+01:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"claim": {
"reference": "urn:uuid:87b897a8-87ea-7bc5-c877-6795f7520f4c"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:6d1e4349-525c-ac78-3139-29902bd1aa3f"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"servicedPeriod": {
"start": "2014-12-19T21:33:10+01:00",
"end": "2014-12-19T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:95084245-f1bb-1c23-f9d9-85c99449babe"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"servicedPeriod": {
"start": "2014-12-19T21:33:10+01:00",
"end": "2014-12-19T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 136.80,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:dd02a3ee-a111-9c73-382a-def02091e20c",
"resource": {
"resourceType": "Encounter",
"id": "dd02a3ee-a111-9c73-382a-def02091e20c",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "dd02a3ee-a111-9c73-382a-def02091e20c"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185347001",
"display": "Encounter for problem"
} ],
"text": "Encounter for problem"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2015-01-02T11:33:10+01:00",
"end": "2015-01-02T11:48:10+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
}
} ],
"period": {
"start": "2015-01-02T11:33:10+01:00",
"end": "2015-01-02T11:48:10+01:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "102263004",
"display": "Eggs (edible) (substance)"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:d6ca3639-0461-f948-73fa-0975d10c563a",
"resource": {
"resourceType": "CareTeam",
"id": "d6ca3639-0461-f948-73fa-0975d10c563a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam" ]
},
"status": "active",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:dd02a3ee-a111-9c73-382a-def02091e20c"
},
"period": {
"start": "2015-01-02T11:33:10+01:00"
},
"participant": [ {
"role": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "116154003",
"display": "Patient"
} ],
"text": "Patient"
} ],
"member": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
}
}, {
"role": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "223366009",
"display": "Healthcare professional (occupation)"
} ],
"text": "Healthcare professional (occupation)"
} ],
"member": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
}
}, {
"role": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "224891009",
"display": "Healthcare services (qualifier value)"
} ],
"text": "Healthcare services (qualifier value)"
} ],
"member": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
}
} ],
"managingOrganization": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
} ]
},
"request": {
"method": "POST",
"url": "CareTeam"
}
}, {
"fullUrl": "urn:uuid:9122b747-7385-5eeb-015b-7a20fefed327",
"resource": {
"resourceType": "CarePlan",
"id": "9122b747-7385-5eeb-015b-7a20fefed327",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan" ]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Care Plan for Self-care interventions (procedure).<br/>Activities: <ul><li>Self-care interventions (procedure)</li><li>Self-care interventions (procedure)</li></ul></div>"
},
"status": "active",
"intent": "order",
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/careplan-category",
"code": "assess-plan"
} ]
}, {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "384758001",
"display": "Self-care interventions (procedure)"
} ],
"text": "Self-care interventions (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:dd02a3ee-a111-9c73-382a-def02091e20c"
},
"period": {
"start": "2015-01-02T11:33:10+01:00"
},
"careTeam": [ {
"reference": "urn:uuid:d6ca3639-0461-f948-73fa-0975d10c563a"
} ],
"activity": [ {
"detail": {
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "409002",
"display": "Food allergy diet"
} ],
"text": "Food allergy diet"
},
"status": "in-progress",
"location": {
"display": "AP MEDICAL LLC"
}
}
}, {
"detail": {
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "58332002",
"display": "Allergy education"
} ],
"text": "Allergy education"
},
"status": "in-progress",
"location": {
"display": "AP MEDICAL LLC"
}
}
} ]
},
"request": {
"method": "POST",
"url": "CarePlan"
}
}, {
"fullUrl": "urn:uuid:4baf4018-b4e0-1e72-8f96-7c7ff67f9bff",
"resource": {
"resourceType": "DiagnosticReport",
"id": "4baf4018-b4e0-1e72-8f96-7c7ff67f9bff",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:dd02a3ee-a111-9c73-382a-def02091e20c"
},
"effectiveDateTime": "2015-01-02T11:33:10+01:00",
"issued": "2015-01-02T11:33:10.614+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:f7ac69f8-249f-778f-f398-d4175e82b19c",
"resource": {
"resourceType": "DocumentReference",
"id": "f7ac69f8-249f-778f-f398-d4175e82b19c",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:4baf4018-b4e0-1e72-8f96-7c7ff67f9bff"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2015-01-02T11:33:10.614+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:dd02a3ee-a111-9c73-382a-def02091e20c"
} ],
"period": {
"start": "2015-01-02T11:33:10+01:00",
"end": "2015-01-02T11:48:10+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:97ffe146-2a0c-d21a-a11f-70bea59d78c9",
"resource": {
"resourceType": "Claim",
"id": "97ffe146-2a0c-d21a-a11f-70bea59d78c9",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2015-01-02T11:33:10+01:00",
"end": "2015-01-02T11:48:10+01:00"
},
"created": "2015-01-02T11:48:10+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185347001",
"display": "Encounter for problem"
} ],
"text": "Encounter for problem"
},
"encounter": [ {
"reference": "urn:uuid:dd02a3ee-a111-9c73-382a-def02091e20c"
} ]
} ],
"total": {
"value": 85.55,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:3514731b-27a6-7f87-042e-46185b734a2d",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "3514731b-27a6-7f87-042e-46185b734a2d",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "97ffe146-2a0c-d21a-a11f-70bea59d78c9"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2015-01-02T11:48:10+01:00",
"end": "2016-01-02T11:48:10+01:00"
},
"created": "2015-01-02T11:48:10+01:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
},
"claim": {
"reference": "urn:uuid:97ffe146-2a0c-d21a-a11f-70bea59d78c9"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185347001",
"display": "Encounter for problem"
} ],
"text": "Encounter for problem"
},
"servicedPeriod": {
"start": "2015-01-02T11:33:10+01:00",
"end": "2015-01-02T11:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:dd02a3ee-a111-9c73-382a-def02091e20c"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 85.55,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1",
"resource": {
"resourceType": "Encounter",
"id": "c2f04081-6198-8e47-02e9-7fc1dea458b1",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "c2f04081-6198-8e47-02e9-7fc1dea458b1"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185347001",
"display": "Encounter for problem"
} ],
"text": "Encounter for problem"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2015-01-12T07:33:10+01:00",
"end": "2015-01-12T08:12:21+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
}
} ],
"period": {
"start": "2015-01-12T07:33:10+01:00",
"end": "2015-01-12T08:12:21+01:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "419199007",
"display": "Allergy to substance (finding)"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:17c42322-f465-7164-21a2-3c87e76a62b2",
"resource": {
"resourceType": "AllergyIntolerance",
"id": "17c42322-f465-7164-21a2-3c87e76a62b2",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code": "confirmed"
} ]
},
"type": "allergy",
"category": [ "environment" ],
"criticality": "low",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "419199007",
"display": "Allergy to substance (finding)"
} ],
"text": "Allergy to substance (finding)"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"recordedDate": "2015-01-12T07:33:10+01:00"
},
"request": {
"method": "POST",
"url": "AllergyIntolerance"
}
}, {
"fullUrl": "urn:uuid:4c5fbcfc-4374-210b-6859-fee6284ee11c",
"resource": {
"resourceType": "AllergyIntolerance",
"id": "4c5fbcfc-4374-210b-6859-fee6284ee11c",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code": "confirmed"
} ]
},
"type": "allergy",
"category": [ "environment" ],
"criticality": "low",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "111088007",
"display": "Latex (substance)"
} ],
"text": "Latex (substance)"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"recordedDate": "2015-01-12T07:33:10+01:00",
"reaction": [ {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "39579001",
"display": "Anaphylaxis (disorder)"
} ],
"text": "Anaphylaxis (disorder)"
} ]
} ]
},
"request": {
"method": "POST",
"url": "AllergyIntolerance"
}
}, {
"fullUrl": "urn:uuid:62618968-70c5-0ba4-e662-5418232dda97",
"resource": {
"resourceType": "AllergyIntolerance",
"id": "62618968-70c5-0ba4-e662-5418232dda97",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code": "confirmed"
} ]
},
"type": "allergy",
"category": [ "environment" ],
"criticality": "low",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "288328004",
"display": "Bee venom (substance)"
} ],
"text": "Bee venom (substance)"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"recordedDate": "2015-01-12T07:33:10+01:00",
"reaction": [ {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "271807003",
"display": "Eruption of skin (disorder)"
} ],
"text": "Eruption of skin (disorder)"
} ]
} ]
},
"request": {
"method": "POST",
"url": "AllergyIntolerance"
}
}, {
"fullUrl": "urn:uuid:5c3fb081-fff8-b10d-e65c-48bb61832994",
"resource": {
"resourceType": "AllergyIntolerance",
"id": "5c3fb081-fff8-b10d-e65c-48bb61832994",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code": "confirmed"
} ]
},
"type": "allergy",
"category": [ "environment" ],
"criticality": "low",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "84489001",
"display": "Mold (organism)"
} ],
"text": "Mold (organism)"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"recordedDate": "2015-01-12T07:33:10+01:00",
"reaction": [ {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "21626009",
"display": "Allergic skin rash"
} ],
"text": "Allergic skin rash"
} ]
}, {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "267101005",
"display": "Nose running"
} ],
"text": "Nose running"
} ]
} ]
},
"request": {
"method": "POST",
"url": "AllergyIntolerance"
}
}, {
"fullUrl": "urn:uuid:40a0906a-d708-103a-8779-5f0df6f6eb4e",
"resource": {
"resourceType": "AllergyIntolerance",
"id": "40a0906a-d708-103a-8779-5f0df6f6eb4e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code": "confirmed"
} ]
},
"type": "allergy",
"category": [ "environment" ],
"criticality": "low",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "260147004",
"display": "House dust mite (organism)"
} ],
"text": "House dust mite (organism)"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"recordedDate": "2015-01-12T07:33:10+01:00"
},
"request": {
"method": "POST",
"url": "AllergyIntolerance"
}
}, {
"fullUrl": "urn:uuid:2fe43f3d-9f8b-2416-a335-9bb3f6d081d3",
"resource": {
"resourceType": "AllergyIntolerance",
"id": "2fe43f3d-9f8b-2416-a335-9bb3f6d081d3",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code": "confirmed"
} ]
},
"type": "allergy",
"category": [ "environment" ],
"criticality": "low",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "264287008",
"display": "Animal dander (substance)"
} ],
"text": "Animal dander (substance)"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"recordedDate": "2015-01-12T07:33:10+01:00",
"reaction": [ {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "271807003",
"display": "Eruption of skin (disorder)"
} ],
"text": "Eruption of skin (disorder)"
} ]
} ]
},
"request": {
"method": "POST",
"url": "AllergyIntolerance"
}
}, {
"fullUrl": "urn:uuid:72f14094-2607-e849-bbdc-b7a0cc229f39",
"resource": {
"resourceType": "AllergyIntolerance",
"id": "72f14094-2607-e849-bbdc-b7a0cc229f39",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code": "confirmed"
} ]
},
"type": "allergy",
"category": [ "environment" ],
"criticality": "low",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "256277009",
"display": "Grass pollen (substance)"
} ],
"text": "Grass pollen (substance)"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"recordedDate": "2015-01-12T07:33:10+01:00"
},
"request": {
"method": "POST",
"url": "AllergyIntolerance"
}
}, {
"fullUrl": "urn:uuid:da51cafc-78a0-c084-11a4-092f9bbd31c3",
"resource": {
"resourceType": "AllergyIntolerance",
"id": "da51cafc-78a0-c084-11a4-092f9bbd31c3",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code": "confirmed"
} ]
},
"type": "allergy",
"category": [ "environment" ],
"criticality": "low",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "782576004",
"display": "Tree pollen (substance)"
} ],
"text": "Tree pollen (substance)"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"recordedDate": "2015-01-12T07:33:10+01:00"
},
"request": {
"method": "POST",
"url": "AllergyIntolerance"
}
}, {
"fullUrl": "urn:uuid:057d78a0-7ba3-87ff-a359-5606e41740e4",
"resource": {
"resourceType": "AllergyIntolerance",
"id": "057d78a0-7ba3-87ff-a359-5606e41740e4",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code": "confirmed"
} ]
},
"type": "allergy",
"category": [ "medication" ],
"criticality": "low",
"code": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "7984",
"display": "Penicillin V"
} ],
"text": "Penicillin V"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"recordedDate": "2015-01-12T07:33:10+01:00",
"reaction": [ {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "247472004",
"display": "Wheal (finding)"
} ],
"text": "Wheal (finding)"
} ]
}, {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "402387002",
"display": "Allergic angioedema (disorder)"
} ],
"text": "Allergic angioedema (disorder)"
} ]
}, {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "404640003",
"display": "Dizziness (finding)"
} ],
"text": "Dizziness (finding)"
} ]
} ]
},
"request": {
"method": "POST",
"url": "AllergyIntolerance"
}
}, {
"fullUrl": "urn:uuid:69ee883d-1d34-8d44-2d24-26b1a512657e",
"resource": {
"resourceType": "AllergyIntolerance",
"id": "69ee883d-1d34-8d44-2d24-26b1a512657e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code": "confirmed"
} ]
},
"type": "allergy",
"category": [ "food" ],
"criticality": "low",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "102263004",
"display": "Eggs (edible) (substance)"
} ],
"text": "Eggs (edible) (substance)"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"recordedDate": "2015-01-12T07:33:10+01:00",
"reaction": [ {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "247472004",
"display": "Wheal (finding)"
} ],
"text": "Wheal (finding)"
} ]
} ]
},
"request": {
"method": "POST",
"url": "AllergyIntolerance"
}
}, {
"fullUrl": "urn:uuid:7e2188d3-183f-12ea-1e65-aeaf4f6801d6",
"resource": {
"resourceType": "AllergyIntolerance",
"id": "7e2188d3-183f-12ea-1e65-aeaf4f6801d6",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code": "confirmed"
} ]
},
"type": "allergy",
"category": [ "food" ],
"criticality": "low",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "735029006",
"display": "Shellfish (substance)"
} ],
"text": "Shellfish (substance)"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"recordedDate": "2015-01-12T07:33:10+01:00",
"reaction": [ {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "247472004",
"display": "Wheal (finding)"
} ],
"text": "Wheal (finding)"
} ]
}, {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "271807003",
"display": "Eruption of skin (disorder)"
} ],
"text": "Eruption of skin (disorder)"
} ]
}, {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "402387002",
"display": "Allergic angioedema (disorder)"
} ],
"text": "Allergic angioedema (disorder)"
} ]
}, {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "49727002",
"display": "Cough (finding)"
} ],
"text": "Cough (finding)"
} ]
} ]
},
"request": {
"method": "POST",
"url": "AllergyIntolerance"
}
}, {
"fullUrl": "urn:uuid:f847b6f9-3e06-cad0-f6d4-ac18f736dcc7",
"resource": {
"resourceType": "AllergyIntolerance",
"id": "f847b6f9-3e06-cad0-f6d4-ac18f736dcc7",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code": "confirmed"
} ]
},
"type": "allergy",
"category": [ "food" ],
"criticality": "low",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "442571000124108",
"display": "Tree nut (substance)"
} ],
"text": "Tree nut (substance)"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"recordedDate": "2015-01-12T07:33:10+01:00",
"reaction": [ {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "247472004",
"display": "Wheal (finding)"
} ],
"text": "Wheal (finding)"
} ]
}, {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "267036007",
"display": "Dyspnea (finding)"
} ],
"text": "Dyspnea (finding)"
} ]
}, {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "271807003",
"display": "Eruption of skin (disorder)"
} ],
"text": "Eruption of skin (disorder)"
} ]
}, {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "402387002",
"display": "Allergic angioedema (disorder)"
} ],
"text": "Allergic angioedema (disorder)"
} ]
}, {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "418290006",
"display": "Itching (finding)"
} ],
"text": "Itching (finding)"
} ]
}, {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "878820003",
"display": "Rhinoconjunctivitis (disorder)"
} ],
"text": "Rhinoconjunctivitis (disorder)"
} ]
} ]
},
"request": {
"method": "POST",
"url": "AllergyIntolerance"
}
}, {
"fullUrl": "urn:uuid:3ab017d7-b659-5c81-7c46-cd1bc1023bf0",
"resource": {
"resourceType": "AllergyIntolerance",
"id": "3ab017d7-b659-5c81-7c46-cd1bc1023bf0",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code": "confirmed"
} ]
},
"type": "allergy",
"category": [ "food" ],
"criticality": "low",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "762952008",
"display": "Peanut (substance)"
} ],
"text": "Peanut (substance)"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"recordedDate": "2015-01-12T07:33:10+01:00",
"reaction": [ {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "247472004",
"display": "Wheal (finding)"
} ],
"text": "Wheal (finding)"
} ]
}, {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "267036007",
"display": "Dyspnea (finding)"
} ],
"text": "Dyspnea (finding)"
} ]
}, {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "271807003",
"display": "Eruption of skin (disorder)"
} ],
"text": "Eruption of skin (disorder)"
} ]
}, {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "300359004",
"display": "Finding of vomiting (finding)"
} ],
"text": "Finding of vomiting (finding)"
} ]
}, {
"manifestation": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "402387002",
"display": "Allergic angioedema (disorder)"
} ],
"text": "Allergic angioedema (disorder)"
} ]
} ]
},
"request": {
"method": "POST",
"url": "AllergyIntolerance"
}
}, {
"fullUrl": "urn:uuid:ce7bb186-1325-adf3-1575-82dc105953e1",
"resource": {
"resourceType": "Observation",
"id": "ce7bb186-1325-adf3-1575-82dc105953e1",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "6206-7",
"display": "Peanut IgE Ab [Units/volume] in Serum"
} ],
"text": "Peanut IgE Ab [Units/volume] in Serum"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
},
"effectiveDateTime": "2015-01-12T08:12:21+01:00",
"issued": "2015-01-12T08:12:21.614+01:00",
"valueQuantity": {
"value": 0.25345,
"unit": "kU/L",
"system": "http://unitsofmeasure.org",
"code": "kU/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e2ff7a96-9b0c-23ca-6845-cb6146e2fee4",
"resource": {
"resourceType": "Observation",
"id": "e2ff7a96-9b0c-23ca-6845-cb6146e2fee4",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "6273-7",
"display": "Walnut IgE Ab [Units/volume] in Serum"
} ],
"text": "Walnut IgE Ab [Units/volume] in Serum"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
},
"effectiveDateTime": "2015-01-12T08:12:21+01:00",
"issued": "2015-01-12T08:12:21.614+01:00",
"valueQuantity": {
"value": 0.097766,
"unit": "kU/L",
"system": "http://unitsofmeasure.org",
"code": "kU/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:117cbbd1-9b88-6def-77e2-dbb8e026526c",
"resource": {
"resourceType": "Observation",
"id": "117cbbd1-9b88-6def-77e2-dbb8e026526c",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "6082-2",
"display": "Codfish IgE Ab [Units/volume] in Serum"
} ],
"text": "Codfish IgE Ab [Units/volume] in Serum"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
},
"effectiveDateTime": "2015-01-12T08:12:21+01:00",
"issued": "2015-01-12T08:12:21.614+01:00",
"valueQuantity": {
"value": 0.34508,
"unit": "kU/L",
"system": "http://unitsofmeasure.org",
"code": "kU/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:c01a5fce-6c54-653b-18d5-e3051ff184e5",
"resource": {
"resourceType": "Observation",
"id": "c01a5fce-6c54-653b-18d5-e3051ff184e5",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "6246-3",
"display": "Shrimp IgE Ab [Units/volume] in Serum"
} ],
"text": "Shrimp IgE Ab [Units/volume] in Serum"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
},
"effectiveDateTime": "2015-01-12T08:12:21+01:00",
"issued": "2015-01-12T08:12:21.614+01:00",
"valueQuantity": {
"value": 0.28731,
"unit": "kU/L",
"system": "http://unitsofmeasure.org",
"code": "kU/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:50a91143-febe-a56e-3100-bd94775548db",
"resource": {
"resourceType": "Observation",
"id": "50a91143-febe-a56e-3100-bd94775548db",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "6276-0",
"display": "Wheat IgE Ab [Units/volume] in Serum"
} ],
"text": "Wheat IgE Ab [Units/volume] in Serum"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
},
"effectiveDateTime": "2015-01-12T08:12:21+01:00",
"issued": "2015-01-12T08:12:21.614+01:00",
"valueQuantity": {
"value": 0.22911,
"unit": "kU/L",
"system": "http://unitsofmeasure.org",
"code": "kU/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:c8b8f31a-de4d-0894-b3fa-b9a39f0f4fad",
"resource": {
"resourceType": "Observation",
"id": "c8b8f31a-de4d-0894-b3fa-b9a39f0f4fad",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "6106-9",
"display": "Egg white IgE Ab [Units/volume] in Serum"
} ],
"text": "Egg white IgE Ab [Units/volume] in Serum"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
},
"effectiveDateTime": "2015-01-12T08:12:21+01:00",
"issued": "2015-01-12T08:12:21.614+01:00",
"valueQuantity": {
"value": 0.26307,
"unit": "kU/L",
"system": "http://unitsofmeasure.org",
"code": "kU/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:2980cf2b-91df-b247-f8da-c4f874ae998e",
"resource": {
"resourceType": "Observation",
"id": "2980cf2b-91df-b247-f8da-c4f874ae998e",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "6248-9",
"display": "Soybean IgE Ab [Units/volume] in Serum"
} ],
"text": "Soybean IgE Ab [Units/volume] in Serum"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
},
"effectiveDateTime": "2015-01-12T08:12:21+01:00",
"issued": "2015-01-12T08:12:21.614+01:00",
"valueQuantity": {
"value": 0.061396,
"unit": "kU/L",
"system": "http://unitsofmeasure.org",
"code": "kU/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:a0294db4-15e4-d3d2-583f-44d2ac2c1086",
"resource": {
"resourceType": "Observation",
"id": "a0294db4-15e4-d3d2-583f-44d2ac2c1086",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "7258-7",
"display": "Cow milk IgE Ab [Units/volume] in Serum"
} ],
"text": "Cow milk IgE Ab [Units/volume] in Serum"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
},
"effectiveDateTime": "2015-01-12T08:12:21+01:00",
"issued": "2015-01-12T08:12:21.614+01:00",
"valueQuantity": {
"value": 0.20549,
"unit": "kU/L",
"system": "http://unitsofmeasure.org",
"code": "kU/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:a0c7f86c-f546-ca5d-9245-8d279dd6be6a",
"resource": {
"resourceType": "Observation",
"id": "a0c7f86c-f546-ca5d-9245-8d279dd6be6a",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "6189-5",
"display": "White oak IgE Ab [Units/volume] in Serum"
} ],
"text": "White oak IgE Ab [Units/volume] in Serum"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
},
"effectiveDateTime": "2015-01-12T08:12:21+01:00",
"issued": "2015-01-12T08:12:21.614+01:00",
"valueQuantity": {
"value": 0.34882,
"unit": "kU/L",
"system": "http://unitsofmeasure.org",
"code": "kU/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:edd773bb-ac35-eea1-80d9-0526dbab2e0b",
"resource": {
"resourceType": "Observation",
"id": "edd773bb-ac35-eea1-80d9-0526dbab2e0b",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "6085-5",
"display": "Common Ragweed IgE Ab [Units/volume] in Serum"
} ],
"text": "Common Ragweed IgE Ab [Units/volume] in Serum"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
},
"effectiveDateTime": "2015-01-12T08:12:21+01:00",
"issued": "2015-01-12T08:12:21.614+01:00",
"valueQuantity": {
"value": 0.16942,
"unit": "kU/L",
"system": "http://unitsofmeasure.org",
"code": "kU/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:8870c57e-4183-71ea-ed99-56777f0dc606",
"resource": {
"resourceType": "Observation",
"id": "8870c57e-4183-71ea-ed99-56777f0dc606",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "6833-8",
"display": "Cat dander IgE Ab [Units/volume] in Serum"
} ],
"text": "Cat dander IgE Ab [Units/volume] in Serum"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
},
"effectiveDateTime": "2015-01-12T08:12:21+01:00",
"issued": "2015-01-12T08:12:21.614+01:00",
"valueQuantity": {
"value": 0.14817,
"unit": "kU/L",
"system": "http://unitsofmeasure.org",
"code": "kU/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:4b3e845a-5140-8641-c3f5-d9acdfd837fa",
"resource": {
"resourceType": "Observation",
"id": "4b3e845a-5140-8641-c3f5-d9acdfd837fa",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "6095-4",
"display": "American house dust mite IgE Ab [Units/volume] in Serum"
} ],
"text": "American house dust mite IgE Ab [Units/volume] in Serum"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
},
"effectiveDateTime": "2015-01-12T08:12:21+01:00",
"issued": "2015-01-12T08:12:21.614+01:00",
"valueQuantity": {
"value": 0.29671,
"unit": "kU/L",
"system": "http://unitsofmeasure.org",
"code": "kU/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:0191b3a0-821d-e010-f9b6-9dea962a0918",
"resource": {
"resourceType": "Observation",
"id": "0191b3a0-821d-e010-f9b6-9dea962a0918",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "6075-6",
"display": "Cladosporium herbarum IgE Ab [Units/volume] in Serum"
} ],
"text": "Cladosporium herbarum IgE Ab [Units/volume] in Serum"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
},
"effectiveDateTime": "2015-01-12T08:12:21+01:00",
"issued": "2015-01-12T08:12:21.614+01:00",
"valueQuantity": {
"value": 0.072119,
"unit": "kU/L",
"system": "http://unitsofmeasure.org",
"code": "kU/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:6c49af1c-1273-edb3-de96-3aa7d2e6d13d",
"resource": {
"resourceType": "Observation",
"id": "6c49af1c-1273-edb3-de96-3aa7d2e6d13d",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "6844-5",
"display": "Honey bee IgE Ab [Units/volume] in Serum"
} ],
"text": "Honey bee IgE Ab [Units/volume] in Serum"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
},
"effectiveDateTime": "2015-01-12T08:12:21+01:00",
"issued": "2015-01-12T08:12:21.614+01:00",
"valueQuantity": {
"value": 0.27393,
"unit": "kU/L",
"system": "http://unitsofmeasure.org",
"code": "kU/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:bdff2f62-657f-fd9e-ab35-e2118f9ca41f",
"resource": {
"resourceType": "Observation",
"id": "bdff2f62-657f-fd9e-ab35-e2118f9ca41f",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "6158-0",
"display": "Latex IgE Ab [Units/volume] in Serum"
} ],
"text": "Latex IgE Ab [Units/volume] in Serum"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
},
"effectiveDateTime": "2015-01-12T08:12:21+01:00",
"issued": "2015-01-12T08:12:21.614+01:00",
"valueQuantity": {
"value": 0.04884,
"unit": "kU/L",
"system": "http://unitsofmeasure.org",
"code": "kU/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:236564a0-ce2d-14a6-9f50-ee50058bac3e",
"resource": {
"resourceType": "Procedure",
"id": "236564a0-ce2d-14a6-9f50-ee50058bac3e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "395142003",
"display": "Allergy screening test"
} ],
"text": "Allergy screening test"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
},
"performedPeriod": {
"start": "2015-01-12T07:33:10+01:00",
"end": "2015-01-12T08:12:21+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:6d5dea8a-eeb1-8628-422b-378b21b83c33",
"resource": {
"resourceType": "MedicationRequest",
"id": "6d5dea8a-eeb1-8628-422b-378b21b83c33",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest" ]
},
"status": "active",
"intent": "order",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
"code": "community",
"display": "Community"
} ],
"text": "Community"
} ],
"medicationCodeableConcept": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "997488",
"display": "Fexofenadine hydrochloride 30 MG Oral Tablet"
} ],
"text": "Fexofenadine hydrochloride 30 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
},
"authoredOn": "2015-01-12T08:12:21+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
},
"dosageInstruction": [ {
"sequence": 1,
"text": "Take as needed.",
"asNeededBoolean": true
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:c04ff63f-beff-c0ad-d459-f6529433ea1f",
"resource": {
"resourceType": "Claim",
"id": "c04ff63f-beff-c0ad-d459-f6529433ea1f",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2015-01-12T07:33:10+01:00",
"end": "2015-01-12T08:12:21+01:00"
},
"created": "2015-01-12T08:12:21+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:6d5dea8a-eeb1-8628-422b-378b21b83c33"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "997488",
"display": "Fexofenadine hydrochloride 30 MG Oral Tablet"
} ],
"text": "Fexofenadine hydrochloride 30 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
} ]
} ],
"total": {
"value": 307.32,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:1bb8d315-a32b-fa42-0345-bc946fda1d2d",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "1bb8d315-a32b-fa42-0345-bc946fda1d2d",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "c04ff63f-beff-c0ad-d459-f6529433ea1f"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2015-01-12T08:12:21+01:00",
"end": "2016-01-12T08:12:21+01:00"
},
"created": "2015-01-12T08:12:21+01:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
},
"claim": {
"reference": "urn:uuid:c04ff63f-beff-c0ad-d459-f6529433ea1f"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "997488",
"display": "Fexofenadine hydrochloride 30 MG Oral Tablet"
} ],
"text": "Fexofenadine hydrochloride 30 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2015-01-12T07:33:10+01:00",
"end": "2015-01-12T08:12:21+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 307.32,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:80edf5b4-d28f-9fbe-b9b4-a80eff52fbab",
"resource": {
"resourceType": "MedicationRequest",
"id": "80edf5b4-d28f-9fbe-b9b4-a80eff52fbab",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest" ]
},
"status": "active",
"intent": "order",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
"code": "community",
"display": "Community"
} ],
"text": "Community"
} ],
"medicationCodeableConcept": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1870230",
"display": "NDA020800 0.3 ML Epinephrine 1 MG/ML Auto-Injector"
} ],
"text": "NDA020800 0.3 ML Epinephrine 1 MG/ML Auto-Injector"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
},
"authoredOn": "2015-01-12T08:12:21+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
},
"dosageInstruction": [ {
