medax_pipeline/testData/Murray856_Lesch175_0759e805-61d1-ba2b-8b14-9e4308784a84.json
2025-04-16 22:12:19 +02:00

67501 lines
2.2 MiB

{
"resourceType": "Bundle",
"type": "transaction",
"entry": [ {
"fullUrl": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"resource": {
"resourceType": "Patient",
"id": "0759e805-61d1-ba2b-8b14-9e4308784a84",
"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: 4790784346362852822 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": "Wan724 Jaskolski867"
}, {
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
"valueCode": "M"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/patient-birthPlace",
"valueAddress": {
"city": "Royalston",
"state": "Massachusetts",
"country": "US"
}
}, {
"url": "http://synthetichealth.github.io/synthea/disability-adjusted-life-years",
"valueDecimal": 0.5667363282700755
}, {
"url": "http://synthetichealth.github.io/synthea/quality-adjusted-life-years",
"valueDecimal": 34.433263671729925
} ],
"identifier": [ {
"system": "https://github.com/synthetichealth/synthea",
"value": "0759e805-61d1-ba2b-8b14-9e4308784a84"
}, {
"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": "0759e805-61d1-ba2b-8b14-9e4308784a84"
}, {
"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": "999-28-6749"
}, {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "DL",
"display": "Driver's license number"
} ],
"text": "Driver's license number"
},
"system": "urn:oid:2.16.840.1.113883.4.3.25",
"value": "S99914420"
}, {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "PPN",
"display": "Passport Number"
} ],
"text": "Passport Number"
},
"system": "http://standardhealthrecord.org/fhir/StructureDefinition/passportNumber",
"value": "X8922639X"
} ],
"name": [ {
"use": "official",
"family": "Lesch175",
"given": [ "Murray856", "Garfield38" ],
"prefix": [ "Mr." ]
} ],
"telecom": [ {
"system": "phone",
"value": "555-329-3520",
"use": "home"
} ],
"gender": "male",
"birthDate": "1987-09-24",
"address": [ {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/geolocation",
"extension": [ {
"url": "latitude",
"valueDecimal": 42.59846038944856
}, {
"url": "longitude",
"valueDecimal": -71.34152909371126
} ]
} ],
"line": [ "287 Treutel Neck" ],
"city": "Chelmsford",
"state": "MA",
"postalCode": "00000",
"country": "US"
} ],
"maritalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
"code": "M",
"display": "Married"
} ],
"text": "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:ecf5f7fe-6da5-135c-62f2-478efe3f0630",
"resource": {
"resourceType": "Encounter",
"id": "ecf5f7fe-6da5-135c-62f2-478efe3f0630",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "ecf5f7fe-6da5-135c-62f2-478efe3f0630"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2005-11-17T17:15:30+01:00",
"end": "2005-11-17T18:05:10+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
}
} ],
"period": {
"start": "2005-11-17T17:15:30+01:00",
"end": "2005-11-17T18:05:10+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:e9214315-227b-d244-b5c1-a2d8c29c565e",
"resource": {
"resourceType": "Condition",
"id": "e9214315-227b-d244-b5c1-a2d8c29c565e",
"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": "105531004",
"display": "Housing unsatisfactory (finding)"
} ],
"text": "Housing unsatisfactory (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:ecf5f7fe-6da5-135c-62f2-478efe3f0630"
},
"onsetDateTime": "2005-11-17T18:05:10+01:00",
"recordedDate": "2005-11-17T18:05:10+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:15f087e1-b14e-f080-9e6c-4ed645c9855e",
"resource": {
"resourceType": "Condition",
"id": "15f087e1-b14e-f080-9e6c-4ed645c9855e",
"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": "224299000",
"display": "Received higher education (finding)"
} ],
"text": "Received higher education (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:ecf5f7fe-6da5-135c-62f2-478efe3f0630"
},
"onsetDateTime": "2005-11-17T18:05:10+01:00",
"recordedDate": "2005-11-17T18:05:10+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:14e991b9-6414-08bf-7946-f1ba1771d06e",
"resource": {
"resourceType": "Condition",
"id": "14e991b9-6414-08bf-7946-f1ba1771d06e",
"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": "73595000",
"display": "Stress (finding)"
} ],
"text": "Stress (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:ecf5f7fe-6da5-135c-62f2-478efe3f0630"
},
"onsetDateTime": "2005-11-17T18:05:10+01:00",
"abatementDateTime": "2012-11-29T17:55:11+01:00",
"recordedDate": "2005-11-17T18:05:10+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:283d8230-d679-5da6-0078-f2814f1e0042",
"resource": {
"resourceType": "DiagnosticReport",
"id": "283d8230-d679-5da6-0078-f2814f1e0042",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:ecf5f7fe-6da5-135c-62f2-478efe3f0630"
},
"effectiveDateTime": "2005-11-17T17:15:30+01:00",
"issued": "2005-11-17T17:15:30.236+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:7a221c7c-7a79-7425-9f37-7b3e55fbf7ea",
"resource": {
"resourceType": "DocumentReference",
"id": "7a221c7c-7a79-7425-9f37-7b3e55fbf7ea",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:283d8230-d679-5da6-0078-f2814f1e0042"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2005-11-17T17:15:30.236+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "CjIwMDUtMTEtMTcKCiMgQ2hpZWYgQ29tcGxhaW50Ck5vIGNvbXBsYWludHMuCgojIEhpc3Rvcnkgb2YgUHJlc2VudCBJbGxuZXNzCk11cnJheTg1NgogaXMgYSAxOCB5ZWFyLW9sZCBub25oaXNwYW5pYyB3aGl0ZSBtYWxlLgoKIyBTb2NpYWwgSGlzdG9yeQogUGF0aWVudCBxdWl0IHNtb2tpbmcgYXQgYWdlIDE2LgogUGF0aWVudCBpZGVudGlmaWVzIGFzIGhldGVyb3NleHVhbC4KClBhdGllbnQgY29tZXMgZnJvbSBhIGhpZ2ggc29jaW9lY29ub21pYyBiYWNrZ3JvdW5kLgogUGF0aWVudCBpcyBhIGNvbGxlZ2UgZ3JhZHVhdGUuClBhdGllbnQgY3VycmVudGx5IGhhcyBOTyBJTlNVUkFOQ0UuCgojIEFsbGVyZ2llcwpObyBLbm93biBBbGxlcmdpZXMuCgojIE1lZGljYXRpb25zCk5vIEFjdGl2ZSBNZWRpY2F0aW9ucy4KCiMgQXNzZXNzbWVudCBhbmQgUGxhbgpQYXRpZW50IGlzIHByZXNlbnRpbmcgd2l0aCBob3VzaW5nIHVuc2F0aXNmYWN0b3J5IChmaW5kaW5nKSwgcmVjZWl2ZWQgaGlnaGVyIGVkdWNhdGlvbiAoZmluZGluZyksIHN0cmVzcyAoZmluZGluZykuIAoKIyMgUGxhbgoK"
},
"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:ecf5f7fe-6da5-135c-62f2-478efe3f0630"
} ],
"period": {
"start": "2005-11-17T17:15:30+01:00",
"end": "2005-11-17T18:05:10+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:5a5dc2fb-d7b1-bacc-95c1-bb8ec92bacbe",
"resource": {
"resourceType": "Claim",
"id": "5a5dc2fb-d7b1-bacc-95c1-bb8ec92bacbe",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2005-11-17T17:15:30+01:00",
"end": "2005-11-17T18:05:10+01:00"
},
"created": "2005-11-17T18:05:10+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:e9214315-227b-d244-b5c1-a2d8c29c565e"
}
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:15f087e1-b14e-f080-9e6c-4ed645c9855e"
}
}, {
"sequence": 3,
"diagnosisReference": {
"reference": "urn:uuid:14e991b9-6414-08bf-7946-f1ba1771d06e"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:ecf5f7fe-6da5-135c-62f2-478efe3f0630"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "105531004",
"display": "Housing unsatisfactory (finding)"
} ],
"text": "Housing unsatisfactory (finding)"
}
}, {
"sequence": 3,
"diagnosisSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "224299000",
"display": "Received higher education (finding)"
} ],
"text": "Received higher education (finding)"
}
}, {
"sequence": 4,
"diagnosisSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "73595000",
"display": "Stress (finding)"
} ],
"text": "Stress (finding)"
}
} ],
"total": {
"value": 1414.14,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:a9b2431e-7f68-5034-3e83-d79b3718c736",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "a9b2431e-7f68-5034-3e83-d79b3718c736",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "5a5dc2fb-d7b1-bacc-95c1-bb8ec92bacbe"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2005-11-17T18:05:10+01:00",
"end": "2006-11-17T18:05:10+01:00"
},
"created": "2005-11-17T18:05:10+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:5a5dc2fb-d7b1-bacc-95c1-bb8ec92bacbe"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:e9214315-227b-d244-b5c1-a2d8c29c565e"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:15f087e1-b14e-f080-9e6c-4ed645c9855e"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
}, {
"sequence": 3,
"diagnosisReference": {
"reference": "urn:uuid:14e991b9-6414-08bf-7946-f1ba1771d06e"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"servicedPeriod": {
"start": "2005-11-17T17:15:30+01:00",
"end": "2005-11-17T18:05:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:ecf5f7fe-6da5-135c-62f2-478efe3f0630"
} ]
}, {
"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": "105531004",
"display": "Housing unsatisfactory (finding)"
} ],
"text": "Housing unsatisfactory (finding)"
},
"servicedPeriod": {
"start": "2005-11-17T17:15:30+01:00",
"end": "2005-11-17T18:05:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"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": "224299000",
"display": "Received higher education (finding)"
} ],
"text": "Received higher education (finding)"
},
"servicedPeriod": {
"start": "2005-11-17T17:15:30+01:00",
"end": "2005-11-17T18:05:10+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 4,
"diagnosisSequence": [ 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": "73595000",
"display": "Stress (finding)"
} ],
"text": "Stress (finding)"
},
"servicedPeriod": {
"start": "2005-11-17T17:15:30+01:00",
"end": "2005-11-17T18:05:10+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": 1414.14,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:ec132001-972a-5eb1-3464-af51b100ed19",
"resource": {
"resourceType": "Encounter",
"id": "ec132001-972a-5eb1-3464-af51b100ed19",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "ec132001-972a-5eb1-3464-af51b100ed19"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2009-11-26T17:15:30+01:00",
"end": "2009-11-26T18:04:59+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
}
} ],
"period": {
"start": "2009-11-26T17:15:30+01:00",
"end": "2009-11-26T18:04:59+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:36d9b422-e4c3-f63e-09a5-105707781240",
"resource": {
"resourceType": "Condition",
"id": "36d9b422-e4c3-f63e-09a5-105707781240",
"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": "160903007",
"display": "Full-time employment (finding)"
} ],
"text": "Full-time employment (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:ec132001-972a-5eb1-3464-af51b100ed19"
},
"onsetDateTime": "2009-11-26T18:04:59+01:00",
"abatementDateTime": "2012-11-29T17:55:11+01:00",
"recordedDate": "2009-11-26T18:04:59+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:32cffbc5-fbe5-71ca-5cbe-b470cfe887d0",
"resource": {
"resourceType": "Condition",
"id": "32cffbc5-fbe5-71ca-5cbe-b470cfe887d0",
"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": "10939881000119105",
"display": "Unhealthy alcohol drinking behavior (finding)"
} ],
"text": "Unhealthy alcohol drinking behavior (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:ec132001-972a-5eb1-3464-af51b100ed19"
},
"onsetDateTime": "2009-11-26T20:15:39+01:00",
"abatementDateTime": "2017-03-02T19:36:06+01:00",
"recordedDate": "2009-11-26T20:15:39+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:10c79f7c-ebaa-22e6-0210-e4b49c210387",
"resource": {
"resourceType": "DiagnosticReport",
"id": "10c79f7c-ebaa-22e6-0210-e4b49c210387",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:ec132001-972a-5eb1-3464-af51b100ed19"
},
"effectiveDateTime": "2009-11-26T17:15:30+01:00",
"issued": "2009-11-26T17:15:30.236+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:18430b69-9b66-4c24-cf48-12f3e59009a7",
"resource": {
"resourceType": "DocumentReference",
"id": "18430b69-9b66-4c24-cf48-12f3e59009a7",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:10c79f7c-ebaa-22e6-0210-e4b49c210387"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2009-11-26T17:15:30.236+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE 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:ec132001-972a-5eb1-3464-af51b100ed19"
} ],
"period": {
"start": "2009-11-26T17:15:30+01:00",
"end": "2009-11-26T18:04:59+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:99c6d263-f40a-3404-6f7c-d9f329482f8e",
"resource": {
"resourceType": "Claim",
"id": "99c6d263-f40a-3404-6f7c-d9f329482f8e",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2009-11-26T17:15:30+01:00",
"end": "2009-11-26T18:04:59+01:00"
},
"created": "2009-11-26T18:04:59+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:36d9b422-e4c3-f63e-09a5-105707781240"
}
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:32cffbc5-fbe5-71ca-5cbe-b470cfe887d0"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:ec132001-972a-5eb1-3464-af51b100ed19"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "160903007",
"display": "Full-time employment (finding)"
} ],
"text": "Full-time employment (finding)"
}
}, {
"sequence": 3,
"diagnosisSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "10939881000119105",
"display": "Unhealthy alcohol drinking behavior (finding)"
} ],
"text": "Unhealthy alcohol drinking behavior (finding)"
}
} ],
"total": {
"value": 1573.84,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:d33a81e2-1f4d-8ce5-b67e-3179155c6d8e",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "d33a81e2-1f4d-8ce5-b67e-3179155c6d8e",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "99c6d263-f40a-3404-6f7c-d9f329482f8e"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2009-11-26T18:04:59+01:00",
"end": "2010-11-26T18:04:59+01:00"
},
"created": "2009-11-26T18:04:59+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:99c6d263-f40a-3404-6f7c-d9f329482f8e"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:36d9b422-e4c3-f63e-09a5-105707781240"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:32cffbc5-fbe5-71ca-5cbe-b470cfe887d0"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"servicedPeriod": {
"start": "2009-11-26T17:15:30+01:00",
"end": "2009-11-26T18:04:59+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:ec132001-972a-5eb1-3464-af51b100ed19"
} ]
}, {
"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": "160903007",
"display": "Full-time employment (finding)"
} ],
"text": "Full-time employment (finding)"
},
"servicedPeriod": {
"start": "2009-11-26T17:15:30+01:00",
"end": "2009-11-26T18:04:59+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"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": "10939881000119105",
"display": "Unhealthy alcohol drinking behavior (finding)"
} ],
"text": "Unhealthy alcohol drinking behavior (finding)"
},
"servicedPeriod": {
"start": "2009-11-26T17:15:30+01:00",
"end": "2009-11-26T18:04:59+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": 1573.84,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:69b0a09c-c3f1-573b-15a1-98cb9d58b1d0",
"resource": {
"resourceType": "Encounter",
"id": "69b0a09c-c3f1-573b-15a1-98cb9d58b1d0",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "69b0a09c-c3f1-573b-15a1-98cb9d58b1d0"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2012-11-29T17:15:30+01:00",
"end": "2012-11-29T17:55:11+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
}
} ],
"period": {
"start": "2012-11-29T17:15:30+01:00",
"end": "2012-11-29T17:55:11+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:35d057bd-1db3-2ea8-90be-13303678eb61",
"resource": {
"resourceType": "Condition",
"id": "35d057bd-1db3-2ea8-90be-13303678eb61",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:69b0a09c-c3f1-573b-15a1-98cb9d58b1d0"
},
"onsetDateTime": "2012-11-29T17:15:30+01:00",
"abatementDateTime": "2016-02-25T17:15:30+01:00",
"recordedDate": "2012-11-29T17:15:30+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:f8ca14b3-4fa7-810b-989c-5ece7a110a1b",
"resource": {
"resourceType": "Condition",
"id": "f8ca14b3-4fa7-810b-989c-5ece7a110a1b",
"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": "160904001",
"display": "Part-time employment (finding)"
} ],
"text": "Part-time employment (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:69b0a09c-c3f1-573b-15a1-98cb9d58b1d0"
},
"onsetDateTime": "2012-11-29T17:55:11+01:00",
"abatementDateTime": "2014-02-13T18:10:17+01:00",
"recordedDate": "2012-11-29T17:55:11+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:b6421bf5-1563-65fe-db57-7ab6f0e5e9c3",
"resource": {
"resourceType": "DiagnosticReport",
"id": "b6421bf5-1563-65fe-db57-7ab6f0e5e9c3",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:69b0a09c-c3f1-573b-15a1-98cb9d58b1d0"
},
"effectiveDateTime": "2012-11-29T17:15:30+01:00",
"issued": "2012-11-29T17:15:30.236+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:c29b832b-be6c-947d-d6b9-ac546562a359",
"resource": {
"resourceType": "DocumentReference",
"id": "c29b832b-be6c-947d-d6b9-ac546562a359",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:b6421bf5-1563-65fe-db57-7ab6f0e5e9c3"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2012-11-29T17:15:30.236+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "CjIwMTItMTEtMjkKCiMgQ2hpZWYgQ29tcGxhaW50Ck5vIGNvbXBsYWludHMuCgojIEhpc3Rvcnkgb2YgUHJlc2VudCBJbGxuZXNzCk11cnJheTg1NgogaXMgYSAyNSB5ZWFyLW9sZCBub25oaXNwYW5pYyB3aGl0ZSBtYWxlLiBQYXRpZW50IGhhcyBhIGhpc3Rvcnkgb2YgdW5oZWFsdGh5IGFsY29ob2wgZHJpbmtpbmcgYmVoYXZpb3IgKGZpbmRpbmcpLCBmdWxsLXRpbWUgZW1wbG95bWVudCAoZmluZGluZyksIHN0cmVzcyAoZmluZGluZykuCgojIFNvY2lhbCBIaXN0b3J5ClBhdGllbnQgaXMgbWFycmllZC4gUGF0aWVudCBxdWl0IHNtb2tpbmcgYXQgYWdlIDE2LgogUGF0aWVudCBpZGVudGlmaWVzIGFzIGhldGVyb3NleHVhbC4KClBhdGllbnQgY29tZXMgZnJvbSBhIGhpZ2ggc29jaW9lY29ub21pYyBiYWNrZ3JvdW5kLgogUGF0aWVudCBpcyBhIGNvbGxlZ2UgZ3JhZHVhdGUuClBhdGllbnQgY3VycmVudGx5IGhhcyBOTyBJTlNVUkFOQ0UuCgojIEFsbGVyZ2llcwpObyBLbm93biBBbGxlcmdpZXMuCgojIE1lZGljYXRpb25zCk5vIEFjdGl2ZSBNZWRpY2F0aW9ucy4KCiMgQXNzZXNzbWVudCBhbmQgUGxhbgpQYXRpZW50IGlzIHByZXNlbnRpbmcgd2l0aCBtZWRpY2F0aW9uIHJldmlldyBkdWUgKHNpdHVhdGlvbiksIHBhcnQtdGltZSBlbXBsb3ltZW50IChmaW5kaW5nKS4gCgojIyBQbGFuCgo="
},
"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:69b0a09c-c3f1-573b-15a1-98cb9d58b1d0"
} ],
"period": {
"start": "2012-11-29T17:15:30+01:00",
"end": "2012-11-29T17:55:11+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:bc5260c6-8e03-40ad-8647-188e736c1e98",
"resource": {
"resourceType": "Claim",
"id": "bc5260c6-8e03-40ad-8647-188e736c1e98",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2012-11-29T17:15:30+01:00",
"end": "2012-11-29T17:55:11+01:00"
},
"created": "2012-11-29T17:55:11+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:35d057bd-1db3-2ea8-90be-13303678eb61"
}
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:f8ca14b3-4fa7-810b-989c-5ece7a110a1b"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:69b0a09c-c3f1-573b-15a1-98cb9d58b1d0"
} ]
}, {
"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,
"diagnosisSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "160904001",
"display": "Part-time employment (finding)"
} ],
"text": "Part-time employment (finding)"
}
} ],
"total": {
"value": 704.20,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:5ce5ff1a-6d7d-86a1-64f0-8ed66a353718",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "5ce5ff1a-6d7d-86a1-64f0-8ed66a353718",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "bc5260c6-8e03-40ad-8647-188e736c1e98"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2012-11-29T17:55:11+01:00",
"end": "2013-11-29T17:55:11+01:00"
},
"created": "2012-11-29T17:55:11+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:bc5260c6-8e03-40ad-8647-188e736c1e98"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:35d057bd-1db3-2ea8-90be-13303678eb61"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:f8ca14b3-4fa7-810b-989c-5ece7a110a1b"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"servicedPeriod": {
"start": "2012-11-29T17:15:30+01:00",
"end": "2012-11-29T17:55:11+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:69b0a09c-c3f1-573b-15a1-98cb9d58b1d0"
} ]
}, {
"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": "2012-11-29T17:15:30+01:00",
"end": "2012-11-29T17:55:11+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"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": "160904001",
"display": "Part-time employment (finding)"
} ],
"text": "Part-time employment (finding)"
},
"servicedPeriod": {
"start": "2012-11-29T17:15:30+01:00",
"end": "2012-11-29T17:55:11+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": 704.20,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:42d57e75-711d-fdec-a646-d06d96205450",
"resource": {
"resourceType": "Encounter",
"id": "42d57e75-711d-fdec-a646-d06d96205450",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "42d57e75-711d-fdec-a646-d06d96205450"
} ],
"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 (procedure)"
} ],
"text": "Encounter for problem (procedure)"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2014-02-01T17:15:30+01:00",
"end": "2014-02-01T17:30:30+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798",
"display": "Dr. Marcus77 Schamberger479"
}
} ],
"period": {
"start": "2014-02-01T17:15:30+01:00",
"end": "2014-02-01T17:30:30+01:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "82423001",
"display": "Chronic pain (finding)"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2d8335a7-e37a-3004-9254-6f7de59ab66a",
"display": "THE LOWELL GENERAL HOSPITAL"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|5fcff9db-16e4-3e56-aa78-abbc16338097",
"display": "THE LOWELL GENERAL HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:09590c89-5201-9f82-00b6-b878a68c1bde",
"resource": {
"resourceType": "Condition",
"id": "09590c89-5201-9f82-00b6-b878a68c1bde",
"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": "82423001",
"display": "Chronic pain (finding)"
} ],
"text": "Chronic pain (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:42d57e75-711d-fdec-a646-d06d96205450"
},
"onsetDateTime": "2014-02-01T17:15:30+01:00",
"recordedDate": "2014-02-01T17:15:30+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:f88974d2-0636-c2b5-c8c1-f354856e08dd",
"resource": {
"resourceType": "Condition",
"id": "f88974d2-0636-c2b5-c8c1-f354856e08dd",
"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": "278860009",
"display": "Chronic low back pain (finding)"
} ],
"text": "Chronic low back pain (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:42d57e75-711d-fdec-a646-d06d96205450"
},
"onsetDateTime": "2014-02-01T17:15:30+01:00",
"recordedDate": "2014-02-01T17:15:30+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:d38ff67e-d693-ac03-2e0f-bc3ecdd63232",
"resource": {
"resourceType": "Observation",
"id": "d38ff67e-d693-ac03-2e0f-bc3ecdd63232",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "91148-7",
"display": "Pain intensity, Enjoyment of life, General activity (PEG) 3 item pain scale"
} ],
"text": "Pain intensity, Enjoyment of life, General activity (PEG) 3 item pain scale"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:42d57e75-711d-fdec-a646-d06d96205450"
},
"effectiveDateTime": "2014-02-01T17:15:30+01:00",
"issued": "2014-02-01T17:15:30.236+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "91146-1",
"display": "What number best describes how pain has interfered with your general activity during the past week"
} ],
"text": "What number best describes how pain has interfered with your general activity during the past week"
},
"valueQuantity": {
"value": 5.2043,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "91145-3",
"display": "What number best describes how pain has interfered with your enjoyment of life during the past week"
} ],
"text": "What number best describes how pain has interfered with your enjoyment of life during the past week"
},
"valueQuantity": {
"value": 5.7626,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "75893-8",
"display": "Pain severity in the past week - 0-10 numeric rating [Reported]"
} ],
"text": "Pain severity in the past week - 0-10 numeric rating [Reported]"
},
"valueQuantity": {
"value": 9.2441,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:74aee4ba-3f6a-f1ff-c0af-5e177f886eda",
"resource": {
"resourceType": "Observation",
"id": "74aee4ba-3f6a-f1ff-c0af-5e177f886eda",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "65750-2",
"display": "Drugs of abuse 5 panel - Urine by Screen method"
} ],
"text": "Drugs of abuse 5 panel - Urine by Screen method"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:42d57e75-711d-fdec-a646-d06d96205450"
},
"effectiveDateTime": "2014-02-01T17:15:30+01:00",
"issued": "2014-02-01T17:15:30.236+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "260385009",
"display": "Negative (qualifier value)"
} ],
"text": "Negative (qualifier value)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d5aeb0e3-65fc-2ed2-202a-34613fa8b15c",
"resource": {
"resourceType": "MedicationRequest",
"id": "d5aeb0e3-65fc-2ed2-202a-34613fa8b15c",
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:42d57e75-711d-fdec-a646-d06d96205450"
},
"authoredOn": "2014-02-01T17:15:30+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798",
"display": "Dr. Marcus77 Schamberger479"
},
"dosageInstruction": [ {
"sequence": 1,
"text": "Every six hours (qualifier value)",
"additionalInstruction": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "307468000",
"display": "Every six hours (qualifier value)"
} ],
"text": "Every six hours (qualifier value)"
} ],
"timing": {
"repeat": {
"frequency": 4,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:0355d21c-df0e-a24c-8bf1-f1e77471e54a",
"resource": {
"resourceType": "Claim",
"id": "0355d21c-df0e-a24c-8bf1-f1e77471e54a",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2014-02-01T17:15:30+01:00",
"end": "2014-02-01T17:30:30+01:00"
},
"created": "2014-02-01T17:30:30+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|5fcff9db-16e4-3e56-aa78-abbc16338097",
"display": "THE LOWELL GENERAL HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:d5aeb0e3-65fc-2ed2-202a-34613fa8b15c"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"encounter": [ {
"reference": "urn:uuid:42d57e75-711d-fdec-a646-d06d96205450"
} ]
} ],
"total": {
"value": 129.94,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:38970323-346c-acd6-f6f2-db5eb8fc0936",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "38970323-346c-acd6-f6f2-db5eb8fc0936",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "0355d21c-df0e-a24c-8bf1-f1e77471e54a"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2014-02-01T17:30:30+01:00",
"end": "2015-02-01T17:30:30+01:00"
},
"created": "2014-02-01T17:30:30+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2d8335a7-e37a-3004-9254-6f7de59ab66a",
"display": "THE LOWELL GENERAL HOSPITAL"
},
"claim": {
"reference": "urn:uuid:0355d21c-df0e-a24c-8bf1-f1e77471e54a"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"servicedPeriod": {
"start": "2014-02-01T17:15:30+01:00",
"end": "2014-02-01T17:30:30+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:42d57e75-711d-fdec-a646-d06d96205450"
} ]
} ],
"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:1fe20dbc-eebf-6477-61c4-a0475e205238",
"resource": {
"resourceType": "DiagnosticReport",
"id": "1fe20dbc-eebf-6477-61c4-a0475e205238",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:42d57e75-711d-fdec-a646-d06d96205450"
},
"effectiveDateTime": "2014-02-01T17:15:30+01:00",
"issued": "2014-02-01T17:15:30.236+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798",
"display": "Dr. Marcus77 Schamberger479"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:eff102b4-d72a-bfa8-f75f-0cc3ebbf1323",
"resource": {
"resourceType": "DocumentReference",
"id": "eff102b4-d72a-bfa8-f75f-0cc3ebbf1323",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:1fe20dbc-eebf-6477-61c4-a0475e205238"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2014-02-01T17:15:30.236+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798",
"display": "Dr. Marcus77 Schamberger479"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|5fcff9db-16e4-3e56-aa78-abbc16338097",
"display": "THE LOWELL GENERAL HOSPITAL"
},
"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:42d57e75-711d-fdec-a646-d06d96205450"
} ],
"period": {
"start": "2014-02-01T17:15:30+01:00",
"end": "2014-02-01T17:30:30+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:af7f23f5-59ca-ad14-5120-cde92cdbe032",
"resource": {
"resourceType": "Claim",
"id": "af7f23f5-59ca-ad14-5120-cde92cdbe032",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2014-02-01T17:15:30+01:00",
"end": "2014-02-01T17:30:30+01:00"
},
"created": "2014-02-01T17:30:30+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|5fcff9db-16e4-3e56-aa78-abbc16338097",
"display": "THE LOWELL GENERAL HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2d8335a7-e37a-3004-9254-6f7de59ab66a",
"display": "THE LOWELL GENERAL HOSPITAL"
},
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:09590c89-5201-9f82-00b6-b878a68c1bde"
}
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:f88974d2-0636-c2b5-c8c1-f354856e08dd"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185347001",
"display": "Encounter for problem (procedure)"
} ],
"text": "Encounter for problem (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:42d57e75-711d-fdec-a646-d06d96205450"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "82423001",
"display": "Chronic pain (finding)"
} ],
"text": "Chronic pain (finding)"
}
}, {
"sequence": 3,
"diagnosisSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "278860009",
"display": "Chronic low back pain (finding)"
} ],
"text": "Chronic low back pain (finding)"
}
} ],
"total": {
"value": 85.55,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:bd317e58-5b2b-254c-833d-6415dee36e42",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "bd317e58-5b2b-254c-833d-6415dee36e42",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "af7f23f5-59ca-ad14-5120-cde92cdbe032"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2014-02-01T17:30:30+01:00",
"end": "2015-02-01T17:30:30+01:00"
},
"created": "2014-02-01T17:30:30+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2d8335a7-e37a-3004-9254-6f7de59ab66a",
"display": "THE LOWELL GENERAL HOSPITAL"
},
"claim": {
"reference": "urn:uuid:af7f23f5-59ca-ad14-5120-cde92cdbe032"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:09590c89-5201-9f82-00b6-b878a68c1bde"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:f88974d2-0636-c2b5-c8c1-f354856e08dd"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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 (procedure)"
} ],
"text": "Encounter for problem (procedure)"
},
"servicedPeriod": {
"start": "2014-02-01T17:15:30+01:00",
"end": "2014-02-01T17:30:30+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:42d57e75-711d-fdec-a646-d06d96205450"
} ]
}, {
"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": "82423001",
"display": "Chronic pain (finding)"
} ],
"text": "Chronic pain (finding)"
},
"servicedPeriod": {
"start": "2014-02-01T17:15:30+01:00",
"end": "2014-02-01T17:30:30+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
}
}, {
"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": "278860009",
"display": "Chronic low back pain (finding)"
} ],
"text": "Chronic low back pain (finding)"
},
"servicedPeriod": {
"start": "2014-02-01T17:15:30+01:00",
"end": "2014-02-01T17:30:30+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:35039fc8-332d-9815-3b94-aec207f33b47",
"resource": {
"resourceType": "Encounter",
"id": "35039fc8-332d-9815-3b94-aec207f33b47",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "35039fc8-332d-9815-3b94-aec207f33b47"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2014-02-13T17:15:30+01:00",
"end": "2014-02-13T18:10:17+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
}
} ],
"period": {
"start": "2014-02-13T17:15:30+01:00",
"end": "2014-02-13T18:10:17+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:5ee3e334-4ddc-cb64-119c-10e29ed254be",
"resource": {
"resourceType": "Condition",
"id": "5ee3e334-4ddc-cb64-119c-10e29ed254be",
"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": "160903007",
"display": "Full-time employment (finding)"
} ],
"text": "Full-time employment (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"onsetDateTime": "2014-02-13T18:10:17+01:00",
"abatementDateTime": "2016-02-25T17:55:07+01:00",
"recordedDate": "2014-02-13T18:10:17+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:c0c590ed-0d31-3da5-8260-750a8f73c11b",
"resource": {
"resourceType": "Condition",
"id": "c0c590ed-0d31-3da5-8260-750a8f73c11b",
"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": "73595000",
"display": "Stress (finding)"
} ],
"text": "Stress (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"onsetDateTime": "2014-02-13T18:10:17+01:00",
"abatementDateTime": "2016-02-25T17:55:07+01:00",
"recordedDate": "2014-02-13T18:10:17+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:f3591df5-a52e-b93f-d0b7-ac274bcf9aaf",
"resource": {
"resourceType": "Observation",
"id": "f3591df5-a52e-b93f-d0b7-ac274bcf9aaf",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"effectiveDateTime": "2014-02-13T17:15:30+01:00",
"issued": "2014-02-13T17:15:30.236+01:00",
"valueQuantity": {
"value": 174.1,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:34658444-f6b8-6261-74f3-5d6c8999fc81",
"resource": {
"resourceType": "Observation",
"id": "34658444-f6b8-6261-74f3-5d6c8999fc81",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"effectiveDateTime": "2014-02-13T17:15:30+01:00",
"issued": "2014-02-13T17:15:30.236+01:00",
"valueQuantity": {
"value": 0,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:139ea944-18f8-b0ea-7be8-cca5e3e48ecb",
"resource": {
"resourceType": "Observation",
"id": "139ea944-18f8-b0ea-7be8-cca5e3e48ecb",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"effectiveDateTime": "2014-02-13T17:15:30+01:00",
"issued": "2014-02-13T17:15:30.236+01:00",
"valueQuantity": {
"value": 84.9,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:62934773-8841-5b27-7676-386cc8923a61",
"resource": {
"resourceType": "Observation",
"id": "62934773-8841-5b27-7676-386cc8923a61",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"effectiveDateTime": "2014-02-13T17:15:30+01:00",
"issued": "2014-02-13T17:15:30.236+01:00",
"valueQuantity": {
"value": 28.01,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:6839c1ee-d271-f10b-f2d2-44af76bcd5c8",
"resource": {
"resourceType": "Observation",
"id": "6839c1ee-d271-f10b-f2d2-44af76bcd5c8",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"effectiveDateTime": "2014-02-13T17:15:30+01:00",
"issued": "2014-02-13T17:15:30.236+01:00",
"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": 110,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:6163e744-5cde-0a93-6f53-fe177b270cfb",
"resource": {
"resourceType": "Observation",
"id": "6163e744-5cde-0a93-6f53-fe177b270cfb",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"effectiveDateTime": "2014-02-13T17:15:30+01:00",
"issued": "2014-02-13T17:15:30.236+01:00",
"valueQuantity": {
"value": 66,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:5c1017e1-0ccd-b5fd-0222-1e7eb5f53c1b",
"resource": {
"resourceType": "Observation",
"id": "5c1017e1-0ccd-b5fd-0222-1e7eb5f53c1b",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"effectiveDateTime": "2014-02-13T17:15:30+01:00",
"issued": "2014-02-13T17:15:30.236+01:00",
"valueQuantity": {
"value": 14,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e5f40230-457d-d068-938f-b142fc03779e",
"resource": {
"resourceType": "Observation",
"id": "e5f40230-457d-d068-938f-b142fc03779e",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"effectiveDateTime": "2014-02-13T17:15:30+01:00",
"issued": "2014-02-13T17:15:30.236+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "8517006",
"display": "Ex-smoker (finding)"
} ],
"text": "Ex-smoker (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:96b63773-69bf-4b6f-caaa-c0d6ed30c19a",
"resource": {
"resourceType": "Observation",
"id": "96b63773-69bf-4b6f-caaa-c0d6ed30c19a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93025-5",
"display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
} ],
"text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"effectiveDateTime": "2014-02-13T18:10:17+01:00",
"issued": "2014-02-13T18:10:17.236+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76501-6",
"display": "Within the last year, have you been afraid of your partner or ex-partner?"
} ],
"text": "Within the last year, have you been afraid of your partner or ex-partner?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93026-3",
"display": "Do you feel physically and emotionally safe where you currently live?"
} ],
"text": "Do you feel physically and emotionally safe where you currently live?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93027-1",
"display": "Are you a refugee?"
} ],
"text": "Are you a refugee?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93028-9",
"display": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
} ],
"text": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93038-8",
"display": "Stress level"
} ],
"text": "Stress level"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA13863-8",
"display": "A little bit"
} ],
"text": "A little bit"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93029-7",
"display": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
} ],
"text": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30131-9",
"display": "3 to 5 times a week"
} ],
"text": "3 to 5 times a week"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93030-5",
"display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
} ],
"text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93031-3",
"display": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
} ],
"text": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30122-8",
"display": "I choose not to answer this question"
} ],
"text": "I choose not to answer this question"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63586-2",
"display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
} ],
"text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
},
"valueQuantity": {
"value": 55950,
"unit": "/a",
"system": "http://unitsofmeasure.org",
"code": "/a"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76437-3",
"display": "Primary insurance"
} ],
"text": "Primary insurance"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30194-7",
"display": "None/uninsured"
} ],
"text": "None/uninsured"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "67875-5",
"display": "Employment status - current"
} ],
"text": "Employment status - current"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30136-8",
"display": "Full-time work"
} ],
"text": "Full-time work"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82589-3",
"display": "Highest level of education"
} ],
"text": "Highest level of education"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30193-9",
"display": "More than high school"
} ],
"text": "More than high school"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56799-0",
"display": "Address"
} ],
"text": "Address"
},
"valueString": "287 Treutel Neck"
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93033-9",
"display": "Are you worried about losing your housing?"
} ],
"text": "Are you worried about losing your housing?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "71802-3",
"display": "Housing status"
} ],
"text": "Housing status"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30189-7",
"display": "I have housing"
} ],
"text": "I have housing"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63512-8",
"display": "How many people are living or staying at this address?"
} ],
"text": "How many people are living or staying at this address?"
},
"valueQuantity": {
"value": 7,
"unit": "{#}",
"system": "http://unitsofmeasure.org",
"code": "{#}"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "54899-0",
"display": "Preferred language"
} ],
"text": "Preferred language"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA43-5",
"display": "English"
} ],
"text": "English"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93034-7",
"display": "Have you been discharged from the armed forces of the United States?"
} ],
"text": "Have you been discharged from the armed forces of the United States?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93035-4",
"display": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
} ],
"text": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "32624-9",
"display": "Race"
} ],
"text": "Race"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA4457-3",
"display": "White"
} ],
"text": "White"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56051-6",
"display": "Do you consider yourself Hispanic/Latino?"