"sequence": 1,
"text": "Take as needed.",
"asNeededBoolean": true
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:3d50d436-4e48-f544-6fab-67f533962a6d",
"resource": {
"resourceType": "Claim",
"id": "3d50d436-4e48-f544-6fab-67f533962a6d",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2015-01-12T07:33:10+01:00",
"end": "2015-01-12T08:12:21+01:00"
},
"created": "2015-01-12T08:12:21+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:80edf5b4-d28f-9fbe-b9b4-a80eff52fbab"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1870230",
"display": "NDA020800 0.3 ML Epinephrine 1 MG/ML Auto-Injector"
} ],
"text": "NDA020800 0.3 ML Epinephrine 1 MG/ML Auto-Injector"
},
"encounter": [ {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
} ]
} ],
"total": {
"value": 140.41,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:25bcb732-73dc-9580-df9f-f19227081e3a",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "25bcb732-73dc-9580-df9f-f19227081e3a",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "3d50d436-4e48-f544-6fab-67f533962a6d"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2015-01-12T08:12:21+01:00",
"end": "2016-01-12T08:12:21+01:00"
},
"created": "2015-01-12T08:12:21+01:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
},
"claim": {
"reference": "urn:uuid:3d50d436-4e48-f544-6fab-67f533962a6d"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1870230",
"display": "NDA020800 0.3 ML Epinephrine 1 MG/ML Auto-Injector"
} ],
"text": "NDA020800 0.3 ML Epinephrine 1 MG/ML Auto-Injector"
},
"servicedPeriod": {
"start": "2015-01-12T07:33:10+01:00",
"end": "2015-01-12T08:12:21+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 140.41,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:c6807f90-e369-f986-6386-fd8718799678",
"resource": {
"resourceType": "DiagnosticReport",
"id": "c6807f90-e369-f986-6386-fd8718799678",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
},
"effectiveDateTime": "2015-01-12T07:33:10+01:00",
"issued": "2015-01-12T07:33:10.614+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:ba34b750-afd7-6a79-371c-4438e3c71c22",
"resource": {
"resourceType": "DocumentReference",
"id": "ba34b750-afd7-6a79-371c-4438e3c71c22",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:c6807f90-e369-f986-6386-fd8718799678"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2015-01-12T07:33:10.614+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
} ],
"period": {
"start": "2015-01-12T07:33:10+01:00",
"end": "2015-01-12T08:12:21+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:dda61cf9-f432-1241-c360-ca00aa717a8b",
"resource": {
"resourceType": "Claim",
"id": "dda61cf9-f432-1241-c360-ca00aa717a8b",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2015-01-12T07:33:10+01:00",
"end": "2015-01-12T08:12:21+01:00"
},
"created": "2015-01-12T08:12:21+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
},
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:236564a0-ce2d-14a6-9f50-ee50058bac3e"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185347001",
"display": "Encounter for problem"
} ],
"text": "Encounter for problem"
},
"encounter": [ {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
} ]
}, {
"sequence": 2,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "395142003",
"display": "Allergy screening test"
} ],
"text": "Allergy screening test"
},
"net": {
"value": 431.40,
"currency": "USD"
}
} ],
"total": {
"value": 516.95,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:796911cc-eccb-83ff-1f38-2b9fea649886",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "796911cc-eccb-83ff-1f38-2b9fea649886",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "dda61cf9-f432-1241-c360-ca00aa717a8b"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2015-01-12T08:12:21+01:00",
"end": "2016-01-12T08:12:21+01:00"
},
"created": "2015-01-12T08:12:21+01:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
},
"claim": {
"reference": "urn:uuid:dda61cf9-f432-1241-c360-ca00aa717a8b"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185347001",
"display": "Encounter for problem"
} ],
"text": "Encounter for problem"
},
"servicedPeriod": {
"start": "2015-01-12T07:33:10+01:00",
"end": "2015-01-12T08:12:21+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
} ]
}, {
"sequence": 2,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "395142003",
"display": "Allergy screening test"
} ],
"text": "Allergy screening test"
},
"servicedPeriod": {
"start": "2015-01-12T07:33:10+01:00",
"end": "2015-01-12T08:12:21+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"net": {
"value": 431.40,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 86.28,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 345.12,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 431.40,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 431.40,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 516.95,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 345.12,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:d5217369-478c-6b43-176b-482b8e3920e3",
"resource": {
"resourceType": "Encounter",
"id": "d5217369-478c-6b43-176b-482b8e3920e3",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "d5217369-478c-6b43-176b-482b8e3920e3"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185349003",
"display": "Encounter for check up"
} ],
"text": "Encounter for check up"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2015-02-03T21:53:59+01:00",
"end": "2015-02-03T22:08:59+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
}
} ],
"period": {
"start": "2015-02-03T21:53:59+01:00",
"end": "2015-02-03T22:08:59+01:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "33737001",
"display": "Fracture of rib"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:bbc3d75d-8a13-3fb7-1f14-d12ca3e3a797",
"resource": {
"resourceType": "DiagnosticReport",
"id": "bbc3d75d-8a13-3fb7-1f14-d12ca3e3a797",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d5217369-478c-6b43-176b-482b8e3920e3"
},
"effectiveDateTime": "2015-02-03T21:53:59+01:00",
"issued": "2015-02-03T21:53:59.614+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:631b6c14-0564-38a6-e65a-672e8d32b174",
"resource": {
"resourceType": "DocumentReference",
"id": "631b6c14-0564-38a6-e65a-672e8d32b174",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:bbc3d75d-8a13-3fb7-1f14-d12ca3e3a797"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2015-02-03T21:53:59.614+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:d5217369-478c-6b43-176b-482b8e3920e3"
} ],
"period": {
"start": "2015-02-03T21:53:59+01:00",
"end": "2015-02-03T22:08:59+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:36f6d2d8-614f-cb5e-b6d1-d6a48f1833a7",
"resource": {
"resourceType": "Claim",
"id": "36f6d2d8-614f-cb5e-b6d1-d6a48f1833a7",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2015-02-03T21:53:59+01:00",
"end": "2015-02-03T22:08:59+01:00"
},
"created": "2015-02-03T22:08:59+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185349003",
"display": "Encounter for check up"
} ],
"text": "Encounter for check up"
},
"encounter": [ {
"reference": "urn:uuid:d5217369-478c-6b43-176b-482b8e3920e3"
} ]
} ],
"total": {
"value": 85.55,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:a45f8b5b-3c51-8984-4a5c-8f04513d27b8",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "a45f8b5b-3c51-8984-4a5c-8f04513d27b8",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "36f6d2d8-614f-cb5e-b6d1-d6a48f1833a7"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2015-02-03T22:08:59+01:00",
"end": "2016-02-03T22:08:59+01:00"
},
"created": "2015-02-03T22:08:59+01:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
},
"claim": {
"reference": "urn:uuid:36f6d2d8-614f-cb5e-b6d1-d6a48f1833a7"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185349003",
"display": "Encounter for check up"
} ],
"text": "Encounter for check up"
},
"servicedPeriod": {
"start": "2015-02-03T21:53:59+01:00",
"end": "2015-02-03T22:08:59+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:d5217369-478c-6b43-176b-482b8e3920e3"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 85.55,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8",
"resource": {
"resourceType": "Encounter",
"id": "d51f6bd0-1fd4-008e-f75c-150452f693e8",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "d51f6bd0-1fd4-008e-f75c-150452f693e8"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2015-03-20T21:33:10+01:00",
"end": "2015-03-20T21:48:10+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
}
} ],
"period": {
"start": "2015-03-20T21:33:10+01:00",
"end": "2015-03-20T21:48:10+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:06e5718f-5309-f9f8-5ff3-1840a2571da0",
"resource": {
"resourceType": "Observation",
"id": "06e5718f-5309-f9f8-5ff3-1840a2571da0",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8302-2",
"display": "Body Height"
} ],
"text": "Body Height"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
},
"effectiveDateTime": "2015-03-20T21:33:10+01:00",
"issued": "2015-03-20T21:33:10.614+01:00",
"valueQuantity": {
"value": 80.2,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:283a3e28-32e8-e0da-75e7-724c44683650",
"resource": {
"resourceType": "Observation",
"id": "283a3e28-32e8-e0da-75e7-724c44683650",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72514-3",
"display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
} ],
"text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
},
"effectiveDateTime": "2015-03-20T21:33:10+01:00",
"issued": "2015-03-20T21:33:10.614+01:00",
"valueQuantity": {
"value": 1,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:1b982914-254a-c15a-2e80-3fa60234eba4",
"resource": {
"resourceType": "Observation",
"id": "1b982914-254a-c15a-2e80-3fa60234eba4",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "29463-7",
"display": "Body Weight"
} ],
"text": "Body Weight"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
},
"effectiveDateTime": "2015-03-20T21:33:10+01:00",
"issued": "2015-03-20T21:33:10.614+01:00",
"valueQuantity": {
"value": 12.6,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:29e1a611-4499-aa6b-5c68-9928d9a865f7",
"resource": {
"resourceType": "Observation",
"id": "29e1a611-4499-aa6b-5c68-9928d9a865f7",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-weight-for-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "77606-2",
"display": "Weight-for-length Per age and sex"
} ],
"text": "Weight-for-length Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
},
"effectiveDateTime": "2015-03-20T21:33:10+01:00",
"issued": "2015-03-20T21:33:10.614+01:00",
"valueQuantity": {
"value": 96.294,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d64df70b-e707-aac0-8aa5-46a5fbcf2ade",
"resource": {
"resourceType": "Observation",
"id": "d64df70b-e707-aac0-8aa5-46a5fbcf2ade",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/head-occipital-frontal-circumference-percentile" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8289-1",
"display": "Head Occipital-frontal circumference Percentile"
} ],
"text": "Head Occipital-frontal circumference Percentile"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
},
"effectiveDateTime": "2015-03-20T21:33:10+01:00",
"issued": "2015-03-20T21:33:10.614+01:00",
"valueQuantity": {
"value": 74.37,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:8274b7a6-c2fc-dab8-5238-efc5e9d87212",
"resource": {
"resourceType": "Observation",
"id": "8274b7a6-c2fc-dab8-5238-efc5e9d87212",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-head-circumference" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9843-4",
"display": "Head Occipital-frontal circumference"
} ],
"text": "Head Occipital-frontal circumference"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
},
"effectiveDateTime": "2015-03-20T21:33:10+01:00",
"issued": "2015-03-20T21:33:10.614+01:00",
"valueQuantity": {
"value": 47.88,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:146bd588-8dc9-d7d8-8acd-b42165d6d1c4",
"resource": {
"resourceType": "Observation",
"id": "146bd588-8dc9-d7d8-8acd-b42165d6d1c4",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "85354-9",
"display": "Blood pressure panel with all children optional"
} ],
"text": "Blood pressure panel with all children optional"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
},
"effectiveDateTime": "2015-03-20T21:33:10+01:00",
"issued": "2015-03-20T21:33:10.614+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 81,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8480-6",
"display": "Systolic Blood Pressure"
} ],
"text": "Systolic Blood Pressure"
},
"valueQuantity": {
"value": 122,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:fa0b6a19-6e77-74d7-3e9e-c2861dd472a7",
"resource": {
"resourceType": "Observation",
"id": "fa0b6a19-6e77-74d7-3e9e-c2861dd472a7",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8867-4",
"display": "Heart rate"
} ],
"text": "Heart rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
},
"effectiveDateTime": "2015-03-20T21:33:10+01:00",
"issued": "2015-03-20T21:33:10.614+01:00",
"valueQuantity": {
"value": 96,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d0e03028-c3c6-c0fb-c1a8-812da33b715e",
"resource": {
"resourceType": "Observation",
"id": "d0e03028-c3c6-c0fb-c1a8-812da33b715e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9279-1",
"display": "Respiratory rate"
} ],
"text": "Respiratory rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
},
"effectiveDateTime": "2015-03-20T21:33:10+01:00",
"issued": "2015-03-20T21:33:10.614+01:00",
"valueQuantity": {
"value": 14,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:94e612b3-8c7e-64a2-f2fb-4664ba7e2a3c",
"resource": {
"resourceType": "Observation",
"id": "94e612b3-8c7e-64a2-f2fb-4664ba7e2a3c",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social history"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72166-2",
"display": "Tobacco smoking status"
} ],
"text": "Tobacco smoking status"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
},
"effectiveDateTime": "2015-03-20T21:33:10+01:00",
"issued": "2015-03-20T21:33:10.614+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "266919005",
"display": "Never smoked tobacco (finding)"
} ],
"text": "Never smoked tobacco (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:2075836a-2e10-84c6-e3fa-5fa27ce0e5c6",
"resource": {
"resourceType": "Procedure",
"id": "2075836a-2e10-84c6-e3fa-5fa27ce0e5c6",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
},
"performedPeriod": {
"start": "2015-03-20T21:33:10+01:00",
"end": "2015-03-20T21:48:10+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:89ac0496-7ecf-f6cc-0199-da9e65250ead",
"resource": {
"resourceType": "Immunization",
"id": "89ac0496-7ecf-f6cc-0199-da9e65250ead",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "49",
"display": "Hib (PRP-OMP)"
} ],
"text": "Hib (PRP-OMP)"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
},
"occurrenceDateTime": "2015-03-20T21:33:10+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:2c8ca559-e3b3-fcd9-229a-d9b29528bd68",
"resource": {
"resourceType": "Immunization",
"id": "2c8ca559-e3b3-fcd9-229a-d9b29528bd68",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "21",
"display": "varicella"
} ],
"text": "varicella"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
},
"occurrenceDateTime": "2015-03-20T21:33:10+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:23bd4079-412e-7e8b-d817-80d0a0aa9be8",
"resource": {
"resourceType": "Immunization",
"id": "23bd4079-412e-7e8b-d817-80d0a0aa9be8",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "03",
"display": "MMR"
} ],
"text": "MMR"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
},
"occurrenceDateTime": "2015-03-20T21:33:10+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:ac6d5e4b-051b-21cd-3ad1-c44e1236825b",
"resource": {
"resourceType": "Immunization",
"id": "ac6d5e4b-051b-21cd-3ad1-c44e1236825b",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "133",
"display": "Pneumococcal conjugate PCV 13"
} ],
"text": "Pneumococcal conjugate PCV 13"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
},
"occurrenceDateTime": "2015-03-20T21:33:10+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:02f101fc-f49c-d726-a5c6-24d00f97d3e0",
"resource": {
"resourceType": "Immunization",
"id": "02f101fc-f49c-d726-a5c6-24d00f97d3e0",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "83",
"display": "Hep A, ped/adol, 2 dose"
} ],
"text": "Hep A, ped/adol, 2 dose"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
},
"occurrenceDateTime": "2015-03-20T21:33:10+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:883d37cb-fb39-6917-79da-3e49f16e78b4",
"resource": {
"resourceType": "DiagnosticReport",
"id": "883d37cb-fb39-6917-79da-3e49f16e78b4",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
},
"effectiveDateTime": "2015-03-20T21:33:10+01:00",
"issued": "2015-03-20T21:33:10.614+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:29b324be-8e20-3abd-d230-0c4b76542a6e",
"resource": {
"resourceType": "DocumentReference",
"id": "29b324be-8e20-3abd-d230-0c4b76542a6e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:883d37cb-fb39-6917-79da-3e49f16e78b4"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2015-03-20T21:33:10.614+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
} ],
"period": {
"start": "2015-03-20T21:33:10+01:00",
"end": "2015-03-20T21:48:10+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:03afa0f2-6cfe-d20d-e452-340850ee68de",
"resource": {
"resourceType": "Claim",
"id": "03afa0f2-6cfe-d20d-e452-340850ee68de",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2015-03-20T21:33:10+01:00",
"end": "2015-03-20T21:48:10+01:00"
},
"created": "2015-03-20T21:48:10+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:89ac0496-7ecf-f6cc-0199-da9e65250ead"
}
}, {
"sequence": 2,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:2c8ca559-e3b3-fcd9-229a-d9b29528bd68"
}
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:23bd4079-412e-7e8b-d817-80d0a0aa9be8"
}
}, {
"sequence": 4,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:ac6d5e4b-051b-21cd-3ad1-c44e1236825b"
}
}, {
"sequence": 5,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:02f101fc-f49c-d726-a5c6-24d00f97d3e0"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:2075836a-2e10-84c6-e3fa-5fa27ce0e5c6"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "49",
"display": "Hib (PRP-OMP)"
} ],
"text": "Hib (PRP-OMP)"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 3,
"informationSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "21",
"display": "varicella"
} ],
"text": "varicella"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 4,
"informationSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "03",
"display": "MMR"
} ],
"text": "MMR"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 5,
"informationSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "133",
"display": "Pneumococcal conjugate PCV 13"
} ],
"text": "Pneumococcal conjugate PCV 13"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 6,
"informationSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "83",
"display": "Hep A, ped/adol, 2 dose"
} ],
"text": "Hep A, ped/adol, 2 dose"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 7,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"net": {
"value": 703.32,
"currency": "USD"
}
} ],
"total": {
"value": 1520.12,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:1a0f55c2-800a-9103-019c-3f42a89ff356",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "1a0f55c2-800a-9103-019c-3f42a89ff356",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "03afa0f2-6cfe-d20d-e452-340850ee68de"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2015-03-20T21:48:10+01:00",
"end": "2016-03-20T21:48:10+01:00"
},
"created": "2015-03-20T21:48:10+01:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"claim": {
"reference": "urn:uuid:03afa0f2-6cfe-d20d-e452-340850ee68de"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"servicedPeriod": {
"start": "2015-03-20T21:33:10+01:00",
"end": "2015-03-20T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "49",
"display": "Hib (PRP-OMP)"
} ],
"text": "Hib (PRP-OMP)"
},
"servicedPeriod": {
"start": "2015-03-20T21:33:10+01:00",
"end": "2015-03-20T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 3,
"informationSequence": [ 2 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "21",
"display": "varicella"
} ],
"text": "varicella"
},
"servicedPeriod": {
"start": "2015-03-20T21:33:10+01:00",
"end": "2015-03-20T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 4,
"informationSequence": [ 3 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "03",
"display": "MMR"
} ],
"text": "MMR"
},
"servicedPeriod": {
"start": "2015-03-20T21:33:10+01:00",
"end": "2015-03-20T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 5,
"informationSequence": [ 4 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "133",
"display": "Pneumococcal conjugate PCV 13"
} ],
"text": "Pneumococcal conjugate PCV 13"
},
"servicedPeriod": {
"start": "2015-03-20T21:33:10+01:00",
"end": "2015-03-20T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 6,
"informationSequence": [ 5 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "83",
"display": "Hep A, ped/adol, 2 dose"
} ],
"text": "Hep A, ped/adol, 2 dose"
},
"servicedPeriod": {
"start": "2015-03-20T21:33:10+01:00",
"end": "2015-03-20T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 7,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"servicedPeriod": {
"start": "2015-03-20T21:33:10+01:00",
"end": "2015-03-20T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 703.32,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 140.66400000000002,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 562.6560000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 703.32,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 703.32,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 1520.12,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 1106.656,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:3d32375b-71f0-3ad1-f0ce-fb7af2031e29",
"resource": {
"resourceType": "Encounter",
"id": "3d32375b-71f0-3ad1-f0ce-fb7af2031e29",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "3d32375b-71f0-3ad1-f0ce-fb7af2031e29"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2015-06-19T22:33:10+02:00",
"end": "2015-06-19T22:48:10+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
}
} ],
"period": {
"start": "2015-06-19T22:33:10+02:00",
"end": "2015-06-19T22:48:10+02:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:5583478b-6fb5-10e5-73d1-0e7a8e690f70",
"resource": {
"resourceType": "Condition",
"id": "5583478b-6fb5-10e5-73d1-0e7a8e690f70",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "resolved"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed"
} ]
},
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-category",
"code": "encounter-diagnosis",
"display": "Encounter Diagnosis"
} ]
} ],
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:3d32375b-71f0-3ad1-f0ce-fb7af2031e29"
},
"onsetDateTime": "2015-06-19T22:33:10+02:00",
"abatementDateTime": "2016-12-16T21:33:10+01:00",
"recordedDate": "2015-06-19T22:33:10+02:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:4a9b0577-ed6d-0dcd-3289-b84789675cc7",
"resource": {
"resourceType": "Observation",
"id": "4a9b0577-ed6d-0dcd-3289-b84789675cc7",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8302-2",
"display": "Body Height"
} ],
"text": "Body Height"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:3d32375b-71f0-3ad1-f0ce-fb7af2031e29"
},
"effectiveDateTime": "2015-06-19T22:33:10+02:00",
"issued": "2015-06-19T22:33:10.614+02:00",
"valueQuantity": {
"value": 83.3,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:fb616ae3-7908-729b-d9fd-f5f827300ce5",
"resource": {
"resourceType": "Observation",
"id": "fb616ae3-7908-729b-d9fd-f5f827300ce5",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72514-3",
"display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
} ],
"text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:3d32375b-71f0-3ad1-f0ce-fb7af2031e29"
},
"effectiveDateTime": "2015-06-19T22:33:10+02:00",
"issued": "2015-06-19T22:33:10.614+02:00",
"valueQuantity": {
"value": 0,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:0e466e1e-2146-9cca-75f7-442af9221085",
"resource": {
"resourceType": "Observation",
"id": "0e466e1e-2146-9cca-75f7-442af9221085",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "29463-7",
"display": "Body Weight"
} ],
"text": "Body Weight"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:3d32375b-71f0-3ad1-f0ce-fb7af2031e29"
},
"effectiveDateTime": "2015-06-19T22:33:10+02:00",
"issued": "2015-06-19T22:33:10.614+02:00",
"valueQuantity": {
"value": 13.3,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:f09da1a2-0871-0315-a4b6-9335f2104b5a",
"resource": {
"resourceType": "Observation",
"id": "f09da1a2-0871-0315-a4b6-9335f2104b5a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-weight-for-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "77606-2",
"display": "Weight-for-length Per age and sex"
} ],
"text": "Weight-for-length Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:3d32375b-71f0-3ad1-f0ce-fb7af2031e29"
},
"effectiveDateTime": "2015-06-19T22:33:10+02:00",
"issued": "2015-06-19T22:33:10.614+02:00",
"valueQuantity": {
"value": 95.851,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:2c1cbc42-6b05-5fbb-7f65-9f1af542103e",
"resource": {
"resourceType": "Observation",
"id": "2c1cbc42-6b05-5fbb-7f65-9f1af542103e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/head-occipital-frontal-circumference-percentile" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8289-1",
"display": "Head Occipital-frontal circumference Percentile"
} ],
"text": "Head Occipital-frontal circumference Percentile"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:3d32375b-71f0-3ad1-f0ce-fb7af2031e29"
},
"effectiveDateTime": "2015-06-19T22:33:10+02:00",
"issued": "2015-06-19T22:33:10.614+02:00",
"valueQuantity": {
"value": 74.37,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:f2b36c60-0d3c-a20a-3cf8-3bb4e952229c",
"resource": {
"resourceType": "Observation",
"id": "f2b36c60-0d3c-a20a-3cf8-3bb4e952229c",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-head-circumference" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9843-4",
"display": "Head Occipital-frontal circumference"
} ],
"text": "Head Occipital-frontal circumference"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:3d32375b-71f0-3ad1-f0ce-fb7af2031e29"
},
"effectiveDateTime": "2015-06-19T22:33:10+02:00",
"issued": "2015-06-19T22:33:10.614+02:00",
"valueQuantity": {
"value": 48.55,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:61081602-ef62-c936-423c-de3fee000d2a",
"resource": {
"resourceType": "Observation",
"id": "61081602-ef62-c936-423c-de3fee000d2a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "85354-9",
"display": "Blood pressure panel with all children optional"
} ],
"text": "Blood pressure panel with all children optional"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:3d32375b-71f0-3ad1-f0ce-fb7af2031e29"
},
"effectiveDateTime": "2015-06-19T22:33:10+02:00",
"issued": "2015-06-19T22:33:10.614+02:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 87,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8480-6",
"display": "Systolic Blood Pressure"
} ],
"text": "Systolic Blood Pressure"
},
"valueQuantity": {
"value": 124,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:20e31eae-3cb6-30dd-a585-b2a0e151c3c1",
"resource": {
"resourceType": "Observation",
"id": "20e31eae-3cb6-30dd-a585-b2a0e151c3c1",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8867-4",
"display": "Heart rate"
} ],
"text": "Heart rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:3d32375b-71f0-3ad1-f0ce-fb7af2031e29"
},
"effectiveDateTime": "2015-06-19T22:33:10+02:00",
"issued": "2015-06-19T22:33:10.614+02:00",
"valueQuantity": {
"value": 79,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:b28fa7a2-5bbd-e9eb-dbdb-9dac4776ea86",
"resource": {
"resourceType": "Observation",
"id": "b28fa7a2-5bbd-e9eb-dbdb-9dac4776ea86",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9279-1",
"display": "Respiratory rate"
} ],
"text": "Respiratory rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:3d32375b-71f0-3ad1-f0ce-fb7af2031e29"
},
"effectiveDateTime": "2015-06-19T22:33:10+02:00",
"issued": "2015-06-19T22:33:10.614+02:00",
"valueQuantity": {
"value": 13,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:93ac150b-89db-5924-538a-36c990f8d879",
"resource": {
"resourceType": "Observation",
"id": "93ac150b-89db-5924-538a-36c990f8d879",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social history"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72166-2",
"display": "Tobacco smoking status"
} ],
"text": "Tobacco smoking status"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:3d32375b-71f0-3ad1-f0ce-fb7af2031e29"
},
"effectiveDateTime": "2015-06-19T22:33:10+02:00",
"issued": "2015-06-19T22:33:10.614+02:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "266919005",
"display": "Never smoked tobacco (finding)"
} ],
"text": "Never smoked tobacco (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:51d444fe-0da1-9428-e9a3-940d40c973ec",
"resource": {
"resourceType": "Immunization",
"id": "51d444fe-0da1-9428-e9a3-940d40c973ec",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "20",
"display": "DTaP"
} ],
"text": "DTaP"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:3d32375b-71f0-3ad1-f0ce-fb7af2031e29"
},
"occurrenceDateTime": "2015-06-19T22:33:10+02:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:fa370fcb-fd9c-7b90-771e-9cb4318c2d39",
"resource": {
"resourceType": "DiagnosticReport",
"id": "fa370fcb-fd9c-7b90-771e-9cb4318c2d39",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:3d32375b-71f0-3ad1-f0ce-fb7af2031e29"
},
"effectiveDateTime": "2015-06-19T22:33:10+02:00",
"issued": "2015-06-19T22:33:10.614+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:baf77b37-02e1-0593-3884-bf1e3f484733",
"resource": {
"resourceType": "DocumentReference",
"id": "baf77b37-02e1-0593-3884-bf1e3f484733",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:fa370fcb-fd9c-7b90-771e-9cb4318c2d39"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2015-06-19T22:33:10.614+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:3d32375b-71f0-3ad1-f0ce-fb7af2031e29"
} ],
"period": {
"start": "2015-06-19T22:33:10+02:00",
"end": "2015-06-19T22:48:10+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:10be5003-828c-e485-a5ca-efc852571e30",
"resource": {
"resourceType": "Claim",
"id": "10be5003-828c-e485-a5ca-efc852571e30",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2015-06-19T22:33:10+02:00",
"end": "2015-06-19T22:48:10+02:00"
},
"created": "2015-06-19T22:48:10+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:51d444fe-0da1-9428-e9a3-940d40c973ec"
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:5583478b-6fb5-10e5-73d1-0e7a8e690f70"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:3d32375b-71f0-3ad1-f0ce-fb7af2031e29"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "20",
"display": "DTaP"
} ],
"text": "DTaP"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 3,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
}
} ],
"total": {
"value": 272.80,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:07109a13-6f98-a57e-cd85-5b120ba3cef1",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "07109a13-6f98-a57e-cd85-5b120ba3cef1",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "10be5003-828c-e485-a5ca-efc852571e30"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2015-06-19T22:48:10+02:00",