} ],
"text": "Do you consider yourself Hispanic/Latino?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:012e5304-4c54-58e6-540e-79ff3ad45518",
"resource": {
"resourceType": "Observation",
"id": "012e5304-4c54-58e6-540e-79ff3ad45518",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "55758-7",
"display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"effectiveDateTime": "2014-02-13T18:49:08+01:00",
"issued": "2014-02-13T18:49:08.236+01:00",
"valueQuantity": {
"value": 2,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:339f683b-2cef-6673-c18d-a542604b897c",
"resource": {
"resourceType": "Observation",
"id": "339f683b-2cef-6673-c18d-a542604b897c",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82667-7",
"display": "Total score [DAST-10]"
} ],
"text": "Total score [DAST-10]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"effectiveDateTime": "2014-02-13T19:29:32+01:00",
"issued": "2014-02-13T19:29:32.236+01:00",
"valueQuantity": {
"value": 1,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:3c0480fc-672c-1b17-ca73-ed858082256a",
"resource": {
"resourceType": "Procedure",
"id": "3c0480fc-672c-1b17-ca73-ed858082256a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"performedPeriod": {
"start": "2014-02-13T17:15:30+01:00",
"end": "2014-02-13T18:10:17+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:f801cea9-362b-a461-50c1-c52157eff68c",
"resource": {
"resourceType": "Procedure",
"id": "f801cea9-362b-a461-50c1-c52157eff68c",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"performedPeriod": {
"start": "2014-02-13T18:10:17+01:00",
"end": "2014-02-13T18:23:57+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:752292d6-f615-6e83-c039-974df3a8fc7b",
"resource": {
"resourceType": "Procedure",
"id": "752292d6-f615-6e83-c039-974df3a8fc7b",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"performedPeriod": {
"start": "2014-02-13T18:23:57+01:00",
"end": "2014-02-13T18:49:08+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:45bb8b49-907f-6e2b-3d94-c73e75131374",
"resource": {
"resourceType": "Procedure",
"id": "45bb8b49-907f-6e2b-3d94-c73e75131374",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"performedPeriod": {
"start": "2014-02-13T18:49:08+01:00",
"end": "2014-02-13T19:00:54+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:93855b44-b3df-75e7-b170-3a4701c9ee7a",
"resource": {
"resourceType": "Procedure",
"id": "93855b44-b3df-75e7-b170-3a4701c9ee7a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "713106006",
"display": "Screening for drug abuse (procedure)"
} ],
"text": "Screening for drug abuse (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"performedPeriod": {
"start": "2014-02-13T19:00:54+01:00",
"end": "2014-02-13T19:29:32+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:46e99e40-79e2-6f80-9d59-b87b122ca0f2",
"resource": {
"resourceType": "MedicationRequest",
"id": "46e99e40-79e2-6f80-9d59-b87b122ca0f2",
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"authoredOn": "2014-02-13T17:15:30+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"dosageInstruction": [ {
"sequence": 1,
"text": "Every six hours (qualifier value)",
"additionalInstruction": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "307468000",
"display": "Every six hours (qualifier value)"
} ],
"text": "Every six hours (qualifier value)"
} ],
"timing": {
"repeat": {
"frequency": 4,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:084c110b-2454-e19e-f1ad-78d034c89b91",
"resource": {
"resourceType": "Claim",
"id": "084c110b-2454-e19e-f1ad-78d034c89b91",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2014-02-13T17:15:30+01:00",
"end": "2014-02-13T18:10:17+01:00"
},
"created": "2014-02-13T18:10:17+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:46e99e40-79e2-6f80-9d59-b87b122ca0f2"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"encounter": [ {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
} ]
} ],
"total": {
"value": 129.94,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:9d8025de-211a-81c2-6bc9-9575172962e7",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "9d8025de-211a-81c2-6bc9-9575172962e7",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "084c110b-2454-e19e-f1ad-78d034c89b91"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2014-02-13T18:10:17+01:00",
"end": "2015-02-13T18:10:17+01:00"
},
"created": "2014-02-13T18:10:17+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:084c110b-2454-e19e-f1ad-78d034c89b91"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"servicedPeriod": {
"start": "2014-02-13T17:15:30+01:00",
"end": "2014-02-13T18:10:17+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
} ]
} ],
"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:9f14eeeb-08e5-e35b-984d-20bae6bcf879",
"resource": {
"resourceType": "Immunization",
"id": "9f14eeeb-08e5-e35b-984d-20bae6bcf879",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"occurrenceDateTime": "2014-02-13T17:15:30+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:b721d3de-719c-97e6-86bd-002b54c84032",
"resource": {
"resourceType": "DiagnosticReport",
"id": "b721d3de-719c-97e6-86bd-002b54c84032",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"effectiveDateTime": "2014-02-13T18:49:08+01:00",
"issued": "2014-02-13T18:49:08.236+01:00",
"result": [ {
"reference": "urn:uuid:012e5304-4c54-58e6-540e-79ff3ad45518",
"display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:25470208-818e-4cbd-8246-a10327d47e35",
"resource": {
"resourceType": "DiagnosticReport",
"id": "25470208-818e-4cbd-8246-a10327d47e35",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82666-9",
"display": "Drug Abuse Screening Test-10 [DAST-10]"
} ],
"text": "Drug Abuse Screening Test-10 [DAST-10]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"effectiveDateTime": "2014-02-13T19:29:32+01:00",
"issued": "2014-02-13T19:29:32.236+01:00",
"result": [ {
"reference": "urn:uuid:339f683b-2cef-6673-c18d-a542604b897c",
"display": "Total score [DAST-10]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:18da592a-65b5-76c8-04f8-1152a207c81e",
"resource": {
"resourceType": "DiagnosticReport",
"id": "18da592a-65b5-76c8-04f8-1152a207c81e",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
},
"effectiveDateTime": "2014-02-13T17:15:30+01:00",
"issued": "2014-02-13T17:15:30.236+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:83512e59-9b7b-c9e6-15db-9dba893d0bc9",
"resource": {
"resourceType": "DocumentReference",
"id": "83512e59-9b7b-c9e6-15db-9dba893d0bc9",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:18da592a-65b5-76c8-04f8-1152a207c81e"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2014-02-13T17:15:30.236+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE 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:35039fc8-332d-9815-3b94-aec207f33b47"
} ],
"period": {
"start": "2014-02-13T17:15:30+01:00",
"end": "2014-02-13T18:10:17+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:78305e76-4823-1027-0c08-4eed02910f63",
"resource": {
"resourceType": "Claim",
"id": "78305e76-4823-1027-0c08-4eed02910f63",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2014-02-13T17:15:30+01:00",
"end": "2014-02-13T18:10:17+01:00"
},
"created": "2014-02-13T18:10:17+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:9f14eeeb-08e5-e35b-984d-20bae6bcf879"
}
}, {
"sequence": 2,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:5ee3e334-4ddc-cb64-119c-10e29ed254be"
}
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:c0c590ed-0d31-3da5-8260-750a8f73c11b"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:3c0480fc-672c-1b17-ca73-ed858082256a"
}
}, {
"sequence": 2,
"procedureReference": {
"reference": "urn:uuid:f801cea9-362b-a461-50c1-c52157eff68c"
}
}, {
"sequence": 3,
"procedureReference": {
"reference": "urn:uuid:752292d6-f615-6e83-c039-974df3a8fc7b"
}
}, {
"sequence": 4,
"procedureReference": {
"reference": "urn:uuid:45bb8b49-907f-6e2b-3d94-c73e75131374"
}
}, {
"sequence": 5,
"procedureReference": {
"reference": "urn:uuid:93855b44-b3df-75e7-b170-3a4701c9ee7a"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
} ]
}, {
"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": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 4,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "160903007",
"display": "Full-time employment (finding)"
} ],
"text": "Full-time employment (finding)"
}
}, {
"sequence": 5,
"diagnosisSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "73595000",
"display": "Stress (finding)"
} ],
"text": "Stress (finding)"
}
}, {
"sequence": 6,
"procedureSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 7,
"procedureSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 8,
"informationSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 9,
"procedureSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 10,
"procedureSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "713106006",
"display": "Screening for drug abuse (procedure)"
} ],
"text": "Screening for drug abuse (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 11,
"informationSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "82666-9",
"display": "Drug Abuse Screening Test-10 [DAST-10]"
} ],
"text": "Drug Abuse Screening Test-10 [DAST-10]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
} ],
"total": {
"value": 704.20,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:057017a3-c26d-214b-2a3e-61135963302c",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "057017a3-c26d-214b-2a3e-61135963302c",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "78305e76-4823-1027-0c08-4eed02910f63"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2014-02-13T18:10:17+01:00",
"end": "2015-02-13T18:10:17+01:00"
},
"created": "2014-02-13T18:10:17+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:78305e76-4823-1027-0c08-4eed02910f63"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:5ee3e334-4ddc-cb64-119c-10e29ed254be"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:c0c590ed-0d31-3da5-8260-750a8f73c11b"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"servicedPeriod": {
"start": "2014-02-13T17:15:30+01:00",
"end": "2014-02-13T18:10:17+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
} ]
}, {
"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": "2014-02-13T17:15:30+01:00",
"end": "2014-02-13T18:10:17+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": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"servicedPeriod": {
"start": "2014-02-13T17:15:30+01:00",
"end": "2014-02-13T18:10:17+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 4,
"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": "160903007",
"display": "Full-time employment (finding)"
} ],
"text": "Full-time employment (finding)"
},
"servicedPeriod": {
"start": "2014-02-13T17:15:30+01:00",
"end": "2014-02-13T18:10:17+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 5,
"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": "73595000",
"display": "Stress (finding)"
} ],
"text": "Stress (finding)"
},
"servicedPeriod": {
"start": "2014-02-13T17:15:30+01:00",
"end": "2014-02-13T18:10:17+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 6,
"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": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"servicedPeriod": {
"start": "2014-02-13T17:15:30+01:00",
"end": "2014-02-13T18:10:17+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"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": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"servicedPeriod": {
"start": "2014-02-13T17:15:30+01:00",
"end": "2014-02-13T18:10:17+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 8,
"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": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"servicedPeriod": {
"start": "2014-02-13T17:15:30+01:00",
"end": "2014-02-13T18:10:17+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"
} ]
}
} ]
}, {
"sequence": 9,
"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": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"servicedPeriod": {
"start": "2014-02-13T17:15:30+01:00",
"end": "2014-02-13T18:10:17+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 10,
"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": "713106006",
"display": "Screening for drug abuse (procedure)"
} ],
"text": "Screening for drug abuse (procedure)"
},
"servicedPeriod": {
"start": "2014-02-13T17:15:30+01:00",
"end": "2014-02-13T18:10:17+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 11,
"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://loinc.org",
"code": "82666-9",
"display": "Drug Abuse Screening Test-10 [DAST-10]"
} ],
"text": "Drug Abuse Screening Test-10 [DAST-10]"
},
"servicedPeriod": {
"start": "2014-02-13T17:15:30+01:00",
"end": "2014-02-13T18:10:17+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": 704.20,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 1953.7279999999998,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:486cf3e7-7159-7e2c-f9f9-486b99cf2c97",
"resource": {
"resourceType": "Encounter",
"id": "486cf3e7-7159-7e2c-f9f9-486b99cf2c97",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "486cf3e7-7159-7e2c-f9f9-486b99cf2c97"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "390906007",
"display": "Follow-up encounter (procedure)"
} ],
"text": "Follow-up encounter (procedure)"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2014-03-24T23:15:30+01:00",
"end": "2014-03-24T23:30:30+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
}
} ],
"period": {
"start": "2014-03-24T23:15:30+01:00",
"end": "2014-03-24T23:30:30+01:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "82423001",
"display": "Chronic pain (finding)"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:23cae86c-9324-9e87-6b7f-743d556d7008",
"resource": {
"resourceType": "Observation",
"id": "23cae86c-9324-9e87-6b7f-743d556d7008",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "65750-2",
"display": "Drugs of abuse 5 panel - Urine by Screen method"
} ],
"text": "Drugs of abuse 5 panel - Urine by Screen method"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:486cf3e7-7159-7e2c-f9f9-486b99cf2c97"
},
"effectiveDateTime": "2014-03-24T23:15:30+01:00",
"issued": "2014-03-24T23:15:30.236+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "260385009",
"display": "Negative (qualifier value)"
} ],
"text": "Negative (qualifier value)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:b3592d07-d824-c642-2777-91b2ac40f9f6",
"resource": {
"resourceType": "Observation",
"id": "b3592d07-d824-c642-2777-91b2ac40f9f6",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "91148-7",
"display": "Pain intensity, Enjoyment of life, General activity (PEG) 3 item pain scale"
} ],
"text": "Pain intensity, Enjoyment of life, General activity (PEG) 3 item pain scale"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:486cf3e7-7159-7e2c-f9f9-486b99cf2c97"
},
"effectiveDateTime": "2014-03-24T23:15:30+01:00",
"issued": "2014-03-24T23:15:30.236+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "91146-1",
"display": "What number best describes how pain has interfered with your general activity during the past week"
} ],
"text": "What number best describes how pain has interfered with your general activity during the past week"
},
"valueQuantity": {
"value": 6.451,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "91145-3",
"display": "What number best describes how pain has interfered with your enjoyment of life during the past week"
} ],
"text": "What number best describes how pain has interfered with your enjoyment of life during the past week"
},
"valueQuantity": {
"value": 7.6809,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "75893-8",
"display": "Pain severity in the past week - 0-10 numeric rating [Reported]"
} ],
"text": "Pain severity in the past week - 0-10 numeric rating [Reported]"
},
"valueQuantity": {
"value": 8.644,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d30da092-0f4d-9be5-c0d9-1b997fe1974d",
"resource": {
"resourceType": "CareTeam",
"id": "d30da092-0f4d-9be5-c0d9-1b997fe1974d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam" ]
},
"status": "active",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:486cf3e7-7159-7e2c-f9f9-486b99cf2c97"
},
"period": {
"start": "2014-03-24T23:15:30+01:00"
},
"participant": [ {
"role": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "116154003",
"display": "Patient"
} ],
"text": "Patient"
} ],
"member": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
}
}, {
"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|9999990598",
"display": "Dr. Kai187 Mann644"
}
}, {
"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|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
}
} ],
"managingOrganization": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
} ]
},
"request": {
"method": "POST",
"url": "CareTeam"
}
}, {
"fullUrl": "urn:uuid:801015e2-e16b-1834-29c4-eebb53443092",
"resource": {
"resourceType": "CarePlan",
"id": "801015e2-e16b-1834-29c4-eebb53443092",
"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 Therapy (regime/therapy).<br/>Activities: <ul><li>Therapy (regime/therapy)</li><li>Therapy (regime/therapy)</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": "276239002",
"display": "Therapy (regime/therapy)"
} ],
"text": "Therapy (regime/therapy)"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:486cf3e7-7159-7e2c-f9f9-486b99cf2c97"
},
"period": {
"start": "2014-03-24T23:15:30+01:00"
},
"careTeam": [ {
"reference": "urn:uuid:d30da092-0f4d-9be5-c0d9-1b997fe1974d"
} ],
"activity": [ {
"detail": {
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "91251008",
"display": "Physical therapy procedure (regime/therapy)"
} ],
"text": "Physical therapy procedure (regime/therapy)"
},
"status": "in-progress",
"location": {
"display": "EMERSON HOSPITAL"
}
}
}, {
"detail": {
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "228557008",
"display": "Cognitive and behavioral therapy (regime/therapy)"
} ],
"text": "Cognitive and behavioral therapy (regime/therapy)"
},
"status": "in-progress",
"location": {
"display": "EMERSON HOSPITAL"
}
}
} ]
},
"request": {
"method": "POST",
"url": "CarePlan"
}
}, {
"fullUrl": "urn:uuid:27c6ffb0-6184-5a8a-3c5b-532b68f26499",
"resource": {
"resourceType": "DiagnosticReport",
"id": "27c6ffb0-6184-5a8a-3c5b-532b68f26499",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:486cf3e7-7159-7e2c-f9f9-486b99cf2c97"
},
"effectiveDateTime": "2014-03-24T23:15:30+01:00",
"issued": "2014-03-24T23:15:30.236+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:adf1ff74-1ea6-aadc-1e42-7818c1428318",
"resource": {
"resourceType": "DocumentReference",
"id": "adf1ff74-1ea6-aadc-1e42-7818c1428318",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:27c6ffb0-6184-5a8a-3c5b-532b68f26499"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2014-03-24T23:15:30.236+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"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:486cf3e7-7159-7e2c-f9f9-486b99cf2c97"
} ],
"period": {
"start": "2014-03-24T23:15:30+01:00",
"end": "2014-03-24T23:30:30+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:f981acae-64b6-7c45-2144-e75c400b21ff",
"resource": {
"resourceType": "Claim",
"id": "f981acae-64b6-7c45-2144-e75c400b21ff",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2014-03-24T23:15:30+01:00",
"end": "2014-03-24T23:30:30+01:00"
},
"created": "2014-03-24T23:30:30+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "390906007",
"display": "Follow-up encounter (procedure)"
} ],
"text": "Follow-up encounter (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:486cf3e7-7159-7e2c-f9f9-486b99cf2c97"
} ]
} ],
"total": {
"value": 85.55,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:0aad4c58-ff27-ae12-cc89-7157d9232170",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "0aad4c58-ff27-ae12-cc89-7157d9232170",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "f981acae-64b6-7c45-2144-e75c400b21ff"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2014-03-24T23:30:30+01:00",
"end": "2015-03-24T23:30:30+01:00"
},
"created": "2014-03-24T23:30:30+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"claim": {
"reference": "urn:uuid:f981acae-64b6-7c45-2144-e75c400b21ff"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "390906007",
"display": "Follow-up encounter (procedure)"
} ],
"text": "Follow-up encounter (procedure)"
},
"servicedPeriod": {
"start": "2014-03-24T23:15:30+01:00",
"end": "2014-03-24T23:30:30+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:486cf3e7-7159-7e2c-f9f9-486b99cf2c97"
} ]
} ],
"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:b877e42a-204c-3f8e-eab7-b3c44ec636a4",
"resource": {
"resourceType": "Encounter",
"id": "b877e42a-204c-3f8e-eab7-b3c44ec636a4",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "b877e42a-204c-3f8e-eab7-b3c44ec636a4"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2014-04-19T14:15:30+02:00",
"end": "2014-04-19T14:30:30+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
}
} ],
"period": {
"start": "2014-04-19T14:15:30+02:00",
"end": "2014-04-19T14:30:30+02:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "195662009",
"display": "Acute viral pharyngitis (disorder)"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:a0cb3230-cfef-9ddd-cffc-991f4a474332",
"resource": {
"resourceType": "Condition",
"id": "a0cb3230-cfef-9ddd-cffc-991f4a474332",
"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": "195662009",
"display": "Acute viral pharyngitis (disorder)"
} ],
"text": "Acute viral pharyngitis (disorder)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b877e42a-204c-3f8e-eab7-b3c44ec636a4"
},
"onsetDateTime": "2014-04-19T14:15:30+02:00",
"abatementDateTime": "2014-04-27T08:15:30+02:00",
"recordedDate": "2014-04-19T14:15:30+02:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:df374d74-18f2-da26-7716-7cc8e246aefe",
"resource": {
"resourceType": "Observation",
"id": "df374d74-18f2-da26-7716-7cc8e246aefe",
"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": "8310-5",
"display": "Body temperature"
}, {
"system": "http://loinc.org",
"code": "8331-1",
"display": "Oral temperature"
} ],
"text": "Body temperature"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b877e42a-204c-3f8e-eab7-b3c44ec636a4"
},
"effectiveDateTime": "2014-04-19T14:15:30+02:00",
"issued": "2014-04-19T14:15:30.236+02:00",
"valueQuantity": {
"value": 37.484,
"unit": "Cel",
"system": "http://unitsofmeasure.org",
"code": "Cel"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:96ef4eef-83f9-2cb5-84b0-90d216839c16",
"resource": {
"resourceType": "DiagnosticReport",
"id": "96ef4eef-83f9-2cb5-84b0-90d216839c16",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b877e42a-204c-3f8e-eab7-b3c44ec636a4"
},
"effectiveDateTime": "2014-04-19T14:15:30+02:00",
"issued": "2014-04-19T14:15:30.236+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:9fc1343a-e62d-42dc-f33c-3ba8f03c5770",
"resource": {
"resourceType": "DocumentReference",
"id": "9fc1343a-e62d-42dc-f33c-3ba8f03c5770",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:96ef4eef-83f9-2cb5-84b0-90d216839c16"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2014-04-19T14:15:30.236+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"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:b877e42a-204c-3f8e-eab7-b3c44ec636a4"
} ],
"period": {
"start": "2014-04-19T14:15:30+02:00",
"end": "2014-04-19T14:30:30+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:4de77f63-1eb2-7d61-55a9-d66e762d1f12",
"resource": {
"resourceType": "Claim",
"id": "4de77f63-1eb2-7d61-55a9-d66e762d1f12",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2014-04-19T14:15:30+02:00",
"end": "2014-04-19T14:30:30+02:00"
},
"created": "2014-04-19T14:30:30+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:a0cb3230-cfef-9ddd-cffc-991f4a474332"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
},
"encounter": [ {
"reference": "urn:uuid:b877e42a-204c-3f8e-eab7-b3c44ec636a4"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "195662009",
"display": "Acute viral pharyngitis (disorder)"
} ],
"text": "Acute viral pharyngitis (disorder)"
}
} ],
"total": {
"value": 85.55,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:3f912e23-cc8b-5143-3f0a-9d84ba9df1a0",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "3f912e23-cc8b-5143-3f0a-9d84ba9df1a0",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "4de77f63-1eb2-7d61-55a9-d66e762d1f12"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2014-04-19T14:30:30+02:00",
"end": "2015-04-19T14:30:30+02:00"
},
"created": "2014-04-19T14:30:30+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"claim": {
"reference": "urn:uuid:4de77f63-1eb2-7d61-55a9-d66e762d1f12"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:a0cb3230-cfef-9ddd-cffc-991f4a474332"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "2014-04-19T14:15:30+02:00",
"end": "2014-04-19T14:30:30+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:b877e42a-204c-3f8e-eab7-b3c44ec636a4"
} ]
}, {
"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": "195662009",
"display": "Acute viral pharyngitis (disorder)"
} ],
"text": "Acute viral pharyngitis (disorder)"
},
"servicedPeriod": {
"start": "2014-04-19T14:15:30+02:00",
"end": "2014-04-19T14:30:30+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:d62aa78d-aacc-47cb-b89b-bac37f48767e",
"resource": {
"resourceType": "Encounter",
"id": "d62aa78d-aacc-47cb-b89b-bac37f48767e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "d62aa78d-aacc-47cb-b89b-bac37f48767e"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2015-02-19T17:15:30+01:00",
"end": "2015-02-19T18:02:09+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
}
} ],
"period": {
"start": "2015-02-19T17:15:30+01:00",
"end": "2015-02-19T18:02:09+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:12e9619e-499f-8e93-9b71-8272c174aa42",
"resource": {
"resourceType": "Condition",
"id": "12e9619e-499f-8e93-9b71-8272c174aa42",
"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": "424393004",
"display": "Reports of violence in the environment (finding)"
} ],
"text": "Reports of violence in the environment (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"onsetDateTime": "2015-02-19T18:02:09+01:00",
"abatementDateTime": "2016-02-25T17:55:07+01:00",
"recordedDate": "2015-02-19T18:02:09+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:af3a63d7-7074-8e08-618e-cdce5283101e",
"resource": {
"resourceType": "Observation",
"id": "af3a63d7-7074-8e08-618e-cdce5283101e",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 174.1,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:0ecea5a1-da92-4d76-037f-dc031221cd76",
"resource": {
"resourceType": "Observation",
"id": "0ecea5a1-da92-4d76-037f-dc031221cd76",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 3,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e928c953-bc14-8f17-944a-3fc79313427c",
"resource": {
"resourceType": "Observation",
"id": "e928c953-bc14-8f17-944a-3fc79313427c",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 86.5,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:cc509a8c-6f43-feac-0790-b9134bee7277",
"resource": {
"resourceType": "Observation",
"id": "cc509a8c-6f43-feac-0790-b9134bee7277",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 28.54,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:6913e291-38ea-bdc7-4839-33d5c42eb306",
"resource": {
"resourceType": "Observation",
"id": "6913e291-38ea-bdc7-4839-33d5c42eb306",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 71,
"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": 118,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:0be3308f-8c52-cc2f-a32d-1d04c6ec6e7b",
"resource": {
"resourceType": "Observation",
"id": "0be3308f-8c52-cc2f-a32d-1d04c6ec6e7b",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 94,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:93ac2fe6-9bc0-cf4e-1572-81cd525f0ea4",
"resource": {
"resourceType": "Observation",
"id": "93ac2fe6-9bc0-cf4e-1572-81cd525f0ea4",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 13,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:7feea98c-f483-b086-e07e-0a54c4e8b6ec",
"resource": {
"resourceType": "Observation",
"id": "7feea98c-f483-b086-e07e-0a54c4e8b6ec",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 8.5577,
"unit": "10*3/uL",
"system": "http://unitsofmeasure.org",
"code": "10*3/uL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:cd2a9350-00b9-b4a6-0aba-93c597c20a39",
"resource": {
"resourceType": "Observation",
"id": "cd2a9350-00b9-b4a6-0aba-93c597c20a39",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 4.4581,
"unit": "10*6/uL",
"system": "http://unitsofmeasure.org",
"code": "10*6/uL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:43c2674f-6b56-16ab-437a-0f1159a189bc",
"resource": {
"resourceType": "Observation",
"id": "43c2674f-6b56-16ab-437a-0f1159a189bc",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 16.618,
"unit": "g/dL",
"system": "http://unitsofmeasure.org",
"code": "g/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:42f1caa1-104d-ebe5-120a-17f28cdcc64c",
"resource": {
"resourceType": "Observation",
"id": "42f1caa1-104d-ebe5-120a-17f28cdcc64c",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 35.596,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:bed5b5ca-8859-9f22-fac5-6bbae9e7f9d5",
"resource": {
"resourceType": "Observation",
"id": "bed5b5ca-8859-9f22-fac5-6bbae9e7f9d5",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 93.511,
"unit": "fL",
"system": "http://unitsofmeasure.org",
"code": "fL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:8cdc585d-edb9-2542-68e0-40eb3491204b",
"resource": {
"resourceType": "Observation",
"id": "8cdc585d-edb9-2542-68e0-40eb3491204b",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 28.655,
"unit": "pg",
"system": "http://unitsofmeasure.org",
"code": "pg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:346ee6c2-d4e8-8854-2efb-c0a42c903c12",
"resource": {
"resourceType": "Observation",
"id": "346ee6c2-d4e8-8854-2efb-c0a42c903c12",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 33.17,
"unit": "g/dL",
"system": "http://unitsofmeasure.org",
"code": "g/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:4fd5c897-68ea-3cbc-d050-9bdd07cbd219",
"resource": {
"resourceType": "Observation",
"id": "4fd5c897-68ea-3cbc-d050-9bdd07cbd219",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 42.304,
"unit": "fL",
"system": "http://unitsofmeasure.org",
"code": "fL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:1e15ab2b-669f-d822-2ab8-a5ce55b50820",
"resource": {
"resourceType": "Observation",
"id": "1e15ab2b-669f-d822-2ab8-a5ce55b50820",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 380.3,
"unit": "10*3/uL",
"system": "http://unitsofmeasure.org",
"code": "10*3/uL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:15439f01-c5ed-c40a-fad9-d216921a3bd9",
"resource": {
"resourceType": "Observation",
"id": "15439f01-c5ed-c40a-fad9-d216921a3bd9",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 486.53,
"unit": "fL",
"system": "http://unitsofmeasure.org",
"code": "fL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:0df2f064-5e44-7672-190d-c08c7a38f3eb",
"resource": {
"resourceType": "Observation",
"id": "0df2f064-5e44-7672-190d-c08c7a38f3eb",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 12.268,
"unit": "fL",
"system": "http://unitsofmeasure.org",
"code": "fL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:82d571b6-e2eb-c3fb-137a-6275614625f0",
"resource": {
"resourceType": "Observation",
"id": "82d571b6-e2eb-c3fb-137a-6275614625f0",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "8517006",
"display": "Ex-smoker (finding)"
} ],
"text": "Ex-smoker (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:33380ca1-b461-e538-aea3-754506f7433d",
"resource": {
"resourceType": "Observation",
"id": "33380ca1-b461-e538-aea3-754506f7433d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93025-5",
"display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
} ],
"text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T18:02:09+01:00",
"issued": "2015-02-19T18:02:09.236+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76501-6",
"display": "Within the last year, have you been afraid of your partner or ex-partner?"
} ],
"text": "Within the last year, have you been afraid of your partner or ex-partner?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93026-3",
"display": "Do you feel physically and emotionally safe where you currently live?"
} ],
"text": "Do you feel physically and emotionally safe where you currently live?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93027-1",
"display": "Are you a refugee?"
} ],
"text": "Are you a refugee?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93028-9",
"display": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
} ],
"text": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93038-8",
"display": "Stress level"
} ],
"text": "Stress level"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA13863-8",
"display": "A little bit"
} ],
"text": "A little bit"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93029-7",
"display": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
} ],
"text": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30132-7",
"display": "5 or more times a week"
} ],
"text": "5 or more times a week"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93030-5",
"display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
} ],
"text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93031-3",
"display": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
} ],
"text": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30124-4",
"display": "Utilities"
} ],
"text": "Utilities"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63586-2",
"display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
} ],
"text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
},
"valueQuantity": {
"value": 55950,
"unit": "/a",
"system": "http://unitsofmeasure.org",
"code": "/a"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76437-3",
"display": "Primary insurance"
} ],
"text": "Primary insurance"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30194-7",
"display": "None/uninsured"
} ],
"text": "None/uninsured"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "67875-5",
"display": "Employment status - current"
} ],
"text": "Employment status - current"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30136-8",
"display": "Full-time work"
} ],
"text": "Full-time work"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82589-3",
"display": "Highest level of education"
} ],
"text": "Highest level of education"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30193-9",
"display": "More than high school"
} ],
"text": "More than high school"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56799-0",
"display": "Address"
} ],
"text": "Address"
},
"valueString": "287 Treutel Neck"
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93033-9",
"display": "Are you worried about losing your housing?"
} ],
"text": "Are you worried about losing your housing?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "71802-3",
"display": "Housing status"
} ],
"text": "Housing status"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30189-7",
"display": "I have housing"
} ],
"text": "I have housing"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63512-8",
"display": "How many people are living or staying at this address?"
} ],
"text": "How many people are living or staying at this address?"
},
"valueQuantity": {
"value": 7,
"unit": "{#}",
"system": "http://unitsofmeasure.org",
"code": "{#}"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "54899-0",
"display": "Preferred language"
} ],
"text": "Preferred language"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA43-5",
"display": "English"
} ],
"text": "English"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93034-7",
"display": "Have you been discharged from the armed forces of the United States?"
} ],
"text": "Have you been discharged from the armed forces of the United States?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93035-4",
"display": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
} ],
"text": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "32624-9",
"display": "Race"
} ],
"text": "Race"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA4457-3",
"display": "White"
} ],
"text": "White"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56051-6",
"display": "Do you consider yourself Hispanic/Latino?"
} ],
"text": "Do you consider yourself Hispanic/Latino?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:04f008fa-23e0-1a3f-b4e0-412fe274fe59",
"resource": {
"resourceType": "Observation",
"id": "04f008fa-23e0-1a3f-b4e0-412fe274fe59",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82667-7",
"display": "Total score [DAST-10]"
} ],
"text": "Total score [DAST-10]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T18:45:40+01:00",
"issued": "2015-02-19T18:45:40.236+01:00",
"valueQuantity": {
"value": 2,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:6c0af8b6-c5cf-01fa-45cb-a65c5570b348",
"resource": {
"resourceType": "Procedure",
"id": "6c0af8b6-c5cf-01fa-45cb-a65c5570b348",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"performedPeriod": {
"start": "2015-02-19T17:15:30+01:00",
"end": "2015-02-19T18:02:09+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:3d99a471-04d8-4e35-fb37-c7c3de74fdde",
"resource": {
"resourceType": "Procedure",
"id": "3d99a471-04d8-4e35-fb37-c7c3de74fdde",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"performedPeriod": {
"start": "2015-02-19T18:02:09+01:00",
"end": "2015-02-19T18:17:05+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:d30b4127-cc14-59a0-258d-be576a17c334",
"resource": {
"resourceType": "Procedure",
"id": "d30b4127-cc14-59a0-258d-be576a17c334",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "713106006",
"display": "Screening for drug abuse (procedure)"
} ],
"text": "Screening for drug abuse (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"performedPeriod": {
"start": "2015-02-19T18:17:05+01:00",
"end": "2015-02-19T18:45:40+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:b726a886-e255-f6b1-2e59-8d815ffc6101",
"resource": {
"resourceType": "MedicationRequest",
"id": "b726a886-e255-f6b1-2e59-8d815ffc6101",
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"authoredOn": "2015-02-19T17:15:30+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"dosageInstruction": [ {
"sequence": 1,
"text": "Every six hours (qualifier value)",
"additionalInstruction": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "307468000",
"display": "Every six hours (qualifier value)"
} ],
"text": "Every six hours (qualifier value)"
} ],
"timing": {
"repeat": {
"frequency": 4,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:2a002c1d-3028-ba28-7df4-47e820105ed9",
"resource": {
"resourceType": "Claim",
"id": "2a002c1d-3028-ba28-7df4-47e820105ed9",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2015-02-19T17:15:30+01:00",
"end": "2015-02-19T18:02:09+01:00"
},
"created": "2015-02-19T18:02:09+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:b726a886-e255-f6b1-2e59-8d815ffc6101"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"encounter": [ {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
} ]
} ],
"total": {
"value": 129.94,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:2dbd1e4c-ef4f-f1de-5847-8a465eb0dff2",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "2dbd1e4c-ef4f-f1de-5847-8a465eb0dff2",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "2a002c1d-3028-ba28-7df4-47e820105ed9"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2015-02-19T18:02:09+01:00",
"end": "2016-02-19T18:02:09+01:00"
},
"created": "2015-02-19T18:02:09+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:2a002c1d-3028-ba28-7df4-47e820105ed9"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"servicedPeriod": {
"start": "2015-02-19T17:15:30+01:00",
"end": "2015-02-19T18:02:09+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
} ]
} ],
"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:30c5f900-80ab-dbdf-0351-d103df87154f",
"resource": {
"resourceType": "Immunization",
"id": "30c5f900-80ab-dbdf-0351-d103df87154f",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"occurrenceDateTime": "2015-02-19T17:15:30+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:4267c847-afbf-c812-fdb1-aa5a440228c4",
"resource": {
"resourceType": "DiagnosticReport",
"id": "4267c847-afbf-c812-fdb1-aa5a440228c4",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"performer": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
} ],
"result": [ {
"reference": "urn:uuid:7feea98c-f483-b086-e07e-0a54c4e8b6ec",
"display": "Leukocytes [#/volume] in Blood by Automated count"
}, {
"reference": "urn:uuid:cd2a9350-00b9-b4a6-0aba-93c597c20a39",
"display": "Erythrocytes [#/volume] in Blood by Automated count"
}, {
"reference": "urn:uuid:43c2674f-6b56-16ab-437a-0f1159a189bc",
"display": "Hemoglobin [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:42f1caa1-104d-ebe5-120a-17f28cdcc64c",
"display": "Hematocrit [Volume Fraction] of Blood by Automated count"
}, {
"reference": "urn:uuid:bed5b5ca-8859-9f22-fac5-6bbae9e7f9d5",
"display": "MCV [Entitic volume] by Automated count"
}, {
"reference": "urn:uuid:8cdc585d-edb9-2542-68e0-40eb3491204b",
"display": "MCH [Entitic mass] by Automated count"
}, {
"reference": "urn:uuid:346ee6c2-d4e8-8854-2efb-c0a42c903c12",
"display": "MCHC [Mass/volume] by Automated count"
}, {
"reference": "urn:uuid:4fd5c897-68ea-3cbc-d050-9bdd07cbd219",
"display": "Erythrocyte distribution width [Entitic volume] by Automated count"
}, {
"reference": "urn:uuid:1e15ab2b-669f-d822-2ab8-a5ce55b50820",
"display": "Platelets [#/volume] in Blood by Automated count"
}, {
"reference": "urn:uuid:15439f01-c5ed-c40a-fad9-d216921a3bd9",
"display": "Platelet distribution width [Entitic volume] in Blood by Automated count"
}, {
"reference": "urn:uuid:0df2f064-5e44-7672-190d-c08c7a38f3eb",
"display": "Platelet mean volume [Entitic volume] in Blood by Automated count"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:84d08d2e-d5ee-ae04-1b65-421c16546add",
"resource": {
"resourceType": "DiagnosticReport",
"id": "84d08d2e-d5ee-ae04-1b65-421c16546add",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82666-9",
"display": "Drug Abuse Screening Test-10 [DAST-10]"
} ],
"text": "Drug Abuse Screening Test-10 [DAST-10]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T18:45:40+01:00",
"issued": "2015-02-19T18:45:40.236+01:00",
"result": [ {
"reference": "urn:uuid:04f008fa-23e0-1a3f-b4e0-412fe274fe59",
"display": "Total score [DAST-10]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:e9560c94-27cf-95ec-5760-1ba8bc2310f4",
"resource": {
"resourceType": "DiagnosticReport",
"id": "e9560c94-27cf-95ec-5760-1ba8bc2310f4",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
},
"effectiveDateTime": "2015-02-19T17:15:30+01:00",
"issued": "2015-02-19T17:15:30.236+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:180ba361-2e12-d725-b3e3-ded17e8b7bc7",
"resource": {
"resourceType": "DocumentReference",
"id": "180ba361-2e12-d725-b3e3-ded17e8b7bc7",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:e9560c94-27cf-95ec-5760-1ba8bc2310f4"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2015-02-19T17:15:30.236+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE 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:d62aa78d-aacc-47cb-b89b-bac37f48767e"
} ],
"period": {
"start": "2015-02-19T17:15:30+01:00",
"end": "2015-02-19T18:02:09+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:99b08787-ab80-dabf-6abd-ff0ffc2c758f",
"resource": {
"resourceType": "Claim",
"id": "99b08787-ab80-dabf-6abd-ff0ffc2c758f",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2015-02-19T17:15:30+01:00",
"end": "2015-02-19T18:02:09+01:00"
},
"created": "2015-02-19T18:02:09+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:30c5f900-80ab-dbdf-0351-d103df87154f"
}
}, {
"sequence": 2,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:12e9619e-499f-8e93-9b71-8272c174aa42"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:6c0af8b6-c5cf-01fa-45cb-a65c5570b348"
}
}, {
"sequence": 2,
"procedureReference": {
"reference": "urn:uuid:3d99a471-04d8-4e35-fb37-c7c3de74fdde"
}
}, {
"sequence": 3,
"procedureReference": {
"reference": "urn:uuid:d30b4127-cc14-59a0-258d-be576a17c334"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
} ]
}, {
"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,
"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"
}
}, {
"sequence": 4,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 5,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "424393004",
"display": "Reports of violence in the environment (finding)"
} ],
"text": "Reports of violence in the environment (finding)"
}
}, {
"sequence": 6,
"procedureSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 7,
"procedureSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "713106006",
"display": "Screening for drug abuse (procedure)"
} ],
"text": "Screening for drug abuse (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 8,
"informationSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "82666-9",
"display": "Drug Abuse Screening Test-10 [DAST-10]"
} ],
"text": "Drug Abuse Screening Test-10 [DAST-10]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
} ],
"total": {
"value": 778.78,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:15e368d7-e4cd-bec8-0201-2b5d361b3dfe",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "15e368d7-e4cd-bec8-0201-2b5d361b3dfe",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "99b08787-ab80-dabf-6abd-ff0ffc2c758f"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2015-02-19T18:02:09+01:00",
"end": "2016-02-19T18:02:09+01:00"
},
"created": "2015-02-19T18:02:09+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:99b08787-ab80-dabf-6abd-ff0ffc2c758f"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:12e9619e-499f-8e93-9b71-8272c174aa42"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"servicedPeriod": {
"start": "2015-02-19T17:15:30+01:00",
"end": "2015-02-19T18:02:09+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
} ]
}, {
"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": "2015-02-19T17:15:30+01:00",
"end": "2015-02-19T18:02:09+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://loinc.org",
"code": "58410-2",
"display": "CBC panel - Blood by Automated count"
} ],
"text": "CBC panel - Blood by Automated count"
},
"servicedPeriod": {
"start": "2015-02-19T17:15:30+01:00",
"end": "2015-02-19T18:02:09+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"
} ]
}
} ]
}, {
"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": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"servicedPeriod": {
"start": "2015-02-19T17:15:30+01:00",
"end": "2015-02-19T18:02:09+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 5,
"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": "424393004",
"display": "Reports of violence in the environment (finding)"
} ],
"text": "Reports of violence in the environment (finding)"
},
"servicedPeriod": {
"start": "2015-02-19T17:15:30+01:00",
"end": "2015-02-19T18:02:09+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 6,
"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": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"servicedPeriod": {
"start": "2015-02-19T17:15:30+01:00",
"end": "2015-02-19T18:02:09+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"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": "713106006",
"display": "Screening for drug abuse (procedure)"
} ],
"text": "Screening for drug abuse (procedure)"
},
"servicedPeriod": {
"start": "2015-02-19T17:15:30+01:00",
"end": "2015-02-19T18:02:09+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 8,
"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://loinc.org",
"code": "82666-9",
"display": "Drug Abuse Screening Test-10 [DAST-10]"
} ],
"text": "Drug Abuse Screening Test-10 [DAST-10]"
},
"servicedPeriod": {
"start": "2015-02-19T17:15:30+01:00",
"end": "2015-02-19T18:02:09+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": 778.78,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 1263.488,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f",
"resource": {
"resourceType": "Encounter",
"id": "25b19df7-3e7c-d61e-aff5-21585f26863f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "25b19df7-3e7c-d61e-aff5-21585f26863f"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2016-02-25T17:15:30+01:00",
"end": "2016-02-25T17:55:07+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
}
} ],
"period": {
"start": "2016-02-25T17:15:30+01:00",
"end": "2016-02-25T17:55:07+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:799e6738-5cdb-0458-f789-6123a6bf2358",
"resource": {
"resourceType": "Condition",
"id": "799e6738-5cdb-0458-f789-6123a6bf2358",
"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": "160904001",
"display": "Part-time employment (finding)"
} ],
"text": "Part-time employment (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"onsetDateTime": "2016-02-25T17:55:07+01:00",
"abatementDateTime": "2017-03-02T17:49:47+01:00",
"recordedDate": "2016-02-25T17:55:07+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:3571d926-35fd-d827-a3a2-b1de3ab8c2b0",
"resource": {
"resourceType": "Observation",
"id": "3571d926-35fd-d827-a3a2-b1de3ab8c2b0",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"effectiveDateTime": "2016-02-25T17:15:30+01:00",
"issued": "2016-02-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 174.1,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:267c2e4a-b56b-5447-2bfe-bf4db1a71275",
"resource": {
"resourceType": "Observation",
"id": "267c2e4a-b56b-5447-2bfe-bf4db1a71275",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"effectiveDateTime": "2016-02-25T17:15:30+01:00",
"issued": "2016-02-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 2,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:875fd198-fa6e-091c-7bc0-861f5a3f3beb",
"resource": {
"resourceType": "Observation",
"id": "875fd198-fa6e-091c-7bc0-861f5a3f3beb",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"effectiveDateTime": "2016-02-25T17:15:30+01:00",
"issued": "2016-02-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 88,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:5a253f2f-1a7b-a19f-4983-6bbede0f0b25",
"resource": {
"resourceType": "Observation",
"id": "5a253f2f-1a7b-a19f-4983-6bbede0f0b25",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"effectiveDateTime": "2016-02-25T17:15:30+01:00",
"issued": "2016-02-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 29.03,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:f2df27db-0f22-c0b7-4512-dfb0281f02d3",
"resource": {
"resourceType": "Observation",
"id": "f2df27db-0f22-c0b7-4512-dfb0281f02d3",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"effectiveDateTime": "2016-02-25T17:15:30+01:00",
"issued": "2016-02-25T17:15:30.236+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 75,
"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": 117,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:2ce71ed1-f5b4-fb31-0791-96125beac8fc",
"resource": {
"resourceType": "Observation",
"id": "2ce71ed1-f5b4-fb31-0791-96125beac8fc",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"effectiveDateTime": "2016-02-25T17:15:30+01:00",
"issued": "2016-02-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 68,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:f92d2053-9c02-2821-22f1-ed4737dd1332",
"resource": {
"resourceType": "Observation",
"id": "f92d2053-9c02-2821-22f1-ed4737dd1332",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"effectiveDateTime": "2016-02-25T17:15:30+01:00",
"issued": "2016-02-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 15,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d6fdd58a-2255-b686-9a4f-d5d36c2be048",
"resource": {
"resourceType": "Observation",
"id": "d6fdd58a-2255-b686-9a4f-d5d36c2be048",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"effectiveDateTime": "2016-02-25T17:15:30+01:00",
"issued": "2016-02-25T17:15:30.236+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "8517006",
"display": "Ex-smoker (finding)"
} ],
"text": "Ex-smoker (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:879b2554-87e9-0ea1-a5ae-e69418b416ab",
"resource": {
"resourceType": "Observation",
"id": "879b2554-87e9-0ea1-a5ae-e69418b416ab",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93025-5",
"display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
} ],
"text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"effectiveDateTime": "2016-02-25T17:55:07+01:00",
"issued": "2016-02-25T17:55:07.236+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76501-6",
"display": "Within the last year, have you been afraid of your partner or ex-partner?"
} ],
"text": "Within the last year, have you been afraid of your partner or ex-partner?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93026-3",
"display": "Do you feel physically and emotionally safe where you currently live?"
} ],
"text": "Do you feel physically and emotionally safe where you currently live?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93027-1",
"display": "Are you a refugee?"
} ],
"text": "Are you a refugee?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93028-9",
"display": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
} ],
"text": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93038-8",
"display": "Stress level"
} ],
"text": "Stress level"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA6568-5",
"display": "Not at all"
} ],
"text": "Not at all"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93029-7",
"display": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
} ],
"text": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30131-9",
"display": "3 to 5 times a week"
} ],
"text": "3 to 5 times a week"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93030-5",
"display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
} ],
"text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93031-3",
"display": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
} ],
"text": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30122-8",
"display": "I choose not to answer this question"
} ],
"text": "I choose not to answer this question"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63586-2",
"display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
} ],
"text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
},
"valueQuantity": {
"value": 55950,
"unit": "/a",
"system": "http://unitsofmeasure.org",
"code": "/a"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76437-3",
"display": "Primary insurance"
} ],
"text": "Primary insurance"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30194-7",
"display": "None/uninsured"
} ],
"text": "None/uninsured"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "67875-5",
"display": "Employment status - current"
} ],
"text": "Employment status - current"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30138-4",
"display": "Part-time or temporary work"
} ],
"text": "Part-time or temporary work"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82589-3",
"display": "Highest level of education"
} ],
"text": "Highest level of education"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30193-9",
"display": "More than high school"
} ],
"text": "More than high school"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56799-0",
"display": "Address"
} ],
"text": "Address"
},
"valueString": "287 Treutel Neck"
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93033-9",
"display": "Are you worried about losing your housing?"
} ],
"text": "Are you worried about losing your housing?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "71802-3",
"display": "Housing status"
} ],
"text": "Housing status"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30189-7",
"display": "I have housing"
} ],
"text": "I have housing"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63512-8",
"display": "How many people are living or staying at this address?"
} ],
"text": "How many people are living or staying at this address?"
},
"valueQuantity": {
"value": 7,
"unit": "{#}",
"system": "http://unitsofmeasure.org",
"code": "{#}"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "54899-0",
"display": "Preferred language"
} ],
"text": "Preferred language"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA43-5",
"display": "English"
} ],
"text": "English"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93034-7",
"display": "Have you been discharged from the armed forces of the United States?"
} ],
"text": "Have you been discharged from the armed forces of the United States?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93035-4",
"display": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
} ],
"text": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "32624-9",
"display": "Race"
} ],
"text": "Race"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA4457-3",
"display": "White"
} ],
"text": "White"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56051-6",
"display": "Do you consider yourself Hispanic/Latino?"