"end": "2016-06-19T22:48:10+02:00"
},
"created": "2015-06-19T22:48:10+02:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"claim": {
"reference": "urn:uuid:10be5003-828c-e485-a5ca-efc852571e30"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:5583478b-6fb5-10e5-73d1-0e7a8e690f70"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"servicedPeriod": {
"start": "2015-06-19T22:33:10+02:00",
"end": "2015-06-19T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:3d32375b-71f0-3ad1-f0ce-fb7af2031e29"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "20",
"display": "DTaP"
} ],
"text": "DTaP"
},
"servicedPeriod": {
"start": "2015-06-19T22:33:10+02:00",
"end": "2015-06-19T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 3,
"diagnosisSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"servicedPeriod": {
"start": "2015-06-19T22:33:10+02:00",
"end": "2015-06-19T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 272.80,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:a2640468-4717-03fd-61eb-83b32d1fc2c2",
"resource": {
"resourceType": "Encounter",
"id": "a2640468-4717-03fd-61eb-83b32d1fc2c2",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "a2640468-4717-03fd-61eb-83b32d1fc2c2"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2015-12-18T21:33:10+01:00",
"end": "2015-12-18T21:48:10+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
}
} ],
"period": {
"start": "2015-12-18T21:33:10+01:00",
"end": "2015-12-18T21:48:10+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:043e1e10-dd8f-a5aa-a5f2-feacc1c0dc9f",
"resource": {
"resourceType": "Observation",
"id": "043e1e10-dd8f-a5aa-a5f2-feacc1c0dc9f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8302-2",
"display": "Body Height"
} ],
"text": "Body Height"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:a2640468-4717-03fd-61eb-83b32d1fc2c2"
},
"effectiveDateTime": "2015-12-18T21:33:10+01:00",
"issued": "2015-12-18T21:33:10.614+01:00",
"valueQuantity": {
"value": 88.9,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:1b021fa3-5620-2dc0-83e5-2a00f99e28ee",
"resource": {
"resourceType": "Observation",
"id": "1b021fa3-5620-2dc0-83e5-2a00f99e28ee",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72514-3",
"display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
} ],
"text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:a2640468-4717-03fd-61eb-83b32d1fc2c2"
},
"effectiveDateTime": "2015-12-18T21:33:10+01:00",
"issued": "2015-12-18T21:33:10.614+01:00",
"valueQuantity": {
"value": 1,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:3be66966-f554-96b5-765f-aa1646524dfc",
"resource": {
"resourceType": "Observation",
"id": "3be66966-f554-96b5-765f-aa1646524dfc",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "29463-7",
"display": "Body Weight"
} ],
"text": "Body Weight"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:a2640468-4717-03fd-61eb-83b32d1fc2c2"
},
"effectiveDateTime": "2015-12-18T21:33:10+01:00",
"issued": "2015-12-18T21:33:10.614+01:00",
"valueQuantity": {
"value": 14.4,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:8134e375-3701-6ae8-29ec-d65c236166a0",
"resource": {
"resourceType": "Observation",
"id": "8134e375-3701-6ae8-29ec-d65c236166a0",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-weight-for-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "77606-2",
"display": "Weight-for-length Per age and sex"
} ],
"text": "Weight-for-length Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:a2640468-4717-03fd-61eb-83b32d1fc2c2"
},
"effectiveDateTime": "2015-12-18T21:33:10+01:00",
"issued": "2015-12-18T21:33:10.614+01:00",
"valueQuantity": {
"value": 91.354,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:6b04a03b-46e4-65f7-83e3-058c49c327a5",
"resource": {
"resourceType": "Observation",
"id": "6b04a03b-46e4-65f7-83e3-058c49c327a5",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/head-occipital-frontal-circumference-percentile" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8289-1",
"display": "Head Occipital-frontal circumference Percentile"
} ],
"text": "Head Occipital-frontal circumference Percentile"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:a2640468-4717-03fd-61eb-83b32d1fc2c2"
},
"effectiveDateTime": "2015-12-18T21:33:10+01:00",
"issued": "2015-12-18T21:33:10.614+01:00",
"valueQuantity": {
"value": 74.37,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:0155f2eb-c294-0eff-3fc3-d3c847e5964a",
"resource": {
"resourceType": "Observation",
"id": "0155f2eb-c294-0eff-3fc3-d3c847e5964a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-head-circumference" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9843-4",
"display": "Head Occipital-frontal circumference"
} ],
"text": "Head Occipital-frontal circumference"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:a2640468-4717-03fd-61eb-83b32d1fc2c2"
},
"effectiveDateTime": "2015-12-18T21:33:10+01:00",
"issued": "2015-12-18T21:33:10.614+01:00",
"valueQuantity": {
"value": 49.52,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:98c1c76c-119d-1ce4-17e4-c91cea2b271e",
"resource": {
"resourceType": "Observation",
"id": "98c1c76c-119d-1ce4-17e4-c91cea2b271e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "85354-9",
"display": "Blood pressure panel with all children optional"
} ],
"text": "Blood pressure panel with all children optional"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:a2640468-4717-03fd-61eb-83b32d1fc2c2"
},
"effectiveDateTime": "2015-12-18T21:33:10+01:00",
"issued": "2015-12-18T21:33:10.614+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 86,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8480-6",
"display": "Systolic Blood Pressure"
} ],
"text": "Systolic Blood Pressure"
},
"valueQuantity": {
"value": 119,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:0a975327-89b4-3aec-35fa-513f5dd3f12d",
"resource": {
"resourceType": "Observation",
"id": "0a975327-89b4-3aec-35fa-513f5dd3f12d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8867-4",
"display": "Heart rate"
} ],
"text": "Heart rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:a2640468-4717-03fd-61eb-83b32d1fc2c2"
},
"effectiveDateTime": "2015-12-18T21:33:10+01:00",
"issued": "2015-12-18T21:33:10.614+01:00",
"valueQuantity": {
"value": 62,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:419b79b0-22d0-3264-c15e-1ede30de3c73",
"resource": {
"resourceType": "Observation",
"id": "419b79b0-22d0-3264-c15e-1ede30de3c73",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9279-1",
"display": "Respiratory rate"
} ],
"text": "Respiratory rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:a2640468-4717-03fd-61eb-83b32d1fc2c2"
},
"effectiveDateTime": "2015-12-18T21:33:10+01:00",
"issued": "2015-12-18T21:33:10.614+01:00",
"valueQuantity": {
"value": 15,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:c625317b-0aee-625f-a084-338ff410b2ce",
"resource": {
"resourceType": "Observation",
"id": "c625317b-0aee-625f-a084-338ff410b2ce",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social history"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72166-2",
"display": "Tobacco smoking status"
} ],
"text": "Tobacco smoking status"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:a2640468-4717-03fd-61eb-83b32d1fc2c2"
},
"effectiveDateTime": "2015-12-18T21:33:10+01:00",
"issued": "2015-12-18T21:33:10.614+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "266919005",
"display": "Never smoked tobacco (finding)"
} ],
"text": "Never smoked tobacco (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:16f27cbd-f8d9-3499-ffaf-e5143df38a7a",
"resource": {
"resourceType": "Immunization",
"id": "16f27cbd-f8d9-3499-ffaf-e5143df38a7a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:a2640468-4717-03fd-61eb-83b32d1fc2c2"
},
"occurrenceDateTime": "2015-12-18T21:33:10+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:43e78795-7b13-b330-02ae-298919475400",
"resource": {
"resourceType": "DiagnosticReport",
"id": "43e78795-7b13-b330-02ae-298919475400",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:a2640468-4717-03fd-61eb-83b32d1fc2c2"
},
"effectiveDateTime": "2015-12-18T21:33:10+01:00",
"issued": "2015-12-18T21:33:10.614+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:5134fd7b-a809-f971-ee3b-7b71dd199662",
"resource": {
"resourceType": "DocumentReference",
"id": "5134fd7b-a809-f971-ee3b-7b71dd199662",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:43e78795-7b13-b330-02ae-298919475400"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2015-12-18T21:33:10.614+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:a2640468-4717-03fd-61eb-83b32d1fc2c2"
} ],
"period": {
"start": "2015-12-18T21:33:10+01:00",
"end": "2015-12-18T21:48:10+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:33c8a19d-1606-8adf-959c-f5b7b277542e",
"resource": {
"resourceType": "Claim",
"id": "33c8a19d-1606-8adf-959c-f5b7b277542e",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2015-12-18T21:33:10+01:00",
"end": "2015-12-18T21:48:10+01:00"
},
"created": "2015-12-18T21:48:10+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:16f27cbd-f8d9-3499-ffaf-e5143df38a7a"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:a2640468-4717-03fd-61eb-83b32d1fc2c2"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"net": {
"value": 136.00,
"currency": "USD"
}
} ],
"total": {
"value": 272.80,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:8456f0bd-f52a-01c7-debe-c8a323a2d05f",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "8456f0bd-f52a-01c7-debe-c8a323a2d05f",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "33c8a19d-1606-8adf-959c-f5b7b277542e"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2015-12-18T21:48:10+01:00",
"end": "2016-12-18T21:48:10+01:00"
},
"created": "2015-12-18T21:48:10+01:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"claim": {
"reference": "urn:uuid:33c8a19d-1606-8adf-959c-f5b7b277542e"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"servicedPeriod": {
"start": "2015-12-18T21:33:10+01:00",
"end": "2015-12-18T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:a2640468-4717-03fd-61eb-83b32d1fc2c2"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"servicedPeriod": {
"start": "2015-12-18T21:33:10+01:00",
"end": "2015-12-18T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 272.80,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:709ad708-371f-08cb-6cad-8b009011bd75",
"resource": {
"resourceType": "Encounter",
"id": "709ad708-371f-08cb-6cad-8b009011bd75",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "709ad708-371f-08cb-6cad-8b009011bd75"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2016-06-17T22:33:10+02:00",
"end": "2016-06-17T22:48:10+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
}
} ],
"period": {
"start": "2016-06-17T22:33:10+02:00",
"end": "2016-06-17T22:48:10+02:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:2806abea-cefb-686c-e912-6b6f43b1214b",
"resource": {
"resourceType": "Observation",
"id": "2806abea-cefb-686c-e912-6b6f43b1214b",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8302-2",
"display": "Body Height"
} ],
"text": "Body Height"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:709ad708-371f-08cb-6cad-8b009011bd75"
},
"effectiveDateTime": "2016-06-17T22:33:10+02:00",
"issued": "2016-06-17T22:33:10.614+02:00",
"valueQuantity": {
"value": 92.8,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:7667a7ff-4f76-51b0-bc6a-d0976ffdc119",
"resource": {
"resourceType": "Observation",
"id": "7667a7ff-4f76-51b0-bc6a-d0976ffdc119",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72514-3",
"display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
} ],
"text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:709ad708-371f-08cb-6cad-8b009011bd75"
},
"effectiveDateTime": "2016-06-17T22:33:10+02:00",
"issued": "2016-06-17T22:33:10.614+02:00",
"valueQuantity": {
"value": 4,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:8470833f-984c-b58f-e103-fa2d906c8ba1",
"resource": {
"resourceType": "Observation",
"id": "8470833f-984c-b58f-e103-fa2d906c8ba1",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "29463-7",
"display": "Body Weight"
} ],
"text": "Body Weight"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:709ad708-371f-08cb-6cad-8b009011bd75"
},
"effectiveDateTime": "2016-06-17T22:33:10+02:00",
"issued": "2016-06-17T22:33:10.614+02:00",
"valueQuantity": {
"value": 15.4,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:9a2ec227-e3c4-cfae-136b-8a44354e35bd",
"resource": {
"resourceType": "Observation",
"id": "9a2ec227-e3c4-cfae-136b-8a44354e35bd",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-weight-for-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "77606-2",
"display": "Weight-for-length Per age and sex"
} ],
"text": "Weight-for-length Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:709ad708-371f-08cb-6cad-8b009011bd75"
},
"effectiveDateTime": "2016-06-17T22:33:10+02:00",
"issued": "2016-06-17T22:33:10.614+02:00",
"valueQuantity": {
"value": 90.532,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:4566b150-bc44-c1fd-a56a-6135684b809e",
"resource": {
"resourceType": "Observation",
"id": "4566b150-bc44-c1fd-a56a-6135684b809e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/head-occipital-frontal-circumference-percentile" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8289-1",
"display": "Head Occipital-frontal circumference Percentile"
} ],
"text": "Head Occipital-frontal circumference Percentile"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:709ad708-371f-08cb-6cad-8b009011bd75"
},
"effectiveDateTime": "2016-06-17T22:33:10+02:00",
"issued": "2016-06-17T22:33:10.614+02:00",
"valueQuantity": {
"value": 74.37,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:bb9375c7-d51d-2fd7-7434-bbf4c9e27d5b",
"resource": {
"resourceType": "Observation",
"id": "bb9375c7-d51d-2fd7-7434-bbf4c9e27d5b",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-head-circumference" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9843-4",
"display": "Head Occipital-frontal circumference"
} ],
"text": "Head Occipital-frontal circumference"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:709ad708-371f-08cb-6cad-8b009011bd75"
},
"effectiveDateTime": "2016-06-17T22:33:10+02:00",
"issued": "2016-06-17T22:33:10.614+02:00",
"valueQuantity": {
"value": 50.2,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:a48f1723-ef93-8088-6f3b-1e41aab4fd15",
"resource": {
"resourceType": "Observation",
"id": "a48f1723-ef93-8088-6f3b-1e41aab4fd15",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "39156-5",
"display": "Body mass index (BMI) [Ratio]"
} ],
"text": "Body mass index (BMI) [Ratio]"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:709ad708-371f-08cb-6cad-8b009011bd75"
},
"effectiveDateTime": "2016-06-17T22:33:10+02:00",
"issued": "2016-06-17T22:33:10.614+02:00",
"valueQuantity": {
"value": 17.88,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:f2e896d9-a9ef-460f-7fe3-2c1cd78b5f5b",
"resource": {
"resourceType": "Observation",
"id": "f2e896d9-a9ef-460f-7fe3-2c1cd78b5f5b",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-bmi-for-age" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "59576-9",
"display": "Body mass index (BMI) [Percentile] Per age and sex"
} ],
"text": "Body mass index (BMI) [Percentile] Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:709ad708-371f-08cb-6cad-8b009011bd75"
},
"effectiveDateTime": "2016-06-17T22:33:10+02:00",
"issued": "2016-06-17T22:33:10.614+02:00",
"valueQuantity": {
"value": 86.975,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:fdf66b7d-085b-bd4a-704d-3820e0d076be",
"resource": {
"resourceType": "Observation",
"id": "fdf66b7d-085b-bd4a-704d-3820e0d076be",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "85354-9",
"display": "Blood pressure panel with all children optional"
} ],
"text": "Blood pressure panel with all children optional"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:709ad708-371f-08cb-6cad-8b009011bd75"
},
"effectiveDateTime": "2016-06-17T22:33:10+02:00",
"issued": "2016-06-17T22:33:10.614+02:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 83,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8480-6",
"display": "Systolic Blood Pressure"
} ],
"text": "Systolic Blood Pressure"
},
"valueQuantity": {
"value": 125,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:a0569ee9-dc1f-ab09-e93d-01eaedeae519",
"resource": {
"resourceType": "Observation",
"id": "a0569ee9-dc1f-ab09-e93d-01eaedeae519",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8867-4",
"display": "Heart rate"
} ],
"text": "Heart rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:709ad708-371f-08cb-6cad-8b009011bd75"
},
"effectiveDateTime": "2016-06-17T22:33:10+02:00",
"issued": "2016-06-17T22:33:10.614+02:00",
"valueQuantity": {
"value": 100,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:77f39f02-73ea-25e6-0249-c43e2590a61a",
"resource": {
"resourceType": "Observation",
"id": "77f39f02-73ea-25e6-0249-c43e2590a61a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9279-1",
"display": "Respiratory rate"
} ],
"text": "Respiratory rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:709ad708-371f-08cb-6cad-8b009011bd75"
},
"effectiveDateTime": "2016-06-17T22:33:10+02:00",
"issued": "2016-06-17T22:33:10.614+02:00",
"valueQuantity": {
"value": 14,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:c05394e5-d698-40af-53e5-de2e2308bf9c",
"resource": {
"resourceType": "Observation",
"id": "c05394e5-d698-40af-53e5-de2e2308bf9c",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social history"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72166-2",
"display": "Tobacco smoking status"
} ],
"text": "Tobacco smoking status"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:709ad708-371f-08cb-6cad-8b009011bd75"
},
"effectiveDateTime": "2016-06-17T22:33:10+02:00",
"issued": "2016-06-17T22:33:10.614+02:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "266919005",
"display": "Never smoked tobacco (finding)"
} ],
"text": "Never smoked tobacco (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:56739c3e-380a-98b7-5c97-1e10834ba9e6",
"resource": {
"resourceType": "Immunization",
"id": "56739c3e-380a-98b7-5c97-1e10834ba9e6",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "83",
"display": "Hep A, ped/adol, 2 dose"
} ],
"text": "Hep A, ped/adol, 2 dose"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:709ad708-371f-08cb-6cad-8b009011bd75"
},
"occurrenceDateTime": "2016-06-17T22:33:10+02:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:1c23435c-0d00-bc9a-361b-1c304bf4830e",
"resource": {
"resourceType": "DiagnosticReport",
"id": "1c23435c-0d00-bc9a-361b-1c304bf4830e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:709ad708-371f-08cb-6cad-8b009011bd75"
},
"effectiveDateTime": "2016-06-17T22:33:10+02:00",
"issued": "2016-06-17T22:33:10.614+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:65c3c150-85a8-5a15-03f7-6220446efc09",
"resource": {
"resourceType": "DocumentReference",
"id": "65c3c150-85a8-5a15-03f7-6220446efc09",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:1c23435c-0d00-bc9a-361b-1c304bf4830e"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2016-06-17T22:33:10.614+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:709ad708-371f-08cb-6cad-8b009011bd75"
} ],
"period": {
"start": "2016-06-17T22:33:10+02:00",
"end": "2016-06-17T22:48:10+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:b2381852-7efd-e7b0-ddbd-9b5286d3559d",
"resource": {
"resourceType": "Claim",
"id": "b2381852-7efd-e7b0-ddbd-9b5286d3559d",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2016-06-17T22:33:10+02:00",
"end": "2016-06-17T22:48:10+02:00"
},
"created": "2016-06-17T22:48:10+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:56739c3e-380a-98b7-5c97-1e10834ba9e6"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:709ad708-371f-08cb-6cad-8b009011bd75"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "83",
"display": "Hep A, ped/adol, 2 dose"
} ],
"text": "Hep A, ped/adol, 2 dose"
},
"net": {
"value": 136.00,
"currency": "USD"
}
} ],
"total": {
"value": 272.80,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:1718a054-a807-e009-e175-91f1d931d865",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "1718a054-a807-e009-e175-91f1d931d865",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "b2381852-7efd-e7b0-ddbd-9b5286d3559d"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2016-06-17T22:48:10+02:00",
"end": "2017-06-17T22:48:10+02:00"
},
"created": "2016-06-17T22:48:10+02:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"claim": {
"reference": "urn:uuid:b2381852-7efd-e7b0-ddbd-9b5286d3559d"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"servicedPeriod": {
"start": "2016-06-17T22:33:10+02:00",
"end": "2016-06-17T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:709ad708-371f-08cb-6cad-8b009011bd75"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "83",
"display": "Hep A, ped/adol, 2 dose"
} ],
"text": "Hep A, ped/adol, 2 dose"
},
"servicedPeriod": {
"start": "2016-06-17T22:33:10+02:00",
"end": "2016-06-17T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 272.80,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:26c73d51-fadd-dc75-bb94-c82bca7e3f81",
"resource": {
"resourceType": "Encounter",
"id": "26c73d51-fadd-dc75-bb94-c82bca7e3f81",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "26c73d51-fadd-dc75-bb94-c82bca7e3f81"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2016-12-16T21:33:10+01:00",
"end": "2016-12-16T21:48:10+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
}
} ],
"period": {
"start": "2016-12-16T21:33:10+01:00",
"end": "2016-12-16T21:48:10+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:f02cee3d-a7a3-6e28-003e-2e1142e78a43",
"resource": {
"resourceType": "Observation",
"id": "f02cee3d-a7a3-6e28-003e-2e1142e78a43",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8302-2",
"display": "Body Height"
} ],
"text": "Body Height"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:26c73d51-fadd-dc75-bb94-c82bca7e3f81"
},
"effectiveDateTime": "2016-12-16T21:33:10+01:00",
"issued": "2016-12-16T21:33:10.614+01:00",
"valueQuantity": {
"value": 96.9,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:fdf21ec5-2932-c400-afa7-0256215dbd14",
"resource": {
"resourceType": "Observation",
"id": "fdf21ec5-2932-c400-afa7-0256215dbd14",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72514-3",
"display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
} ],
"text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:26c73d51-fadd-dc75-bb94-c82bca7e3f81"
},
"effectiveDateTime": "2016-12-16T21:33:10+01:00",
"issued": "2016-12-16T21:33:10.614+01:00",
"valueQuantity": {
"value": 1,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:2e01deca-7718-e743-a70a-a242701cfc0a",
"resource": {
"resourceType": "Observation",
"id": "2e01deca-7718-e743-a70a-a242701cfc0a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "29463-7",
"display": "Body Weight"
} ],
"text": "Body Weight"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:26c73d51-fadd-dc75-bb94-c82bca7e3f81"
},
"effectiveDateTime": "2016-12-16T21:33:10+01:00",
"issued": "2016-12-16T21:33:10.614+01:00",
"valueQuantity": {
"value": 16.3,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:6ab72f71-dd4e-3059-d0be-09be7e94345a",
"resource": {
"resourceType": "Observation",
"id": "6ab72f71-dd4e-3059-d0be-09be7e94345a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-weight-for-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "77606-2",
"display": "Weight-for-length Per age and sex"
} ],
"text": "Weight-for-length Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:26c73d51-fadd-dc75-bb94-c82bca7e3f81"
},
"effectiveDateTime": "2016-12-16T21:33:10+01:00",
"issued": "2016-12-16T21:33:10.614+01:00",
"valueQuantity": {
"value": 87.407,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:dc13d722-f69c-36ae-1b35-123033983e07",
"resource": {
"resourceType": "Observation",
"id": "dc13d722-f69c-36ae-1b35-123033983e07",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/head-occipital-frontal-circumference-percentile" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8289-1",
"display": "Head Occipital-frontal circumference Percentile"
} ],
"text": "Head Occipital-frontal circumference Percentile"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:26c73d51-fadd-dc75-bb94-c82bca7e3f81"
},
"effectiveDateTime": "2016-12-16T21:33:10+01:00",
"issued": "2016-12-16T21:33:10.614+01:00",
"valueQuantity": {
"value": 74.37,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:266f765a-c627-3782-a4b6-fb6e85de353a",
"resource": {
"resourceType": "Observation",
"id": "266f765a-c627-3782-a4b6-fb6e85de353a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-head-circumference" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9843-4",
"display": "Head Occipital-frontal circumference"
} ],
"text": "Head Occipital-frontal circumference"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:26c73d51-fadd-dc75-bb94-c82bca7e3f81"
},
"effectiveDateTime": "2016-12-16T21:33:10+01:00",
"issued": "2016-12-16T21:33:10.614+01:00",
"valueQuantity": {
"value": 50.69,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:8daf28f3-53b0-d7dd-a2fc-38aa7a708f55",
"resource": {
"resourceType": "Observation",
"id": "8daf28f3-53b0-d7dd-a2fc-38aa7a708f55",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "39156-5",
"display": "Body mass index (BMI) [Ratio]"
} ],
"text": "Body mass index (BMI) [Ratio]"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:26c73d51-fadd-dc75-bb94-c82bca7e3f81"
},
"effectiveDateTime": "2016-12-16T21:33:10+01:00",
"issued": "2016-12-16T21:33:10.614+01:00",
"valueQuantity": {
"value": 17.36,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:447f77a6-93f0-91c0-86e1-a78868b7ed47",
"resource": {
"resourceType": "Observation",
"id": "447f77a6-93f0-91c0-86e1-a78868b7ed47",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-bmi-for-age" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "59576-9",
"display": "Body mass index (BMI) [Percentile] Per age and sex"
} ],
"text": "Body mass index (BMI) [Percentile] Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:26c73d51-fadd-dc75-bb94-c82bca7e3f81"
},
"effectiveDateTime": "2016-12-16T21:33:10+01:00",
"issued": "2016-12-16T21:33:10.614+01:00",
"valueQuantity": {
"value": 84.678,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:281c2ba7-1443-d7ad-5c17-78a7cc08f8ae",
"resource": {
"resourceType": "Observation",
"id": "281c2ba7-1443-d7ad-5c17-78a7cc08f8ae",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "85354-9",
"display": "Blood pressure panel with all children optional"
} ],
"text": "Blood pressure panel with all children optional"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:26c73d51-fadd-dc75-bb94-c82bca7e3f81"
},
"effectiveDateTime": "2016-12-16T21:33:10+01:00",
"issued": "2016-12-16T21:33:10.614+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 86,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8480-6",
"display": "Systolic Blood Pressure"
} ],
"text": "Systolic Blood Pressure"
},
"valueQuantity": {
"value": 115,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:a9f5390e-b894-9f43-e0e5-9a187227b1d1",
"resource": {
"resourceType": "Observation",
"id": "a9f5390e-b894-9f43-e0e5-9a187227b1d1",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8867-4",
"display": "Heart rate"
} ],
"text": "Heart rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:26c73d51-fadd-dc75-bb94-c82bca7e3f81"
},
"effectiveDateTime": "2016-12-16T21:33:10+01:00",
"issued": "2016-12-16T21:33:10.614+01:00",
"valueQuantity": {
"value": 89,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:fd3c4eb9-9dae-b614-60b2-5f0c2c2949af",
"resource": {
"resourceType": "Observation",
"id": "fd3c4eb9-9dae-b614-60b2-5f0c2c2949af",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9279-1",
"display": "Respiratory rate"
} ],
"text": "Respiratory rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:26c73d51-fadd-dc75-bb94-c82bca7e3f81"
},
"effectiveDateTime": "2016-12-16T21:33:10+01:00",
"issued": "2016-12-16T21:33:10.614+01:00",
"valueQuantity": {
"value": 13,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:5599f1f1-1d89-af87-ad68-42ebf5ffe974",
"resource": {
"resourceType": "Observation",
"id": "5599f1f1-1d89-af87-ad68-42ebf5ffe974",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social history"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72166-2",
"display": "Tobacco smoking status"
} ],
"text": "Tobacco smoking status"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:26c73d51-fadd-dc75-bb94-c82bca7e3f81"
},
"effectiveDateTime": "2016-12-16T21:33:10+01:00",
"issued": "2016-12-16T21:33:10.614+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "266919005",
"display": "Never smoked tobacco (finding)"
} ],
"text": "Never smoked tobacco (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:9bc852fd-ea54-ceb2-12a8-03acb9939169",
"resource": {
"resourceType": "Procedure",
"id": "9bc852fd-ea54-ceb2-12a8-03acb9939169",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:26c73d51-fadd-dc75-bb94-c82bca7e3f81"
},
"performedPeriod": {
"start": "2016-12-16T21:33:10+01:00",
"end": "2016-12-16T21:48:10+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:cc3e4d65-94cb-0bf0-4518-af4033a47939",
"resource": {
"resourceType": "Immunization",
"id": "cc3e4d65-94cb-0bf0-4518-af4033a47939",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:26c73d51-fadd-dc75-bb94-c82bca7e3f81"
},
"occurrenceDateTime": "2016-12-16T21:33:10+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:b37e9d17-e599-4ecc-a9b3-acb4d736554a",
"resource": {
"resourceType": "DiagnosticReport",
"id": "b37e9d17-e599-4ecc-a9b3-acb4d736554a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:26c73d51-fadd-dc75-bb94-c82bca7e3f81"
},
"effectiveDateTime": "2016-12-16T21:33:10+01:00",
"issued": "2016-12-16T21:33:10.614+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:23d8407f-5353-2452-0c0c-3030fbd00bdf",
"resource": {
"resourceType": "DocumentReference",
"id": "23d8407f-5353-2452-0c0c-3030fbd00bdf",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:b37e9d17-e599-4ecc-a9b3-acb4d736554a"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2016-12-16T21:33:10.614+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:26c73d51-fadd-dc75-bb94-c82bca7e3f81"
} ],
"period": {
"start": "2016-12-16T21:33:10+01:00",
"end": "2016-12-16T21:48:10+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:d6a4cd6a-4e39-ecc1-95ec-c898582e93ac",
"resource": {
"resourceType": "Claim",
"id": "d6a4cd6a-4e39-ecc1-95ec-c898582e93ac",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2016-12-16T21:33:10+01:00",
"end": "2016-12-16T21:48:10+01:00"
},
"created": "2016-12-16T21:48:10+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:cc3e4d65-94cb-0bf0-4518-af4033a47939"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:9bc852fd-ea54-ceb2-12a8-03acb9939169"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:26c73d51-fadd-dc75-bb94-c82bca7e3f81"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 3,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"net": {
"value": 464.19,
"currency": "USD"
}
} ],
"total": {
"value": 736.99,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:653822e2-1387-4370-1f1b-5d4551c95705",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "653822e2-1387-4370-1f1b-5d4551c95705",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "d6a4cd6a-4e39-ecc1-95ec-c898582e93ac"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2016-12-16T21:48:10+01:00",