} ],
"text": "Do you consider yourself Hispanic/Latino?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:9acec9af-815d-03d9-ab3b-2dac54f096b1",
"resource": {
"resourceType": "Observation",
"id": "9acec9af-815d-03d9-ab3b-2dac54f096b1",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "55758-7",
"display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"effectiveDateTime": "2016-02-25T18:30:13+01:00",
"issued": "2016-02-25T18:30:13.236+01:00",
"valueQuantity": {
"value": 2,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:8c417014-604a-8150-513f-371a0f582058",
"resource": {
"resourceType": "Observation",
"id": "8c417014-604a-8150-513f-371a0f582058",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82667-7",
"display": "Total score [DAST-10]"
} ],
"text": "Total score [DAST-10]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"effectiveDateTime": "2016-02-25T19:03:39+01:00",
"issued": "2016-02-25T19:03:39.236+01:00",
"valueQuantity": {
"value": 2,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:7fa3d4ea-5270-1115-c8d5-403503dba203",
"resource": {
"resourceType": "Procedure",
"id": "7fa3d4ea-5270-1115-c8d5-403503dba203",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"performedPeriod": {
"start": "2016-02-25T17:15:30+01:00",
"end": "2016-02-25T17:30:30+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:877928db-02d4-6eab-b060-086e8dc7c09d",
"resource": {
"resourceType": "Procedure",
"id": "877928db-02d4-6eab-b060-086e8dc7c09d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"performedPeriod": {
"start": "2016-02-25T17:15:30+01:00",
"end": "2016-02-25T17:55:07+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:9e8d6888-30c8-81da-3abe-2ade7d8f7194",
"resource": {
"resourceType": "Procedure",
"id": "9e8d6888-30c8-81da-3abe-2ade7d8f7194",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"performedPeriod": {
"start": "2016-02-25T17:55:07+01:00",
"end": "2016-02-25T18:06:18+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:7d308f25-63ab-dfec-c7a4-3a3324566862",
"resource": {
"resourceType": "Procedure",
"id": "7d308f25-63ab-dfec-c7a4-3a3324566862",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"performedPeriod": {
"start": "2016-02-25T18:06:18+01:00",
"end": "2016-02-25T18:30:13+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:d7985ee0-7a6b-3c79-7068-b17af07af84b",
"resource": {
"resourceType": "Procedure",
"id": "d7985ee0-7a6b-3c79-7068-b17af07af84b",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"performedPeriod": {
"start": "2016-02-25T18:30:13+01:00",
"end": "2016-02-25T18:41:53+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:d8b0bf00-6d9d-ac0d-f2e0-91fe11593d8e",
"resource": {
"resourceType": "Procedure",
"id": "d8b0bf00-6d9d-ac0d-f2e0-91fe11593d8e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "713106006",
"display": "Screening for drug abuse (procedure)"
} ],
"text": "Screening for drug abuse (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"performedPeriod": {
"start": "2016-02-25T18:41:53+01:00",
"end": "2016-02-25T19:03:39+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:9df57034-e89d-ebeb-3609-02986c1fe112",
"resource": {
"resourceType": "MedicationRequest",
"id": "9df57034-e89d-ebeb-3609-02986c1fe112",
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"authoredOn": "2016-02-25T17:15:30+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"dosageInstruction": [ {
"sequence": 1,
"text": "Every six hours (qualifier value)",
"additionalInstruction": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "307468000",
"display": "Every six hours (qualifier value)"
} ],
"text": "Every six hours (qualifier value)"
} ],
"timing": {
"repeat": {
"frequency": 4,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:bb8d484c-03de-0f2e-214d-7fdc7f912da7",
"resource": {
"resourceType": "Claim",
"id": "bb8d484c-03de-0f2e-214d-7fdc7f912da7",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2016-02-25T17:15:30+01:00",
"end": "2016-02-25T17:55:07+01:00"
},
"created": "2016-02-25T17:55:07+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:9df57034-e89d-ebeb-3609-02986c1fe112"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"encounter": [ {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
} ]
} ],
"total": {
"value": 129.94,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:301427db-51b7-f865-9f75-15f159e8395e",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "301427db-51b7-f865-9f75-15f159e8395e",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "bb8d484c-03de-0f2e-214d-7fdc7f912da7"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2016-02-25T17:55:07+01:00",
"end": "2017-02-25T17:55:07+01:00"
},
"created": "2016-02-25T17:55:07+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:bb8d484c-03de-0f2e-214d-7fdc7f912da7"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"servicedPeriod": {
"start": "2016-02-25T17:15:30+01:00",
"end": "2016-02-25T17:55:07+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
} ]
} ],
"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:1f72ab64-ff79-281f-ff1a-76aa24021ebf",
"resource": {
"resourceType": "Immunization",
"id": "1f72ab64-ff79-281f-ff1a-76aa24021ebf",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"occurrenceDateTime": "2016-02-25T17:15:30+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:8793ad56-5644-5329-db8d-21f23c4c7d18",
"resource": {
"resourceType": "DiagnosticReport",
"id": "8793ad56-5644-5329-db8d-21f23c4c7d18",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"effectiveDateTime": "2016-02-25T18:30:13+01:00",
"issued": "2016-02-25T18:30:13.236+01:00",
"result": [ {
"reference": "urn:uuid:9acec9af-815d-03d9-ab3b-2dac54f096b1",
"display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:3114bafd-a887-725d-ec6d-db89c66b4f05",
"resource": {
"resourceType": "DiagnosticReport",
"id": "3114bafd-a887-725d-ec6d-db89c66b4f05",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82666-9",
"display": "Drug Abuse Screening Test-10 [DAST-10]"
} ],
"text": "Drug Abuse Screening Test-10 [DAST-10]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"effectiveDateTime": "2016-02-25T19:03:39+01:00",
"issued": "2016-02-25T19:03:39.236+01:00",
"result": [ {
"reference": "urn:uuid:8c417014-604a-8150-513f-371a0f582058",
"display": "Total score [DAST-10]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:09f80eea-3425-b321-ec8a-995995137462",
"resource": {
"resourceType": "DiagnosticReport",
"id": "09f80eea-3425-b321-ec8a-995995137462",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
},
"effectiveDateTime": "2016-02-25T17:15:30+01:00",
"issued": "2016-02-25T17:15:30.236+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:e4c2be16-7d4f-9b1b-52cc-cd2b11a31623",
"resource": {
"resourceType": "DocumentReference",
"id": "e4c2be16-7d4f-9b1b-52cc-cd2b11a31623",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:09f80eea-3425-b321-ec8a-995995137462"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2016-02-25T17:15:30.236+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE 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:25b19df7-3e7c-d61e-aff5-21585f26863f"
} ],
"period": {
"start": "2016-02-25T17:15:30+01:00",
"end": "2016-02-25T17:55:07+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:27775b4e-9607-9aa6-bb90-2a8326fd1db9",
"resource": {
"resourceType": "Claim",
"id": "27775b4e-9607-9aa6-bb90-2a8326fd1db9",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2016-02-25T17:15:30+01:00",
"end": "2016-02-25T17:55:07+01:00"
},
"created": "2016-02-25T17:55:07+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:1f72ab64-ff79-281f-ff1a-76aa24021ebf"
}
}, {
"sequence": 2,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:799e6738-5cdb-0458-f789-6123a6bf2358"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:7fa3d4ea-5270-1115-c8d5-403503dba203"
}
}, {
"sequence": 2,
"procedureReference": {
"reference": "urn:uuid:877928db-02d4-6eab-b060-086e8dc7c09d"
}
}, {
"sequence": 3,
"procedureReference": {
"reference": "urn:uuid:9e8d6888-30c8-81da-3abe-2ade7d8f7194"
}
}, {
"sequence": 4,
"procedureReference": {
"reference": "urn:uuid:7d308f25-63ab-dfec-c7a4-3a3324566862"
}
}, {
"sequence": 5,
"procedureReference": {
"reference": "urn:uuid:d7985ee0-7a6b-3c79-7068-b17af07af84b"
}
}, {
"sequence": 6,
"procedureReference": {
"reference": "urn:uuid:d8b0bf00-6d9d-ac0d-f2e0-91fe11593d8e"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
} ]
}, {
"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": 424.99,
"currency": "USD"
}
}, {
"sequence": 4,
"procedureSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 5,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "160904001",
"display": "Part-time employment (finding)"
} ],
"text": "Part-time employment (finding)"
}
}, {
"sequence": 6,
"procedureSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 7,
"procedureSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 8,
"informationSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 9,
"procedureSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 10,
"procedureSequence": [ 6 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "713106006",
"display": "Screening for drug abuse (procedure)"
} ],
"text": "Screening for drug abuse (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 11,
"informationSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "82666-9",
"display": "Drug Abuse Screening Test-10 [DAST-10]"
} ],
"text": "Drug Abuse Screening Test-10 [DAST-10]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
} ],
"total": {
"value": 1129.19,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:a53a9d7d-5514-8e92-6716-c98db59681f1",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "a53a9d7d-5514-8e92-6716-c98db59681f1",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "27775b4e-9607-9aa6-bb90-2a8326fd1db9"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2016-02-25T17:55:07+01:00",
"end": "2017-02-25T17:55:07+01:00"
},
"created": "2016-02-25T17:55:07+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:27775b4e-9607-9aa6-bb90-2a8326fd1db9"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:799e6738-5cdb-0458-f789-6123a6bf2358"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"servicedPeriod": {
"start": "2016-02-25T17:15:30+01:00",
"end": "2016-02-25T17:55:07+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
} ]
}, {
"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": "2016-02-25T17:15:30+01:00",
"end": "2016-02-25T17:55:07+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": "2016-02-25T17:15:30+01:00",
"end": "2016-02-25T17:55:07+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 424.99,
"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": 84.998,
"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": 339.992,
"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": 424.99,
"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": 424.99,
"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,
"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": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"servicedPeriod": {
"start": "2016-02-25T17:15:30+01:00",
"end": "2016-02-25T17:55:07+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 5,
"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": "160904001",
"display": "Part-time employment (finding)"
} ],
"text": "Part-time employment (finding)"
},
"servicedPeriod": {
"start": "2016-02-25T17:15:30+01:00",
"end": "2016-02-25T17:55:07+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 6,
"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": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"servicedPeriod": {
"start": "2016-02-25T17:15:30+01:00",
"end": "2016-02-25T17:55:07+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"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": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"servicedPeriod": {
"start": "2016-02-25T17:15:30+01:00",
"end": "2016-02-25T17:55:07+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 8,
"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": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"servicedPeriod": {
"start": "2016-02-25T17:15:30+01:00",
"end": "2016-02-25T17:55:07+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"
} ]
}
} ]
}, {
"sequence": 9,
"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": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"servicedPeriod": {
"start": "2016-02-25T17:15:30+01:00",
"end": "2016-02-25T17:55:07+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 10,
"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": "713106006",
"display": "Screening for drug abuse (procedure)"
} ],
"text": "Screening for drug abuse (procedure)"
},
"servicedPeriod": {
"start": "2016-02-25T17:15:30+01:00",
"end": "2016-02-25T17:55:07+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 11,
"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://loinc.org",
"code": "82666-9",
"display": "Drug Abuse Screening Test-10 [DAST-10]"
} ],
"text": "Drug Abuse Screening Test-10 [DAST-10]"
},
"servicedPeriod": {
"start": "2016-02-25T17:15:30+01:00",
"end": "2016-02-25T17:55:07+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": 1129.19,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 2293.7200000000003,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49",
"resource": {
"resourceType": "Encounter",
"id": "404579ff-bc16-574f-e03c-dc8d3ac82f49",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "404579ff-bc16-574f-e03c-dc8d3ac82f49"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
}
} ],
"period": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:7f40a25f-f7c5-d090-0777-da6c4e98c5c3",
"resource": {
"resourceType": "Condition",
"id": "7f40a25f-f7c5-d090-0777-da6c4e98c5c3",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"onsetDateTime": "2017-03-02T17:15:30+01:00",
"abatementDateTime": "2018-05-17T18:15:30+02:00",
"recordedDate": "2017-03-02T17:15:30+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:4f524ecd-a8cf-1c77-1564-e331a276d98a",
"resource": {
"resourceType": "Condition",
"id": "4f524ecd-a8cf-1c77-1564-e331a276d98a",
"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": "15777000",
"display": "Prediabetes"
} ],
"text": "Prediabetes"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"onsetDateTime": "2017-03-02T17:15:30+01:00",
"recordedDate": "2017-03-02T17:15:30+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:b660e41e-2f50-c8ab-ff71-3333b2127959",
"resource": {
"resourceType": "Condition",
"id": "b660e41e-2f50-c8ab-ff71-3333b2127959",
"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": "160903007",
"display": "Full-time employment (finding)"
} ],
"text": "Full-time employment (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"onsetDateTime": "2017-03-02T17:49:47+01:00",
"abatementDateTime": "2020-12-24T17:56:50+01:00",
"recordedDate": "2017-03-02T17:49:47+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:feb6eaea-1dbe-0b27-9397-1c90b547fe64",
"resource": {
"resourceType": "Condition",
"id": "feb6eaea-1dbe-0b27-9397-1c90b547fe64",
"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": "73595000",
"display": "Stress (finding)"
} ],
"text": "Stress (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"onsetDateTime": "2017-03-02T17:49:47+01:00",
"abatementDateTime": "2018-05-17T18:48:10+02:00",
"recordedDate": "2017-03-02T17:49:47+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:fc4c6dd4-889c-fc6a-1028-1344e10cd293",
"resource": {
"resourceType": "Observation",
"id": "fc4c6dd4-889c-fc6a-1028-1344e10cd293",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "4548-4",
"display": "Hemoglobin A1c/Hemoglobin.total in Blood"
} ],
"text": "Hemoglobin A1c/Hemoglobin.total in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T17:15:30+01:00",
"issued": "2017-03-02T17:15:30.236+01:00",
"valueQuantity": {
"value": 6.21,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:f448b5ef-8d4d-938f-8dcb-6b6378cbc9bd",
"resource": {
"resourceType": "Observation",
"id": "f448b5ef-8d4d-938f-8dcb-6b6378cbc9bd",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T17:15:30+01:00",
"issued": "2017-03-02T17:15:30.236+01:00",
"valueQuantity": {
"value": 174.1,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:79c0c399-f135-6245-140c-0d928754098c",
"resource": {
"resourceType": "Observation",
"id": "79c0c399-f135-6245-140c-0d928754098c",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T17:15:30+01:00",
"issued": "2017-03-02T17:15:30.236+01:00",
"valueQuantity": {
"value": 1,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:302f82c5-76f1-65a5-6da2-0ef28f4fbbe0",
"resource": {
"resourceType": "Observation",
"id": "302f82c5-76f1-65a5-6da2-0ef28f4fbbe0",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T17:15:30+01:00",
"issued": "2017-03-02T17:15:30.236+01:00",
"valueQuantity": {
"value": 90,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:58c6c09d-2a2b-859a-a8cd-be3104ea9278",
"resource": {
"resourceType": "Observation",
"id": "58c6c09d-2a2b-859a-a8cd-be3104ea9278",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T17:15:30+01:00",
"issued": "2017-03-02T17:15:30.236+01:00",
"valueQuantity": {
"value": 29.69,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:b5ecb804-77b2-7828-6361-ac2de93ea6bc",
"resource": {
"resourceType": "Observation",
"id": "b5ecb804-77b2-7828-6361-ac2de93ea6bc",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T17:15:30+01:00",
"issued": "2017-03-02T17:15:30.236+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 75,
"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": 112,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:86b98ac1-2061-8551-fa0b-73ebdb70d4c1",
"resource": {
"resourceType": "Observation",
"id": "86b98ac1-2061-8551-fa0b-73ebdb70d4c1",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T17:15:30+01:00",
"issued": "2017-03-02T17:15:30.236+01:00",
"valueQuantity": {
"value": 80,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:4c9d36b9-5a68-4c71-473c-dbd3e0f8fc7c",
"resource": {
"resourceType": "Observation",
"id": "4c9d36b9-5a68-4c71-473c-dbd3e0f8fc7c",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T17:15:30+01:00",
"issued": "2017-03-02T17:15:30.236+01:00",
"valueQuantity": {
"value": 14,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:1db661c7-b745-7a7b-c979-bef7be608b77",
"resource": {
"resourceType": "Observation",
"id": "1db661c7-b745-7a7b-c979-bef7be608b77",
"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": "2339-0",
"display": "Glucose [Mass/volume] in Blood"
} ],
"text": "Glucose [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T17:15:30+01:00",
"issued": "2017-03-02T17:15:30.236+01:00",
"valueQuantity": {
"value": 75.9,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:2191a01f-52c0-5d1c-52f4-580e7ef8b73e",
"resource": {
"resourceType": "Observation",
"id": "2191a01f-52c0-5d1c-52f4-580e7ef8b73e",
"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": "6299-2",
"display": "Urea nitrogen [Mass/volume] in Blood"
} ],
"text": "Urea nitrogen [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T17:15:30+01:00",
"issued": "2017-03-02T17:15:30.236+01:00",
"valueQuantity": {
"value": 9.8,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:619fb6ba-39a4-d735-12d6-c0db15dfc8a5",
"resource": {
"resourceType": "Observation",
"id": "619fb6ba-39a4-d735-12d6-c0db15dfc8a5",
"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": "38483-4",
"display": "Creatinine [Mass/volume] in Blood"
} ],
"text": "Creatinine [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T17:15:30+01:00",
"issued": "2017-03-02T17:15:30.236+01:00",
"valueQuantity": {
"value": 1.65,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:44ea56af-ff74-9b9a-b135-0fa0897dde2f",
"resource": {
"resourceType": "Observation",
"id": "44ea56af-ff74-9b9a-b135-0fa0897dde2f",
"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": "49765-1",
"display": "Calcium [Mass/volume] in Blood"
} ],
"text": "Calcium [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T17:15:30+01:00",
"issued": "2017-03-02T17:15:30.236+01:00",
"valueQuantity": {
"value": 8.93,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:1708b9cc-a9aa-d016-feff-57d50820f0b3",
"resource": {
"resourceType": "Observation",
"id": "1708b9cc-a9aa-d016-feff-57d50820f0b3",
"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": "2947-0",
"display": "Sodium [Moles/volume] in Blood"
} ],
"text": "Sodium [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T17:15:30+01:00",
"issued": "2017-03-02T17:15:30.236+01:00",
"valueQuantity": {
"value": 136.77,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:79e8f45d-4968-5cb2-3e46-82153441fe3c",
"resource": {
"resourceType": "Observation",
"id": "79e8f45d-4968-5cb2-3e46-82153441fe3c",
"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": "6298-4",
"display": "Potassium [Moles/volume] in Blood"
} ],
"text": "Potassium [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T17:15:30+01:00",
"issued": "2017-03-02T17:15:30.236+01:00",
"valueQuantity": {
"value": 4.52,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:45fc104a-5cff-6b36-04e2-2f583b377f31",
"resource": {
"resourceType": "Observation",
"id": "45fc104a-5cff-6b36-04e2-2f583b377f31",
"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": "2069-3",
"display": "Chloride [Moles/volume] in Blood"
} ],
"text": "Chloride [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T17:15:30+01:00",
"issued": "2017-03-02T17:15:30.236+01:00",
"valueQuantity": {
"value": 105.18,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:bea04569-5538-daf0-11b5-1b666eb789b5",
"resource": {
"resourceType": "Observation",
"id": "bea04569-5538-daf0-11b5-1b666eb789b5",
"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": "20565-8",
"display": "Carbon dioxide, total [Moles/volume] in Blood"
} ],
"text": "Carbon dioxide, total [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T17:15:30+01:00",
"issued": "2017-03-02T17:15:30.236+01:00",
"valueQuantity": {
"value": 26.31,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:0680beeb-6182-ab22-ee8f-ce877513a0ce",
"resource": {
"resourceType": "Observation",
"id": "0680beeb-6182-ab22-ee8f-ce877513a0ce",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T17:15:30+01:00",
"issued": "2017-03-02T17:15:30.236+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "8517006",
"display": "Ex-smoker (finding)"
} ],
"text": "Ex-smoker (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:6afcff1d-8121-c461-4c8e-813260aebebf",
"resource": {
"resourceType": "Observation",
"id": "6afcff1d-8121-c461-4c8e-813260aebebf",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93025-5",
"display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
} ],
"text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T17:49:47+01:00",
"issued": "2017-03-02T17:49:47.236+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76501-6",
"display": "Within the last year, have you been afraid of your partner or ex-partner?"
} ],
"text": "Within the last year, have you been afraid of your partner or ex-partner?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93026-3",
"display": "Do you feel physically and emotionally safe where you currently live?"
} ],
"text": "Do you feel physically and emotionally safe where you currently live?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93027-1",
"display": "Are you a refugee?"
} ],
"text": "Are you a refugee?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93028-9",
"display": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
} ],
"text": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93038-8",
"display": "Stress level"
} ],
"text": "Stress level"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA13863-8",
"display": "A little bit"
} ],
"text": "A little bit"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93029-7",
"display": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
} ],
"text": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30131-9",
"display": "3 to 5 times a week"
} ],
"text": "3 to 5 times a week"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93030-5",
"display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
} ],
"text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93031-3",
"display": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
} ],
"text": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30128-5",
"display": "Medicine or Any Health Care (Medical, Dental, Mental Health, Vision)"
} ],
"text": "Medicine or Any Health Care (Medical, Dental, Mental Health, Vision)"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63586-2",
"display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
} ],
"text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
},
"valueQuantity": {
"value": 55950,
"unit": "/a",
"system": "http://unitsofmeasure.org",
"code": "/a"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76437-3",
"display": "Primary insurance"
} ],
"text": "Primary insurance"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30194-7",
"display": "None/uninsured"
} ],
"text": "None/uninsured"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "67875-5",
"display": "Employment status - current"
} ],
"text": "Employment status - current"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30136-8",
"display": "Full-time work"
} ],
"text": "Full-time work"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82589-3",
"display": "Highest level of education"
} ],
"text": "Highest level of education"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30193-9",
"display": "More than high school"
} ],
"text": "More than high school"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56799-0",
"display": "Address"
} ],
"text": "Address"
},
"valueString": "287 Treutel Neck"
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93033-9",
"display": "Are you worried about losing your housing?"
} ],
"text": "Are you worried about losing your housing?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "71802-3",
"display": "Housing status"
} ],
"text": "Housing status"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30189-7",
"display": "I have housing"
} ],
"text": "I have housing"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63512-8",
"display": "How many people are living or staying at this address?"
} ],
"text": "How many people are living or staying at this address?"
},
"valueQuantity": {
"value": 7,
"unit": "{#}",
"system": "http://unitsofmeasure.org",
"code": "{#}"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "54899-0",
"display": "Preferred language"
} ],
"text": "Preferred language"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA43-5",
"display": "English"
} ],
"text": "English"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93034-7",
"display": "Have you been discharged from the armed forces of the United States?"
} ],
"text": "Have you been discharged from the armed forces of the United States?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93035-4",
"display": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
} ],
"text": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "32624-9",
"display": "Race"
} ],
"text": "Race"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA4457-3",
"display": "White"
} ],
"text": "White"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56051-6",
"display": "Do you consider yourself Hispanic/Latino?"
} ],
"text": "Do you consider yourself Hispanic/Latino?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d83e1162-ae8c-885a-fc35-23f6ddf6ac09",
"resource": {
"resourceType": "Observation",
"id": "d83e1162-ae8c-885a-fc35-23f6ddf6ac09",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "70274-6",
"display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T18:17:31+01:00",
"issued": "2017-03-02T18:17:31.236+01:00",
"valueQuantity": {
"value": 1,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:0c2dbe79-e84f-fe3a-1530-6d4040b4d037",
"resource": {
"resourceType": "Observation",
"id": "0c2dbe79-e84f-fe3a-1530-6d4040b4d037",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "55758-7",
"display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T18:54:19+01:00",
"issued": "2017-03-02T18:54:19.236+01:00",
"valueQuantity": {
"value": 0,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:7be3d6ce-1d6d-a18d-18ad-4ee427e6fa2a",
"resource": {
"resourceType": "Observation",
"id": "7be3d6ce-1d6d-a18d-18ad-4ee427e6fa2a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "75626-2",
"display": "Total score [AUDIT-C]"
} ],
"text": "Total score [AUDIT-C]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T19:36:06+01:00",
"issued": "2017-03-02T19:36:06.236+01:00",
"valueQuantity": {
"value": 2,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:be013d0e-b588-d32e-f84b-cec829354467",
"resource": {
"resourceType": "Procedure",
"id": "be013d0e-b588-d32e-f84b-cec829354467",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"performedPeriod": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:f8db9b5c-dbb4-6985-be81-5f8c1e4587dc",
"resource": {
"resourceType": "Procedure",
"id": "f8db9b5c-dbb4-6985-be81-5f8c1e4587dc",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"performedPeriod": {
"start": "2017-03-02T17:49:47+01:00",
"end": "2017-03-02T18:17:31+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:74274553-6b86-9351-302c-021fd48f70fe",
"resource": {
"resourceType": "Procedure",
"id": "74274553-6b86-9351-302c-021fd48f70fe",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"performedPeriod": {
"start": "2017-03-02T18:17:31+01:00",
"end": "2017-03-02T18:29:09+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:6e307fbd-01d2-d4b6-13f4-803150583c08",
"resource": {
"resourceType": "Procedure",
"id": "6e307fbd-01d2-d4b6-13f4-803150583c08",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"performedPeriod": {
"start": "2017-03-02T18:29:09+01:00",
"end": "2017-03-02T18:54:19+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:b3e7dc0f-8cea-38cd-163f-647881c3b1b9",
"resource": {
"resourceType": "Procedure",
"id": "b3e7dc0f-8cea-38cd-163f-647881c3b1b9",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"performedPeriod": {
"start": "2017-03-02T18:54:19+01:00",
"end": "2017-03-02T19:07:45+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:1eb7c3f2-3553-442d-f8a4-3e11d79a7571",
"resource": {
"resourceType": "Procedure",
"id": "1eb7c3f2-3553-442d-f8a4-3e11d79a7571",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "763302001",
"display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
} ],
"text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"performedPeriod": {
"start": "2017-03-02T19:07:45+01:00",
"end": "2017-03-02T19:36:06+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:8e2bde4a-3d78-66b9-ab87-241f4b3f5cba",
"resource": {
"resourceType": "Device",
"id": "8e2bde4a-3d78-66b9-ab87-241f4b3f5cba",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-implantable-device" ]
},
"udiCarrier": [ {
"deviceIdentifier": "77568189243935",
"carrierHRF": "(01)77568189243935(11)170209(17)420224(10)808700742(21)70034"
} ],
"status": "active",
"distinctIdentifier": "77568189243935",
"manufactureDate": "2017-02-09T17:15:30+01:00",
"expirationDate": "2042-02-24T17:15:30+01:00",
"lotNumber": "808700742",
"serialNumber": "70034",
"deviceName": [ {
"name": "Blood glucose meter (physical object)",
"type": "user-friendly-name"
} ],
"type": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "337414009",
"display": "Blood glucose meter (physical object)"
} ],
"text": "Blood glucose meter (physical object)"
},
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
}
},
"request": {
"method": "POST",
"url": "Device"
}
}, {
"fullUrl": "urn:uuid:73f670fd-a68d-0554-5f28-ff45c5148df5",
"resource": {
"resourceType": "SupplyDelivery",
"id": "73f670fd-a68d-0554-5f28-ff45c5148df5",
"status": "completed",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/supply-item-type",
"code": "device",
"display": "Device"
} ]
},
"suppliedItem": {
"quantity": {
"value": 50
},
"itemCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
}
},
"occurrenceDateTime": "2017-03-02T17:15:30+01:00"
},
"request": {
"method": "POST",
"url": "SupplyDelivery"
}
}, {
"fullUrl": "urn:uuid:f595e663-d3d2-6865-fcf4-1bef077ead03",
"resource": {
"resourceType": "MedicationRequest",
"id": "f595e663-d3d2-6865-fcf4-1bef077ead03",
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"authoredOn": "2017-03-02T17:15:30+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"dosageInstruction": [ {
"sequence": 1,
"text": "Every six hours (qualifier value)",
"additionalInstruction": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "307468000",
"display": "Every six hours (qualifier value)"
} ],
"text": "Every six hours (qualifier value)"
} ],
"timing": {
"repeat": {
"frequency": 4,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:295a50f2-2fb5-d557-8f50-d5d895650102",
"resource": {
"resourceType": "Claim",
"id": "295a50f2-2fb5-d557-8f50-d5d895650102",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+01:00"
},
"created": "2017-03-02T17:49:47+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:f595e663-d3d2-6865-fcf4-1bef077ead03"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"encounter": [ {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
} ]
} ],
"total": {
"value": 129.94,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:f17a6cde-900a-175c-2d00-665415887335",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "f17a6cde-900a-175c-2d00-665415887335",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "295a50f2-2fb5-d557-8f50-d5d895650102"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2017-03-02T17:49:47+01:00",
"end": "2018-03-02T17:49:47+01:00"
},
"created": "2017-03-02T17:49:47+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:295a50f2-2fb5-d557-8f50-d5d895650102"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"servicedPeriod": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
} ]
} ],
"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:afc35f43-71fd-2656-5ce2-32222180668f",
"resource": {
"resourceType": "Immunization",
"id": "afc35f43-71fd-2656-5ce2-32222180668f",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"occurrenceDateTime": "2017-03-02T17:15:30+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:3285e310-3696-acb3-aeb0-b28b52ce4750",
"resource": {
"resourceType": "DiagnosticReport",
"id": "3285e310-3696-acb3-aeb0-b28b52ce4750",
"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": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T17:15:30+01:00",
"issued": "2017-03-02T17:15:30.236+01:00",
"performer": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
} ],
"result": [ {
"reference": "urn:uuid:1db661c7-b745-7a7b-c979-bef7be608b77",
"display": "Glucose [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:2191a01f-52c0-5d1c-52f4-580e7ef8b73e",
"display": "Urea nitrogen [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:619fb6ba-39a4-d735-12d6-c0db15dfc8a5",
"display": "Creatinine [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:44ea56af-ff74-9b9a-b135-0fa0897dde2f",
"display": "Calcium [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:1708b9cc-a9aa-d016-feff-57d50820f0b3",
"display": "Sodium [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:79e8f45d-4968-5cb2-3e46-82153441fe3c",
"display": "Potassium [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:45fc104a-5cff-6b36-04e2-2f583b377f31",
"display": "Chloride [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:bea04569-5538-daf0-11b5-1b666eb789b5",
"display": "Carbon dioxide, total [Moles/volume] in Blood"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:805f8f4c-8270-131f-1a25-abd87af039cf",
"resource": {
"resourceType": "DiagnosticReport",
"id": "805f8f4c-8270-131f-1a25-abd87af039cf",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T18:17:31+01:00",
"issued": "2017-03-02T18:17:31.236+01:00",
"result": [ {
"reference": "urn:uuid:d83e1162-ae8c-885a-fc35-23f6ddf6ac09",
"display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:2eb8d091-dbba-f1b1-fc6a-243e8a634325",
"resource": {
"resourceType": "DiagnosticReport",
"id": "2eb8d091-dbba-f1b1-fc6a-243e8a634325",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T18:54:19+01:00",
"issued": "2017-03-02T18:54:19.236+01:00",
"result": [ {
"reference": "urn:uuid:0c2dbe79-e84f-fe3a-1530-6d4040b4d037",
"display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:baf64dc5-708c-7639-c091-1ca242394749",
"resource": {
"resourceType": "DiagnosticReport",
"id": "baf64dc5-708c-7639-c091-1ca242394749",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72109-2",
"display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
} ],
"text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T19:36:06+01:00",
"issued": "2017-03-02T19:36:06.236+01:00",
"result": [ {
"reference": "urn:uuid:7be3d6ce-1d6d-a18d-18ad-4ee427e6fa2a",
"display": "Total score [AUDIT-C]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:eff024bc-2a01-f624-5f51-12d40fd80c1e",
"resource": {
"resourceType": "CareTeam",
"id": "eff024bc-2a01-f624-5f51-12d40fd80c1e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam" ]
},
"status": "active",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"period": {
"start": "2017-03-02T17:15:30+01:00"
},
"participant": [ {
"role": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "116154003",
"display": "Patient"
} ],
"text": "Patient"
} ],
"member": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
}
}, {
"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|9999965491",
"display": "Dr. Alvin56 Hayes766"
}
}, {
"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|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
} ],
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "15777000",
"display": "Prediabetes"
} ],
"text": "Prediabetes"
} ],
"managingOrganization": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
} ]
},
"request": {
"method": "POST",
"url": "CareTeam"
}
}, {
"fullUrl": "urn:uuid:9083f77e-e75f-4e01-1f01-4c262800fdff",
"resource": {
"resourceType": "CarePlan",
"id": "9083f77e-e75f-4e01-1f01-4c262800fdff",
"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 Diabetes self management plan.<br/>Care plan is meant to treat Prediabetes.<br/>Activities: <ul><li>Diabetes self management plan</li><li>Diabetes self management plan</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": "698360004",
"display": "Diabetes self management plan"
} ],
"text": "Diabetes self management plan"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"period": {
"start": "2017-03-02T17:15:30+01:00"
},
"careTeam": [ {
"reference": "urn:uuid:eff024bc-2a01-f624-5f51-12d40fd80c1e"
} ],
"addresses": [ {
"reference": "urn:uuid:4f524ecd-a8cf-1c77-1564-e331a276d98a"
} ],
"activity": [ {
"detail": {
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "160670007",
"display": "Diabetic diet"
} ],
"text": "Diabetic diet"
},
"reasonReference": [ {
"reference": "urn:uuid:4f524ecd-a8cf-1c77-1564-e331a276d98a"
} ],
"status": "in-progress",
"location": {
"display": "CHELMSFORD PRIMARY CARE LLC"
}
}
}, {
"detail": {
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "229065009",
"display": "Exercise therapy"
} ],
"text": "Exercise therapy"
},
"reasonReference": [ {
"reference": "urn:uuid:4f524ecd-a8cf-1c77-1564-e331a276d98a"
} ],
"status": "in-progress",
"location": {
"display": "CHELMSFORD PRIMARY CARE LLC"
}
}
} ]
},
"request": {
"method": "POST",
"url": "CarePlan"
}
}, {
"fullUrl": "urn:uuid:917dfe83-d0e5-4434-d6b5-aefab186357d",
"resource": {
"resourceType": "DiagnosticReport",
"id": "917dfe83-d0e5-4434-d6b5-aefab186357d",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
},
"effectiveDateTime": "2017-03-02T17:15:30+01:00",
"issued": "2017-03-02T17:15:30.236+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:050502f6-472f-3a2b-0c8f-4d2004b2f130",
"resource": {
"resourceType": "DocumentReference",
"id": "050502f6-472f-3a2b-0c8f-4d2004b2f130",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:917dfe83-d0e5-4434-d6b5-aefab186357d"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2017-03-02T17:15:30.236+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE 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:404579ff-bc16-574f-e03c-dc8d3ac82f49"
} ],
"period": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:82d4e373-ff2b-735d-2b61-53199b6b1fa7",
"resource": {
"resourceType": "Claim",
"id": "82d4e373-ff2b-735d-2b61-53199b6b1fa7",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+01:00"
},
"created": "2017-03-02T17:49:47+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:afc35f43-71fd-2656-5ce2-32222180668f"
}
}, {
"sequence": 2,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 4,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 5,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 6,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 7,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:7f40a25f-f7c5-d090-0777-da6c4e98c5c3"
}
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:4f524ecd-a8cf-1c77-1564-e331a276d98a"
}
}, {
"sequence": 3,
"diagnosisReference": {
"reference": "urn:uuid:b660e41e-2f50-c8ab-ff71-3333b2127959"
}
}, {
"sequence": 4,
"diagnosisReference": {
"reference": "urn:uuid:feb6eaea-1dbe-0b27-9397-1c90b547fe64"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:be013d0e-b588-d32e-f84b-cec829354467"
}
}, {
"sequence": 2,
"procedureReference": {
"reference": "urn:uuid:f8db9b5c-dbb4-6985-be81-5f8c1e4587dc"
}
}, {
"sequence": 3,
"procedureReference": {
"reference": "urn:uuid:74274553-6b86-9351-302c-021fd48f70fe"
}
}, {
"sequence": 4,
"procedureReference": {
"reference": "urn:uuid:6e307fbd-01d2-d4b6-13f4-803150583c08"
}
}, {
"sequence": 5,
"procedureReference": {
"reference": "urn:uuid:b3e7dc0f-8cea-38cd-163f-647881c3b1b9"
}
}, {
"sequence": 6,
"procedureReference": {
"reference": "urn:uuid:1eb7c3f2-3553-442d-f8a4-3e11d79a7571"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
} ]
}, {
"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,
"diagnosisSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "15777000",
"display": "Prediabetes"
} ],
"text": "Prediabetes"
}
}, {
"sequence": 5,
"informationSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "337414009",
"display": "Blood glucose meter (physical object)"
} ],
"text": "Blood glucose meter (physical object)"
},
"net": {
"value": 63.64,
"currency": "USD"
}
}, {
"sequence": 6,
"informationSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
},
"net": {
"value": 6.80,
"currency": "USD"
}
}, {
"sequence": 7,
"informationSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 8,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 9,
"diagnosisSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "160903007",
"display": "Full-time employment (finding)"
} ],
"text": "Full-time employment (finding)"
}
}, {
"sequence": 10,
"diagnosisSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "73595000",
"display": "Stress (finding)"
} ],
"text": "Stress (finding)"
}
}, {
"sequence": 11,
"procedureSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 12,
"informationSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 13,
"procedureSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 14,
"procedureSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 15,
"informationSequence": [ 6 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 16,
"procedureSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 17,
"procedureSequence": [ 6 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "763302001",
"display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
} ],
"text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 18,
"informationSequence": [ 7 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "72109-2",
"display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
} ],
"text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
} ],
"total": {
"value": 849.22,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:b2ec6b24-022a-55f0-ac5b-cc121a102c06",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "b2ec6b24-022a-55f0-ac5b-cc121a102c06",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "82d4e373-ff2b-735d-2b61-53199b6b1fa7"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2017-03-02T17:49:47+01:00",
"end": "2018-03-02T17:49:47+01:00"
},
"created": "2017-03-02T17:49:47+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:82d4e373-ff2b-735d-2b61-53199b6b1fa7"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:7f40a25f-f7c5-d090-0777-da6c4e98c5c3"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:4f524ecd-a8cf-1c77-1564-e331a276d98a"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
}, {
"sequence": 3,
"diagnosisReference": {
"reference": "urn:uuid:b660e41e-2f50-c8ab-ff71-3333b2127959"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
}, {
"sequence": 4,
"diagnosisReference": {
"reference": "urn:uuid:feb6eaea-1dbe-0b27-9397-1c90b547fe64"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"servicedPeriod": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
} ]
}, {
"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": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+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": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 4,
"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": "15777000",
"display": "Prediabetes"
} ],
"text": "Prediabetes"
},
"servicedPeriod": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"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://snomed.info/sct",
"code": "337414009",
"display": "Blood glucose meter (physical object)"
} ],
"text": "Blood glucose meter (physical object)"
},
"servicedPeriod": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 63.64,
"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": 12.728000000000002,
"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": 50.912000000000006,
"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": 63.64,
"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": 63.64,
"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": [ 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": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
},
"servicedPeriod": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 6.80,
"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": 1.36,
"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": 5.44,
"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": 6.80,
"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": 6.80,
"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,
"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://loinc.org",
"code": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"servicedPeriod": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+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"
} ]
}
} ]
}, {
"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": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"servicedPeriod": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 9,
"diagnosisSequence": [ 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": "160903007",
"display": "Full-time employment (finding)"
} ],
"text": "Full-time employment (finding)"
},
"servicedPeriod": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 10,
"diagnosisSequence": [ 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": "73595000",
"display": "Stress (finding)"
} ],
"text": "Stress (finding)"
},
"servicedPeriod": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 11,
"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": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"servicedPeriod": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 12,
"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://loinc.org",
"code": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"servicedPeriod": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+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"
} ]
}
} ]
}, {
"sequence": 13,
"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": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"servicedPeriod": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 14,
"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": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"servicedPeriod": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 15,
"informationSequence": [ 6 ],
"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": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"servicedPeriod": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+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"
} ]
}
} ]
}, {
"sequence": 16,
"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": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"servicedPeriod": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 17,
"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": "763302001",
"display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
} ],
"text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
},
"servicedPeriod": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 18,
"informationSequence": [ 7 ],
"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": "72109-2",
"display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
} ],
"text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
},
"servicedPeriod": {
"start": "2017-03-02T17:15:30+01:00",
"end": "2017-03-02T17:49:47+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": 849.22,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 2474.5280000000002,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2",
"resource": {
"resourceType": "Encounter",
"id": "7b01102b-7804-a9d4-e9e2-c1247e2051e2",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "7b01102b-7804-a9d4-e9e2-c1247e2051e2"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
}
} ],
"period": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4",
"resource": {
"resourceType": "Condition",
"id": "f442da11-4ee2-ad8b-5ffd-338dcae832a4",
"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": "59621000",
"display": "Essential hypertension (disorder)"
} ],
"text": "Essential hypertension (disorder)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"onsetDateTime": "2018-03-08T17:15:30+01:00",
"recordedDate": "2018-03-08T17:15:30+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:4667d279-6e93-6038-30de-c970dec13412",
"resource": {
"resourceType": "Observation",
"id": "4667d279-6e93-6038-30de-c970dec13412",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "4548-4",
"display": "Hemoglobin A1c/Hemoglobin.total in Blood"
} ],
"text": "Hemoglobin A1c/Hemoglobin.total in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"valueQuantity": {
"value": 6,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:740e0592-2683-e14b-c9bb-8c1a01d9c1f0",
"resource": {
"resourceType": "Observation",
"id": "740e0592-2683-e14b-c9bb-8c1a01d9c1f0",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"valueQuantity": {
"value": 174.1,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:c05d2e32-0de8-b335-35a7-f55dc34386f5",
"resource": {
"resourceType": "Observation",
"id": "c05d2e32-0de8-b335-35a7-f55dc34386f5",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"valueQuantity": {
"value": 0,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e7f1019c-fb12-3a70-f452-51395c3f0372",
"resource": {
"resourceType": "Observation",
"id": "e7f1019c-fb12-3a70-f452-51395c3f0372",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"valueQuantity": {
"value": 88.3,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:818e134b-396f-13d7-aab3-f55a94bd29f8",
"resource": {
"resourceType": "Observation",
"id": "818e134b-396f-13d7-aab3-f55a94bd29f8",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"valueQuantity": {
"value": 29.12,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:2fd2a7e7-e576-92f0-ff3c-4df445946d10",
"resource": {
"resourceType": "Observation",
"id": "2fd2a7e7-e576-92f0-ff3c-4df445946d10",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 94,
"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": 129,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e12f2ada-a8fa-646d-29c0-fc10755ba324",
"resource": {
"resourceType": "Observation",
"id": "e12f2ada-a8fa-646d-29c0-fc10755ba324",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"valueQuantity": {
"value": 77,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:f9351122-8d48-bd31-cd73-56722cc4ac98",
"resource": {
"resourceType": "Observation",
"id": "f9351122-8d48-bd31-cd73-56722cc4ac98",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"valueQuantity": {
"value": 14,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:6f204efb-0ebf-da52-c91c-b78e018748d6",
"resource": {
"resourceType": "Observation",
"id": "6f204efb-0ebf-da52-c91c-b78e018748d6",
"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": "2339-0",
"display": "Glucose [Mass/volume] in Blood"
} ],
"text": "Glucose [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"valueQuantity": {
"value": 84.05,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:74342955-03c8-e2de-07ab-85ee448fd4e5",
"resource": {
"resourceType": "Observation",
"id": "74342955-03c8-e2de-07ab-85ee448fd4e5",
"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": "6299-2",
"display": "Urea nitrogen [Mass/volume] in Blood"
} ],
"text": "Urea nitrogen [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"valueQuantity": {
"value": 14.35,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:aac062fb-c0f0-6331-945b-f85f9f6b046b",
"resource": {
"resourceType": "Observation",
"id": "aac062fb-c0f0-6331-945b-f85f9f6b046b",
"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": "38483-4",
"display": "Creatinine [Mass/volume] in Blood"
} ],
"text": "Creatinine [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"valueQuantity": {
"value": 1.35,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:7160ec77-5d08-1c04-048a-8c09e94b9500",
"resource": {
"resourceType": "Observation",
"id": "7160ec77-5d08-1c04-048a-8c09e94b9500",
"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": "49765-1",
"display": "Calcium [Mass/volume] in Blood"
} ],
"text": "Calcium [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"valueQuantity": {
"value": 10,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e78617d2-ae57-24de-df16-e7cf5ca0f7b8",
"resource": {
"resourceType": "Observation",
"id": "e78617d2-ae57-24de-df16-e7cf5ca0f7b8",
"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": "2947-0",
"display": "Sodium [Moles/volume] in Blood"
} ],
"text": "Sodium [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"valueQuantity": {
"value": 138.37,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:c765c4a5-cf85-41ca-bd87-11f600768001",
"resource": {
"resourceType": "Observation",
"id": "c765c4a5-cf85-41ca-bd87-11f600768001",
"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": "6298-4",
"display": "Potassium [Moles/volume] in Blood"
} ],
"text": "Potassium [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"valueQuantity": {
"value": 5.2,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:cb04c84e-aef9-604a-0475-dc0c92962bb0",
"resource": {
"resourceType": "Observation",
"id": "cb04c84e-aef9-604a-0475-dc0c92962bb0",
"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": "2069-3",
"display": "Chloride [Moles/volume] in Blood"
} ],
"text": "Chloride [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"valueQuantity": {
"value": 103.31,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:67381681-8a6e-6f8b-a421-a90aab875855",
"resource": {
"resourceType": "Observation",
"id": "67381681-8a6e-6f8b-a421-a90aab875855",
"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": "20565-8",
"display": "Carbon dioxide, total [Moles/volume] in Blood"
} ],
"text": "Carbon dioxide, total [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"valueQuantity": {
"value": 21.97,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:68238db0-832b-9555-b384-2b40ef7c263b",
"resource": {
"resourceType": "Observation",
"id": "68238db0-832b-9555-b384-2b40ef7c263b",
"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": "2093-3",
"display": "Cholesterol [Mass/volume] in Serum or Plasma"
} ],
"text": "Cholesterol [Mass/volume] in Serum or Plasma"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"valueQuantity": {
"value": 154.79,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:afc635c4-8d4d-f9e4-1a1a-f43eb7b50ac6",
"resource": {
"resourceType": "Observation",
"id": "afc635c4-8d4d-f9e4-1a1a-f43eb7b50ac6",
"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": "2571-8",
"display": "Triglycerides"
} ],
"text": "Triglycerides"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"valueQuantity": {
"value": 119.81,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:2842795b-b1b8-da6a-257c-abb6edc59e46",
"resource": {
"resourceType": "Observation",
"id": "2842795b-b1b8-da6a-257c-abb6edc59e46",
"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": "18262-6",
"display": "Low Density Lipoprotein Cholesterol"
} ],
"text": "Low Density Lipoprotein Cholesterol"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"valueQuantity": {
"value": 76.47,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:10142431-da04-0b37-55be-d68db35aa4ac",
"resource": {
"resourceType": "Observation",
"id": "10142431-da04-0b37-55be-d68db35aa4ac",
"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": "2085-9",
"display": "Cholesterol in HDL [Mass/volume] in Serum or Plasma"
} ],
"text": "Cholesterol in HDL [Mass/volume] in Serum or Plasma"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"valueQuantity": {
"value": 54.36,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:4bb4ca26-9bdf-e193-201b-bb6615b949cb",
"resource": {
"resourceType": "Observation",
"id": "4bb4ca26-9bdf-e193-201b-bb6615b949cb",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "8517006",
"display": "Ex-smoker (finding)"
} ],
"text": "Ex-smoker (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:57da79b5-845c-4885-13fa-5401976e5c46",
"resource": {
"resourceType": "Observation",
"id": "57da79b5-845c-4885-13fa-5401976e5c46",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93025-5",
"display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
} ],
"text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:50:06+01:00",
"issued": "2018-03-08T17:50:06.236+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76501-6",
"display": "Within the last year, have you been afraid of your partner or ex-partner?"