"end": "2017-12-16T21:48:10+01:00"
},
"created": "2016-12-16T21:48:10+01:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"claim": {
"reference": "urn:uuid:d6a4cd6a-4e39-ecc1-95ec-c898582e93ac"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"servicedPeriod": {
"start": "2016-12-16T21:33:10+01:00",
"end": "2016-12-16T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:26c73d51-fadd-dc75-bb94-c82bca7e3f81"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"servicedPeriod": {
"start": "2016-12-16T21:33:10+01:00",
"end": "2016-12-16T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"servicedPeriod": {
"start": "2016-12-16T21:33:10+01:00",
"end": "2016-12-16T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 464.19,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 92.83800000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 371.35200000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 464.19,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 464.19,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 736.99,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 480.15200000000004,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:a4fe77e5-6ca5-d363-ff95-16579f7b14ee",
"resource": {
"resourceType": "Encounter",
"id": "a4fe77e5-6ca5-d363-ff95-16579f7b14ee",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "a4fe77e5-6ca5-d363-ff95-16579f7b14ee"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2017-05-30T00:33:10+02:00",
"end": "2017-05-30T00:48:10+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
}
} ],
"period": {
"start": "2017-05-30T00:33:10+02:00",
"end": "2017-05-30T00:48:10+02:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "444814009",
"display": "Viral sinusitis (disorder)"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:21f6155b-bf59-58fe-67af-da49c47c70fa",
"resource": {
"resourceType": "Condition",
"id": "21f6155b-bf59-58fe-67af-da49c47c70fa",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "resolved"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed"
} ]
},
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-category",
"code": "encounter-diagnosis",
"display": "Encounter Diagnosis"
} ]
} ],
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "444814009",
"display": "Viral sinusitis (disorder)"
} ],
"text": "Viral sinusitis (disorder)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:a4fe77e5-6ca5-d363-ff95-16579f7b14ee"
},
"onsetDateTime": "2017-05-30T00:33:10+02:00",
"abatementDateTime": "2017-06-06T00:33:10+02:00",
"recordedDate": "2017-05-30T00:33:10+02:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:e4788780-cfce-0217-b8b7-7b4743e7f9f0",
"resource": {
"resourceType": "DiagnosticReport",
"id": "e4788780-cfce-0217-b8b7-7b4743e7f9f0",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:a4fe77e5-6ca5-d363-ff95-16579f7b14ee"
},
"effectiveDateTime": "2017-05-30T00:33:10+02:00",
"issued": "2017-05-30T00:33:10.614+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "CjIwMTctMDUtMzAKCiMgQ2hpZWYgQ29tcGxhaW50Ck5vIGNvbXBsYWludHMuCgojIEhpc3Rvcnkgb2YgUHJlc2VudCBJbGxuZXNzCkRvbm5lbGw1MzQKIGlzIGEgMyB5ZWFyLW9sZCBub25oaXNwYW5pYyB3aGl0ZSBtYWxlLiBQYXRpZW50IGhhcyBhIGhpc3Rvcnkgb2YgbWVkaWNhdGlvbiByZXZpZXcgZHVlIChzaXR1YXRpb24pLCBmcmFjdHVyZSBvZiBib25lIChkaXNvcmRlciksIGZyYWN0dXJlIG9mIHJpYi4KCiMgU29jaWFsIEhpc3RvcnkKIFBhdGllbnQgaGFzIG5ldmVyIHNtb2tlZC4KCgpQYXRpZW50IGNvbWVzIGZyb20gYSBoaWdoIHNvY2lvZWNvbm9taWMgYmFja2dyb3VuZC4KClBhdGllbnQgY3VycmVudGx5IGhhcyBBbnRoZW0uCgojIEFsbGVyZ2llcwpObyBLbm93biBBbGxlcmdpZXMuCgojIE1lZGljYXRpb25zCmlidXByb2ZlbiAxMDAgbWcgb3JhbCB0YWJsZXQKCiMgQXNzZXNzbWVudCBhbmQgUGxhbgpQYXRpZW50IGlzIHByZXNlbnRpbmcgd2l0aCB2aXJhbCBzaW51c2l0aXMgKGRpc29yZGVyKS4gCgojIyBQbGFuCgo="
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:ff7c4c9d-71d1-98ec-cf3b-133f656fcc8d",
"resource": {
"resourceType": "DocumentReference",
"id": "ff7c4c9d-71d1-98ec-cf3b-133f656fcc8d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:e4788780-cfce-0217-b8b7-7b4743e7f9f0"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2017-05-30T00:33:10.614+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:a4fe77e5-6ca5-d363-ff95-16579f7b14ee"
} ],
"period": {
"start": "2017-05-30T00:33:10+02:00",
"end": "2017-05-30T00:48:10+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:0664b9d8-6ec1-f09b-dc5b-a6fcfe0172c4",
"resource": {
"resourceType": "Claim",
"id": "0664b9d8-6ec1-f09b-dc5b-a6fcfe0172c4",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2017-05-30T00:33:10+02:00",
"end": "2017-05-30T00:48:10+02:00"
},
"created": "2017-05-30T00:48:10+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
},
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:21f6155b-bf59-58fe-67af-da49c47c70fa"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
},
"encounter": [ {
"reference": "urn:uuid:a4fe77e5-6ca5-d363-ff95-16579f7b14ee"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "444814009",
"display": "Viral sinusitis (disorder)"
} ],
"text": "Viral sinusitis (disorder)"
}
} ],
"total": {
"value": 85.55,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:071b132e-fe1e-06ce-3763-edc63a855350",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "071b132e-fe1e-06ce-3763-edc63a855350",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "0664b9d8-6ec1-f09b-dc5b-a6fcfe0172c4"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2017-05-30T00:48:10+02:00",
"end": "2018-05-30T00:48:10+02:00"
},
"created": "2017-05-30T00:48:10+02:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
},
"claim": {
"reference": "urn:uuid:0664b9d8-6ec1-f09b-dc5b-a6fcfe0172c4"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:21f6155b-bf59-58fe-67af-da49c47c70fa"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
},
"servicedPeriod": {
"start": "2017-05-30T00:33:10+02:00",
"end": "2017-05-30T00:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:a4fe77e5-6ca5-d363-ff95-16579f7b14ee"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "444814009",
"display": "Viral sinusitis (disorder)"
} ],
"text": "Viral sinusitis (disorder)"
},
"servicedPeriod": {
"start": "2017-05-30T00:33:10+02:00",
"end": "2017-05-30T00:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
}
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 85.55,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:1941eae6-2d7b-ae4c-c20c-842fdda6afc9",
"resource": {
"resourceType": "Encounter",
"id": "1941eae6-2d7b-ae4c-c20c-842fdda6afc9",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "1941eae6-2d7b-ae4c-c20c-842fdda6afc9"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2017-06-16T22:33:10+02:00",
"end": "2017-06-16T22:48:10+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
}
} ],
"period": {
"start": "2017-06-16T22:33:10+02:00",
"end": "2017-06-16T22:48:10+02:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:bf8502ee-a6ae-90ef-f89d-7676c333f741",
"resource": {
"resourceType": "Condition",
"id": "bf8502ee-a6ae-90ef-f89d-7676c333f741",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "resolved"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed"
} ]
},
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-category",
"code": "encounter-diagnosis",
"display": "Encounter Diagnosis"
} ]
} ],
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:1941eae6-2d7b-ae4c-c20c-842fdda6afc9"
},
"onsetDateTime": "2017-06-16T22:33:10+02:00",
"abatementDateTime": "2017-06-16T22:33:10+02:00",
"recordedDate": "2017-06-16T22:33:10+02:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:c3996be9-e0a8-d99c-4526-a583bbe47206",
"resource": {
"resourceType": "Observation",
"id": "c3996be9-e0a8-d99c-4526-a583bbe47206",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8302-2",
"display": "Body Height"
} ],
"text": "Body Height"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:1941eae6-2d7b-ae4c-c20c-842fdda6afc9"
},
"effectiveDateTime": "2017-06-16T22:33:10+02:00",
"issued": "2017-06-16T22:33:10.614+02:00",
"valueQuantity": {
"value": 100.8,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:5bc8b90b-4a92-5817-4c0a-9fe9f2c6414c",
"resource": {
"resourceType": "Observation",
"id": "5bc8b90b-4a92-5817-4c0a-9fe9f2c6414c",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72514-3",
"display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
} ],
"text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:1941eae6-2d7b-ae4c-c20c-842fdda6afc9"
},
"effectiveDateTime": "2017-06-16T22:33:10+02:00",
"issued": "2017-06-16T22:33:10.614+02:00",
"valueQuantity": {
"value": 0,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e81d2f54-ac02-44bb-9b33-f03fe6339254",
"resource": {
"resourceType": "Observation",
"id": "e81d2f54-ac02-44bb-9b33-f03fe6339254",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "29463-7",
"display": "Body Weight"
} ],
"text": "Body Weight"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:1941eae6-2d7b-ae4c-c20c-842fdda6afc9"
},
"effectiveDateTime": "2017-06-16T22:33:10+02:00",
"issued": "2017-06-16T22:33:10.614+02:00",
"valueQuantity": {
"value": 17,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d15fc61c-1fba-a7b2-7d18-255ce09907d6",
"resource": {
"resourceType": "Observation",
"id": "d15fc61c-1fba-a7b2-7d18-255ce09907d6",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-weight-for-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "77606-2",
"display": "Weight-for-length Per age and sex"
} ],
"text": "Weight-for-length Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:1941eae6-2d7b-ae4c-c20c-842fdda6afc9"
},
"effectiveDateTime": "2017-06-16T22:33:10+02:00",
"issued": "2017-06-16T22:33:10.614+02:00",
"valueQuantity": {
"value": 84.42,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:738f79a9-a7da-e0f1-fa1b-2f55c5420129",
"resource": {
"resourceType": "Observation",
"id": "738f79a9-a7da-e0f1-fa1b-2f55c5420129",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/head-occipital-frontal-circumference-percentile" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8289-1",
"display": "Head Occipital-frontal circumference Percentile"
} ],
"text": "Head Occipital-frontal circumference Percentile"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:1941eae6-2d7b-ae4c-c20c-842fdda6afc9"
},
"effectiveDateTime": "2017-06-16T22:33:10+02:00",
"issued": "2017-06-16T22:33:10.614+02:00",
"valueQuantity": {
"value": 74.37,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:53ea12d4-582f-e980-4518-2a3a8d008643",
"resource": {
"resourceType": "Observation",
"id": "53ea12d4-582f-e980-4518-2a3a8d008643",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-head-circumference" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9843-4",
"display": "Head Occipital-frontal circumference"
} ],
"text": "Head Occipital-frontal circumference"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:1941eae6-2d7b-ae4c-c20c-842fdda6afc9"
},
"effectiveDateTime": "2017-06-16T22:33:10+02:00",
"issued": "2017-06-16T22:33:10.614+02:00",
"valueQuantity": {
"value": 50.73,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:c8be2026-4470-26a5-c7bc-9c65d076497f",
"resource": {
"resourceType": "Observation",
"id": "c8be2026-4470-26a5-c7bc-9c65d076497f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "39156-5",
"display": "Body mass index (BMI) [Ratio]"
} ],
"text": "Body mass index (BMI) [Ratio]"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:1941eae6-2d7b-ae4c-c20c-842fdda6afc9"
},
"effectiveDateTime": "2017-06-16T22:33:10+02:00",
"issued": "2017-06-16T22:33:10.614+02:00",
"valueQuantity": {
"value": 16.78,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:0ac6ce5e-8bbe-cb42-9328-c613784581a0",
"resource": {
"resourceType": "Observation",
"id": "0ac6ce5e-8bbe-cb42-9328-c613784581a0",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-bmi-for-age" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "59576-9",
"display": "Body mass index (BMI) [Percentile] Per age and sex"
} ],
"text": "Body mass index (BMI) [Percentile] Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:1941eae6-2d7b-ae4c-c20c-842fdda6afc9"
},
"effectiveDateTime": "2017-06-16T22:33:10+02:00",
"issued": "2017-06-16T22:33:10.614+02:00",
"valueQuantity": {
"value": 78.376,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:423d5f20-0317-0b38-f16c-70e02d7b266e",
"resource": {
"resourceType": "Observation",
"id": "423d5f20-0317-0b38-f16c-70e02d7b266e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "85354-9",
"display": "Blood pressure panel with all children optional"
} ],
"text": "Blood pressure panel with all children optional"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:1941eae6-2d7b-ae4c-c20c-842fdda6afc9"
},
"effectiveDateTime": "2017-06-16T22:33:10+02:00",
"issued": "2017-06-16T22:33:10.614+02:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 86,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8480-6",
"display": "Systolic Blood Pressure"
} ],
"text": "Systolic Blood Pressure"
},
"valueQuantity": {
"value": 122,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d22bf566-a477-8845-49a9-cc560a6abf52",
"resource": {
"resourceType": "Observation",
"id": "d22bf566-a477-8845-49a9-cc560a6abf52",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8867-4",
"display": "Heart rate"
} ],
"text": "Heart rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:1941eae6-2d7b-ae4c-c20c-842fdda6afc9"
},
"effectiveDateTime": "2017-06-16T22:33:10+02:00",
"issued": "2017-06-16T22:33:10.614+02:00",
"valueQuantity": {
"value": 77,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:85e6c226-f295-9779-360b-4d812c3e7606",
"resource": {
"resourceType": "Observation",
"id": "85e6c226-f295-9779-360b-4d812c3e7606",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9279-1",
"display": "Respiratory rate"
} ],
"text": "Respiratory rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:1941eae6-2d7b-ae4c-c20c-842fdda6afc9"
},
"effectiveDateTime": "2017-06-16T22:33:10+02:00",
"issued": "2017-06-16T22:33:10.614+02:00",
"valueQuantity": {
"value": 12,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:810a4947-facb-9831-ed8f-778776c42529",
"resource": {
"resourceType": "Observation",
"id": "810a4947-facb-9831-ed8f-778776c42529",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social history"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72166-2",
"display": "Tobacco smoking status"
} ],
"text": "Tobacco smoking status"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:1941eae6-2d7b-ae4c-c20c-842fdda6afc9"
},
"effectiveDateTime": "2017-06-16T22:33:10+02:00",
"issued": "2017-06-16T22:33:10.614+02:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "266919005",
"display": "Never smoked tobacco (finding)"
} ],
"text": "Never smoked tobacco (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:51f07480-5041-8304-a3f5-1ee83a7b7053",
"resource": {
"resourceType": "Procedure",
"id": "51f07480-5041-8304-a3f5-1ee83a7b7053",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:1941eae6-2d7b-ae4c-c20c-842fdda6afc9"
},
"performedPeriod": {
"start": "2017-06-16T22:33:10+02:00",
"end": "2017-06-16T22:48:10+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:19271e95-7207-ddea-d7ed-c089103b7eb9",
"resource": {
"resourceType": "DiagnosticReport",
"id": "19271e95-7207-ddea-d7ed-c089103b7eb9",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:1941eae6-2d7b-ae4c-c20c-842fdda6afc9"
},
"effectiveDateTime": "2017-06-16T22:33:10+02:00",
"issued": "2017-06-16T22:33:10.614+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:d25acc25-a4c2-193c-6f61-4a1bd9d1b62e",
"resource": {
"resourceType": "DocumentReference",
"id": "d25acc25-a4c2-193c-6f61-4a1bd9d1b62e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:19271e95-7207-ddea-d7ed-c089103b7eb9"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2017-06-16T22:33:10.614+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "CjIwMTctMDYtMTYKCiMgQ2hpZWYgQ29tcGxhaW50Ck5vIGNvbXBsYWludHMuCgojIEhpc3Rvcnkgb2YgUHJlc2VudCBJbGxuZXNzCkRvbm5lbGw1MzQKIGlzIGEgMyB5ZWFyLW9sZCBub25oaXNwYW5pYyB3aGl0ZSBtYWxlLiBQYXRpZW50IGhhcyBhIGhpc3Rvcnkgb2YgbWVkaWNhdGlvbiByZXZpZXcgZHVlIChzaXR1YXRpb24pLCBmcmFjdHVyZSBvZiBib25lIChkaXNvcmRlciksIGZyYWN0dXJlIG9mIHJpYiwgdmlyYWwgc2ludXNpdGlzIChkaXNvcmRlcikuCgojIFNvY2lhbCBIaXN0b3J5CiBQYXRpZW50IGhhcyBuZXZlciBzbW9rZWQuCgoKUGF0aWVudCBjb21lcyBmcm9tIGEgaGlnaCBzb2Npb2Vjb25vbWljIGJhY2tncm91bmQuCgpQYXRpZW50IGN1cnJlbnRseSBoYXMgQW50aGVtLgoKIyBBbGxlcmdpZXMKTm8gS25vd24gQWxsZXJnaWVzLgoKIyBNZWRpY2F0aW9ucwppYnVwcm9mZW4gMTAwIG1nIG9yYWwgdGFibGV0CgojIEFzc2Vzc21lbnQgYW5kIFBsYW4KUGF0aWVudCBpcyBwcmVzZW50aW5nIHdpdGggbWVkaWNhdGlvbiByZXZpZXcgZHVlIChzaXR1YXRpb24pLiAKCiMjIFBsYW4KClRoZSBmb2xsb3dpbmcgcHJvY2VkdXJlcyB3ZXJlIGNvbmR1Y3RlZDoKLSBtZWRpY2F0aW9uIHJlY29uY2lsaWF0aW9uIChwcm9jZWR1cmUpCg=="
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:1941eae6-2d7b-ae4c-c20c-842fdda6afc9"
} ],
"period": {
"start": "2017-06-16T22:33:10+02:00",
"end": "2017-06-16T22:48:10+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:1874879e-1dd7-f358-3265-0cc05e9ce65d",
"resource": {
"resourceType": "Claim",
"id": "1874879e-1dd7-f358-3265-0cc05e9ce65d",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2017-06-16T22:33:10+02:00",
"end": "2017-06-16T22:48:10+02:00"
},
"created": "2017-06-16T22:48:10+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:bf8502ee-a6ae-90ef-f89d-7676c333f741"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:51f07480-5041-8304-a3f5-1ee83a7b7053"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:1941eae6-2d7b-ae4c-c20c-842fdda6afc9"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
}
}, {
"sequence": 3,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"net": {
"value": 574.65,
"currency": "USD"
}
} ],
"total": {
"value": 711.45,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:fd311ec9-40be-d484-41cc-8b6f0fd8a7a6",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "fd311ec9-40be-d484-41cc-8b6f0fd8a7a6",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "1874879e-1dd7-f358-3265-0cc05e9ce65d"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2017-06-16T22:48:10+02:00",
"end": "2018-06-16T22:48:10+02:00"
},
"created": "2017-06-16T22:48:10+02:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"claim": {
"reference": "urn:uuid:1874879e-1dd7-f358-3265-0cc05e9ce65d"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:bf8502ee-a6ae-90ef-f89d-7676c333f741"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"servicedPeriod": {
"start": "2017-06-16T22:33:10+02:00",
"end": "2017-06-16T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:1941eae6-2d7b-ae4c-c20c-842fdda6afc9"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"servicedPeriod": {
"start": "2017-06-16T22:33:10+02:00",
"end": "2017-06-16T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"servicedPeriod": {
"start": "2017-06-16T22:33:10+02:00",
"end": "2017-06-16T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 574.65,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 114.93,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 459.72,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 574.65,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 574.65,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 711.45,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 459.72,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30",
"resource": {
"resourceType": "Encounter",
"id": "742482d7-d60d-8b78-a21d-938ab759ea30",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "742482d7-d60d-8b78-a21d-938ab759ea30"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2017-12-15T21:33:10+01:00",
"end": "2017-12-15T21:48:10+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
}
} ],
"period": {
"start": "2017-12-15T21:33:10+01:00",
"end": "2017-12-15T21:48:10+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:3d227fb5-0824-f946-8eeb-1a063c177eb7",
"resource": {
"resourceType": "Condition",
"id": "3d227fb5-0824-f946-8eeb-1a063c177eb7",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "resolved"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed"
} ]
},
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-category",
"code": "encounter-diagnosis",
"display": "Encounter Diagnosis"
} ]
} ],
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30"
},
"onsetDateTime": "2017-12-15T21:33:10+01:00",
"abatementDateTime": "2017-12-15T21:33:10+01:00",
"recordedDate": "2017-12-15T21:33:10+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:696a32b6-8c7c-4167-5382-94c6d472175b",
"resource": {
"resourceType": "Observation",
"id": "696a32b6-8c7c-4167-5382-94c6d472175b",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8302-2",
"display": "Body Height"
} ],
"text": "Body Height"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30"
},
"effectiveDateTime": "2017-12-15T21:33:10+01:00",
"issued": "2017-12-15T21:33:10.614+01:00",
"valueQuantity": {
"value": 104.4,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:8ecd6c09-1dee-9d1c-8a28-4bde6d8cc997",
"resource": {
"resourceType": "Observation",
"id": "8ecd6c09-1dee-9d1c-8a28-4bde6d8cc997",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72514-3",
"display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
} ],
"text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30"
},
"effectiveDateTime": "2017-12-15T21:33:10+01:00",
"issued": "2017-12-15T21:33:10.614+01:00",
"valueQuantity": {
"value": 0,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:ccbc8628-74da-b95e-cf3e-ab52516eb36f",
"resource": {
"resourceType": "Observation",
"id": "ccbc8628-74da-b95e-cf3e-ab52516eb36f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "29463-7",
"display": "Body Weight"
} ],
"text": "Body Weight"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30"
},
"effectiveDateTime": "2017-12-15T21:33:10+01:00",
"issued": "2017-12-15T21:33:10.614+01:00",
"valueQuantity": {
"value": 18,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:ec2c0f2b-0a4c-f590-3665-944a07234f7f",
"resource": {
"resourceType": "Observation",
"id": "ec2c0f2b-0a4c-f590-3665-944a07234f7f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-weight-for-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "77606-2",
"display": "Weight-for-length Per age and sex"
} ],
"text": "Weight-for-length Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30"
},
"effectiveDateTime": "2017-12-15T21:33:10+01:00",
"issued": "2017-12-15T21:33:10.614+01:00",
"valueQuantity": {
"value": 84.42,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:dc7afc29-ce77-76d9-feeb-e127267ad5e0",
"resource": {
"resourceType": "Observation",
"id": "dc7afc29-ce77-76d9-feeb-e127267ad5e0",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/head-occipital-frontal-circumference-percentile" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8289-1",
"display": "Head Occipital-frontal circumference Percentile"
} ],
"text": "Head Occipital-frontal circumference Percentile"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30"
},
"effectiveDateTime": "2017-12-15T21:33:10+01:00",
"issued": "2017-12-15T21:33:10.614+01:00",
"valueQuantity": {
"value": 74.37,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:2e2e27c8-5369-ba48-7ebb-36f3b1b5bea9",
"resource": {
"resourceType": "Observation",
"id": "2e2e27c8-5369-ba48-7ebb-36f3b1b5bea9",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-head-circumference" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9843-4",
"display": "Head Occipital-frontal circumference"
} ],
"text": "Head Occipital-frontal circumference"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30"
},
"effectiveDateTime": "2017-12-15T21:33:10+01:00",
"issued": "2017-12-15T21:33:10.614+01:00",
"valueQuantity": {
"value": 50.73,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:780a3301-45b5-6050-b63c-ddc8dc8ebc82",
"resource": {
"resourceType": "Observation",
"id": "780a3301-45b5-6050-b63c-ddc8dc8ebc82",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "39156-5",
"display": "Body mass index (BMI) [Ratio]"
} ],
"text": "Body mass index (BMI) [Ratio]"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30"
},
"effectiveDateTime": "2017-12-15T21:33:10+01:00",
"issued": "2017-12-15T21:33:10.614+01:00",
"valueQuantity": {
"value": 16.49,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:65e42e25-7acf-bb73-bc09-3b73d5514c77",
"resource": {
"resourceType": "Observation",
"id": "65e42e25-7acf-bb73-bc09-3b73d5514c77",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-bmi-for-age" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "59576-9",
"display": "Body mass index (BMI) [Percentile] Per age and sex"
} ],
"text": "Body mass index (BMI) [Percentile] Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30"
},
"effectiveDateTime": "2017-12-15T21:33:10+01:00",
"issued": "2017-12-15T21:33:10.614+01:00",
"valueQuantity": {
"value": 75.646,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:2c0a7ccc-b495-5389-bcc0-7348981956d1",
"resource": {
"resourceType": "Observation",
"id": "2c0a7ccc-b495-5389-bcc0-7348981956d1",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "85354-9",
"display": "Blood pressure panel with all children optional"
} ],
"text": "Blood pressure panel with all children optional"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30"
},
"effectiveDateTime": "2017-12-15T21:33:10+01:00",
"issued": "2017-12-15T21:33:10.614+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 80,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8480-6",
"display": "Systolic Blood Pressure"
} ],
"text": "Systolic Blood Pressure"
},
"valueQuantity": {
"value": 125,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:49a90229-1a22-e27b-3a43-f81ca6482f58",
"resource": {
"resourceType": "Observation",
"id": "49a90229-1a22-e27b-3a43-f81ca6482f58",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8867-4",
"display": "Heart rate"
} ],
"text": "Heart rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30"
},
"effectiveDateTime": "2017-12-15T21:33:10+01:00",
"issued": "2017-12-15T21:33:10.614+01:00",
"valueQuantity": {
"value": 62,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:79208408-32ab-6ccf-3a82-3e4ca6cd257c",
"resource": {
"resourceType": "Observation",
"id": "79208408-32ab-6ccf-3a82-3e4ca6cd257c",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9279-1",
"display": "Respiratory rate"
} ],
"text": "Respiratory rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30"
},
"effectiveDateTime": "2017-12-15T21:33:10+01:00",
"issued": "2017-12-15T21:33:10.614+01:00",
"valueQuantity": {
"value": 16,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d8cac53e-c184-2e43-51e8-70fd5d8c529e",
"resource": {
"resourceType": "Observation",
"id": "d8cac53e-c184-2e43-51e8-70fd5d8c529e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social history"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72166-2",
"display": "Tobacco smoking status"
} ],
"text": "Tobacco smoking status"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30"
},
"effectiveDateTime": "2017-12-15T21:33:10+01:00",
"issued": "2017-12-15T21:33:10.614+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "266919005",
"display": "Never smoked tobacco (finding)"
} ],
"text": "Never smoked tobacco (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:2e4eed92-944c-fd1b-7d4e-812115251970",
"resource": {
"resourceType": "Procedure",
"id": "2e4eed92-944c-fd1b-7d4e-812115251970",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30"
},
"performedPeriod": {
"start": "2017-12-15T21:33:10+01:00",
"end": "2017-12-15T21:48:10+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:46e24d27-7dd8-5342-4119-52d3fcf421fb",
"resource": {
"resourceType": "Immunization",
"id": "46e24d27-7dd8-5342-4119-52d3fcf421fb",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30"
},
"occurrenceDateTime": "2017-12-15T21:33:10+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:256c6bda-728d-f510-5f4f-a5e76e7a5f2f",
"resource": {
"resourceType": "DiagnosticReport",
"id": "256c6bda-728d-f510-5f4f-a5e76e7a5f2f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30"
},
"effectiveDateTime": "2017-12-15T21:33:10+01:00",
"issued": "2017-12-15T21:33:10.614+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:3665575a-9c95-eb4a-99b6-5129b6665329",
"resource": {
"resourceType": "DocumentReference",
"id": "3665575a-9c95-eb4a-99b6-5129b6665329",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:256c6bda-728d-f510-5f4f-a5e76e7a5f2f"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2017-12-15T21:33:10.614+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30"
} ],
"period": {
"start": "2017-12-15T21:33:10+01:00",
"end": "2017-12-15T21:48:10+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:9e4e7a6e-7e2d-52a1-51da-46fec0f15bfb",
"resource": {
"resourceType": "Claim",
"id": "9e4e7a6e-7e2d-52a1-51da-46fec0f15bfb",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2017-12-15T21:33:10+01:00",
"end": "2017-12-15T21:48:10+01:00"
},
"created": "2017-12-15T21:48:10+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:46e24d27-7dd8-5342-4119-52d3fcf421fb"
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:3d227fb5-0824-f946-8eeb-1a063c177eb7"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:2e4eed92-944c-fd1b-7d4e-812115251970"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 3,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
}
}, {
"sequence": 4,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"net": {
"value": 489.89,
"currency": "USD"
}
} ],
"total": {
"value": 762.69,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:ba3561b6-67e9-c7ce-0d1c-ee9ffc355aed",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "ba3561b6-67e9-c7ce-0d1c-ee9ffc355aed",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "9e4e7a6e-7e2d-52a1-51da-46fec0f15bfb"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2017-12-15T21:48:10+01:00",
"end": "2018-12-15T21:48:10+01:00"
},
"created": "2017-12-15T21:48:10+01:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"claim": {
"reference": "urn:uuid:9e4e7a6e-7e2d-52a1-51da-46fec0f15bfb"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:3d227fb5-0824-f946-8eeb-1a063c177eb7"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"servicedPeriod": {
"start": "2017-12-15T21:33:10+01:00",
"end": "2017-12-15T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"servicedPeriod": {
"start": "2017-12-15T21:33:10+01:00",
"end": "2017-12-15T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 3,
"diagnosisSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"servicedPeriod": {
"start": "2017-12-15T21:33:10+01:00",
"end": "2017-12-15T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 4,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"servicedPeriod": {
"start": "2017-12-15T21:33:10+01:00",
"end": "2017-12-15T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 489.89,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 97.97800000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 391.91200000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 489.89,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 489.89,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 762.69,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 500.71200000000005,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:4c23b36a-fdb7-5022-43be-2bd4026cc885",
"resource": {
"resourceType": "Encounter",
"id": "4c23b36a-fdb7-5022-43be-2bd4026cc885",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "4c23b36a-fdb7-5022-43be-2bd4026cc885"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2018-05-19T22:33:10+02:00",
"end": "2018-05-19T22:48:10+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
}
} ],
"period": {
"start": "2018-05-19T22:33:10+02:00",
"end": "2018-05-19T22:48:10+02:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "65363002",
"display": "Otitis media"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:6ef17dfb-0046-3eaa-a42f-dfa449a7a845",
"resource": {
"resourceType": "Condition",
"id": "6ef17dfb-0046-3eaa-a42f-dfa449a7a845",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "resolved"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed"
} ]
},
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-category",
"code": "encounter-diagnosis",
"display": "Encounter Diagnosis"
} ]
} ],
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "65363002",
"display": "Otitis media"
} ],
"text": "Otitis media"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:4c23b36a-fdb7-5022-43be-2bd4026cc885"
},
"onsetDateTime": "2018-05-19T22:33:10+02:00",
"abatementDateTime": "2018-12-21T21:33:10+01:00",
"recordedDate": "2018-05-19T22:33:10+02:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:a42e9e43-9b6c-f281-f328-2c4649dc871b",
"resource": {
"resourceType": "MedicationRequest",
"id": "a42e9e43-9b6c-f281-f328-2c4649dc871b",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest" ]
},
"status": "stopped",
"intent": "order",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
"code": "community",
"display": "Community"
} ],
"text": "Community"
} ],
"medicationCodeableConcept": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "141962",
"display": "Azithromycin 250 MG Oral Capsule"
} ],
"text": "Azithromycin 250 MG Oral Capsule"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:4c23b36a-fdb7-5022-43be-2bd4026cc885"
},
"authoredOn": "2018-05-19T22:33:10+02:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
}
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:966d696b-a33a-600c-92f2-2c49e09872ff",
"resource": {
"resourceType": "Claim",
"id": "966d696b-a33a-600c-92f2-2c49e09872ff",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2018-05-19T22:33:10+02:00",
"end": "2018-05-19T22:48:10+02:00"
},
"created": "2018-05-19T22:48:10+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:a42e9e43-9b6c-f281-f328-2c4649dc871b"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "141962",
"display": "Azithromycin 250 MG Oral Capsule"
} ],
"text": "Azithromycin 250 MG Oral Capsule"
},
"encounter": [ {
"reference": "urn:uuid:4c23b36a-fdb7-5022-43be-2bd4026cc885"
} ]
} ],
"total": {
"value": 129.94,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:a8d8595b-36f3-6ccf-427c-ff2a50c69ba3",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "a8d8595b-36f3-6ccf-427c-ff2a50c69ba3",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "966d696b-a33a-600c-92f2-2c49e09872ff"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2018-05-19T22:48:10+02:00",
"end": "2019-05-19T22:48:10+02:00"
},
"created": "2018-05-19T22:48:10+02:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
},
"claim": {
"reference": "urn:uuid:966d696b-a33a-600c-92f2-2c49e09872ff"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "141962",
"display": "Azithromycin 250 MG Oral Capsule"
} ],
"text": "Azithromycin 250 MG Oral Capsule"
},
"servicedPeriod": {
"start": "2018-05-19T22:33:10+02:00",
"end": "2018-05-19T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:4c23b36a-fdb7-5022-43be-2bd4026cc885"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 129.94,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:0278501e-0f10-6745-1952-deea9ce4e409",
"resource": {
"resourceType": "MedicationRequest",
"id": "0278501e-0f10-6745-1952-deea9ce4e409",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest" ]
},
"status": "stopped",
"intent": "order",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
"code": "community",
"display": "Community"
} ],
"text": "Community"
} ],
"medicationCodeableConcept": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "198405",
"display": "Ibuprofen 100 MG Oral Tablet"
} ],
"text": "Ibuprofen 100 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:4c23b36a-fdb7-5022-43be-2bd4026cc885"
},
"authoredOn": "2018-05-19T22:33:10+02:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
},
"dosageInstruction": [ {
"sequence": 1,
"text": "Take as needed.",
"asNeededBoolean": true
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:1f531b0e-b671-807e-da4b-47ac47dc3d9a",
"resource": {
"resourceType": "Claim",
"id": "1f531b0e-b671-807e-da4b-47ac47dc3d9a",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2018-05-19T22:33:10+02:00",
"end": "2018-05-19T22:48:10+02:00"
},
"created": "2018-05-19T22:48:10+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:0278501e-0f10-6745-1952-deea9ce4e409"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "198405",
"display": "Ibuprofen 100 MG Oral Tablet"
} ],
"text": "Ibuprofen 100 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:4c23b36a-fdb7-5022-43be-2bd4026cc885"
} ]
} ],
"total": {
"value": 326.25,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:84d59811-8aa1-2e83-ce21-364530fed5b6",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "84d59811-8aa1-2e83-ce21-364530fed5b6",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "1f531b0e-b671-807e-da4b-47ac47dc3d9a"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2018-05-19T22:48:10+02:00",
"end": "2019-05-19T22:48:10+02:00"
},
"created": "2018-05-19T22:48:10+02:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
},
"claim": {
"reference": "urn:uuid:1f531b0e-b671-807e-da4b-47ac47dc3d9a"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "198405",
"display": "Ibuprofen 100 MG Oral Tablet"
} ],
"text": "Ibuprofen 100 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2018-05-19T22:33:10+02:00",
"end": "2018-05-19T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:4c23b36a-fdb7-5022-43be-2bd4026cc885"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 326.25,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:a7ef2c35-32a9-0611-1c09-240e06e7f9d8",
"resource": {
"resourceType": "DiagnosticReport",
"id": "a7ef2c35-32a9-0611-1c09-240e06e7f9d8",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:4c23b36a-fdb7-5022-43be-2bd4026cc885"
},
"effectiveDateTime": "2018-05-19T22:33:10+02:00",
"issued": "2018-05-19T22:33:10.614+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:f5d2a85c-40cd-370e-e970-dbfd108bfdb0",
"resource": {
"resourceType": "DocumentReference",
"id": "f5d2a85c-40cd-370e-e970-dbfd108bfdb0",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:a7ef2c35-32a9-0611-1c09-240e06e7f9d8"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2018-05-19T22:33:10.614+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:4c23b36a-fdb7-5022-43be-2bd4026cc885"
} ],
"period": {
"start": "2018-05-19T22:33:10+02:00",
"end": "2018-05-19T22:48:10+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:06b0b5e2-8316-8471-5c6e-20e34773140c",
"resource": {
"resourceType": "Claim",
"id": "06b0b5e2-8316-8471-5c6e-20e34773140c",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2018-05-19T22:33:10+02:00",
"end": "2018-05-19T22:48:10+02:00"
},
"created": "2018-05-19T22:48:10+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
},
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:6ef17dfb-0046-3eaa-a42f-dfa449a7a845"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
},
"encounter": [ {
"reference": "urn:uuid:4c23b36a-fdb7-5022-43be-2bd4026cc885"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "65363002",
"display": "Otitis media"
} ],
"text": "Otitis media"
}
} ],
"total": {
"value": 85.55,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:f1d1dadc-3f4d-205e-3d70-0e829cf453a8",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "f1d1dadc-3f4d-205e-3d70-0e829cf453a8",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "06b0b5e2-8316-8471-5c6e-20e34773140c"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2018-05-19T22:48:10+02:00",
"end": "2019-05-19T22:48:10+02:00"
},
"created": "2018-05-19T22:48:10+02:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
},
"claim": {
"reference": "urn:uuid:06b0b5e2-8316-8471-5c6e-20e34773140c"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:6ef17dfb-0046-3eaa-a42f-dfa449a7a845"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
},
"servicedPeriod": {
"start": "2018-05-19T22:33:10+02:00",
"end": "2018-05-19T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:4c23b36a-fdb7-5022-43be-2bd4026cc885"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "65363002",
"display": "Otitis media"
} ],
"text": "Otitis media"
},
"servicedPeriod": {
"start": "2018-05-19T22:33:10+02:00",
"end": "2018-05-19T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
}
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 85.55,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215",
"resource": {
"resourceType": "Encounter",
"id": "b789ba28-e858-a67b-b4fc-2586070e3215",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "b789ba28-e858-a67b-b4fc-2586070e3215"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2018-12-21T21:33:10+01:00",
"end": "2018-12-21T21:48:10+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
}
} ],
"period": {
"start": "2018-12-21T21:33:10+01:00",
"end": "2018-12-21T21:48:10+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:f7976f85-edb5-dcb9-9a37-fe296b97ed37",
"resource": {
"resourceType": "Condition",
"id": "f7976f85-edb5-dcb9-9a37-fe296b97ed37",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "resolved"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed"
} ]
},
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-category",
"code": "encounter-diagnosis",
"display": "Encounter Diagnosis"
} ]
} ],
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
},
"onsetDateTime": "2018-12-21T21:33:10+01:00",
"abatementDateTime": "2018-12-21T21:33:10+01:00",
"recordedDate": "2018-12-21T21:33:10+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:a26c003f-e737-62a6-1fa0-9cd87496d1eb",
"resource": {
"resourceType": "Observation",
"id": "a26c003f-e737-62a6-1fa0-9cd87496d1eb",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8302-2",
"display": "Body Height"
} ],
"text": "Body Height"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
},
"effectiveDateTime": "2018-12-21T21:33:10+01:00",
"issued": "2018-12-21T21:33:10.614+01:00",
"valueQuantity": {
"value": 111.3,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:2f576606-3377-ab88-33cc-e9cdc34d9113",
"resource": {
"resourceType": "Observation",
"id": "2f576606-3377-ab88-33cc-e9cdc34d9113",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72514-3",
"display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
} ],
"text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
},
"effectiveDateTime": "2018-12-21T21:33:10+01:00",
"issued": "2018-12-21T21:33:10.614+01:00",
"valueQuantity": {
"value": 1,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:9298f219-003e-ad2c-8e98-1fa0386dd2a7",
"resource": {
"resourceType": "Observation",
"id": "9298f219-003e-ad2c-8e98-1fa0386dd2a7",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "29463-7",
"display": "Body Weight"
} ],
"text": "Body Weight"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
},
"effectiveDateTime": "2018-12-21T21:33:10+01:00",
"issued": "2018-12-21T21:33:10.614+01:00",
"valueQuantity": {
"value": 20,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:bb4a4a13-05fc-a782-f5fd-fb426bf2a1bc",
"resource": {
"resourceType": "Observation",
"id": "bb4a4a13-05fc-a782-f5fd-fb426bf2a1bc",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "39156-5",
"display": "Body mass index (BMI) [Ratio]"
} ],
"text": "Body mass index (BMI) [Ratio]"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
},
"effectiveDateTime": "2018-12-21T21:33:10+01:00",
"issued": "2018-12-21T21:33:10.614+01:00",
"valueQuantity": {
"value": 16.11,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:b10183d0-bb77-1336-d3ff-8cc0d912ba3d",
"resource": {
"resourceType": "Observation",
"id": "b10183d0-bb77-1336-d3ff-8cc0d912ba3d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-bmi-for-age" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "59576-9",
"display": "Body mass index (BMI) [Percentile] Per age and sex"
} ],
"text": "Body mass index (BMI) [Percentile] Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
},
"effectiveDateTime": "2018-12-21T21:33:10+01:00",
"issued": "2018-12-21T21:33:10.614+01:00",
"valueQuantity": {
"value": 70.677,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:98f76698-632c-ce1f-5e37-8f439d51b16a",
"resource": {
"resourceType": "Observation",
"id": "98f76698-632c-ce1f-5e37-8f439d51b16a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "85354-9",
"display": "Blood pressure panel with all children optional"
} ],
"text": "Blood pressure panel with all children optional"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
},
"effectiveDateTime": "2018-12-21T21:33:10+01:00",
"issued": "2018-12-21T21:33:10.614+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 84,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8480-6",
"display": "Systolic Blood Pressure"
} ],
"text": "Systolic Blood Pressure"
},
"valueQuantity": {
"value": 127,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:f18da8b1-8fdb-4f1b-3f54-0aedfc9eb8b8",
"resource": {
"resourceType": "Observation",
"id": "f18da8b1-8fdb-4f1b-3f54-0aedfc9eb8b8",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8867-4",
"display": "Heart rate"
} ],
"text": "Heart rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
},
"effectiveDateTime": "2018-12-21T21:33:10+01:00",
"issued": "2018-12-21T21:33:10.614+01:00",
"valueQuantity": {
"value": 96,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:1e47a792-c648-a57d-dae0-72a1a5c0c52c",
"resource": {
"resourceType": "Observation",
"id": "1e47a792-c648-a57d-dae0-72a1a5c0c52c",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9279-1",
"display": "Respiratory rate"
} ],
"text": "Respiratory rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
},
"effectiveDateTime": "2018-12-21T21:33:10+01:00",
"issued": "2018-12-21T21:33:10.614+01:00",
"valueQuantity": {
"value": 13,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:c986e8ee-12dc-2383-f38e-8b99962036e0",
"resource": {
"resourceType": "Observation",
"id": "c986e8ee-12dc-2383-f38e-8b99962036e0",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social history"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72166-2",
"display": "Tobacco smoking status"
} ],
"text": "Tobacco smoking status"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
},
"effectiveDateTime": "2018-12-21T21:33:10+01:00",
"issued": "2018-12-21T21:33:10.614+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "266919005",
"display": "Never smoked tobacco (finding)"
} ],
"text": "Never smoked tobacco (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e7041a58-70b2-c811-7c1e-296506ad4a69",
"resource": {
"resourceType": "Procedure",
"id": "e7041a58-70b2-c811-7c1e-296506ad4a69",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
},
"performedPeriod": {
"start": "2018-12-21T21:33:10+01:00",
"end": "2018-12-21T21:48:10+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:6edd3577-5f49-eff7-71af-581fc8257368",
"resource": {
"resourceType": "Immunization",
"id": "6edd3577-5f49-eff7-71af-581fc8257368",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "21",
"display": "varicella"
} ],
"text": "varicella"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
},
"occurrenceDateTime": "2018-12-21T21:33:10+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:234d3440-87e1-b222-29f5-85a3cd45b7f8",
"resource": {
"resourceType": "Immunization",
"id": "234d3440-87e1-b222-29f5-85a3cd45b7f8",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "10",
"display": "IPV"
} ],
"text": "IPV"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
},
"occurrenceDateTime": "2018-12-21T21:33:10+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:902bd5b7-e460-79ae-b22c-231267ba8fe8",
"resource": {
"resourceType": "Immunization",
"id": "902bd5b7-e460-79ae-b22c-231267ba8fe8",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
},
"occurrenceDateTime": "2018-12-21T21:33:10+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:6a7142e9-e9a4-d791-c10e-13f969b8917e",
"resource": {
"resourceType": "Immunization",
"id": "6a7142e9-e9a4-d791-c10e-13f969b8917e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "20",
"display": "DTaP"
} ],
"text": "DTaP"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
},
"occurrenceDateTime": "2018-12-21T21:33:10+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:c38bdf31-9ffc-9726-c613-2a16d8f3309c",
"resource": {
"resourceType": "Immunization",
"id": "c38bdf31-9ffc-9726-c613-2a16d8f3309c",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "03",
"display": "MMR"
} ],
"text": "MMR"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
},
"occurrenceDateTime": "2018-12-21T21:33:10+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:f5d1a05c-b3a7-23d9-97c5-3e905476e2a0",
"resource": {
"resourceType": "DiagnosticReport",
"id": "f5d1a05c-b3a7-23d9-97c5-3e905476e2a0",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
},
"effectiveDateTime": "2018-12-21T21:33:10+01:00",
"issued": "2018-12-21T21:33:10.614+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:b47b3b7b-fa52-9d32-3271-708b97443a39",
"resource": {
"resourceType": "DocumentReference",
"id": "b47b3b7b-fa52-9d32-3271-708b97443a39",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:f5d1a05c-b3a7-23d9-97c5-3e905476e2a0"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2018-12-21T21:33:10.614+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
} ],
"period": {
"start": "2018-12-21T21:33:10+01:00",
"end": "2018-12-21T21:48:10+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:b8c7e55a-e661-ac45-1307-dad7189accb5",
"resource": {
"resourceType": "Claim",
"id": "b8c7e55a-e661-ac45-1307-dad7189accb5",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2018-12-21T21:33:10+01:00",
"end": "2018-12-21T21:48:10+01:00"
},
"created": "2018-12-21T21:48:10+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:6edd3577-5f49-eff7-71af-581fc8257368"
}
}, {
"sequence": 2,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:234d3440-87e1-b222-29f5-85a3cd45b7f8"
}
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:902bd5b7-e460-79ae-b22c-231267ba8fe8"
}
}, {
"sequence": 4,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:6a7142e9-e9a4-d791-c10e-13f969b8917e"
}
}, {
"sequence": 5,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:c38bdf31-9ffc-9726-c613-2a16d8f3309c"
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:f7976f85-edb5-dcb9-9a37-fe296b97ed37"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:e7041a58-70b2-c811-7c1e-296506ad4a69"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "21",
"display": "varicella"
} ],
"text": "varicella"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 3,
"informationSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "10",
"display": "IPV"
} ],
"text": "IPV"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 4,
"informationSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 5,
"informationSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "20",
"display": "DTaP"
} ],
"text": "DTaP"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 6,
"informationSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "03",
"display": "MMR"
} ],
"text": "MMR"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 7,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
}
}, {
"sequence": 8,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"net": {
"value": 564.08,
"currency": "USD"
}
} ],
"total": {
"value": 1380.88,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:3b213eea-df55-89e5-e190-4794a8a12818",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "3b213eea-df55-89e5-e190-4794a8a12818",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "b8c7e55a-e661-ac45-1307-dad7189accb5"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2018-12-21T21:48:10+01:00",
"end": "2019-12-21T21:48:10+01:00"
},
"created": "2018-12-21T21:48:10+01:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"claim": {
"reference": "urn:uuid:b8c7e55a-e661-ac45-1307-dad7189accb5"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:f7976f85-edb5-dcb9-9a37-fe296b97ed37"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"servicedPeriod": {
"start": "2018-12-21T21:33:10+01:00",
"end": "2018-12-21T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "21",
"display": "varicella"
} ],
"text": "varicella"
},
"servicedPeriod": {
"start": "2018-12-21T21:33:10+01:00",
"end": "2018-12-21T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 3,
"informationSequence": [ 2 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "10",
"display": "IPV"
} ],
"text": "IPV"
},
"servicedPeriod": {
"start": "2018-12-21T21:33:10+01:00",
"end": "2018-12-21T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 4,
"informationSequence": [ 3 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"servicedPeriod": {
"start": "2018-12-21T21:33:10+01:00",
"end": "2018-12-21T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 5,
"informationSequence": [ 4 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "20",
"display": "DTaP"
} ],
"text": "DTaP"
},
"servicedPeriod": {
"start": "2018-12-21T21:33:10+01:00",
"end": "2018-12-21T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 6,
"informationSequence": [ 5 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "03",
"display": "MMR"
} ],
"text": "MMR"
},
"servicedPeriod": {
"start": "2018-12-21T21:33:10+01:00",
"end": "2018-12-21T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 7,
"diagnosisSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"servicedPeriod": {
"start": "2018-12-21T21:33:10+01:00",
"end": "2018-12-21T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 8,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"servicedPeriod": {
"start": "2018-12-21T21:33:10+01:00",
"end": "2018-12-21T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 564.08,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 112.81600000000002,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 451.26400000000007,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 564.08,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 564.08,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 1380.88,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 995.2640000000001,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:d2ebe93e-3f62-6a2f-417a-62e099a26b48",
"resource": {
"resourceType": "Encounter",
"id": "d2ebe93e-3f62-6a2f-417a-62e099a26b48",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "d2ebe93e-3f62-6a2f-417a-62e099a26b48"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "EMER"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "50849002",
"display": "Emergency room admission (procedure)"
} ],
"text": "Emergency room admission (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2019-04-01T12:33:10+02:00",
"end": "2019-04-01T16:25:10+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996",
"display": "Dr. Orpha286 Marks830"
}
} ],
"period": {
"start": "2019-04-01T12:33:10+02:00",
"end": "2019-04-01T16:25:10+02:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "241929008",
"display": "Acute allergic reaction"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|d9dfd791-2798-33ee-b149-c9bf3b11c8cd",
"display": "HATHAWAY MANOR EXTENDED CARE"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|d140ed3f-2696-3e78-bd77-1c959ec4fc4d",
"display": "HATHAWAY MANOR EXTENDED CARE"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:035c72f6-e9c6-04c8-6f85-fe296ce31c3e",
"resource": {
"resourceType": "Condition",
"id": "035c72f6-e9c6-04c8-6f85-fe296ce31c3e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "resolved"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed"
} ]
},
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-category",
"code": "encounter-diagnosis",
"display": "Encounter Diagnosis"
} ]
} ],
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "241929008",
"display": "Acute allergic reaction"
} ],
"text": "Acute allergic reaction"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d2ebe93e-3f62-6a2f-417a-62e099a26b48"
},
"onsetDateTime": "2019-04-01T12:33:10+02:00",
"abatementDateTime": "2019-04-01T16:25:10+02:00",
"recordedDate": "2019-04-01T12:33:10+02:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:9c0ef020-f6cb-a79e-4d0c-7de003eef2be",
"resource": {
"resourceType": "Procedure",
"id": "9c0ef020-f6cb-a79e-4d0c-7de003eef2be",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "313191000",
"display": "Injection of epinephrine (procedure)"
} ],
"text": "Injection of epinephrine (procedure)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d2ebe93e-3f62-6a2f-417a-62e099a26b48"
},
"performedPeriod": {
"start": "2019-04-01T12:33:10+02:00",
"end": "2019-04-01T12:48:10+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|d9dfd791-2798-33ee-b149-c9bf3b11c8cd",
"display": "HATHAWAY MANOR EXTENDED CARE"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:dca64ee0-44b2-191c-79da-07ffbf3c760e",
"resource": {
"resourceType": "Medication",
"id": "dca64ee0-44b2-191c-79da-07ffbf3c760e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication" ]
},
"code": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "312617",
"display": "predniSONE 5 MG Oral Tablet"
} ],
"text": "predniSONE 5 MG Oral Tablet"
},
"status": "active"
},
"request": {
"method": "POST",
"url": "Medication"
}
}, {
"fullUrl": "urn:uuid:50e83580-e2ec-5493-cf25-f215c6540cd4",
"resource": {
"resourceType": "MedicationRequest",
"id": "50e83580-e2ec-5493-cf25-f215c6540cd4",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest" ]
},
"status": "stopped",
"intent": "order",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
"code": "community",
"display": "Community"
} ],
"text": "Community"
} ],
"medicationReference": {
"reference": "urn:uuid:dca64ee0-44b2-191c-79da-07ffbf3c760e"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d2ebe93e-3f62-6a2f-417a-62e099a26b48"
},
"authoredOn": "2019-04-01T16:25:10+02:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996",
"display": "Dr. Orpha286 Marks830"
}
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:dee5565a-0322-3f9b-eb87-6f4f15cac139",
"resource": {
"resourceType": "Claim",
"id": "dee5565a-0322-3f9b-eb87-6f4f15cac139",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2019-04-01T12:33:10+02:00",
"end": "2019-04-01T16:25:10+02:00"
},
"created": "2019-04-01T16:25:10+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|d140ed3f-2696-3e78-bd77-1c959ec4fc4d",
"display": "HATHAWAY MANOR EXTENDED CARE"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:50e83580-e2ec-5493-cf25-f215c6540cd4"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "312617",
"display": "predniSONE 5 MG Oral Tablet"
} ],
"text": "predniSONE 5 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:d2ebe93e-3f62-6a2f-417a-62e099a26b48"
} ]
} ],
"total": {
"value": 8.84,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:1d7f45d1-084f-9290-01fd-2ffafc16075f",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "1d7f45d1-084f-9290-01fd-2ffafc16075f",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "dee5565a-0322-3f9b-eb87-6f4f15cac139"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2019-04-01T16:25:10+02:00",
"end": "2020-04-01T16:25:10+02:00"
},
"created": "2019-04-01T16:25:10+02:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|d9dfd791-2798-33ee-b149-c9bf3b11c8cd",
"display": "HATHAWAY MANOR EXTENDED CARE"
},
"claim": {
"reference": "urn:uuid:dee5565a-0322-3f9b-eb87-6f4f15cac139"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "312617",
"display": "predniSONE 5 MG Oral Tablet"
} ],
"text": "predniSONE 5 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2019-04-01T12:33:10+02:00",
"end": "2019-04-01T16:25:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
},
"encounter": [ {
"reference": "urn:uuid:d2ebe93e-3f62-6a2f-417a-62e099a26b48"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 8.84,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:3553b131-09e1-d913-19d1-9b5afda84de2",
"resource": {
"resourceType": "MedicationAdministration",
"id": "3553b131-09e1-d913-19d1-9b5afda84de2",
"status": "completed",
"medicationCodeableConcept": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "312617",
"display": "predniSONE 5 MG Oral Tablet"
} ],
"text": "predniSONE 5 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"context": {
"reference": "urn:uuid:d2ebe93e-3f62-6a2f-417a-62e099a26b48"
},
"effectiveDateTime": "2019-04-01T16:25:10+02:00"
},
"request": {
"method": "POST",
"url": "MedicationAdministration"
}
}, {
"fullUrl": "urn:uuid:25a2453c-fd43-8000-5f85-7f49f92fea1f",
"resource": {
"resourceType": "DiagnosticReport",
"id": "25a2453c-fd43-8000-5f85-7f49f92fea1f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:d2ebe93e-3f62-6a2f-417a-62e099a26b48"
},
"effectiveDateTime": "2019-04-01T12:33:10+02:00",
"issued": "2019-04-01T12:33:10.614+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996",
"display": "Dr. Orpha286 Marks830"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:e2bcd75f-a7bb-939f-460d-d12ec18bfb7f",
"resource": {
"resourceType": "DocumentReference",
"id": "e2bcd75f-a7bb-939f-460d-d12ec18bfb7f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:25a2453c-fd43-8000-5f85-7f49f92fea1f"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2019-04-01T12:33:10.614+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996",
"display": "Dr. Orpha286 Marks830"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|d140ed3f-2696-3e78-bd77-1c959ec4fc4d",
"display": "HATHAWAY MANOR EXTENDED CARE"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:d2ebe93e-3f62-6a2f-417a-62e099a26b48"
} ],
"period": {
"start": "2019-04-01T12:33:10+02:00",
"end": "2019-04-01T16:25:10+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:374a15e2-4136-ec1d-763a-e3b4e5f112e5",
"resource": {
"resourceType": "Claim",
"id": "374a15e2-4136-ec1d-763a-e3b4e5f112e5",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "institutional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2019-04-01T12:33:10+02:00",
"end": "2019-04-01T16:25:10+02:00"
},
"created": "2019-04-01T16:25:10+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|d140ed3f-2696-3e78-bd77-1c959ec4fc4d",
"display": "HATHAWAY MANOR EXTENDED CARE"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|d9dfd791-2798-33ee-b149-c9bf3b11c8cd",
"display": "HATHAWAY MANOR EXTENDED CARE"
},
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:035c72f6-e9c6-04c8-6f85-fe296ce31c3e"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:9c0ef020-f6cb-a79e-4d0c-7de003eef2be"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "50849002",
"display": "Emergency room admission (procedure)"
} ],
"text": "Emergency room admission (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:d2ebe93e-3f62-6a2f-417a-62e099a26b48"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "241929008",
"display": "Acute allergic reaction"
} ],
"text": "Acute allergic reaction"
}
}, {
"sequence": 3,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "313191000",
"display": "Injection of epinephrine (procedure)"
} ],
"text": "Injection of epinephrine (procedure)"
},
"net": {
"value": 1495.05,
"currency": "USD"
}
} ],
"total": {