} ],
"text": "Within the last year, have you been afraid of your partner or ex-partner?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93026-3",
"display": "Do you feel physically and emotionally safe where you currently live?"
} ],
"text": "Do you feel physically and emotionally safe where you currently live?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93027-1",
"display": "Are you a refugee?"
} ],
"text": "Are you a refugee?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93028-9",
"display": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
} ],
"text": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93038-8",
"display": "Stress level"
} ],
"text": "Stress level"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA13863-8",
"display": "A little bit"
} ],
"text": "A little bit"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93029-7",
"display": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
} ],
"text": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30132-7",
"display": "5 or more times a week"
} ],
"text": "5 or more times a week"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93030-5",
"display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
} ],
"text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93031-3",
"display": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
} ],
"text": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30125-1",
"display": "Food"
} ],
"text": "Food"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63586-2",
"display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
} ],
"text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
},
"valueQuantity": {
"value": 55950,
"unit": "/a",
"system": "http://unitsofmeasure.org",
"code": "/a"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76437-3",
"display": "Primary insurance"
} ],
"text": "Primary insurance"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30194-7",
"display": "None/uninsured"
} ],
"text": "None/uninsured"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "67875-5",
"display": "Employment status - current"
} ],
"text": "Employment status - current"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30136-8",
"display": "Full-time work"
} ],
"text": "Full-time work"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82589-3",
"display": "Highest level of education"
} ],
"text": "Highest level of education"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30193-9",
"display": "More than high school"
} ],
"text": "More than high school"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56799-0",
"display": "Address"
} ],
"text": "Address"
},
"valueString": "287 Treutel Neck"
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93033-9",
"display": "Are you worried about losing your housing?"
} ],
"text": "Are you worried about losing your housing?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "71802-3",
"display": "Housing status"
} ],
"text": "Housing status"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30189-7",
"display": "I have housing"
} ],
"text": "I have housing"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63512-8",
"display": "How many people are living or staying at this address?"
} ],
"text": "How many people are living or staying at this address?"
},
"valueQuantity": {
"value": 7,
"unit": "{#}",
"system": "http://unitsofmeasure.org",
"code": "{#}"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "54899-0",
"display": "Preferred language"
} ],
"text": "Preferred language"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA43-5",
"display": "English"
} ],
"text": "English"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93034-7",
"display": "Have you been discharged from the armed forces of the United States?"
} ],
"text": "Have you been discharged from the armed forces of the United States?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93035-4",
"display": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
} ],
"text": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "32624-9",
"display": "Race"
} ],
"text": "Race"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA4457-3",
"display": "White"
} ],
"text": "White"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56051-6",
"display": "Do you consider yourself Hispanic/Latino?"
} ],
"text": "Do you consider yourself Hispanic/Latino?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:b2d01746-a5c9-7206-dc7d-378d7db0457b",
"resource": {
"resourceType": "Observation",
"id": "b2d01746-a5c9-7206-dc7d-378d7db0457b",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "70274-6",
"display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T18:15:09+01:00",
"issued": "2018-03-08T18:15:09.236+01:00",
"valueQuantity": {
"value": 4,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:97dc94ac-83a1-2df8-27ba-7d8c81e79498",
"resource": {
"resourceType": "Observation",
"id": "97dc94ac-83a1-2df8-27ba-7d8c81e79498",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76504-0",
"display": "Total score [HARK]"
} ],
"text": "Total score [HARK]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T18:43:33+01:00",
"issued": "2018-03-08T18:43:33.236+01:00",
"valueQuantity": {
"value": 0,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d6b0f307-af18-d494-fb92-f75a81548802",
"resource": {
"resourceType": "Observation",
"id": "d6b0f307-af18-d494-fb92-f75a81548802",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "55758-7",
"display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T19:27:08+01:00",
"issued": "2018-03-08T19:27:08.236+01:00",
"valueQuantity": {
"value": 1,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e72ab75d-8b76-7285-704f-a48f337153be",
"resource": {
"resourceType": "Procedure",
"id": "e72ab75d-8b76-7285-704f-a48f337153be",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"performedPeriod": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:b91a16b8-341d-f018-eb2a-45c77ce269b3",
"resource": {
"resourceType": "Procedure",
"id": "b91a16b8-341d-f018-eb2a-45c77ce269b3",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"performedPeriod": {
"start": "2018-03-08T17:50:06+01:00",
"end": "2018-03-08T18:15:09+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:20bb8f49-39ab-c282-d548-f263d7cc5485",
"resource": {
"resourceType": "Procedure",
"id": "20bb8f49-39ab-c282-d548-f263d7cc5485",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "866148006",
"display": "Screening for domestic abuse (procedure)"
} ],
"text": "Screening for domestic abuse (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"performedPeriod": {
"start": "2018-03-08T18:15:09+01:00",
"end": "2018-03-08T18:43:33+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:0559355b-8090-4770-c84a-cd71442a8bcf",
"resource": {
"resourceType": "Procedure",
"id": "0559355b-8090-4770-c84a-cd71442a8bcf",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"performedPeriod": {
"start": "2018-03-08T18:43:33+01:00",
"end": "2018-03-08T18:57:38+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:682b6dc3-2c57-11fe-4c60-596f13ae1422",
"resource": {
"resourceType": "Procedure",
"id": "682b6dc3-2c57-11fe-4c60-596f13ae1422",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"performedPeriod": {
"start": "2018-03-08T18:57:38+01:00",
"end": "2018-03-08T19:27:08+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:4109e540-a9a7-a07b-e5a9-344fa455995f",
"resource": {
"resourceType": "SupplyDelivery",
"id": "4109e540-a9a7-a07b-e5a9-344fa455995f",
"status": "completed",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/supply-item-type",
"code": "device",
"display": "Device"
} ]
},
"suppliedItem": {
"quantity": {
"value": 50
},
"itemCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
}
},
"occurrenceDateTime": "2018-03-08T17:15:30+01:00"
},
"request": {
"method": "POST",
"url": "SupplyDelivery"
}
}, {
"fullUrl": "urn:uuid:4506ce53-9413-164e-0f7f-5c6b7555518a",
"resource": {
"resourceType": "SupplyDelivery",
"id": "4506ce53-9413-164e-0f7f-5c6b7555518a",
"status": "completed",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/supply-item-type",
"code": "device",
"display": "Device"
} ]
},
"suppliedItem": {
"quantity": {
"value": 50
},
"itemCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
}
},
"occurrenceDateTime": "2018-03-08T17:15:30+01:00"
},
"request": {
"method": "POST",
"url": "SupplyDelivery"
}
}, {
"fullUrl": "urn:uuid:0695d40b-8431-fc6b-3870-69980d1e672b",
"resource": {
"resourceType": "MedicationRequest",
"id": "0695d40b-8431-fc6b-3870-69980d1e672b",
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"authoredOn": "2018-03-08T17:15:30+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"dosageInstruction": [ {
"sequence": 1,
"text": "Every six hours (qualifier value)",
"additionalInstruction": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "307468000",
"display": "Every six hours (qualifier value)"
} ],
"text": "Every six hours (qualifier value)"
} ],
"timing": {
"repeat": {
"frequency": 4,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:ba0e1726-a26d-72b3-c2e9-221135efb555",
"resource": {
"resourceType": "Claim",
"id": "ba0e1726-a26d-72b3-c2e9-221135efb555",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+01:00"
},
"created": "2018-03-08T17:50:06+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:0695d40b-8431-fc6b-3870-69980d1e672b"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"encounter": [ {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
} ]
} ],
"total": {
"value": 129.94,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:b4c874f4-330e-8258-c3aa-112bf1be194e",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "b4c874f4-330e-8258-c3aa-112bf1be194e",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "ba0e1726-a26d-72b3-c2e9-221135efb555"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-03-08T17:50:06+01:00",
"end": "2019-03-08T17:50:06+01:00"
},
"created": "2018-03-08T17:50:06+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:ba0e1726-a26d-72b3-c2e9-221135efb555"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"servicedPeriod": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
} ]
} ],
"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:f1cc8416-e7b7-7332-abe9-00937228097d",
"resource": {
"resourceType": "MedicationRequest",
"id": "f1cc8416-e7b7-7332-abe9-00937228097d",
"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": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"authoredOn": "2018-03-08T17:15:30+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"reasonReference": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4",
"display": "Essential hypertension (disorder)"
} ],
"dosageInstruction": [ {
"sequence": 1,
"timing": {
"repeat": {
"frequency": 1,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:d8391c25-0e09-fc50-29bb-addf3b93d75b",
"resource": {
"resourceType": "Claim",
"id": "d8391c25-0e09-fc50-29bb-addf3b93d75b",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+01:00"
},
"created": "2018-03-08T17:50:06+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:f1cc8416-e7b7-7332-abe9-00937228097d"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
} ]
} ],
"total": {
"value": 0.91,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:2d8add4f-17b7-4650-9e69-d80d738f81d6",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "2d8add4f-17b7-4650-9e69-d80d738f81d6",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "d8391c25-0e09-fc50-29bb-addf3b93d75b"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-03-08T17:50:06+01:00",
"end": "2019-03-08T17:50:06+01:00"
},
"created": "2018-03-08T17:50:06+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:d8391c25-0e09-fc50-29bb-addf3b93d75b"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 0.91,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:9b48399c-7b2d-5375-3579-1e9659bf8140",
"resource": {
"resourceType": "Immunization",
"id": "9b48399c-7b2d-5375-3579-1e9659bf8140",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"occurrenceDateTime": "2018-03-08T17:15:30+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:f7716e02-b501-07d9-a79e-f1b3de32f9d6",
"resource": {
"resourceType": "DiagnosticReport",
"id": "f7716e02-b501-07d9-a79e-f1b3de32f9d6",
"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": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"performer": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
} ],
"result": [ {
"reference": "urn:uuid:6f204efb-0ebf-da52-c91c-b78e018748d6",
"display": "Glucose [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:74342955-03c8-e2de-07ab-85ee448fd4e5",
"display": "Urea nitrogen [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:aac062fb-c0f0-6331-945b-f85f9f6b046b",
"display": "Creatinine [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:7160ec77-5d08-1c04-048a-8c09e94b9500",
"display": "Calcium [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:e78617d2-ae57-24de-df16-e7cf5ca0f7b8",
"display": "Sodium [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:c765c4a5-cf85-41ca-bd87-11f600768001",
"display": "Potassium [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:cb04c84e-aef9-604a-0475-dc0c92962bb0",
"display": "Chloride [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:67381681-8a6e-6f8b-a421-a90aab875855",
"display": "Carbon dioxide, total [Moles/volume] in Blood"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:1bf538ae-b7fa-cfc1-e4b5-f72ebfc8d7de",
"resource": {
"resourceType": "DiagnosticReport",
"id": "1bf538ae-b7fa-cfc1-e4b5-f72ebfc8d7de",
"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": "57698-3",
"display": "Lipid panel with direct LDL - Serum or Plasma"
} ],
"text": "Lipid panel with direct LDL - Serum or Plasma"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"performer": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
} ],
"result": [ {
"reference": "urn:uuid:68238db0-832b-9555-b384-2b40ef7c263b",
"display": "Cholesterol [Mass/volume] in Serum or Plasma"
}, {
"reference": "urn:uuid:afc635c4-8d4d-f9e4-1a1a-f43eb7b50ac6",
"display": "Triglycerides"
}, {
"reference": "urn:uuid:2842795b-b1b8-da6a-257c-abb6edc59e46",
"display": "Low Density Lipoprotein Cholesterol"
}, {
"reference": "urn:uuid:10142431-da04-0b37-55be-d68db35aa4ac",
"display": "Cholesterol in HDL [Mass/volume] in Serum or Plasma"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:c90ff7f7-1a67-459a-d764-9d65c85b5c79",
"resource": {
"resourceType": "DiagnosticReport",
"id": "c90ff7f7-1a67-459a-d764-9d65c85b5c79",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T18:15:09+01:00",
"issued": "2018-03-08T18:15:09.236+01:00",
"result": [ {
"reference": "urn:uuid:b2d01746-a5c9-7206-dc7d-378d7db0457b",
"display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:5b400ea0-5da7-3800-90ae-5669d37c22a3",
"resource": {
"resourceType": "DiagnosticReport",
"id": "5b400ea0-5da7-3800-90ae-5669d37c22a3",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76499-3",
"display": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
} ],
"text": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T18:43:33+01:00",
"issued": "2018-03-08T18:43:33.236+01:00",
"result": [ {
"reference": "urn:uuid:97dc94ac-83a1-2df8-27ba-7d8c81e79498",
"display": "Total score [HARK]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:4aeda98a-3c63-ba6a-3baf-2991d719bb91",
"resource": {
"resourceType": "DiagnosticReport",
"id": "4aeda98a-3c63-ba6a-3baf-2991d719bb91",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T19:27:08+01:00",
"issued": "2018-03-08T19:27:08.236+01:00",
"result": [ {
"reference": "urn:uuid:d6b0f307-af18-d494-fb92-f75a81548802",
"display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:719d456e-69ff-0096-8f60-7ddde75e3682",
"resource": {
"resourceType": "CareTeam",
"id": "719d456e-69ff-0096-8f60-7ddde75e3682",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam" ]
},
"status": "active",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"period": {
"start": "2018-03-08T17:15:30+01:00"
},
"participant": [ {
"role": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "116154003",
"display": "Patient"
} ],
"text": "Patient"
} ],
"member": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
}
}, {
"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|9999965491",
"display": "Dr. Alvin56 Hayes766"
}
}, {
"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|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
} ],
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "59621000",
"display": "Essential hypertension (disorder)"
} ],
"text": "Essential hypertension (disorder)"
} ],
"managingOrganization": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
} ]
},
"request": {
"method": "POST",
"url": "CareTeam"
}
}, {
"fullUrl": "urn:uuid:c39de5a5-f4f6-64a0-e3de-1c5ce90b877a",
"resource": {
"resourceType": "CarePlan",
"id": "c39de5a5-f4f6-64a0-e3de-1c5ce90b877a",
"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 Lifestyle education regarding hypertension.<br/>Care plan is meant to treat Essential hypertension (disorder).<br/>Activities: <ul><li>Lifestyle education regarding hypertension</li><li>Lifestyle education regarding hypertension</li><li>Lifestyle education regarding hypertension</li><li>Lifestyle education regarding hypertension</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": "443402002",
"display": "Lifestyle education regarding hypertension"
} ],
"text": "Lifestyle education regarding hypertension"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"period": {
"start": "2018-03-08T17:15:30+01:00"
},
"careTeam": [ {
"reference": "urn:uuid:719d456e-69ff-0096-8f60-7ddde75e3682"
} ],
"addresses": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4"
} ],
"activity": [ {
"detail": {
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "386463000",
"display": "Prescribed activity/exercise education"
} ],
"text": "Prescribed activity/exercise education"
},
"reasonReference": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4"
} ],
"status": "in-progress",
"location": {
"display": "CHELMSFORD PRIMARY CARE LLC"
}
}
}, {
"detail": {
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "413473000",
"display": "Counseling about alcohol consumption"
} ],
"text": "Counseling about alcohol consumption"
},
"reasonReference": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4"
} ],
"status": "in-progress",
"location": {
"display": "CHELMSFORD PRIMARY CARE LLC"
}
}
}, {
"detail": {
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "1151000175103",
"display": "Dietary approaches to stop hypertension diet"
} ],
"text": "Dietary approaches to stop hypertension diet"
},
"reasonReference": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4"
} ],
"status": "in-progress",
"location": {
"display": "CHELMSFORD PRIMARY CARE LLC"
}
}
}, {
"detail": {
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "225323000",
"display": "Smoking cessation education"
} ],
"text": "Smoking cessation education"
},
"reasonReference": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4"
} ],
"status": "in-progress",
"location": {
"display": "CHELMSFORD PRIMARY CARE LLC"
}
}
} ]
},
"request": {
"method": "POST",
"url": "CarePlan"
}
}, {
"fullUrl": "urn:uuid:f02ad92b-b193-aa94-5f8b-c6ecf3763d1f",
"resource": {
"resourceType": "DiagnosticReport",
"id": "f02ad92b-b193-aa94-5f8b-c6ecf3763d1f",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
},
"effectiveDateTime": "2018-03-08T17:15:30+01:00",
"issued": "2018-03-08T17:15:30.236+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "CjIwMTgtMDMtMDgKCiMgQ2hpZWYgQ29tcGxhaW50Ck5vIGNvbXBsYWludHMuCgojIEhpc3Rvcnkgb2YgUHJlc2VudCBJbGxuZXNzCk11cnJheTg1NgogaXMgYSAzMCB5ZWFyLW9sZCBub25oaXNwYW5pYyB3aGl0ZSBtYWxlLiBQYXRpZW50IGhhcyBhIGhpc3Rvcnkgb2YgcGFydC10aW1lIGVtcGxveW1lbnQgKGZpbmRpbmcpLCBtZWRpY2F0aW9uIHJldmlldyBkdWUgKHNpdHVhdGlvbiksIHVuaGVhbHRoeSBhbGNvaG9sIGRyaW5raW5nIGJlaGF2aW9yIChmaW5kaW5nKSwgcmVwb3J0cyBvZiB2aW9sZW5jZSBpbiB0aGUgZW52aXJvbm1lbnQgKGZpbmRpbmcpLCBmdWxsLXRpbWUgZW1wbG95bWVudCAoZmluZGluZyksIGFjdXRlIHZpcmFsIHBoYXJ5bmdpdGlzIChkaXNvcmRlciksIHN0cmVzcyAoZmluZGluZykuCgojIFNvY2lhbCBIaXN0b3J5ClBhdGllbnQgaXMgbWFycmllZC4gUGF0aWVudCBxdWl0IHNtb2tpbmcgYXQgYWdlIDE2LgogUGF0aWVudCBpZGVudGlmaWVzIGFzIGhldGVyb3NleHVhbC4KClBhdGllbnQgY29tZXMgZnJvbSBhIGhpZ2ggc29jaW9lY29ub21pYyBiYWNrZ3JvdW5kLgogUGF0aWVudCBpcyBhIGNvbGxlZ2UgZ3JhZHVhdGUuClBhdGllbnQgY3VycmVudGx5IGhhcyBOTyBJTlNVUkFOQ0UuCgojIEFsbGVyZ2llcwpObyBLbm93biBBbGxlcmdpZXMuCgojIE1lZGljYXRpb25zCmFjZXRhbWlub3BoZW4gMzI1IG1nIC8gb3h5Y29kb25lIGh5ZHJvY2hsb3JpZGUgMTAgbWcgb3JhbCB0YWJsZXQgW3BlcmNvY2V0XQoKIyBBc3Nlc3NtZW50IGFuZCBQbGFuClBhdGllbnQgaXMgcHJlc2VudGluZyB3aXRoIGVzc2VudGlhbCBoeXBlcnRlbnNpb24gKGRpc29yZGVyKS4gCgojIyBQbGFuClBhdGllbnQgd2FzIGdpdmVuIHRoZSBmb2xsb3dpbmcgaW1tdW5pemF0aW9uczogaW5mbHVlbnphLCBzZWFzb25hbCwgaW5qZWN0YWJsZSwgcHJlc2VydmF0aXZlIGZyZWUuIApUaGUgZm9sbG93aW5nIHByb2NlZHVyZXMgd2VyZSBjb25kdWN0ZWQ6Ci0gYXNzZXNzbWVudCBvZiBoZWFsdGggYW5kIHNvY2lhbCBjYXJlIG5lZWRzIChwcm9jZWR1cmUpCi0gYXNzZXNzbWVudCBvZiBhbnhpZXR5IChwcm9jZWR1cmUpCi0gc2NyZWVuaW5nIGZvciBkb21lc3RpYyBhYnVzZSAocHJvY2VkdXJlKQotIGRlcHJlc3Npb24gc2NyZWVuaW5nIChwcm9jZWR1cmUpCi0gZGVwcmVzc2lvbiBzY3JlZW5pbmcgdXNpbmcgcGF0aWVudCBoZWFsdGggcXVlc3Rpb25uYWlyZSB0d28taXRlbSBzY29yZSAocHJvY2VkdXJlKQpUaGUgcGF0aWVudCB3YXMgcHJlc2NyaWJlZCB0aGUgZm9sbG93aW5nIG1lZGljYXRpb25zOgotIGFjZXRhbWlub3BoZW4gMzI1IG1nIC8gb3h5Y29kb25lIGh5ZHJvY2hsb3JpZGUgMTAgbWcgb3JhbCB0YWJsZXQgW3BlcmNvY2V0XQotIGxpc2lub3ByaWwgMTAgbWcgb3JhbCB0YWJsZXQKVGhlIHBhdGllbnQgd2FzIHBsYWNlZCBvbiBhIGNhcmVwbGFuOgotIGxpZmVzdHlsZSBlZHVjYXRpb24gcmVnYXJkaW5nIGh5cGVydGVuc2lvbgo="
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:64117db3-8d0c-2142-78a5-d12e947a2b51",
"resource": {
"resourceType": "DocumentReference",
"id": "64117db3-8d0c-2142-78a5-d12e947a2b51",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:f02ad92b-b193-aa94-5f8b-c6ecf3763d1f"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2018-03-08T17:15:30.236+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE 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:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
} ],
"period": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:516aa582-406e-eb68-5de1-d83bdfe078d5",
"resource": {
"resourceType": "Claim",
"id": "516aa582-406e-eb68-5de1-d83bdfe078d5",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+01:00"
},
"created": "2018-03-08T17:50:06+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:9b48399c-7b2d-5375-3579-1e9659bf8140"
}
}, {