"value": 1641.23,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:9b390ee8-6426-b041-0d42-ea3d1e09eaa9",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "9b390ee8-6426-b041-0d42-ea3d1e09eaa9",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "374a15e2-4136-ec1d-763a-e3b4e5f112e5"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "institutional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2019-04-01T16:25:10+02:00",
"end": "2020-04-01T16:25:10+02:00"
},
"created": "2019-04-01T16:25:10+02:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|d9dfd791-2798-33ee-b149-c9bf3b11c8cd",
"display": "HATHAWAY MANOR EXTENDED CARE"
},
"claim": {
"reference": "urn:uuid:374a15e2-4136-ec1d-763a-e3b4e5f112e5"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999885996"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:035c72f6-e9c6-04c8-6f85-fe296ce31c3e"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "50849002",
"display": "Emergency room admission (procedure)"
} ],
"text": "Emergency room admission (procedure)"
},
"servicedPeriod": {
"start": "2019-04-01T12:33:10+02:00",
"end": "2019-04-01T16:25:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
},
"encounter": [ {
"reference": "urn:uuid:d2ebe93e-3f62-6a2f-417a-62e099a26b48"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "241929008",
"display": "Acute allergic reaction"
} ],
"text": "Acute allergic reaction"
},
"servicedPeriod": {
"start": "2019-04-01T12:33:10+02:00",
"end": "2019-04-01T16:25:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
}
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "313191000",
"display": "Injection of epinephrine (procedure)"
} ],
"text": "Injection of epinephrine (procedure)"
},
"servicedPeriod": {
"start": "2019-04-01T12:33:10+02:00",
"end": "2019-04-01T16:25:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
},
"net": {
"value": 1495.05,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 299.01,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 1196.04,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 1495.05,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 1495.05,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 1641.23,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 1196.04,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:ec21137d-7351-c150-de81-385d7df50d21",
"resource": {
"resourceType": "Encounter",
"id": "ec21137d-7351-c150-de81-385d7df50d21",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "ec21137d-7351-c150-de81-385d7df50d21"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185347001",
"display": "Encounter for problem"
} ],
"text": "Encounter for problem"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2019-04-02T04:25:10+02:00",
"end": "2019-04-02T04:40:10+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
}
} ],
"period": {
"start": "2019-04-02T04:25:10+02:00",
"end": "2019-04-02T04:40:10+02:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "762952008",
"display": "Peanut (substance)"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:6c882b1f-be77-3311-0abb-cbef7d3dd505",
"resource": {
"resourceType": "DiagnosticReport",
"id": "6c882b1f-be77-3311-0abb-cbef7d3dd505",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:ec21137d-7351-c150-de81-385d7df50d21"
},
"effectiveDateTime": "2019-04-02T04:25:10+02:00",
"issued": "2019-04-02T04:25:10.614+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:2565f9c7-cc85-3950-5a75-96b9698bb746",
"resource": {
"resourceType": "DocumentReference",
"id": "2565f9c7-cc85-3950-5a75-96b9698bb746",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:6c882b1f-be77-3311-0abb-cbef7d3dd505"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2019-04-02T04:25:10.614+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:ec21137d-7351-c150-de81-385d7df50d21"
} ],
"period": {
"start": "2019-04-02T04:25:10+02:00",
"end": "2019-04-02T04:40:10+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:c9a2799b-5f74-daca-f77f-a36d743ea2fa",
"resource": {
"resourceType": "Claim",
"id": "c9a2799b-5f74-daca-f77f-a36d743ea2fa",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2019-04-02T04:25:10+02:00",
"end": "2019-04-02T04:40:10+02:00"
},
"created": "2019-04-02T04:40:10+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185347001",
"display": "Encounter for problem"
} ],
"text": "Encounter for problem"
},
"encounter": [ {
"reference": "urn:uuid:ec21137d-7351-c150-de81-385d7df50d21"
} ]
} ],
"total": {
"value": 85.55,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:1457386e-3c34-d21f-f791-9fe11ff566d8",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "1457386e-3c34-d21f-f791-9fe11ff566d8",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "c9a2799b-5f74-daca-f77f-a36d743ea2fa"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2019-04-02T04:40:10+02:00",
"end": "2020-04-02T04:40:10+02:00"
},
"created": "2019-04-02T04:40:10+02:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
},
"claim": {
"reference": "urn:uuid:c9a2799b-5f74-daca-f77f-a36d743ea2fa"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185347001",
"display": "Encounter for problem"
} ],
"text": "Encounter for problem"
},
"servicedPeriod": {
"start": "2019-04-02T04:25:10+02:00",
"end": "2019-04-02T04:40:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:ec21137d-7351-c150-de81-385d7df50d21"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 85.55,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:3201a497-3196-2243-4880-2df17efbaae4",
"resource": {
"resourceType": "Encounter",
"id": "3201a497-3196-2243-4880-2df17efbaae4",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "3201a497-3196-2243-4880-2df17efbaae4"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2019-08-12T22:33:10+02:00",
"end": "2019-08-12T22:48:10+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
}
} ],
"period": {
"start": "2019-08-12T22:33:10+02:00",
"end": "2019-08-12T22:48:10+02:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "367498001",
"display": "Seasonal allergic rhinitis"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:466f0aea-4195-2011-88f4-ce0481df9afb",
"resource": {
"resourceType": "Condition",
"id": "466f0aea-4195-2011-88f4-ce0481df9afb",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed"
} ]
},
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-category",
"code": "encounter-diagnosis",
"display": "Encounter Diagnosis"
} ]
} ],
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "367498001",
"display": "Seasonal allergic rhinitis"
} ],
"text": "Seasonal allergic rhinitis"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:3201a497-3196-2243-4880-2df17efbaae4"
},
"onsetDateTime": "2019-08-12T22:33:10+02:00",
"recordedDate": "2019-08-12T22:33:10+02:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:e519ad38-ff7a-6f62-4c5b-4cb68cbe569f",
"resource": {
"resourceType": "DiagnosticReport",
"id": "e519ad38-ff7a-6f62-4c5b-4cb68cbe569f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:3201a497-3196-2243-4880-2df17efbaae4"
},
"effectiveDateTime": "2019-08-12T22:33:10+02:00",
"issued": "2019-08-12T22:33:10.614+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "CjIwMTktMDgtMTIKCiMgQ2hpZWYgQ29tcGxhaW50Ck5vIGNvbXBsYWludHMuCgojIEhpc3Rvcnkgb2YgUHJlc2VudCBJbGxuZXNzCkRvbm5lbGw1MzQKIGlzIGEgNSB5ZWFyLW9sZCBub25oaXNwYW5pYyB3aGl0ZSBtYWxlLiBQYXRpZW50IGhhcyBhIGhpc3Rvcnkgb2YgYWN1dGUgYWxsZXJnaWMgcmVhY3Rpb24sIG1lZGljYXRpb24gcmV2aWV3IGR1ZSAoc2l0dWF0aW9uKSwgb3RpdGlzIG1lZGlhLCBmcmFjdHVyZSBvZiBib25lIChkaXNvcmRlciksIGZyYWN0dXJlIG9mIHJpYiwgdmlyYWwgc2ludXNpdGlzIChkaXNvcmRlcikuCgojIFNvY2lhbCBIaXN0b3J5CiBQYXRpZW50IGhhcyBuZXZlciBzbW9rZWQuCgoKUGF0aWVudCBjb21lcyBmcm9tIGEgaGlnaCBzb2Npb2Vjb25vbWljIGJhY2tncm91bmQuCgpQYXRpZW50IGN1cnJlbnRseSBoYXMgQW50aGVtLgoKIyBBbGxlcmdpZXMKTm8gS25vd24gQWxsZXJnaWVzLgoKIyBNZWRpY2F0aW9ucwpheml0aHJvbXljaW4gMjUwIG1nIG9yYWwgY2Fwc3VsZTsgcHJlZG5pc29uZSA1IG1nIG9yYWwgdGFibGV0OyBpYnVwcm9mZW4gMTAwIG1nIG9yYWwgdGFibGV0CgojIEFzc2Vzc21lbnQgYW5kIFBsYW4KUGF0aWVudCBpcyBwcmVzZW50aW5nIHdpdGggc2Vhc29uYWwgYWxsZXJnaWMgcmhpbml0aXMuIAoKIyMgUGxhbgoK"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:6e613891-56a0-80d3-8d9b-1bcb639c6d3d",
"resource": {
"resourceType": "DocumentReference",
"id": "6e613891-56a0-80d3-8d9b-1bcb639c6d3d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:e519ad38-ff7a-6f62-4c5b-4cb68cbe569f"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2019-08-12T22:33:10.614+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:3201a497-3196-2243-4880-2df17efbaae4"
} ],
"period": {
"start": "2019-08-12T22:33:10+02:00",
"end": "2019-08-12T22:48:10+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:3b76087d-4654-3a7c-00ea-63c2caf55225",
"resource": {
"resourceType": "Claim",
"id": "3b76087d-4654-3a7c-00ea-63c2caf55225",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2019-08-12T22:33:10+02:00",
"end": "2019-08-12T22:48:10+02:00"
},
"created": "2019-08-12T22:48:10+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
},
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:466f0aea-4195-2011-88f4-ce0481df9afb"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
},
"encounter": [ {
"reference": "urn:uuid:3201a497-3196-2243-4880-2df17efbaae4"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "367498001",
"display": "Seasonal allergic rhinitis"
} ],
"text": "Seasonal allergic rhinitis"
}
} ],
"total": {
"value": 85.55,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:7e23fcf7-d0cb-b380-6575-4754c268e78f",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "7e23fcf7-d0cb-b380-6575-4754c268e78f",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "3b76087d-4654-3a7c-00ea-63c2caf55225"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2019-08-12T22:48:10+02:00",
"end": "2020-08-12T22:48:10+02:00"
},
"created": "2019-08-12T22:48:10+02:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
},
"claim": {
"reference": "urn:uuid:3b76087d-4654-3a7c-00ea-63c2caf55225"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:466f0aea-4195-2011-88f4-ce0481df9afb"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
},
"servicedPeriod": {
"start": "2019-08-12T22:33:10+02:00",
"end": "2019-08-12T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:3201a497-3196-2243-4880-2df17efbaae4"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "367498001",
"display": "Seasonal allergic rhinitis"
} ],
"text": "Seasonal allergic rhinitis"
},
"servicedPeriod": {
"start": "2019-08-12T22:33:10+02:00",
"end": "2019-08-12T22:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
}
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 85.55,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392",
"resource": {
"resourceType": "Encounter",
"id": "9fcdcdfe-fa75-62c2-b0a5-8269a7b92392",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2019-12-27T21:33:10+01:00",
"end": "2019-12-27T21:48:10+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
}
} ],
"period": {
"start": "2019-12-27T21:33:10+01:00",
"end": "2019-12-27T21:48:10+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:0ab583ae-acec-59a8-fac4-31d7322d9a42",
"resource": {
"resourceType": "Condition",
"id": "0ab583ae-acec-59a8-fac4-31d7322d9a42",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "resolved"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed"
} ]
},
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-category",
"code": "encounter-diagnosis",
"display": "Encounter Diagnosis"
} ]
} ],
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"onsetDateTime": "2019-12-27T21:33:10+01:00",
"abatementDateTime": "2021-01-01T21:33:10+01:00",
"recordedDate": "2019-12-27T21:33:10+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:ebf680f8-505f-40c3-abcb-a7309c990cb9",
"resource": {
"resourceType": "Observation",
"id": "ebf680f8-505f-40c3-abcb-a7309c990cb9",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8302-2",
"display": "Body Height"
} ],
"text": "Body Height"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"valueQuantity": {
"value": 118,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:3474b440-c68a-0572-19d7-d92c8c698012",
"resource": {
"resourceType": "Observation",
"id": "3474b440-c68a-0572-19d7-d92c8c698012",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72514-3",
"display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
} ],
"text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"valueQuantity": {
"value": 2,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:bea2072e-e9be-9658-05d8-687a1985b6a5",
"resource": {
"resourceType": "Observation",
"id": "bea2072e-e9be-9658-05d8-687a1985b6a5",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "29463-7",
"display": "Body Weight"
} ],
"text": "Body Weight"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"valueQuantity": {
"value": 22.2,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:76aebd28-b5aa-9059-38f4-dac7433c070d",
"resource": {
"resourceType": "Observation",
"id": "76aebd28-b5aa-9059-38f4-dac7433c070d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "39156-5",
"display": "Body mass index (BMI) [Ratio]"
} ],
"text": "Body mass index (BMI) [Ratio]"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"valueQuantity": {
"value": 15.94,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:f73727f0-66c7-25da-b581-cb81bf9199f0",
"resource": {
"resourceType": "Observation",
"id": "f73727f0-66c7-25da-b581-cb81bf9199f0",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-bmi-for-age" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "59576-9",
"display": "Body mass index (BMI) [Percentile] Per age and sex"
} ],
"text": "Body mass index (BMI) [Percentile] Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"valueQuantity": {
"value": 65.995,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:b036dd23-5af5-db1a-cc72-63562ebbe8b1",
"resource": {
"resourceType": "Observation",
"id": "b036dd23-5af5-db1a-cc72-63562ebbe8b1",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "85354-9",
"display": "Blood pressure panel with all children optional"
} ],
"text": "Blood pressure panel with all children optional"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 83,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8480-6",
"display": "Systolic Blood Pressure"
} ],
"text": "Systolic Blood Pressure"
},
"valueQuantity": {
"value": 127,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:2f71d598-5f20-77ce-ade8-a1ae69d74cb9",
"resource": {
"resourceType": "Observation",
"id": "2f71d598-5f20-77ce-ade8-a1ae69d74cb9",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8867-4",
"display": "Heart rate"
} ],
"text": "Heart rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"valueQuantity": {
"value": 87,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:1e5c09ad-2529-2998-95ee-60785c93af81",
"resource": {
"resourceType": "Observation",
"id": "1e5c09ad-2529-2998-95ee-60785c93af81",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9279-1",
"display": "Respiratory rate"
} ],
"text": "Respiratory rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"valueQuantity": {
"value": 14,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:7d1a1aad-f201-ff84-65ff-0ddaddececf2",
"resource": {
"resourceType": "Observation",
"id": "7d1a1aad-f201-ff84-65ff-0ddaddececf2",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "6690-2",
"display": "Leukocytes [#/volume] in Blood by Automated count"
} ],
"text": "Leukocytes [#/volume] in Blood by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"valueQuantity": {
"value": 6.5865,
"unit": "10*3/uL",
"system": "http://unitsofmeasure.org",
"code": "10*3/uL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:563ba85c-50e3-6379-d121-3d810ceca24d",
"resource": {
"resourceType": "Observation",
"id": "563ba85c-50e3-6379-d121-3d810ceca24d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "789-8",
"display": "Erythrocytes [#/volume] in Blood by Automated count"
} ],
"text": "Erythrocytes [#/volume] in Blood by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"valueQuantity": {
"value": 4.5305,
"unit": "10*6/uL",
"system": "http://unitsofmeasure.org",
"code": "10*6/uL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:9d82ef30-9410-6b55-05a7-c5e1a8e28239",
"resource": {
"resourceType": "Observation",
"id": "9d82ef30-9410-6b55-05a7-c5e1a8e28239",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "718-7",
"display": "Hemoglobin [Mass/volume] in Blood"
} ],
"text": "Hemoglobin [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"valueQuantity": {
"value": 14.885,
"unit": "g/dL",
"system": "http://unitsofmeasure.org",
"code": "g/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e828fca9-ef67-c0e2-61f0-e95eb8acae62",
"resource": {
"resourceType": "Observation",
"id": "e828fca9-ef67-c0e2-61f0-e95eb8acae62",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "4544-3",
"display": "Hematocrit [Volume Fraction] of Blood by Automated count"
} ],
"text": "Hematocrit [Volume Fraction] of Blood by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"valueQuantity": {
"value": 42.876,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:7db360c4-6e81-4b91-3fce-d99739c77d70",
"resource": {
"resourceType": "Observation",
"id": "7db360c4-6e81-4b91-3fce-d99739c77d70",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "787-2",
"display": "MCV [Entitic volume] by Automated count"
} ],
"text": "MCV [Entitic volume] by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"valueQuantity": {
"value": 85.975,
"unit": "fL",
"system": "http://unitsofmeasure.org",
"code": "fL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d22b86a8-1c29-4371-92e6-0b1cb2aa2049",
"resource": {
"resourceType": "Observation",
"id": "d22b86a8-1c29-4371-92e6-0b1cb2aa2049",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "785-6",
"display": "MCH [Entitic mass] by Automated count"
} ],
"text": "MCH [Entitic mass] by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"valueQuantity": {
"value": 28.144,
"unit": "pg",
"system": "http://unitsofmeasure.org",
"code": "pg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:22a8e2d4-f50f-ab4c-55bb-7e813888b43c",
"resource": {
"resourceType": "Observation",
"id": "22a8e2d4-f50f-ab4c-55bb-7e813888b43c",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "786-4",
"display": "MCHC [Mass/volume] by Automated count"
} ],
"text": "MCHC [Mass/volume] by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"valueQuantity": {
"value": 33.601,
"unit": "g/dL",
"system": "http://unitsofmeasure.org",
"code": "g/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:a1e27327-51f9-00f6-de56-bbf41d13a2e2",
"resource": {
"resourceType": "Observation",
"id": "a1e27327-51f9-00f6-de56-bbf41d13a2e2",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "21000-5",
"display": "Erythrocyte distribution width [Entitic volume] by Automated count"
} ],
"text": "Erythrocyte distribution width [Entitic volume] by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"valueQuantity": {
"value": 41.921,
"unit": "fL",
"system": "http://unitsofmeasure.org",
"code": "fL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:ecbee984-b116-3a26-dd62-14ef0532e9de",
"resource": {
"resourceType": "Observation",
"id": "ecbee984-b116-3a26-dd62-14ef0532e9de",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "777-3",
"display": "Platelets [#/volume] in Blood by Automated count"
} ],
"text": "Platelets [#/volume] in Blood by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"valueQuantity": {
"value": 338.66,
"unit": "10*3/uL",
"system": "http://unitsofmeasure.org",
"code": "10*3/uL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e5d0d428-cebb-3177-795d-e3984fbed3c0",
"resource": {
"resourceType": "Observation",
"id": "e5d0d428-cebb-3177-795d-e3984fbed3c0",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "32207-3",
"display": "Platelet distribution width [Entitic volume] in Blood by Automated count"
} ],
"text": "Platelet distribution width [Entitic volume] in Blood by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"valueQuantity": {
"value": 512.63,
"unit": "fL",
"system": "http://unitsofmeasure.org",
"code": "fL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:ce6c3eb1-79a5-4a66-eede-81e78f6520b2",
"resource": {
"resourceType": "Observation",
"id": "ce6c3eb1-79a5-4a66-eede-81e78f6520b2",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "32623-1",
"display": "Platelet mean volume [Entitic volume] in Blood by Automated count"
} ],
"text": "Platelet mean volume [Entitic volume] in Blood by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"valueQuantity": {
"value": 11.287,
"unit": "fL",
"system": "http://unitsofmeasure.org",
"code": "fL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:b8d1a2bb-d9dd-68c4-ee2d-a6752f1415bf",
"resource": {
"resourceType": "Observation",
"id": "b8d1a2bb-d9dd-68c4-ee2d-a6752f1415bf",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social history"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72166-2",
"display": "Tobacco smoking status"
} ],
"text": "Tobacco smoking status"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "266919005",
"display": "Never smoked tobacco (finding)"
} ],
"text": "Never smoked tobacco (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:c7584cfa-d3d7-f42c-7a99-deb1d2d7a9f4",
"resource": {
"resourceType": "Immunization",
"id": "c7584cfa-d3d7-f42c-7a99-deb1d2d7a9f4",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"occurrenceDateTime": "2019-12-27T21:33:10+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:7e12615a-8285-4906-c26c-2d86f38b9c63",
"resource": {
"resourceType": "DiagnosticReport",
"id": "7e12615a-8285-4906-c26c-2d86f38b9c63",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-lab" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v2-0074",
"code": "LAB",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "58410-2",
"display": "CBC panel - Blood by Automated count"
} ],
"text": "CBC panel - Blood by Automated count"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"performer": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
} ],
"result": [ {
"reference": "urn:uuid:7d1a1aad-f201-ff84-65ff-0ddaddececf2",
"display": "Leukocytes [#/volume] in Blood by Automated count"
}, {
"reference": "urn:uuid:563ba85c-50e3-6379-d121-3d810ceca24d",
"display": "Erythrocytes [#/volume] in Blood by Automated count"
}, {
"reference": "urn:uuid:9d82ef30-9410-6b55-05a7-c5e1a8e28239",
"display": "Hemoglobin [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:e828fca9-ef67-c0e2-61f0-e95eb8acae62",
"display": "Hematocrit [Volume Fraction] of Blood by Automated count"
}, {
"reference": "urn:uuid:7db360c4-6e81-4b91-3fce-d99739c77d70",
"display": "MCV [Entitic volume] by Automated count"
}, {
"reference": "urn:uuid:d22b86a8-1c29-4371-92e6-0b1cb2aa2049",
"display": "MCH [Entitic mass] by Automated count"
}, {
"reference": "urn:uuid:22a8e2d4-f50f-ab4c-55bb-7e813888b43c",
"display": "MCHC [Mass/volume] by Automated count"
}, {
"reference": "urn:uuid:a1e27327-51f9-00f6-de56-bbf41d13a2e2",
"display": "Erythrocyte distribution width [Entitic volume] by Automated count"
}, {
"reference": "urn:uuid:ecbee984-b116-3a26-dd62-14ef0532e9de",
"display": "Platelets [#/volume] in Blood by Automated count"
}, {
"reference": "urn:uuid:e5d0d428-cebb-3177-795d-e3984fbed3c0",
"display": "Platelet distribution width [Entitic volume] in Blood by Automated count"
}, {
"reference": "urn:uuid:ce6c3eb1-79a5-4a66-eede-81e78f6520b2",
"display": "Platelet mean volume [Entitic volume] in Blood by Automated count"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:65e88d4a-12c1-d320-9fcb-c7570eae3d3f",
"resource": {
"resourceType": "DiagnosticReport",
"id": "65e88d4a-12c1-d320-9fcb-c7570eae3d3f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
},
"effectiveDateTime": "2019-12-27T21:33:10+01:00",
"issued": "2019-12-27T21:33:10.614+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:d555d95e-7aa2-e84b-38a6-d32d9473502b",
"resource": {
"resourceType": "DocumentReference",
"id": "d555d95e-7aa2-e84b-38a6-d32d9473502b",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:65e88d4a-12c1-d320-9fcb-c7570eae3d3f"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2019-12-27T21:33:10.614+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
} ],
"period": {
"start": "2019-12-27T21:33:10+01:00",
"end": "2019-12-27T21:48:10+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:b2ddda1b-edf0-3149-ec79-fa377e6cc641",
"resource": {
"resourceType": "Claim",
"id": "b2ddda1b-edf0-3149-ec79-fa377e6cc641",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2019-12-27T21:33:10+01:00",
"end": "2019-12-27T21:48:10+01:00"
},
"created": "2019-12-27T21:48:10+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:c7584cfa-d3d7-f42c-7a99-deb1d2d7a9f4"
}
}, {
"sequence": 2,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:0ab583ae-acec-59a8-fac4-31d7322d9a42"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 3,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
}
}, {
"sequence": 4,
"informationSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "58410-2",
"display": "CBC panel - Blood by Automated count"
} ],
"text": "CBC panel - Blood by Automated count"
},
"net": {
"value": 74.58,
"currency": "USD"
}
} ],
"total": {
"value": 347.38,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:218c6379-e087-06a9-9321-1d5d1aefd4d9",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "218c6379-e087-06a9-9321-1d5d1aefd4d9",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "b2ddda1b-edf0-3149-ec79-fa377e6cc641"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2019-12-27T21:48:10+01:00",
"end": "2020-12-27T21:48:10+01:00"
},
"created": "2019-12-27T21:48:10+01:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"claim": {
"reference": "urn:uuid:b2ddda1b-edf0-3149-ec79-fa377e6cc641"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:0ab583ae-acec-59a8-fac4-31d7322d9a42"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"servicedPeriod": {
"start": "2019-12-27T21:33:10+01:00",
"end": "2019-12-27T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"servicedPeriod": {
"start": "2019-12-27T21:33:10+01:00",
"end": "2019-12-27T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 3,
"diagnosisSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"servicedPeriod": {
"start": "2019-12-27T21:33:10+01:00",
"end": "2019-12-27T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 4,
"informationSequence": [ 2 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "58410-2",
"display": "CBC panel - Blood by Automated count"
} ],
"text": "CBC panel - Blood by Automated count"
},
"servicedPeriod": {
"start": "2019-12-27T21:33:10+01:00",
"end": "2019-12-27T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 74.58,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 14.916,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 59.664,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 74.58,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 74.58,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 347.38,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 168.464,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:280094f5-d6ac-9670-c314-381846cfbb99",
"resource": {
"resourceType": "Encounter",
"id": "280094f5-d6ac-9670-c314-381846cfbb99",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "280094f5-d6ac-9670-c314-381846cfbb99"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2021-01-01T21:33:10+01:00",
"end": "2021-01-01T21:48:10+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
}
} ],
"period": {
"start": "2021-01-01T21:33:10+01:00",
"end": "2021-01-01T21:48:10+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:5aafc259-e389-bb51-d7d3-86e9458ff8d2",
"resource": {
"resourceType": "Observation",
"id": "5aafc259-e389-bb51-d7d3-86e9458ff8d2",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8302-2",
"display": "Body Height"
} ],
"text": "Body Height"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:280094f5-d6ac-9670-c314-381846cfbb99"
},
"effectiveDateTime": "2021-01-01T21:33:10+01:00",
"issued": "2021-01-01T21:33:10.614+01:00",
"valueQuantity": {
"value": 124.7,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:012e536a-57af-b2b8-5576-23eea6b27894",
"resource": {
"resourceType": "Observation",
"id": "012e536a-57af-b2b8-5576-23eea6b27894",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72514-3",
"display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
} ],
"text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:280094f5-d6ac-9670-c314-381846cfbb99"
},
"effectiveDateTime": "2021-01-01T21:33:10+01:00",
"issued": "2021-01-01T21:33:10.614+01:00",
"valueQuantity": {
"value": 3,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:8464d783-1487-9a8e-5b2a-b273dcae21ad",
"resource": {
"resourceType": "Observation",
"id": "8464d783-1487-9a8e-5b2a-b273dcae21ad",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "29463-7",
"display": "Body Weight"
} ],
"text": "Body Weight"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:280094f5-d6ac-9670-c314-381846cfbb99"
},
"effectiveDateTime": "2021-01-01T21:33:10+01:00",
"issued": "2021-01-01T21:33:10.614+01:00",
"valueQuantity": {
"value": 25.8,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:b16c2660-5e93-b277-eb0e-e92d8c7e348d",
"resource": {
"resourceType": "Observation",
"id": "b16c2660-5e93-b277-eb0e-e92d8c7e348d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "39156-5",
"display": "Body mass index (BMI) [Ratio]"
} ],
"text": "Body mass index (BMI) [Ratio]"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:280094f5-d6ac-9670-c314-381846cfbb99"
},
"effectiveDateTime": "2021-01-01T21:33:10+01:00",
"issued": "2021-01-01T21:33:10.614+01:00",
"valueQuantity": {
"value": 16.63,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:a5fa174b-2af9-aaf6-d956-7d87a544c55d",
"resource": {
"resourceType": "Observation",
"id": "a5fa174b-2af9-aaf6-d956-7d87a544c55d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-bmi-for-age" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "59576-9",
"display": "Body mass index (BMI) [Percentile] Per age and sex"
} ],
"text": "Body mass index (BMI) [Percentile] Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:280094f5-d6ac-9670-c314-381846cfbb99"
},
"effectiveDateTime": "2021-01-01T21:33:10+01:00",
"issued": "2021-01-01T21:33:10.614+01:00",
"valueQuantity": {
"value": 75.459,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:92280142-fd90-5705-2307-f36f2acdb195",
"resource": {
"resourceType": "Observation",
"id": "92280142-fd90-5705-2307-f36f2acdb195",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "85354-9",
"display": "Blood pressure panel with all children optional"
} ],
"text": "Blood pressure panel with all children optional"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:280094f5-d6ac-9670-c314-381846cfbb99"
},
"effectiveDateTime": "2021-01-01T21:33:10+01:00",
"issued": "2021-01-01T21:33:10.614+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 80,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8480-6",
"display": "Systolic Blood Pressure"
} ],
"text": "Systolic Blood Pressure"
},
"valueQuantity": {
"value": 109,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:4aa2ac57-c201-65e4-e17d-e325a1f90b18",
"resource": {
"resourceType": "Observation",
"id": "4aa2ac57-c201-65e4-e17d-e325a1f90b18",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8867-4",
"display": "Heart rate"
} ],
"text": "Heart rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:280094f5-d6ac-9670-c314-381846cfbb99"
},
"effectiveDateTime": "2021-01-01T21:33:10+01:00",
"issued": "2021-01-01T21:33:10.614+01:00",
"valueQuantity": {
"value": 83,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:9501bd10-06eb-5269-2773-eadedff1b755",
"resource": {
"resourceType": "Observation",
"id": "9501bd10-06eb-5269-2773-eadedff1b755",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9279-1",
"display": "Respiratory rate"
} ],
"text": "Respiratory rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:280094f5-d6ac-9670-c314-381846cfbb99"
},
"effectiveDateTime": "2021-01-01T21:33:10+01:00",
"issued": "2021-01-01T21:33:10.614+01:00",
"valueQuantity": {
"value": 13,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:52a8ddf7-295a-9e5d-e386-65467f484ddf",
"resource": {
"resourceType": "Observation",
"id": "52a8ddf7-295a-9e5d-e386-65467f484ddf",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social history"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72166-2",
"display": "Tobacco smoking status"
} ],
"text": "Tobacco smoking status"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:280094f5-d6ac-9670-c314-381846cfbb99"
},
"effectiveDateTime": "2021-01-01T21:33:10+01:00",
"issued": "2021-01-01T21:33:10.614+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "266919005",
"display": "Never smoked tobacco (finding)"
} ],
"text": "Never smoked tobacco (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:4b1aef2e-6283-5f35-1322-598cb5278184",
"resource": {
"resourceType": "Procedure",
"id": "4b1aef2e-6283-5f35-1322-598cb5278184",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:280094f5-d6ac-9670-c314-381846cfbb99"
},
"performedPeriod": {
"start": "2021-01-01T21:33:10+01:00",
"end": "2021-01-01T21:48:10+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:b0b54bd3-b27e-2bd2-76e8-79aafc992041",
"resource": {
"resourceType": "Immunization",
"id": "b0b54bd3-b27e-2bd2-76e8-79aafc992041",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:280094f5-d6ac-9670-c314-381846cfbb99"
},
"occurrenceDateTime": "2021-01-01T21:33:10+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:23d6f501-ae1b-037e-3e5e-c37a7c9e4279",
"resource": {
"resourceType": "DiagnosticReport",
"id": "23d6f501-ae1b-037e-3e5e-c37a7c9e4279",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:280094f5-d6ac-9670-c314-381846cfbb99"
},
"effectiveDateTime": "2021-01-01T21:33:10+01:00",
"issued": "2021-01-01T21:33:10.614+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:060962cd-ed01-4b03-2001-3ba22bf51177",
"resource": {
"resourceType": "DocumentReference",
"id": "060962cd-ed01-4b03-2001-3ba22bf51177",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:23d6f501-ae1b-037e-3e5e-c37a7c9e4279"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2021-01-01T21:33:10.614+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:280094f5-d6ac-9670-c314-381846cfbb99"
} ],
"period": {
"start": "2021-01-01T21:33:10+01:00",
"end": "2021-01-01T21:48:10+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:dc6bf4ec-20cc-538f-20c0-85a2eb9a080e",
"resource": {
"resourceType": "Claim",
"id": "dc6bf4ec-20cc-538f-20c0-85a2eb9a080e",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2021-01-01T21:33:10+01:00",
"end": "2021-01-01T21:48:10+01:00"
},
"created": "2021-01-01T21:48:10+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:b0b54bd3-b27e-2bd2-76e8-79aafc992041"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:4b1aef2e-6283-5f35-1322-598cb5278184"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:280094f5-d6ac-9670-c314-381846cfbb99"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 3,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"net": {
"value": 693.76,
"currency": "USD"
}
} ],
"total": {
"value": 966.56,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:9e21f0b6-9a72-6492-32db-d3f1051e3ad9",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "9e21f0b6-9a72-6492-32db-d3f1051e3ad9",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "dc6bf4ec-20cc-538f-20c0-85a2eb9a080e"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2021-01-01T21:48:10+01:00",
"end": "2022-01-01T21:48:10+01:00"
},
"created": "2021-01-01T21:48:10+01:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"claim": {
"reference": "urn:uuid:dc6bf4ec-20cc-538f-20c0-85a2eb9a080e"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"servicedPeriod": {
"start": "2021-01-01T21:33:10+01:00",
"end": "2021-01-01T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:280094f5-d6ac-9670-c314-381846cfbb99"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"servicedPeriod": {
"start": "2021-01-01T21:33:10+01:00",
"end": "2021-01-01T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"servicedPeriod": {
"start": "2021-01-01T21:33:10+01:00",
"end": "2021-01-01T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 693.76,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 138.752,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 555.008,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 693.76,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 693.76,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 966.56,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 663.808,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:2258e6f0-1912-76a7-1a54-455c4dd5dd99",
"resource": {
"resourceType": "Encounter",
"id": "2258e6f0-1912-76a7-1a54-455c4dd5dd99",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "2258e6f0-1912-76a7-1a54-455c4dd5dd99"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2021-11-21T06:33:10+01:00",
"end": "2021-11-21T06:48:10+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
}
} ],
"period": {
"start": "2021-11-21T06:33:10+01:00",
"end": "2021-11-21T06:48:10+01:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "444814009",
"display": "Viral sinusitis (disorder)"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:1997f825-41ea-74ea-a67e-29e466571845",
"resource": {
"resourceType": "Condition",
"id": "1997f825-41ea-74ea-a67e-29e466571845",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "resolved"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed"
} ]
},
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-category",
"code": "encounter-diagnosis",
"display": "Encounter Diagnosis"
} ]
} ],
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "444814009",
"display": "Viral sinusitis (disorder)"
} ],
"text": "Viral sinusitis (disorder)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:2258e6f0-1912-76a7-1a54-455c4dd5dd99"
},
"onsetDateTime": "2021-11-21T06:33:10+01:00",
"abatementDateTime": "2021-12-18T06:33:10+01:00",
"recordedDate": "2021-11-21T06:33:10+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:18c85545-b66a-857d-df3c-6f3d8f3ec3f0",
"resource": {
"resourceType": "DiagnosticReport",
"id": "18c85545-b66a-857d-df3c-6f3d8f3ec3f0",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:2258e6f0-1912-76a7-1a54-455c4dd5dd99"
},
"effectiveDateTime": "2021-11-21T06:33:10+01:00",
"issued": "2021-11-21T06:33:10.614+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:cdd5a13a-60d9-9940-6fc9-3f6e01a95807",
"resource": {
"resourceType": "DocumentReference",
"id": "cdd5a13a-60d9-9940-6fc9-3f6e01a95807",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:18c85545-b66a-857d-df3c-6f3d8f3ec3f0"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2021-11-21T06:33:10.614+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390",
"display": "Dr. Josef103 Klein929"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:2258e6f0-1912-76a7-1a54-455c4dd5dd99"
} ],
"period": {
"start": "2021-11-21T06:33:10+01:00",
"end": "2021-11-21T06:48:10+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:24088851-8084-94d4-21c3-68112fcab86b",
"resource": {
"resourceType": "Claim",
"id": "24088851-8084-94d4-21c3-68112fcab86b",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2021-11-21T06:33:10+01:00",
"end": "2021-11-21T06:48:10+01:00"
},
"created": "2021-11-21T06:48:10+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|aade280a-3b90-3e48-9648-91109a964a63",
"display": "AP MEDICAL LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
},
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:1997f825-41ea-74ea-a67e-29e466571845"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
},
"encounter": [ {
"reference": "urn:uuid:2258e6f0-1912-76a7-1a54-455c4dd5dd99"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "444814009",
"display": "Viral sinusitis (disorder)"
} ],
"text": "Viral sinusitis (disorder)"
}
} ],
"total": {
"value": 85.55,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:faf22738-90d1-b0ec-8bc5-0ec57a82e19a",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "faf22738-90d1-b0ec-8bc5-0ec57a82e19a",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "24088851-8084-94d4-21c3-68112fcab86b"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2021-11-21T06:48:10+01:00",
"end": "2022-11-21T06:48:10+01:00"
},
"created": "2021-11-21T06:48:10+01:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2ac42b29-8d6a-3319-a57a-c9b68dc54c0d",
"display": "AP MEDICAL LLC"
},
"claim": {
"reference": "urn:uuid:24088851-8084-94d4-21c3-68112fcab86b"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999985390"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:1997f825-41ea-74ea-a67e-29e466571845"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
},
"servicedPeriod": {
"start": "2021-11-21T06:33:10+01:00",
"end": "2021-11-21T06:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:2258e6f0-1912-76a7-1a54-455c4dd5dd99"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "444814009",
"display": "Viral sinusitis (disorder)"
} ],
"text": "Viral sinusitis (disorder)"
},
"servicedPeriod": {
"start": "2021-11-21T06:33:10+01:00",
"end": "2021-11-21T06:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
}
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 85.55,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:b59f4f4a-3bf2-c2ab-5fc0-beac8d433774",
"resource": {
"resourceType": "Encounter",
"id": "b59f4f4a-3bf2-c2ab-5fc0-beac8d433774",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "b59f4f4a-3bf2-c2ab-5fc0-beac8d433774"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2022-01-07T21:33:10+01:00",
"end": "2022-01-07T21:48:10+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
}
} ],
"period": {
"start": "2022-01-07T21:33:10+01:00",
"end": "2022-01-07T21:48:10+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:56a95927-3c33-de35-2da4-842fede8d306",
"resource": {
"resourceType": "Condition",
"id": "56a95927-3c33-de35-2da4-842fede8d306",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis" ]
},
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed"
} ]
},
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/condition-category",
"code": "encounter-diagnosis",
"display": "Encounter Diagnosis"
} ]
} ],
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b59f4f4a-3bf2-c2ab-5fc0-beac8d433774"
},
"onsetDateTime": "2022-01-07T21:33:10+01:00",
"recordedDate": "2022-01-07T21:33:10+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:c741cd82-8c46-98ef-854c-533f0a56bfac",
"resource": {
"resourceType": "Observation",
"id": "c741cd82-8c46-98ef-854c-533f0a56bfac",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8302-2",
"display": "Body Height"
} ],
"text": "Body Height"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b59f4f4a-3bf2-c2ab-5fc0-beac8d433774"
},
"effectiveDateTime": "2022-01-07T21:33:10+01:00",
"issued": "2022-01-07T21:33:10.614+01:00",
"valueQuantity": {
"value": 131,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:2aa10815-6411-d832-55ff-8f9672219855",
"resource": {
"resourceType": "Observation",
"id": "2aa10815-6411-d832-55ff-8f9672219855",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72514-3",
"display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
} ],
"text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b59f4f4a-3bf2-c2ab-5fc0-beac8d433774"
},
"effectiveDateTime": "2022-01-07T21:33:10+01:00",
"issued": "2022-01-07T21:33:10.614+01:00",
"valueQuantity": {
"value": 3,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:a3b178b4-6254-a96f-6e16-e8053b52c08f",
"resource": {
"resourceType": "Observation",
"id": "a3b178b4-6254-a96f-6e16-e8053b52c08f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "29463-7",
"display": "Body Weight"
} ],
"text": "Body Weight"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b59f4f4a-3bf2-c2ab-5fc0-beac8d433774"
},
"effectiveDateTime": "2022-01-07T21:33:10+01:00",
"issued": "2022-01-07T21:33:10.614+01:00",
"valueQuantity": {
"value": 28,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:62b8566a-e031-bacf-6893-65663dafb354",
"resource": {
"resourceType": "Observation",
"id": "62b8566a-e031-bacf-6893-65663dafb354",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "39156-5",
"display": "Body mass index (BMI) [Ratio]"
} ],
"text": "Body mass index (BMI) [Ratio]"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b59f4f4a-3bf2-c2ab-5fc0-beac8d433774"
},
"effectiveDateTime": "2022-01-07T21:33:10+01:00",
"issued": "2022-01-07T21:33:10.614+01:00",
"valueQuantity": {
"value": 16.3,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:a1b5005d-e9be-2f0c-6769-f3b20a886b4a",
"resource": {
"resourceType": "Observation",
"id": "a1b5005d-e9be-2f0c-6769-f3b20a886b4a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-bmi-for-age" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "59576-9",
"display": "Body mass index (BMI) [Percentile] Per age and sex"
} ],
"text": "Body mass index (BMI) [Percentile] Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b59f4f4a-3bf2-c2ab-5fc0-beac8d433774"
},
"effectiveDateTime": "2022-01-07T21:33:10+01:00",
"issued": "2022-01-07T21:33:10.614+01:00",
"valueQuantity": {
"value": 62.567,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:583740e4-f683-7e38-a56c-9d5f740a2d14",
"resource": {
"resourceType": "Observation",
"id": "583740e4-f683-7e38-a56c-9d5f740a2d14",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "85354-9",
"display": "Blood pressure panel with all children optional"
} ],
"text": "Blood pressure panel with all children optional"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b59f4f4a-3bf2-c2ab-5fc0-beac8d433774"
},
"effectiveDateTime": "2022-01-07T21:33:10+01:00",
"issued": "2022-01-07T21:33:10.614+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 87,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8480-6",
"display": "Systolic Blood Pressure"
} ],
"text": "Systolic Blood Pressure"
},
"valueQuantity": {
"value": 119,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:7d00c6a7-4599-eb53-9eb3-0a58a067266d",
"resource": {
"resourceType": "Observation",
"id": "7d00c6a7-4599-eb53-9eb3-0a58a067266d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8867-4",
"display": "Heart rate"
} ],
"text": "Heart rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b59f4f4a-3bf2-c2ab-5fc0-beac8d433774"
},
"effectiveDateTime": "2022-01-07T21:33:10+01:00",
"issued": "2022-01-07T21:33:10.614+01:00",
"valueQuantity": {
"value": 77,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:66ce6ded-bb73-2b16-0636-1ad86417a1a5",
"resource": {
"resourceType": "Observation",
"id": "66ce6ded-bb73-2b16-0636-1ad86417a1a5",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9279-1",
"display": "Respiratory rate"
} ],
"text": "Respiratory rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b59f4f4a-3bf2-c2ab-5fc0-beac8d433774"
},
"effectiveDateTime": "2022-01-07T21:33:10+01:00",
"issued": "2022-01-07T21:33:10.614+01:00",
"valueQuantity": {
"value": 15,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:f3f822ce-439f-f7ed-ec2e-35b330e1e18f",
"resource": {
"resourceType": "Observation",
"id": "f3f822ce-439f-f7ed-ec2e-35b330e1e18f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social history"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72166-2",
"display": "Tobacco smoking status"
} ],
"text": "Tobacco smoking status"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b59f4f4a-3bf2-c2ab-5fc0-beac8d433774"
},
"effectiveDateTime": "2022-01-07T21:33:10+01:00",
"issued": "2022-01-07T21:33:10.614+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "266919005",
"display": "Never smoked tobacco (finding)"
} ],
"text": "Never smoked tobacco (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:a32929cd-cd66-5f09-f23f-ef70312b8dd2",
"resource": {
"resourceType": "Immunization",
"id": "a32929cd-cd66-5f09-f23f-ef70312b8dd2",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b59f4f4a-3bf2-c2ab-5fc0-beac8d433774"
},
"occurrenceDateTime": "2022-01-07T21:33:10+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:db5a2a81-9013-b636-17c1-6c210da0fa1e",
"resource": {
"resourceType": "DiagnosticReport",
"id": "db5a2a81-9013-b636-17c1-6c210da0fa1e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:b59f4f4a-3bf2-c2ab-5fc0-beac8d433774"
},
"effectiveDateTime": "2022-01-07T21:33:10+01:00",
"issued": "2022-01-07T21:33:10.614+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:754c238c-8043-0339-df6b-5d6fba4fff25",
"resource": {
"resourceType": "DocumentReference",
"id": "754c238c-8043-0339-df6b-5d6fba4fff25",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:db5a2a81-9013-b636-17c1-6c210da0fa1e"
} ],
"status": "superseded",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2022-01-07T21:33:10.614+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:b59f4f4a-3bf2-c2ab-5fc0-beac8d433774"
} ],
"period": {
"start": "2022-01-07T21:33:10+01:00",
"end": "2022-01-07T21:48:10+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:fe6b3ba9-a091-2b4a-ad67-eb24ced06327",
"resource": {
"resourceType": "Claim",
"id": "fe6b3ba9-a091-2b4a-ad67-eb24ced06327",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2022-01-07T21:33:10+01:00",
"end": "2022-01-07T21:48:10+01:00"
},
"created": "2022-01-07T21:48:10+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:a32929cd-cd66-5f09-f23f-ef70312b8dd2"
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:56a95927-3c33-de35-2da4-842fede8d306"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:b59f4f4a-3bf2-c2ab-5fc0-beac8d433774"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"net": {
"value": 136.00,
"currency": "USD"
}
}, {
"sequence": 3,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
}
} ],
"total": {
"value": 272.80,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:8bea9891-fd73-4f40-7fb1-0d6b106b866a",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "8bea9891-fd73-4f40-7fb1-0d6b106b866a",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Anthem"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Anthem"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "fe6b3ba9-a091-2b4a-ad67-eb24ced06327"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2022-01-07T21:48:10+01:00",
"end": "2023-01-07T21:48:10+01:00"
},
"created": "2022-01-07T21:48:10+01:00",
"insurer": {
"display": "Anthem"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"claim": {
"reference": "urn:uuid:fe6b3ba9-a091-2b4a-ad67-eb24ced06327"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:56a95927-3c33-de35-2da4-842fede8d306"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Anthem"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"servicedPeriod": {
"start": "2022-01-07T21:33:10+01:00",
"end": "2022-01-07T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:b59f4f4a-3bf2-c2ab-5fc0-beac8d433774"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"servicedPeriod": {
"start": "2022-01-07T21:33:10+01:00",
"end": "2022-01-07T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
}, {
"sequence": 3,
"diagnosisSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "314529007",
"display": "Medication review due (situation)"
} ],
"text": "Medication review due (situation)"
},
"servicedPeriod": {
"start": "2022-01-07T21:33:10+01:00",
"end": "2022-01-07T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 272.80,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:0ba0ff39-c3e4-2718-ec34-ddc08c6954a7",
"resource": {
"resourceType": "Encounter",
"id": "0ba0ff39-c3e4-2718-ec34-ddc08c6954a7",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "0ba0ff39-c3e4-2718-ec34-ddc08c6954a7"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Ted955 Koss676"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2023-01-13T21:33:10+01:00",
"end": "2023-01-13T21:48:10+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
}
} ],
"period": {
"start": "2023-01-13T21:33:10+01:00",
"end": "2023-01-13T21:48:10+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:9a81c0f2-45b6-ce94-975a-f82d4d7b9ff3",
"resource": {
"resourceType": "Observation",
"id": "9a81c0f2-45b6-ce94-975a-f82d4d7b9ff3",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8302-2",
"display": "Body Height"
} ],
"text": "Body Height"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:0ba0ff39-c3e4-2718-ec34-ddc08c6954a7"
},
"effectiveDateTime": "2023-01-13T21:33:10+01:00",
"issued": "2023-01-13T21:33:10.614+01:00",
"valueQuantity": {
"value": 137.4,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:70e81edd-2dc7-d0e0-1703-7cc36098690d",
"resource": {
"resourceType": "Observation",
"id": "70e81edd-2dc7-d0e0-1703-7cc36098690d",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72514-3",
"display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
} ],
"text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:0ba0ff39-c3e4-2718-ec34-ddc08c6954a7"
},
"effectiveDateTime": "2023-01-13T21:33:10+01:00",
"issued": "2023-01-13T21:33:10.614+01:00",
"valueQuantity": {
"value": 1,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d7246064-4a87-2747-3f26-085943ae43f6",
"resource": {
"resourceType": "Observation",
"id": "d7246064-4a87-2747-3f26-085943ae43f6",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "29463-7",
"display": "Body Weight"
} ],
"text": "Body Weight"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:0ba0ff39-c3e4-2718-ec34-ddc08c6954a7"
},
"effectiveDateTime": "2023-01-13T21:33:10+01:00",
"issued": "2023-01-13T21:33:10.614+01:00",
"valueQuantity": {
"value": 32.5,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:fb0b4ff6-fa0b-60b7-2dc9-262c97cbe8fc",
"resource": {
"resourceType": "Observation",
"id": "fb0b4ff6-fa0b-60b7-2dc9-262c97cbe8fc",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "39156-5",
"display": "Body mass index (BMI) [Ratio]"
} ],
"text": "Body mass index (BMI) [Ratio]"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:0ba0ff39-c3e4-2718-ec34-ddc08c6954a7"
},
"effectiveDateTime": "2023-01-13T21:33:10+01:00",
"issued": "2023-01-13T21:33:10.614+01:00",
"valueQuantity": {
"value": 17.25,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:a3e21b1e-66e2-bbb0-4f87-4fef0ee776e1",
"resource": {
"resourceType": "Observation",
"id": "a3e21b1e-66e2-bbb0-4f87-4fef0ee776e1",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/pediatric-bmi-for-age" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "59576-9",
"display": "Body mass index (BMI) [Percentile] Per age and sex"
} ],
"text": "Body mass index (BMI) [Percentile] Per age and sex"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:0ba0ff39-c3e4-2718-ec34-ddc08c6954a7"
},
"effectiveDateTime": "2023-01-13T21:33:10+01:00",
"issued": "2023-01-13T21:33:10.614+01:00",
"valueQuantity": {
"value": 70.072,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:1d0c67f8-9169-776a-3231-b6c90b9e76e0",
"resource": {
"resourceType": "Observation",
"id": "1d0c67f8-9169-776a-3231-b6c90b9e76e0",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "85354-9",
"display": "Blood pressure panel with all children optional"
} ],
"text": "Blood pressure panel with all children optional"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:0ba0ff39-c3e4-2718-ec34-ddc08c6954a7"
},
"effectiveDateTime": "2023-01-13T21:33:10+01:00",
"issued": "2023-01-13T21:33:10.614+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 82,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8480-6",
"display": "Systolic Blood Pressure"
} ],
"text": "Systolic Blood Pressure"
},
"valueQuantity": {
"value": 128,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e1e54bd8-91ba-8ad7-93bf-1a11a059a35a",
"resource": {
"resourceType": "Observation",
"id": "e1e54bd8-91ba-8ad7-93bf-1a11a059a35a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8867-4",
"display": "Heart rate"
} ],
"text": "Heart rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:0ba0ff39-c3e4-2718-ec34-ddc08c6954a7"
},
"effectiveDateTime": "2023-01-13T21:33:10+01:00",
"issued": "2023-01-13T21:33:10.614+01:00",
"valueQuantity": {
"value": 98,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:8997b27a-96f1-19bf-f922-9b41bc60b3eb",
"resource": {
"resourceType": "Observation",
"id": "8997b27a-96f1-19bf-f922-9b41bc60b3eb",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs",
"display": "Vital signs"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "9279-1",
"display": "Respiratory rate"
} ],
"text": "Respiratory rate"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:0ba0ff39-c3e4-2718-ec34-ddc08c6954a7"
},
"effectiveDateTime": "2023-01-13T21:33:10+01:00",
"issued": "2023-01-13T21:33:10.614+01:00",
"valueQuantity": {
"value": 15,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:80aa01fb-be7f-06eb-a183-1b80d1071eb8",
"resource": {
"resourceType": "Observation",
"id": "80aa01fb-be7f-06eb-a183-1b80d1071eb8",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history",
"display": "Social history"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72166-2",
"display": "Tobacco smoking status"
} ],
"text": "Tobacco smoking status"
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:0ba0ff39-c3e4-2718-ec34-ddc08c6954a7"
},
"effectiveDateTime": "2023-01-13T21:33:10+01:00",
"issued": "2023-01-13T21:33:10.614+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "266919005",
"display": "Never smoked tobacco (finding)"
} ],
"text": "Never smoked tobacco (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d0c58afb-b6cb-d550-bfe4-a8a0d89fdb64",
"resource": {
"resourceType": "Immunization",
"id": "d0c58afb-b6cb-d550-bfe4-a8a0d89fdb64",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:0ba0ff39-c3e4-2718-ec34-ddc08c6954a7"
},
"occurrenceDateTime": "2023-01-13T21:33:10+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:70e699c7-3e44-77c3-5049-eac10d5e482b",
"resource": {
"resourceType": "DiagnosticReport",
"id": "70e699c7-3e44-77c3-5049-eac10d5e482b",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"encounter": {
"reference": "urn:uuid:0ba0ff39-c3e4-2718-ec34-ddc08c6954a7"
},
"effectiveDateTime": "2023-01-13T21:33:10+01:00",
"issued": "2023-01-13T21:33:10.614+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:d288d935-6ab4-e4c3-a10c-1830853cb33c",
"resource": {
"resourceType": "DocumentReference",
"id": "d288d935-6ab4-e4c3-a10c-1830853cb33c",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:70e699c7-3e44-77c3-5049-eac10d5e482b"
} ],
"status": "current",
"type": {
"coding": [ {
"system": "http://loinc.org",
"code": "34117-2",
"display": "History and physical note"
}, {
"system": "http://loinc.org",
"code": "51847-2",
"display": "Evaluation + Plan note"
} ]
},
"category": [ {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
"code": "clinical-note",
"display": "Clinical Note"
} ]
} ],
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"date": "2023-01-13T21:33:10.614+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "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"
},
"format": {
"system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
"code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
"display": "mimeType Sufficient"
}
} ],
"context": {
"encounter": [ {
"reference": "urn:uuid:0ba0ff39-c3e4-2718-ec34-ddc08c6954a7"
} ],
"period": {
"start": "2023-01-13T21:33:10+01:00",
"end": "2023-01-13T21:48:10+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:c8720d0b-beb5-d64a-f7f9-11534e6323a7",
"resource": {
"resourceType": "Claim",
"id": "c8720d0b-beb5-d64a-f7f9-11534e6323a7",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e",
"display": "Donnell534 Koss676"
},
"billablePeriod": {
"start": "2023-01-13T21:33:10+01:00",
"end": "2023-01-13T21:48:10+01:00"
},
"created": "2023-01-13T21:48:10+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:d0c58afb-b6cb-d550-bfe4-a8a0d89fdb64"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "Cigna Health"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:0ba0ff39-c3e4-2718-ec34-ddc08c6954a7"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"net": {
"value": 136.00,
"currency": "USD"
}
} ],
"total": {
"value": 272.80,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:f63b49c4-f2a3-35ab-29e2-303711ac814a",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "f63b49c4-f2a3-35ab-29e2-303711ac814a",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "Cigna Health"
},
"beneficiary": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"payor": [ {
"display": "Cigna Health"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "c8720d0b-beb5-d64a-f7f9-11534e6323a7"
}, {
"system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
"value": "99999999999"
} ],
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
},
"billablePeriod": {
"start": "2023-01-13T21:48:10+01:00",
"end": "2024-01-13T21:48:10+01:00"
},
"created": "2023-01-13T21:48:10+01:00",
"insurer": {
"display": "Cigna Health"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3b7b36e7-479b-33c5-91c9-bfc6c54d04fe",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
},
"claim": {
"reference": "urn:uuid:c8720d0b-beb5-d64a-f7f9-11534e6323a7"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "Cigna Health"
}
} ],
"item": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "410620009",
"display": "Well child visit (procedure)"
} ],
"text": "Well child visit (procedure)"
},
"servicedPeriod": {
"start": "2023-01-13T21:33:10+01:00",
"end": "2023-01-13T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:0ba0ff39-c3e4-2718-ec34-ddc08c6954a7"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
"code": "1",
"display": "Medical care"
} ]
},
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "140",
"display": "Influenza, seasonal, injectable, preservative free"
} ],
"text": "Influenza, seasonal, injectable, preservative free"
},
"servicedPeriod": {
"start": "2023-01-13T21:33:10+01:00",
"end": "2023-01-13T21:48:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 136.00,
"currency": "USD"
},
"adjudication": [ {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
"display": "Line Beneficiary Coinsurance Amount"
} ]
},
"amount": {
"value": 27.200000000000003,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
"display": "Line Provider Payment Amount"
} ]
},
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
"display": "Line Submitted Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
"display": "Line Allowed Charge Amount"
} ]
},
"amount": {
"value": 136.00,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
} ]
},
"amount": {
"value": 0,
"currency": "USD"
}
}, {
"category": {
"coding": [ {
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
"display": "Line Processing Indicator Code"
} ]
}
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 272.80,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 108.80000000000001,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:35ddb615-1a24-6b89-04f7-8903f53f402f",
"resource": {
"resourceType": "Provenance",
"id": "35ddb615-1a24-6b89-04f7-8903f53f402f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-provenance" ]
},
"target": [ {
"reference": "urn:uuid:5fcaaba4-cfdf-43a8-95c6-7d9f2fa6905e"
}, {
"reference": "urn:uuid:320d0b45-ec1b-c298-503c-cb537e27ae59"
}, {
"reference": "urn:uuid:25ea0e18-3ef2-dc5d-ddbe-7902e114b8f3"
}, {
"reference": "urn:uuid:c681dee0-096d-ce83-da51-03708d1fe063"
}, {
"reference": "urn:uuid:ed0db3c9-da26-3097-b007-8aae43176bf2"
}, {
"reference": "urn:uuid:b0a618e8-91fd-accf-8c39-05506824ed92"
}, {
"reference": "urn:uuid:cb47d590-00f4-c94a-9f78-3a7ca4b9dd1b"
}, {
"reference": "urn:uuid:f4cabca9-cfe8-f1a2-0be7-43fd3384e37c"
}, {
"reference": "urn:uuid:9058a658-009c-3a52-a2f8-9c8fb4aeb01c"
}, {
"reference": "urn:uuid:217c402c-225d-af2e-c9d5-fb57f1b82ba9"
}, {
"reference": "urn:uuid:06e71611-068b-a069-80f5-c8fb418e01d8"
}, {
"reference": "urn:uuid:282f815f-df2e-e038-959e-ef84fe3574f6"
}, {
"reference": "urn:uuid:29d0837d-137f-67dc-92f0-f33c5713d3fa"
}, {
"reference": "urn:uuid:8ee4ce6d-d05a-8dcb-0ad5-f97a43eb8e25"
}, {
"reference": "urn:uuid:965d3f39-6355-57bb-c2db-f9818788ef8d"
}, {
"reference": "urn:uuid:0417218d-2552-4159-2354-68b8eafabd24"
}, {
"reference": "urn:uuid:cf9a639b-33dd-4f3a-31a1-e7ba7207817c"
}, {
"reference": "urn:uuid:dcf5e22e-b8c2-7533-7bb0-95bca530d65b"
}, {
"reference": "urn:uuid:ed6352ec-326c-5d03-5f5b-5fdbb709acc9"
}, {
"reference": "urn:uuid:5a7de3b9-ce63-f295-5af1-b51a6b15479a"
}, {
"reference": "urn:uuid:9d7dadc0-43ea-b148-b4db-813e4a89bcaa"
}, {
"reference": "urn:uuid:0b5ae785-b718-91f6-95a1-ffd877b6ef41"
}, {
"reference": "urn:uuid:a8982511-0fe8-3bb5-7ee9-2e0f76222257"
}, {
"reference": "urn:uuid:b9332d0c-6b86-0bb1-f357-10fa23c971b8"
}, {
"reference": "urn:uuid:50123d03-1782-d07d-9f54-d1360fb03aec"
}, {
"reference": "urn:uuid:f14d0a3e-e502-b976-e51e-9baffd63c4cd"
}, {
"reference": "urn:uuid:d02e5263-4a43-f180-50ce-3e174749c98e"
}, {
"reference": "urn:uuid:c43c23c4-142c-fdda-2e5b-5da74e39f9c7"
}, {
"reference": "urn:uuid:1fa49cde-b768-b630-8784-002fb137d000"
}, {
"reference": "urn:uuid:aab6bb49-3365-d6d4-9287-1669eeddd48b"
}, {
"reference": "urn:uuid:10d1969c-61a7-253a-ba1d-34d00784db6f"
}, {
"reference": "urn:uuid:b62a8951-86ff-c9d1-99bd-3562067a87f5"
}, {
"reference": "urn:uuid:1636332d-b9d1-4c6b-5f0e-fd8164049df1"
}, {
"reference": "urn:uuid:c49c76fc-01e8-cc06-655e-647dc31f6a16"
}, {
"reference": "urn:uuid:721048db-d168-4c92-0fab-2b60b0e88945"
}, {
"reference": "urn:uuid:8b6b22b5-97ec-574e-b4cc-5faf6396f78f"
}, {
"reference": "urn:uuid:dab814fd-65bd-1141-7a21-6abd37d92300"
}, {
"reference": "urn:uuid:e784ebcf-6d24-646e-b76d-c09f32e7a6f1"
}, {
"reference": "urn:uuid:38c29740-e49a-fb58-9c1e-1f188d650b6b"
}, {
"reference": "urn:uuid:885eea7c-a5c3-ac93-f512-fa1fd92275fa"
}, {
"reference": "urn:uuid:48a51e48-a91f-e233-8f52-357197c95afd"
}, {
"reference": "urn:uuid:da2027fc-c95e-022b-43ab-e2d6e8025617"
}, {
"reference": "urn:uuid:f37bc261-acfe-e1ec-e0c8-e98a9b410c71"
}, {
"reference": "urn:uuid:c8b58af2-71a2-7167-d100-f1967375bab4"
}, {
"reference": "urn:uuid:9ccff10f-6261-d068-8e2a-f76ffcee90d3"
}, {
"reference": "urn:uuid:5446ca22-f79d-5347-f3c4-5766ded9ba88"
}, {
"reference": "urn:uuid:d163a598-ef28-b25e-b49d-b294db92d198"
}, {
"reference": "urn:uuid:1d4f1d82-40ae-3f0d-d7d7-09d3b6677f36"
}, {
"reference": "urn:uuid:f6b830a8-2452-5847-ff2b-303cde3592a5"
}, {
"reference": "urn:uuid:e22ef8a9-52b2-c2fa-16ad-99de17a4ce3b"
}, {
"reference": "urn:uuid:b6b2cc04-80cb-a8a4-4ef4-e89c9807b2a1"
}, {
"reference": "urn:uuid:9cb1d257-31ed-a1ea-f9b7-2579154b99b6"
}, {
"reference": "urn:uuid:ba675a8c-6be0-30bc-138e-3c100400c343"
}, {
"reference": "urn:uuid:716a8e8d-40d9-4dd5-319c-ce5e7c299874"
}, {
"reference": "urn:uuid:44d9bc28-362d-1970-0234-8108c406675e"
}, {
"reference": "urn:uuid:015d4855-3140-9985-379b-e57cceffde97"
}, {
"reference": "urn:uuid:bb4493c9-cd8e-d7fb-4e24-47171a0597f1"
}, {
"reference": "urn:uuid:dc2d22b3-523c-6ce0-b6d6-e0bf291a057b"
}, {
"reference": "urn:uuid:e4457322-03c8-838c-cfaf-e17c8e958fd6"
}, {
"reference": "urn:uuid:a39bad2c-e228-08a0-bf63-c94c4b90f344"
}, {
"reference": "urn:uuid:726628f8-40f2-60c9-8a17-6342a3569179"
}, {
"reference": "urn:uuid:12cbd6d5-8577-f6c8-f79c-3cbff9b6f5ba"
}, {
"reference": "urn:uuid:c31299ba-60a9-562a-2345-daa49a7102e8"
}, {
"reference": "urn:uuid:a7426a22-7d97-5108-e3c1-3f56696aa2f4"
}, {
"reference": "urn:uuid:aeb15fa7-c53f-f191-6abf-b544087e3db0"
}, {
"reference": "urn:uuid:5cdb3ef7-cbba-68aa-3997-35ea5bf54a19"
}, {
"reference": "urn:uuid:df11acf0-81a7-ced4-1fd0-86a3c00d6d90"
}, {
"reference": "urn:uuid:0322519b-b73c-525f-e65c-5e97a3a67198"
}, {
"reference": "urn:uuid:9f694925-4cd0-9380-f063-183f1d3872e3"
}, {
"reference": "urn:uuid:1c2fbb2a-87f0-117b-7727-b64ce98cea03"
}, {
"reference": "urn:uuid:e0d31490-88ff-812c-93f1-65ba7cc5f5e9"
}, {
"reference": "urn:uuid:5a6d9a68-8a4a-b46c-20a9-5b870a0d0493"
}, {
"reference": "urn:uuid:b4361fcc-3313-98f3-50b1-ea121f9a45ba"
}, {
"reference": "urn:uuid:c2cad048-b297-64b1-fd81-d96288a571c3"
}, {
"reference": "urn:uuid:e2ad57cd-56dd-1848-0673-1208e73bfca8"
}, {
"reference": "urn:uuid:8081c706-205c-ccba-5d60-4a2d2ffca870"
}, {
"reference": "urn:uuid:2b4ad797-c665-d31c-3ed2-0a0a9b0f4e0d"
}, {
"reference": "urn:uuid:1b65742e-cf29-5bd4-b844-b96f7c4c3487"
}, {
"reference": "urn:uuid:dfd79d36-52f6-607a-bb40-435024973e3f"
}, {
"reference": "urn:uuid:c0f08104-e8ff-208d-8f8d-1fb2ee3471ba"
}, {
"reference": "urn:uuid:85eb2225-dcf4-a62c-013d-79e1f091eb07"
}, {
"reference": "urn:uuid:7800eaf2-4e0e-0309-cec5-c71e4186943e"
}, {
"reference": "urn:uuid:e8fbe6b5-8a8c-cced-d870-073f8b06b16d"
}, {
"reference": "urn:uuid:1885dfd0-fc99-70d0-354b-abf43b6e09f6"
}, {
"reference": "urn:uuid:cef5a8ec-46c1-3047-7846-9fef57c08a48"
}, {
"reference": "urn:uuid:573e5fff-054e-a104-8240-9b60ea1f85c1"
}, {
"reference": "urn:uuid:d972a2eb-9f0c-b0a2-7432-dd29225aefd8"
}, {
"reference": "urn:uuid:08bc276b-e00d-7873-d54f-94ca4acbe298"
}, {
"reference": "urn:uuid:ae852503-c81c-a41c-84a8-3de52417a7e1"
}, {
"reference": "urn:uuid:233ac195-7e34-63aa-e201-63891c680479"
}, {
"reference": "urn:uuid:1bd2cc76-41da-196c-b8d9-4a6c76e9b65d"
}, {
"reference": "urn:uuid:4c7f6922-71ee-0568-341f-e0d73c811260"
}, {
"reference": "urn:uuid:7ca67a1f-ad4f-5df9-27f8-0ed99089bca4"
}, {
"reference": "urn:uuid:18cfb879-6c94-f4b7-18b1-f79c5104d0f5"
}, {
"reference": "urn:uuid:4fee0291-8872-f64a-16d9-c02bba20eb76"
}, {
"reference": "urn:uuid:238920fa-ee95-23fb-109a-1cb85fb6fa1b"
}, {
"reference": "urn:uuid:da7185d4-3672-1109-8a59-8e1b8e406323"
}, {
"reference": "urn:uuid:bd3c663a-0b26-dc62-f45a-7518e1ad18e0"
}, {
"reference": "urn:uuid:10574e7a-07e3-a1dd-3857-cd35f6951e33"
}, {
"reference": "urn:uuid:754d6336-38d3-fee7-5fc5-82a1b6afb8aa"
}, {
"reference": "urn:uuid:e9c3c31c-4004-8981-1a3b-57022c0801f4"
}, {
"reference": "urn:uuid:a51d76dc-298f-d94a-665d-82182f0cd04a"
}, {
"reference": "urn:uuid:074161e5-af83-5e10-1aa9-5c67d65865e2"
}, {
"reference": "urn:uuid:4f8295e2-3fdd-1c18-a968-461f0c308dc7"
}, {
"reference": "urn:uuid:8cfb914b-ea1e-1b2c-b73c-c446ef854bad"
}, {
"reference": "urn:uuid:f1a30666-4379-6fb1-101c-7fb312458eeb"
}, {
"reference": "urn:uuid:2023f0d0-2e09-517c-a46a-27741db80c30"
}, {
"reference": "urn:uuid:e1e8fbd3-0211-026f-e090-0b80a8ac41ed"
}, {
"reference": "urn:uuid:dcc3fd8e-8cf5-d5b8-50c4-a4ce82c7c543"
}, {
"reference": "urn:uuid:aa13d63e-6746-052d-240f-94a452981a36"
}, {
"reference": "urn:uuid:7acded99-f0e6-6902-b1b9-319c5d399197"
}, {
"reference": "urn:uuid:581699d6-3764-792e-bff5-fd27313392fe"
}, {
"reference": "urn:uuid:8c29f77e-6304-9863-04f8-7abd5e1f2032"
}, {
"reference": "urn:uuid:f753a40e-44e9-7e21-4b8e-01ca23d5ade3"
}, {
"reference": "urn:uuid:3e97c72e-f7c1-cdad-3917-99c634291991"
}, {
"reference": "urn:uuid:00df02e9-e4e6-adec-6b74-c2c355ec727f"
}, {
"reference": "urn:uuid:2e745d68-2c9a-e1f8-19c7-ea9bc43d5b12"
}, {
"reference": "urn:uuid:93f93188-9945-71ad-66a2-bb4ad4b752bb"
}, {
"reference": "urn:uuid:a5dd34e8-22b5-06fc-c199-2fb2288c4a30"
}, {
"reference": "urn:uuid:0ba7e0c4-b798-3471-52a1-d8bb86543b03"
}, {
"reference": "urn:uuid:f5008691-173f-5021-69a8-390466a61584"
}, {
"reference": "urn:uuid:84a67f26-8293-2c74-0c13-71dc69c9c3f5"
}, {
"reference": "urn:uuid:94441d99-5b84-c25e-777e-7d03e07d1118"
}, {
"reference": "urn:uuid:bf5906ab-d43e-0eab-aff6-fa7248fce3b5"
}, {
"reference": "urn:uuid:52c99c0e-c1dd-6746-04d9-2de2a08cf3ca"
}, {
"reference": "urn:uuid:f20c50af-7173-82ff-30d1-ec9818a909d0"
}, {
"reference": "urn:uuid:bd3f6271-beaf-13d8-fede-dfff0296503f"
}, {
"reference": "urn:uuid:257bf7ce-71cc-6590-5f5f-31db6db8cfaf"
}, {
"reference": "urn:uuid:82041297-6c19-d0b2-282a-86ac7d52df21"
}, {
"reference": "urn:uuid:b98ad508-85c9-725e-9cc5-347305fe0718"
}, {
"reference": "urn:uuid:95084245-f1bb-1c23-f9d9-85c99449babe"
}, {
"reference": "urn:uuid:6d1e4349-525c-ac78-3139-29902bd1aa3f"
}, {
"reference": "urn:uuid:5e60afce-5f0d-efa1-efa6-23d7ac17cd66"
}, {
"reference": "urn:uuid:5442a7a7-d297-caef-141c-6a19555fe397"
}, {
"reference": "urn:uuid:cc7975db-e9c5-5c11-a15d-2bc702d4b351"
}, {
"reference": "urn:uuid:7a980e42-76b4-4fe9-4c02-a71419de162e"
}, {
"reference": "urn:uuid:3e5b9ce7-00a7-b995-f751-e8fcdf459581"
}, {
"reference": "urn:uuid:4749d7b7-c339-a70b-df0b-62ccf645f095"
}, {
"reference": "urn:uuid:3e2f3e40-b8ac-6688-ba97-69874d0c4db5"
}, {
"reference": "urn:uuid:8c182631-abc3-3c4b-b20b-7d0bf839db5a"
}, {
"reference": "urn:uuid:8afc0338-dad9-9bbb-23ae-28ebadf4eb94"
}, {
"reference": "urn:uuid:98675277-19a8-2cfd-1026-019de4e0377e"
}, {
"reference": "urn:uuid:f2a8b37b-2574-3cda-75e7-ae95ad42b5a9"
}, {
"reference": "urn:uuid:0a8825bb-330d-8861-fe4e-99d52ae65c9f"
}, {
"reference": "urn:uuid:87b897a8-87ea-7bc5-c877-6795f7520f4c"
}, {
"reference": "urn:uuid:2360ac01-32b7-1f35-6f53-4b96a54e5b9c"
}, {
"reference": "urn:uuid:dd02a3ee-a111-9c73-382a-def02091e20c"
}, {
"reference": "urn:uuid:d6ca3639-0461-f948-73fa-0975d10c563a"
}, {
"reference": "urn:uuid:9122b747-7385-5eeb-015b-7a20fefed327"
}, {
"reference": "urn:uuid:4baf4018-b4e0-1e72-8f96-7c7ff67f9bff"
}, {
"reference": "urn:uuid:f7ac69f8-249f-778f-f398-d4175e82b19c"
}, {
"reference": "urn:uuid:97ffe146-2a0c-d21a-a11f-70bea59d78c9"
}, {
"reference": "urn:uuid:3514731b-27a6-7f87-042e-46185b734a2d"
}, {
"reference": "urn:uuid:c2f04081-6198-8e47-02e9-7fc1dea458b1"
}, {
"reference": "urn:uuid:17c42322-f465-7164-21a2-3c87e76a62b2"
}, {
"reference": "urn:uuid:4c5fbcfc-4374-210b-6859-fee6284ee11c"
}, {
"reference": "urn:uuid:62618968-70c5-0ba4-e662-5418232dda97"
}, {
"reference": "urn:uuid:5c3fb081-fff8-b10d-e65c-48bb61832994"
}, {
"reference": "urn:uuid:40a0906a-d708-103a-8779-5f0df6f6eb4e"
}, {
"reference": "urn:uuid:2fe43f3d-9f8b-2416-a335-9bb3f6d081d3"
}, {
"reference": "urn:uuid:72f14094-2607-e849-bbdc-b7a0cc229f39"
}, {
"reference": "urn:uuid:da51cafc-78a0-c084-11a4-092f9bbd31c3"
}, {
"reference": "urn:uuid:057d78a0-7ba3-87ff-a359-5606e41740e4"
}, {
"reference": "urn:uuid:69ee883d-1d34-8d44-2d24-26b1a512657e"
}, {
"reference": "urn:uuid:7e2188d3-183f-12ea-1e65-aeaf4f6801d6"
}, {
"reference": "urn:uuid:f847b6f9-3e06-cad0-f6d4-ac18f736dcc7"
}, {
"reference": "urn:uuid:3ab017d7-b659-5c81-7c46-cd1bc1023bf0"
}, {
"reference": "urn:uuid:ce7bb186-1325-adf3-1575-82dc105953e1"
}, {
"reference": "urn:uuid:e2ff7a96-9b0c-23ca-6845-cb6146e2fee4"
}, {
"reference": "urn:uuid:117cbbd1-9b88-6def-77e2-dbb8e026526c"
}, {
"reference": "urn:uuid:c01a5fce-6c54-653b-18d5-e3051ff184e5"
}, {
"reference": "urn:uuid:50a91143-febe-a56e-3100-bd94775548db"
}, {
"reference": "urn:uuid:c8b8f31a-de4d-0894-b3fa-b9a39f0f4fad"
}, {
"reference": "urn:uuid:2980cf2b-91df-b247-f8da-c4f874ae998e"
}, {
"reference": "urn:uuid:a0294db4-15e4-d3d2-583f-44d2ac2c1086"
}, {
"reference": "urn:uuid:a0c7f86c-f546-ca5d-9245-8d279dd6be6a"
}, {
"reference": "urn:uuid:edd773bb-ac35-eea1-80d9-0526dbab2e0b"
}, {
"reference": "urn:uuid:8870c57e-4183-71ea-ed99-56777f0dc606"
}, {
"reference": "urn:uuid:4b3e845a-5140-8641-c3f5-d9acdfd837fa"
}, {
"reference": "urn:uuid:0191b3a0-821d-e010-f9b6-9dea962a0918"
}, {
"reference": "urn:uuid:6c49af1c-1273-edb3-de96-3aa7d2e6d13d"
}, {
"reference": "urn:uuid:bdff2f62-657f-fd9e-ab35-e2118f9ca41f"
}, {
"reference": "urn:uuid:236564a0-ce2d-14a6-9f50-ee50058bac3e"
}, {
"reference": "urn:uuid:6d5dea8a-eeb1-8628-422b-378b21b83c33"
}, {
"reference": "urn:uuid:c04ff63f-beff-c0ad-d459-f6529433ea1f"
}, {
"reference": "urn:uuid:1bb8d315-a32b-fa42-0345-bc946fda1d2d"
}, {
"reference": "urn:uuid:80edf5b4-d28f-9fbe-b9b4-a80eff52fbab"
}, {
"reference": "urn:uuid:3d50d436-4e48-f544-6fab-67f533962a6d"
}, {
"reference": "urn:uuid:25bcb732-73dc-9580-df9f-f19227081e3a"
}, {
"reference": "urn:uuid:c6807f90-e369-f986-6386-fd8718799678"
}, {
"reference": "urn:uuid:ba34b750-afd7-6a79-371c-4438e3c71c22"
}, {
"reference": "urn:uuid:dda61cf9-f432-1241-c360-ca00aa717a8b"
}, {
"reference": "urn:uuid:796911cc-eccb-83ff-1f38-2b9fea649886"
}, {
"reference": "urn:uuid:d5217369-478c-6b43-176b-482b8e3920e3"
}, {
"reference": "urn:uuid:bbc3d75d-8a13-3fb7-1f14-d12ca3e3a797"
}, {
"reference": "urn:uuid:631b6c14-0564-38a6-e65a-672e8d32b174"
}, {
"reference": "urn:uuid:36f6d2d8-614f-cb5e-b6d1-d6a48f1833a7"
}, {
"reference": "urn:uuid:a45f8b5b-3c51-8984-4a5c-8f04513d27b8"
}, {
"reference": "urn:uuid:d51f6bd0-1fd4-008e-f75c-150452f693e8"
}, {
"reference": "urn:uuid:06e5718f-5309-f9f8-5ff3-1840a2571da0"
}, {
"reference": "urn:uuid:283a3e28-32e8-e0da-75e7-724c44683650"
}, {
"reference": "urn:uuid:1b982914-254a-c15a-2e80-3fa60234eba4"
}, {
"reference": "urn:uuid:29e1a611-4499-aa6b-5c68-9928d9a865f7"
}, {
"reference": "urn:uuid:d64df70b-e707-aac0-8aa5-46a5fbcf2ade"
}, {
"reference": "urn:uuid:8274b7a6-c2fc-dab8-5238-efc5e9d87212"
}, {
"reference": "urn:uuid:146bd588-8dc9-d7d8-8acd-b42165d6d1c4"
}, {
"reference": "urn:uuid:fa0b6a19-6e77-74d7-3e9e-c2861dd472a7"
}, {
"reference": "urn:uuid:d0e03028-c3c6-c0fb-c1a8-812da33b715e"
}, {
"reference": "urn:uuid:94e612b3-8c7e-64a2-f2fb-4664ba7e2a3c"
}, {
"reference": "urn:uuid:2075836a-2e10-84c6-e3fa-5fa27ce0e5c6"
}, {
"reference": "urn:uuid:89ac0496-7ecf-f6cc-0199-da9e65250ead"
}, {
"reference": "urn:uuid:2c8ca559-e3b3-fcd9-229a-d9b29528bd68"
}, {
"reference": "urn:uuid:23bd4079-412e-7e8b-d817-80d0a0aa9be8"
}, {
"reference": "urn:uuid:ac6d5e4b-051b-21cd-3ad1-c44e1236825b"
}, {
"reference": "urn:uuid:02f101fc-f49c-d726-a5c6-24d00f97d3e0"
}, {
"reference": "urn:uuid:883d37cb-fb39-6917-79da-3e49f16e78b4"
}, {
"reference": "urn:uuid:29b324be-8e20-3abd-d230-0c4b76542a6e"
}, {
"reference": "urn:uuid:03afa0f2-6cfe-d20d-e452-340850ee68de"
}, {
"reference": "urn:uuid:1a0f55c2-800a-9103-019c-3f42a89ff356"
}, {
"reference": "urn:uuid:3d32375b-71f0-3ad1-f0ce-fb7af2031e29"
}, {
"reference": "urn:uuid:5583478b-6fb5-10e5-73d1-0e7a8e690f70"
}, {
"reference": "urn:uuid:4a9b0577-ed6d-0dcd-3289-b84789675cc7"
}, {
"reference": "urn:uuid:fb616ae3-7908-729b-d9fd-f5f827300ce5"
}, {
"reference": "urn:uuid:0e466e1e-2146-9cca-75f7-442af9221085"
}, {
"reference": "urn:uuid:f09da1a2-0871-0315-a4b6-9335f2104b5a"
}, {
"reference": "urn:uuid:2c1cbc42-6b05-5fbb-7f65-9f1af542103e"
}, {
"reference": "urn:uuid:f2b36c60-0d3c-a20a-3cf8-3bb4e952229c"
}, {
"reference": "urn:uuid:61081602-ef62-c936-423c-de3fee000d2a"
}, {
"reference": "urn:uuid:20e31eae-3cb6-30dd-a585-b2a0e151c3c1"
}, {
"reference": "urn:uuid:b28fa7a2-5bbd-e9eb-dbdb-9dac4776ea86"
}, {
"reference": "urn:uuid:93ac150b-89db-5924-538a-36c990f8d879"
}, {
"reference": "urn:uuid:51d444fe-0da1-9428-e9a3-940d40c973ec"
}, {
"reference": "urn:uuid:fa370fcb-fd9c-7b90-771e-9cb4318c2d39"
}, {
"reference": "urn:uuid:baf77b37-02e1-0593-3884-bf1e3f484733"
}, {
"reference": "urn:uuid:10be5003-828c-e485-a5ca-efc852571e30"
}, {
"reference": "urn:uuid:07109a13-6f98-a57e-cd85-5b120ba3cef1"
}, {
"reference": "urn:uuid:a2640468-4717-03fd-61eb-83b32d1fc2c2"
}, {
"reference": "urn:uuid:043e1e10-dd8f-a5aa-a5f2-feacc1c0dc9f"
}, {
"reference": "urn:uuid:1b021fa3-5620-2dc0-83e5-2a00f99e28ee"
}, {
"reference": "urn:uuid:3be66966-f554-96b5-765f-aa1646524dfc"
}, {
"reference": "urn:uuid:8134e375-3701-6ae8-29ec-d65c236166a0"
}, {
"reference": "urn:uuid:6b04a03b-46e4-65f7-83e3-058c49c327a5"
}, {
"reference": "urn:uuid:0155f2eb-c294-0eff-3fc3-d3c847e5964a"
}, {
"reference": "urn:uuid:98c1c76c-119d-1ce4-17e4-c91cea2b271e"
}, {
"reference": "urn:uuid:0a975327-89b4-3aec-35fa-513f5dd3f12d"
}, {
"reference": "urn:uuid:419b79b0-22d0-3264-c15e-1ede30de3c73"
}, {
"reference": "urn:uuid:c625317b-0aee-625f-a084-338ff410b2ce"
}, {
"reference": "urn:uuid:16f27cbd-f8d9-3499-ffaf-e5143df38a7a"
}, {
"reference": "urn:uuid:43e78795-7b13-b330-02ae-298919475400"
}, {
"reference": "urn:uuid:5134fd7b-a809-f971-ee3b-7b71dd199662"
}, {
"reference": "urn:uuid:33c8a19d-1606-8adf-959c-f5b7b277542e"
}, {
"reference": "urn:uuid:8456f0bd-f52a-01c7-debe-c8a323a2d05f"
}, {
"reference": "urn:uuid:709ad708-371f-08cb-6cad-8b009011bd75"
}, {
"reference": "urn:uuid:2806abea-cefb-686c-e912-6b6f43b1214b"
}, {
"reference": "urn:uuid:7667a7ff-4f76-51b0-bc6a-d0976ffdc119"
}, {
"reference": "urn:uuid:8470833f-984c-b58f-e103-fa2d906c8ba1"
}, {
"reference": "urn:uuid:9a2ec227-e3c4-cfae-136b-8a44354e35bd"
}, {
"reference": "urn:uuid:4566b150-bc44-c1fd-a56a-6135684b809e"
}, {
"reference": "urn:uuid:bb9375c7-d51d-2fd7-7434-bbf4c9e27d5b"
}, {
"reference": "urn:uuid:a48f1723-ef93-8088-6f3b-1e41aab4fd15"
}, {
"reference": "urn:uuid:f2e896d9-a9ef-460f-7fe3-2c1cd78b5f5b"
}, {
"reference": "urn:uuid:fdf66b7d-085b-bd4a-704d-3820e0d076be"
}, {
"reference": "urn:uuid:a0569ee9-dc1f-ab09-e93d-01eaedeae519"
}, {
"reference": "urn:uuid:77f39f02-73ea-25e6-0249-c43e2590a61a"
}, {
"reference": "urn:uuid:c05394e5-d698-40af-53e5-de2e2308bf9c"
}, {
"reference": "urn:uuid:56739c3e-380a-98b7-5c97-1e10834ba9e6"
}, {
"reference": "urn:uuid:1c23435c-0d00-bc9a-361b-1c304bf4830e"
}, {
"reference": "urn:uuid:65c3c150-85a8-5a15-03f7-6220446efc09"
}, {
"reference": "urn:uuid:b2381852-7efd-e7b0-ddbd-9b5286d3559d"
}, {
"reference": "urn:uuid:1718a054-a807-e009-e175-91f1d931d865"
}, {
"reference": "urn:uuid:26c73d51-fadd-dc75-bb94-c82bca7e3f81"
}, {
"reference": "urn:uuid:f02cee3d-a7a3-6e28-003e-2e1142e78a43"
}, {
"reference": "urn:uuid:fdf21ec5-2932-c400-afa7-0256215dbd14"
}, {
"reference": "urn:uuid:2e01deca-7718-e743-a70a-a242701cfc0a"
}, {
"reference": "urn:uuid:6ab72f71-dd4e-3059-d0be-09be7e94345a"
}, {
"reference": "urn:uuid:dc13d722-f69c-36ae-1b35-123033983e07"
}, {
"reference": "urn:uuid:266f765a-c627-3782-a4b6-fb6e85de353a"
}, {
"reference": "urn:uuid:8daf28f3-53b0-d7dd-a2fc-38aa7a708f55"
}, {
"reference": "urn:uuid:447f77a6-93f0-91c0-86e1-a78868b7ed47"
}, {
"reference": "urn:uuid:281c2ba7-1443-d7ad-5c17-78a7cc08f8ae"
}, {
"reference": "urn:uuid:a9f5390e-b894-9f43-e0e5-9a187227b1d1"
}, {
"reference": "urn:uuid:fd3c4eb9-9dae-b614-60b2-5f0c2c2949af"
}, {
"reference": "urn:uuid:5599f1f1-1d89-af87-ad68-42ebf5ffe974"
}, {
"reference": "urn:uuid:9bc852fd-ea54-ceb2-12a8-03acb9939169"
}, {
"reference": "urn:uuid:cc3e4d65-94cb-0bf0-4518-af4033a47939"
}, {
"reference": "urn:uuid:b37e9d17-e599-4ecc-a9b3-acb4d736554a"
}, {
"reference": "urn:uuid:23d8407f-5353-2452-0c0c-3030fbd00bdf"
}, {
"reference": "urn:uuid:d6a4cd6a-4e39-ecc1-95ec-c898582e93ac"
}, {
"reference": "urn:uuid:653822e2-1387-4370-1f1b-5d4551c95705"
}, {
"reference": "urn:uuid:a4fe77e5-6ca5-d363-ff95-16579f7b14ee"
}, {
"reference": "urn:uuid:21f6155b-bf59-58fe-67af-da49c47c70fa"
}, {
"reference": "urn:uuid:e4788780-cfce-0217-b8b7-7b4743e7f9f0"
}, {
"reference": "urn:uuid:ff7c4c9d-71d1-98ec-cf3b-133f656fcc8d"
}, {
"reference": "urn:uuid:0664b9d8-6ec1-f09b-dc5b-a6fcfe0172c4"
}, {
"reference": "urn:uuid:071b132e-fe1e-06ce-3763-edc63a855350"
}, {
"reference": "urn:uuid:1941eae6-2d7b-ae4c-c20c-842fdda6afc9"
}, {
"reference": "urn:uuid:bf8502ee-a6ae-90ef-f89d-7676c333f741"
}, {
"reference": "urn:uuid:c3996be9-e0a8-d99c-4526-a583bbe47206"
}, {
"reference": "urn:uuid:5bc8b90b-4a92-5817-4c0a-9fe9f2c6414c"
}, {
"reference": "urn:uuid:e81d2f54-ac02-44bb-9b33-f03fe6339254"
}, {
"reference": "urn:uuid:d15fc61c-1fba-a7b2-7d18-255ce09907d6"
}, {
"reference": "urn:uuid:738f79a9-a7da-e0f1-fa1b-2f55c5420129"
}, {
"reference": "urn:uuid:53ea12d4-582f-e980-4518-2a3a8d008643"
}, {
"reference": "urn:uuid:c8be2026-4470-26a5-c7bc-9c65d076497f"
}, {
"reference": "urn:uuid:0ac6ce5e-8bbe-cb42-9328-c613784581a0"
}, {
"reference": "urn:uuid:423d5f20-0317-0b38-f16c-70e02d7b266e"
}, {
"reference": "urn:uuid:d22bf566-a477-8845-49a9-cc560a6abf52"
}, {
"reference": "urn:uuid:85e6c226-f295-9779-360b-4d812c3e7606"
}, {
"reference": "urn:uuid:810a4947-facb-9831-ed8f-778776c42529"
}, {
"reference": "urn:uuid:51f07480-5041-8304-a3f5-1ee83a7b7053"
}, {
"reference": "urn:uuid:19271e95-7207-ddea-d7ed-c089103b7eb9"
}, {
"reference": "urn:uuid:d25acc25-a4c2-193c-6f61-4a1bd9d1b62e"
}, {
"reference": "urn:uuid:1874879e-1dd7-f358-3265-0cc05e9ce65d"
}, {
"reference": "urn:uuid:fd311ec9-40be-d484-41cc-8b6f0fd8a7a6"
}, {
"reference": "urn:uuid:742482d7-d60d-8b78-a21d-938ab759ea30"
}, {
"reference": "urn:uuid:3d227fb5-0824-f946-8eeb-1a063c177eb7"
}, {
"reference": "urn:uuid:696a32b6-8c7c-4167-5382-94c6d472175b"
}, {
"reference": "urn:uuid:8ecd6c09-1dee-9d1c-8a28-4bde6d8cc997"
}, {
"reference": "urn:uuid:ccbc8628-74da-b95e-cf3e-ab52516eb36f"
}, {
"reference": "urn:uuid:ec2c0f2b-0a4c-f590-3665-944a07234f7f"
}, {
"reference": "urn:uuid:dc7afc29-ce77-76d9-feeb-e127267ad5e0"
}, {
"reference": "urn:uuid:2e2e27c8-5369-ba48-7ebb-36f3b1b5bea9"
}, {
"reference": "urn:uuid:780a3301-45b5-6050-b63c-ddc8dc8ebc82"
}, {
"reference": "urn:uuid:65e42e25-7acf-bb73-bc09-3b73d5514c77"
}, {
"reference": "urn:uuid:2c0a7ccc-b495-5389-bcc0-7348981956d1"
}, {
"reference": "urn:uuid:49a90229-1a22-e27b-3a43-f81ca6482f58"
}, {
"reference": "urn:uuid:79208408-32ab-6ccf-3a82-3e4ca6cd257c"
}, {
"reference": "urn:uuid:d8cac53e-c184-2e43-51e8-70fd5d8c529e"
}, {
"reference": "urn:uuid:2e4eed92-944c-fd1b-7d4e-812115251970"
}, {
"reference": "urn:uuid:46e24d27-7dd8-5342-4119-52d3fcf421fb"
}, {
"reference": "urn:uuid:256c6bda-728d-f510-5f4f-a5e76e7a5f2f"
}, {
"reference": "urn:uuid:3665575a-9c95-eb4a-99b6-5129b6665329"
}, {
"reference": "urn:uuid:9e4e7a6e-7e2d-52a1-51da-46fec0f15bfb"
}, {
"reference": "urn:uuid:ba3561b6-67e9-c7ce-0d1c-ee9ffc355aed"
}, {
"reference": "urn:uuid:4c23b36a-fdb7-5022-43be-2bd4026cc885"
}, {
"reference": "urn:uuid:6ef17dfb-0046-3eaa-a42f-dfa449a7a845"
}, {
"reference": "urn:uuid:a42e9e43-9b6c-f281-f328-2c4649dc871b"
}, {
"reference": "urn:uuid:966d696b-a33a-600c-92f2-2c49e09872ff"
}, {
"reference": "urn:uuid:a8d8595b-36f3-6ccf-427c-ff2a50c69ba3"
}, {
"reference": "urn:uuid:0278501e-0f10-6745-1952-deea9ce4e409"
}, {
"reference": "urn:uuid:1f531b0e-b671-807e-da4b-47ac47dc3d9a"
}, {
"reference": "urn:uuid:84d59811-8aa1-2e83-ce21-364530fed5b6"
}, {
"reference": "urn:uuid:a7ef2c35-32a9-0611-1c09-240e06e7f9d8"
}, {
"reference": "urn:uuid:f5d2a85c-40cd-370e-e970-dbfd108bfdb0"
}, {
"reference": "urn:uuid:06b0b5e2-8316-8471-5c6e-20e34773140c"
}, {
"reference": "urn:uuid:f1d1dadc-3f4d-205e-3d70-0e829cf453a8"
}, {
"reference": "urn:uuid:b789ba28-e858-a67b-b4fc-2586070e3215"
}, {
"reference": "urn:uuid:f7976f85-edb5-dcb9-9a37-fe296b97ed37"
}, {
"reference": "urn:uuid:a26c003f-e737-62a6-1fa0-9cd87496d1eb"
}, {
"reference": "urn:uuid:2f576606-3377-ab88-33cc-e9cdc34d9113"
}, {
"reference": "urn:uuid:9298f219-003e-ad2c-8e98-1fa0386dd2a7"
}, {
"reference": "urn:uuid:bb4a4a13-05fc-a782-f5fd-fb426bf2a1bc"
}, {
"reference": "urn:uuid:b10183d0-bb77-1336-d3ff-8cc0d912ba3d"
}, {
"reference": "urn:uuid:98f76698-632c-ce1f-5e37-8f439d51b16a"
}, {
"reference": "urn:uuid:f18da8b1-8fdb-4f1b-3f54-0aedfc9eb8b8"
}, {
"reference": "urn:uuid:1e47a792-c648-a57d-dae0-72a1a5c0c52c"
}, {
"reference": "urn:uuid:c986e8ee-12dc-2383-f38e-8b99962036e0"
}, {
"reference": "urn:uuid:e7041a58-70b2-c811-7c1e-296506ad4a69"
}, {
"reference": "urn:uuid:6edd3577-5f49-eff7-71af-581fc8257368"
}, {
"reference": "urn:uuid:234d3440-87e1-b222-29f5-85a3cd45b7f8"
}, {
"reference": "urn:uuid:902bd5b7-e460-79ae-b22c-231267ba8fe8"
}, {
"reference": "urn:uuid:6a7142e9-e9a4-d791-c10e-13f969b8917e"
}, {
"reference": "urn:uuid:c38bdf31-9ffc-9726-c613-2a16d8f3309c"
}, {
"reference": "urn:uuid:f5d1a05c-b3a7-23d9-97c5-3e905476e2a0"
}, {
"reference": "urn:uuid:b47b3b7b-fa52-9d32-3271-708b97443a39"
}, {
"reference": "urn:uuid:b8c7e55a-e661-ac45-1307-dad7189accb5"
}, {
"reference": "urn:uuid:3b213eea-df55-89e5-e190-4794a8a12818"
}, {
"reference": "urn:uuid:d2ebe93e-3f62-6a2f-417a-62e099a26b48"
}, {
"reference": "urn:uuid:035c72f6-e9c6-04c8-6f85-fe296ce31c3e"
}, {
"reference": "urn:uuid:9c0ef020-f6cb-a79e-4d0c-7de003eef2be"
}, {
"reference": "urn:uuid:dca64ee0-44b2-191c-79da-07ffbf3c760e"
}, {
"reference": "urn:uuid:50e83580-e2ec-5493-cf25-f215c6540cd4"
}, {
"reference": "urn:uuid:dee5565a-0322-3f9b-eb87-6f4f15cac139"
}, {
"reference": "urn:uuid:1d7f45d1-084f-9290-01fd-2ffafc16075f"
}, {
"reference": "urn:uuid:3553b131-09e1-d913-19d1-9b5afda84de2"
}, {
"reference": "urn:uuid:25a2453c-fd43-8000-5f85-7f49f92fea1f"
}, {
"reference": "urn:uuid:e2bcd75f-a7bb-939f-460d-d12ec18bfb7f"
}, {
"reference": "urn:uuid:374a15e2-4136-ec1d-763a-e3b4e5f112e5"
}, {
"reference": "urn:uuid:9b390ee8-6426-b041-0d42-ea3d1e09eaa9"
}, {
"reference": "urn:uuid:ec21137d-7351-c150-de81-385d7df50d21"
}, {
"reference": "urn:uuid:6c882b1f-be77-3311-0abb-cbef7d3dd505"
}, {
"reference": "urn:uuid:2565f9c7-cc85-3950-5a75-96b9698bb746"
}, {
"reference": "urn:uuid:c9a2799b-5f74-daca-f77f-a36d743ea2fa"
}, {
"reference": "urn:uuid:1457386e-3c34-d21f-f791-9fe11ff566d8"
}, {
"reference": "urn:uuid:3201a497-3196-2243-4880-2df17efbaae4"
}, {
"reference": "urn:uuid:466f0aea-4195-2011-88f4-ce0481df9afb"
}, {
"reference": "urn:uuid:e519ad38-ff7a-6f62-4c5b-4cb68cbe569f"
}, {
"reference": "urn:uuid:6e613891-56a0-80d3-8d9b-1bcb639c6d3d"
}, {
"reference": "urn:uuid:3b76087d-4654-3a7c-00ea-63c2caf55225"
}, {
"reference": "urn:uuid:7e23fcf7-d0cb-b380-6575-4754c268e78f"
}, {
"reference": "urn:uuid:9fcdcdfe-fa75-62c2-b0a5-8269a7b92392"
}, {
"reference": "urn:uuid:0ab583ae-acec-59a8-fac4-31d7322d9a42"
}, {
"reference": "urn:uuid:ebf680f8-505f-40c3-abcb-a7309c990cb9"
}, {
"reference": "urn:uuid:3474b440-c68a-0572-19d7-d92c8c698012"
}, {
"reference": "urn:uuid:bea2072e-e9be-9658-05d8-687a1985b6a5"
}, {
"reference": "urn:uuid:76aebd28-b5aa-9059-38f4-dac7433c070d"
}, {
"reference": "urn:uuid:f73727f0-66c7-25da-b581-cb81bf9199f0"
}, {
"reference": "urn:uuid:b036dd23-5af5-db1a-cc72-63562ebbe8b1"
}, {
"reference": "urn:uuid:2f71d598-5f20-77ce-ade8-a1ae69d74cb9"
}, {
"reference": "urn:uuid:1e5c09ad-2529-2998-95ee-60785c93af81"
}, {
"reference": "urn:uuid:7d1a1aad-f201-ff84-65ff-0ddaddececf2"
}, {
"reference": "urn:uuid:563ba85c-50e3-6379-d121-3d810ceca24d"
}, {
"reference": "urn:uuid:9d82ef30-9410-6b55-05a7-c5e1a8e28239"
}, {
"reference": "urn:uuid:e828fca9-ef67-c0e2-61f0-e95eb8acae62"
}, {
"reference": "urn:uuid:7db360c4-6e81-4b91-3fce-d99739c77d70"
}, {
"reference": "urn:uuid:d22b86a8-1c29-4371-92e6-0b1cb2aa2049"
}, {
"reference": "urn:uuid:22a8e2d4-f50f-ab4c-55bb-7e813888b43c"
}, {
"reference": "urn:uuid:a1e27327-51f9-00f6-de56-bbf41d13a2e2"
}, {
"reference": "urn:uuid:ecbee984-b116-3a26-dd62-14ef0532e9de"
}, {
"reference": "urn:uuid:e5d0d428-cebb-3177-795d-e3984fbed3c0"
}, {
"reference": "urn:uuid:ce6c3eb1-79a5-4a66-eede-81e78f6520b2"
}, {
"reference": "urn:uuid:b8d1a2bb-d9dd-68c4-ee2d-a6752f1415bf"
}, {
"reference": "urn:uuid:c7584cfa-d3d7-f42c-7a99-deb1d2d7a9f4"
}, {
"reference": "urn:uuid:7e12615a-8285-4906-c26c-2d86f38b9c63"
}, {
"reference": "urn:uuid:65e88d4a-12c1-d320-9fcb-c7570eae3d3f"
}, {
"reference": "urn:uuid:d555d95e-7aa2-e84b-38a6-d32d9473502b"
}, {
"reference": "urn:uuid:b2ddda1b-edf0-3149-ec79-fa377e6cc641"
}, {
"reference": "urn:uuid:218c6379-e087-06a9-9321-1d5d1aefd4d9"
}, {
"reference": "urn:uuid:280094f5-d6ac-9670-c314-381846cfbb99"
}, {
"reference": "urn:uuid:5aafc259-e389-bb51-d7d3-86e9458ff8d2"
}, {
"reference": "urn:uuid:012e536a-57af-b2b8-5576-23eea6b27894"
}, {
"reference": "urn:uuid:8464d783-1487-9a8e-5b2a-b273dcae21ad"
}, {
"reference": "urn:uuid:b16c2660-5e93-b277-eb0e-e92d8c7e348d"
}, {
"reference": "urn:uuid:a5fa174b-2af9-aaf6-d956-7d87a544c55d"
}, {
"reference": "urn:uuid:92280142-fd90-5705-2307-f36f2acdb195"
}, {
"reference": "urn:uuid:4aa2ac57-c201-65e4-e17d-e325a1f90b18"
}, {
"reference": "urn:uuid:9501bd10-06eb-5269-2773-eadedff1b755"
}, {
"reference": "urn:uuid:52a8ddf7-295a-9e5d-e386-65467f484ddf"
}, {
"reference": "urn:uuid:4b1aef2e-6283-5f35-1322-598cb5278184"
}, {
"reference": "urn:uuid:b0b54bd3-b27e-2bd2-76e8-79aafc992041"
}, {
"reference": "urn:uuid:23d6f501-ae1b-037e-3e5e-c37a7c9e4279"
}, {
"reference": "urn:uuid:060962cd-ed01-4b03-2001-3ba22bf51177"
}, {
"reference": "urn:uuid:dc6bf4ec-20cc-538f-20c0-85a2eb9a080e"
}, {
"reference": "urn:uuid:9e21f0b6-9a72-6492-32db-d3f1051e3ad9"
}, {
"reference": "urn:uuid:2258e6f0-1912-76a7-1a54-455c4dd5dd99"
}, {
"reference": "urn:uuid:1997f825-41ea-74ea-a67e-29e466571845"
}, {
"reference": "urn:uuid:18c85545-b66a-857d-df3c-6f3d8f3ec3f0"
}, {
"reference": "urn:uuid:cdd5a13a-60d9-9940-6fc9-3f6e01a95807"
}, {
"reference": "urn:uuid:24088851-8084-94d4-21c3-68112fcab86b"
}, {
"reference": "urn:uuid:faf22738-90d1-b0ec-8bc5-0ec57a82e19a"
}, {
"reference": "urn:uuid:b59f4f4a-3bf2-c2ab-5fc0-beac8d433774"
}, {
"reference": "urn:uuid:56a95927-3c33-de35-2da4-842fede8d306"
}, {
"reference": "urn:uuid:c741cd82-8c46-98ef-854c-533f0a56bfac"
}, {
"reference": "urn:uuid:2aa10815-6411-d832-55ff-8f9672219855"
}, {
"reference": "urn:uuid:a3b178b4-6254-a96f-6e16-e8053b52c08f"
}, {
"reference": "urn:uuid:62b8566a-e031-bacf-6893-65663dafb354"
}, {
"reference": "urn:uuid:a1b5005d-e9be-2f0c-6769-f3b20a886b4a"
}, {
"reference": "urn:uuid:583740e4-f683-7e38-a56c-9d5f740a2d14"
}, {
"reference": "urn:uuid:7d00c6a7-4599-eb53-9eb3-0a58a067266d"
}, {
"reference": "urn:uuid:66ce6ded-bb73-2b16-0636-1ad86417a1a5"
}, {
"reference": "urn:uuid:f3f822ce-439f-f7ed-ec2e-35b330e1e18f"
}, {
"reference": "urn:uuid:a32929cd-cd66-5f09-f23f-ef70312b8dd2"
}, {
"reference": "urn:uuid:db5a2a81-9013-b636-17c1-6c210da0fa1e"
}, {
"reference": "urn:uuid:754c238c-8043-0339-df6b-5d6fba4fff25"
}, {
"reference": "urn:uuid:fe6b3ba9-a091-2b4a-ad67-eb24ced06327"
}, {
"reference": "urn:uuid:8bea9891-fd73-4f40-7fb1-0d6b106b866a"
}, {
"reference": "urn:uuid:0ba0ff39-c3e4-2718-ec34-ddc08c6954a7"
}, {
"reference": "urn:uuid:9a81c0f2-45b6-ce94-975a-f82d4d7b9ff3"
}, {
"reference": "urn:uuid:70e81edd-2dc7-d0e0-1703-7cc36098690d"
}, {
"reference": "urn:uuid:d7246064-4a87-2747-3f26-085943ae43f6"
}, {
"reference": "urn:uuid:fb0b4ff6-fa0b-60b7-2dc9-262c97cbe8fc"
}, {
"reference": "urn:uuid:a3e21b1e-66e2-bbb0-4f87-4fef0ee776e1"
}, {
"reference": "urn:uuid:1d0c67f8-9169-776a-3231-b6c90b9e76e0"
}, {
"reference": "urn:uuid:e1e54bd8-91ba-8ad7-93bf-1a11a059a35a"
}, {
"reference": "urn:uuid:8997b27a-96f1-19bf-f922-9b41bc60b3eb"
}, {
"reference": "urn:uuid:80aa01fb-be7f-06eb-a183-1b80d1071eb8"
}, {
"reference": "urn:uuid:d0c58afb-b6cb-d550-bfe4-a8a0d89fdb64"
}, {
"reference": "urn:uuid:70e699c7-3e44-77c3-5049-eac10d5e482b"
}, {
"reference": "urn:uuid:d288d935-6ab4-e4c3-a10c-1830853cb33c"
}, {
"reference": "urn:uuid:c8720d0b-beb5-d64a-f7f9-11534e6323a7"
}, {
"reference": "urn:uuid:f63b49c4-f2a3-35ab-29e2-303711ac814a"
} ],
"recorded": "2023-09-08T22:33:10.614+02:00",
"agent": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/provenance-participant-type",
"code": "author",
"display": "Author"
} ],
"text": "Author"
},
"who": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
},
"onBehalfOf": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
}, {
"type": {
"coding": [ {
"system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type",
"code": "transmitter",
"display": "Transmitter"
} ],
"text": "Transmitter"
},
"who": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999961094",
"display": "Dr. Ester635 Baca589"
},
"onBehalfOf": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a4b91172-69e7-3895-bd89-b9a0868de5c2",
"display": "DARTMOUTH PRIMARY MEDICINE, LLC"
}
} ]
},
"request": {
"method": "POST",
"url": "Provenance"
}
} ]
}