"sequence": 2,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 4,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 5,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 6,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 7,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 8,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:e72ab75d-8b76-7285-704f-a48f337153be"
}
}, {
"sequence": 2,
"procedureReference": {
"reference": "urn:uuid:b91a16b8-341d-f018-eb2a-45c77ce269b3"
}
}, {
"sequence": 3,
"procedureReference": {
"reference": "urn:uuid:20bb8f49-39ab-c282-d548-f263d7cc5485"
}
}, {
"sequence": 4,
"procedureReference": {
"reference": "urn:uuid:0559355b-8090-4770-c84a-cd71442a8bcf"
}
}, {
"sequence": 5,
"procedureReference": {
"reference": "urn:uuid:682b6dc3-2c57-11fe-4c60-596f13ae1422"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
} ]
}, {
"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": "59621000",
"display": "Essential hypertension (disorder)"
} ],
"text": "Essential hypertension (disorder)"
}
}, {
"sequence": 4,
"informationSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
},
"net": {
"value": 6.80,
"currency": "USD"
}
}, {
"sequence": 5,
"informationSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
},
"net": {
"value": 6.80,
"currency": "USD"
}
}, {
"sequence": 6,
"informationSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 7,
"informationSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "57698-3",
"display": "Lipid panel with direct LDL - Serum or Plasma"
} ],
"text": "Lipid panel with direct LDL - Serum or Plasma"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 8,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 9,
"procedureSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 10,
"informationSequence": [ 6 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 11,
"procedureSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "866148006",
"display": "Screening for domestic abuse (procedure)"
} ],
"text": "Screening for domestic abuse (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 12,
"informationSequence": [ 7 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "76499-3",
"display": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
} ],
"text": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 13,
"procedureSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 14,
"procedureSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 15,
"informationSequence": [ 8 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
} ],
"total": {
"value": 866.96,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:f24dc453-27d6-daf2-632c-bf1183af1679",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "f24dc453-27d6-daf2-632c-bf1183af1679",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "516aa582-406e-eb68-5de1-d83bdfe078d5"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-03-08T17:50:06+01:00",
"end": "2019-03-08T17:50:06+01:00"
},
"created": "2018-03-08T17:50:06+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:516aa582-406e-eb68-5de1-d83bdfe078d5"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"servicedPeriod": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
} ]
}, {
"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": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+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": "59621000",
"display": "Essential hypertension (disorder)"
} ],
"text": "Essential hypertension (disorder)"
},
"servicedPeriod": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+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://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
},
"servicedPeriod": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 6.80,
"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": 1.36,
"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": 5.44,
"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": 6.80,
"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": 6.80,
"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": [ 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": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
},
"servicedPeriod": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 6.80,
"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": 1.36,
"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": 5.44,
"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": 6.80,
"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": 6.80,
"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": [ 4 ],
"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": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"servicedPeriod": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+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"
} ]
}
} ]
}, {
"sequence": 7,
"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://loinc.org",
"code": "57698-3",
"display": "Lipid panel with direct LDL - Serum or Plasma"
} ],
"text": "Lipid panel with direct LDL - Serum or Plasma"
},
"servicedPeriod": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+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"
} ]
}
} ]
}, {
"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": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"servicedPeriod": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 9,
"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": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"servicedPeriod": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 10,
"informationSequence": [ 6 ],
"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": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"servicedPeriod": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+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"
} ]
}
} ]
}, {
"sequence": 11,
"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": "866148006",
"display": "Screening for domestic abuse (procedure)"
} ],
"text": "Screening for domestic abuse (procedure)"
},
"servicedPeriod": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 12,
"informationSequence": [ 7 ],
"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": "76499-3",
"display": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
} ],
"text": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
},
"servicedPeriod": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+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"
} ]
}
} ]
}, {
"sequence": 13,
"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": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"servicedPeriod": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 14,
"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": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"servicedPeriod": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 15,
"informationSequence": [ 8 ],
"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": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"servicedPeriod": {
"start": "2018-03-08T17:15:30+01:00",
"end": "2018-03-08T17:50:06+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": 866.96,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 2143.6,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:a80df190-68b6-6d0d-85c8-c21d0680a459",
"resource": {
"resourceType": "Encounter",
"id": "a80df190-68b6-6d0d-85c8-c21d0680a459",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "a80df190-68b6-6d0d-85c8-c21d0680a459"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2018-03-30T20:15:30+02:00",
"end": "2018-03-30T20:30:30+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
}
} ],
"period": {
"start": "2018-03-30T20:15:30+02:00",
"end": "2018-03-30T20:30:30+02:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "36971009",
"display": "Sinusitis (disorder)"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:3e5863c4-88bf-fea4-2669-1a360e16c2dc",
"resource": {
"resourceType": "Condition",
"id": "3e5863c4-88bf-fea4-2669-1a360e16c2dc",
"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": "36971009",
"display": "Sinusitis (disorder)"
} ],
"text": "Sinusitis (disorder)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:a80df190-68b6-6d0d-85c8-c21d0680a459"
},
"onsetDateTime": "2018-03-30T20:15:30+02:00",
"abatementDateTime": "2018-08-27T20:15:30+02:00",
"recordedDate": "2018-03-30T20:15:30+02:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:22ace0d7-be69-f631-36cb-0a006560050d",
"resource": {
"resourceType": "DiagnosticReport",
"id": "22ace0d7-be69-f631-36cb-0a006560050d",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:a80df190-68b6-6d0d-85c8-c21d0680a459"
},
"effectiveDateTime": "2018-03-30T20:15:30+02:00",
"issued": "2018-03-30T20:15:30.236+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:7efdd590-c372-8b5c-2f74-b631b4bbd094",
"resource": {
"resourceType": "DocumentReference",
"id": "7efdd590-c372-8b5c-2f74-b631b4bbd094",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:22ace0d7-be69-f631-36cb-0a006560050d"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2018-03-30T20:15:30.236+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"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:a80df190-68b6-6d0d-85c8-c21d0680a459"
} ],
"period": {
"start": "2018-03-30T20:15:30+02:00",
"end": "2018-03-30T20:30:30+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:a412dcf3-1ace-cbee-a68b-8ec14cf92b5c",
"resource": {
"resourceType": "Claim",
"id": "a412dcf3-1ace-cbee-a68b-8ec14cf92b5c",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2018-03-30T20:15:30+02:00",
"end": "2018-03-30T20:30:30+02:00"
},
"created": "2018-03-30T20:30:30+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:3e5863c4-88bf-fea4-2669-1a360e16c2dc"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
},
"encounter": [ {
"reference": "urn:uuid:a80df190-68b6-6d0d-85c8-c21d0680a459"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "36971009",
"display": "Sinusitis (disorder)"
} ],
"text": "Sinusitis (disorder)"
}
} ],
"total": {
"value": 85.55,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:917dff6f-48e5-6056-ae35-afe655d55584",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "917dff6f-48e5-6056-ae35-afe655d55584",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "a412dcf3-1ace-cbee-a68b-8ec14cf92b5c"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-03-30T20:30:30+02:00",
"end": "2019-03-30T20:30:30+01:00"
},
"created": "2018-03-30T20:30:30+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"claim": {
"reference": "urn:uuid:a412dcf3-1ace-cbee-a68b-8ec14cf92b5c"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:3e5863c4-88bf-fea4-2669-1a360e16c2dc"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "2018-03-30T20:15:30+02:00",
"end": "2018-03-30T20:30:30+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:a80df190-68b6-6d0d-85c8-c21d0680a459"
} ]
}, {
"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": "36971009",
"display": "Sinusitis (disorder)"
} ],
"text": "Sinusitis (disorder)"
},
"servicedPeriod": {
"start": "2018-03-30T20:15:30+02:00",
"end": "2018-03-30T20:30:30+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:7cac62e1-e89b-44a3-d6ca-b8c99465cecd",
"resource": {
"resourceType": "Encounter",
"id": "7cac62e1-e89b-44a3-d6ca-b8c99465cecd",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "7cac62e1-e89b-44a3-d6ca-b8c99465cecd"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "390906007",
"display": "Follow-up encounter (procedure)"
} ],
"text": "Follow-up encounter (procedure)"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2018-04-07T18:15:30+02:00",
"end": "2018-04-07T18:30:30+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
}
} ],
"period": {
"start": "2018-04-07T18:15:30+02:00",
"end": "2018-04-07T18:30:30+02:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "59621000",
"display": "Essential hypertension (disorder)"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:536604cc-425a-7c5e-5b9f-46521616f905",
"resource": {
"resourceType": "Observation",
"id": "536604cc-425a-7c5e-5b9f-46521616f905",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7cac62e1-e89b-44a3-d6ca-b8c99465cecd"
},
"effectiveDateTime": "2018-04-07T18:15:30+02:00",
"issued": "2018-04-07T18:15:30.236+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": 121,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:6e6afa43-1cbc-a80c-99c6-f08f2a4d2db1",
"resource": {
"resourceType": "MedicationRequest",
"id": "6e6afa43-1cbc-a80c-99c6-f08f2a4d2db1",
"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": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7cac62e1-e89b-44a3-d6ca-b8c99465cecd"
},
"authoredOn": "2018-04-07T18:15:30+02:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
},
"reasonReference": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4",
"display": "Essential hypertension (disorder)"
} ],
"dosageInstruction": [ {
"sequence": 1,
"timing": {
"repeat": {
"frequency": 1,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:901d577e-b38e-f736-2176-cc240d76971f",
"resource": {
"resourceType": "Claim",
"id": "901d577e-b38e-f736-2176-cc240d76971f",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-04-07T18:15:30+02:00",
"end": "2018-04-07T18:30:30+02:00"
},
"created": "2018-04-07T18:30:30+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:6e6afa43-1cbc-a80c-99c6-f08f2a4d2db1"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:7cac62e1-e89b-44a3-d6ca-b8c99465cecd"
} ]
} ],
"total": {
"value": 0.56,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:efa8adcd-83fe-1728-5096-c7b79f9b1098",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "efa8adcd-83fe-1728-5096-c7b79f9b1098",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "901d577e-b38e-f736-2176-cc240d76971f"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-04-07T18:30:30+02:00",
"end": "2019-04-07T18:30:30+02:00"
},
"created": "2018-04-07T18:30:30+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"claim": {
"reference": "urn:uuid:901d577e-b38e-f736-2176-cc240d76971f"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2018-04-07T18:15:30+02:00",
"end": "2018-04-07T18:30:30+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:7cac62e1-e89b-44a3-d6ca-b8c99465cecd"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 0.56,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:146047ed-8de5-4d09-2374-dc4108ecbb13",
"resource": {
"resourceType": "DiagnosticReport",
"id": "146047ed-8de5-4d09-2374-dc4108ecbb13",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:7cac62e1-e89b-44a3-d6ca-b8c99465cecd"
},
"effectiveDateTime": "2018-04-07T18:15:30+02:00",
"issued": "2018-04-07T18:15:30.236+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:00231651-3826-273b-3b93-66c9dcc8c313",
"resource": {
"resourceType": "DocumentReference",
"id": "00231651-3826-273b-3b93-66c9dcc8c313",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:146047ed-8de5-4d09-2374-dc4108ecbb13"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2018-04-07T18:15:30.236+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"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:7cac62e1-e89b-44a3-d6ca-b8c99465cecd"
} ],
"period": {
"start": "2018-04-07T18:15:30+02:00",
"end": "2018-04-07T18:30:30+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:597f2b1a-4e87-17c1-b6b4-8a25a455f5c5",
"resource": {
"resourceType": "Claim",
"id": "597f2b1a-4e87-17c1-b6b4-8a25a455f5c5",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2018-04-07T18:15:30+02:00",
"end": "2018-04-07T18:30:30+02:00"
},
"created": "2018-04-07T18:30:30+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "390906007",
"display": "Follow-up encounter (procedure)"
} ],
"text": "Follow-up encounter (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:7cac62e1-e89b-44a3-d6ca-b8c99465cecd"
} ]
} ],
"total": {
"value": 85.55,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:5ea9a0de-5f60-e687-53b7-6f5b17115d94",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "5ea9a0de-5f60-e687-53b7-6f5b17115d94",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "597f2b1a-4e87-17c1-b6b4-8a25a455f5c5"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-04-07T18:30:30+02:00",
"end": "2019-04-07T18:30:30+02:00"
},
"created": "2018-04-07T18:30:30+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"claim": {
"reference": "urn:uuid:597f2b1a-4e87-17c1-b6b4-8a25a455f5c5"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "390906007",
"display": "Follow-up encounter (procedure)"
} ],
"text": "Follow-up encounter (procedure)"
},
"servicedPeriod": {
"start": "2018-04-07T18:15:30+02:00",
"end": "2018-04-07T18:30:30+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:7cac62e1-e89b-44a3-d6ca-b8c99465cecd"
} ]
} ],
"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:ba2493e7-16ce-3cb0-78eb-99fc23a74828",
"resource": {
"resourceType": "Encounter",
"id": "ba2493e7-16ce-3cb0-78eb-99fc23a74828",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "ba2493e7-16ce-3cb0-78eb-99fc23a74828"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2018-05-08T18:15:30+02:00",
"end": "2018-05-08T18:30:30+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
}
} ],
"period": {
"start": "2018-05-08T18:15:30+02:00",
"end": "2018-05-08T18:30:30+02:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "195662009",
"display": "Acute viral pharyngitis (disorder)"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:c8d077de-f032-b9e4-7902-9dd472145378",
"resource": {
"resourceType": "Condition",
"id": "c8d077de-f032-b9e4-7902-9dd472145378",
"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": "195662009",
"display": "Acute viral pharyngitis (disorder)"
} ],
"text": "Acute viral pharyngitis (disorder)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:ba2493e7-16ce-3cb0-78eb-99fc23a74828"
},
"onsetDateTime": "2018-05-08T18:15:30+02:00",
"abatementDateTime": "2018-05-16T01:15:30+02:00",
"recordedDate": "2018-05-08T18:15:30+02:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:04250566-5e9a-29b0-9a86-0a144482aa3d",
"resource": {
"resourceType": "Observation",
"id": "04250566-5e9a-29b0-9a86-0a144482aa3d",
"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": "8310-5",
"display": "Body temperature"
}, {
"system": "http://loinc.org",
"code": "8331-1",
"display": "Oral temperature"
} ],
"text": "Body temperature"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:ba2493e7-16ce-3cb0-78eb-99fc23a74828"
},
"effectiveDateTime": "2018-05-08T18:15:30+02:00",
"issued": "2018-05-08T18:15:30.236+02:00",
"valueQuantity": {
"value": 37.58,
"unit": "Cel",
"system": "http://unitsofmeasure.org",
"code": "Cel"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e8a2bb4e-e912-3076-4b78-135bbd64c02f",
"resource": {
"resourceType": "Procedure",
"id": "e8a2bb4e-e912-3076-4b78-135bbd64c02f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "117015009",
"display": "Throat culture (procedure)"
} ],
"text": "Throat culture (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:ba2493e7-16ce-3cb0-78eb-99fc23a74828"
},
"performedPeriod": {
"start": "2018-05-08T18:15:30+02:00",
"end": "2018-05-08T18:30:30+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"reasonReference": [ {
"reference": "urn:uuid:a0cb3230-cfef-9ddd-cffc-991f4a474332",
"display": "Acute viral pharyngitis (disorder)"
} ]
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:4608eb46-caba-e795-038c-a24bd24531bf",
"resource": {
"resourceType": "DiagnosticReport",
"id": "4608eb46-caba-e795-038c-a24bd24531bf",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:ba2493e7-16ce-3cb0-78eb-99fc23a74828"
},
"effectiveDateTime": "2018-05-08T18:15:30+02:00",
"issued": "2018-05-08T18:15:30.236+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:f23000b4-2aed-852c-4481-56a048a5ad69",
"resource": {
"resourceType": "DocumentReference",
"id": "f23000b4-2aed-852c-4481-56a048a5ad69",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:4608eb46-caba-e795-038c-a24bd24531bf"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2018-05-08T18:15:30.236+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"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:ba2493e7-16ce-3cb0-78eb-99fc23a74828"
} ],
"period": {
"start": "2018-05-08T18:15:30+02:00",
"end": "2018-05-08T18:30:30+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:991abcea-6ac8-4fd6-ff39-baf4646600e1",
"resource": {
"resourceType": "Claim",
"id": "991abcea-6ac8-4fd6-ff39-baf4646600e1",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2018-05-08T18:15:30+02:00",
"end": "2018-05-08T18:30:30+02:00"
},
"created": "2018-05-08T18:30:30+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:c8d077de-f032-b9e4-7902-9dd472145378"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:e8a2bb4e-e912-3076-4b78-135bbd64c02f"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
},
"encounter": [ {
"reference": "urn:uuid:ba2493e7-16ce-3cb0-78eb-99fc23a74828"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "195662009",
"display": "Acute viral pharyngitis (disorder)"
} ],
"text": "Acute viral pharyngitis (disorder)"
}
}, {
"sequence": 3,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "117015009",
"display": "Throat culture (procedure)"
} ],
"text": "Throat culture (procedure)"
},
"net": {
"value": 2435.36,
"currency": "USD"
}
} ],
"total": {
"value": 2520.91,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:22f12e89-ee94-58c1-08ea-9deadcae6ac6",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "22f12e89-ee94-58c1-08ea-9deadcae6ac6",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "991abcea-6ac8-4fd6-ff39-baf4646600e1"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-05-08T18:30:30+02:00",
"end": "2019-05-08T18:30:30+02:00"
},
"created": "2018-05-08T18:30:30+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"claim": {
"reference": "urn:uuid:991abcea-6ac8-4fd6-ff39-baf4646600e1"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:c8d077de-f032-b9e4-7902-9dd472145378"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "2018-05-08T18:15:30+02:00",
"end": "2018-05-08T18:30:30+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:ba2493e7-16ce-3cb0-78eb-99fc23a74828"
} ]
}, {
"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": "195662009",
"display": "Acute viral pharyngitis (disorder)"
} ],
"text": "Acute viral pharyngitis (disorder)"
},
"servicedPeriod": {
"start": "2018-05-08T18:15:30+02:00",
"end": "2018-05-08T18:30:30+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient 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": "117015009",
"display": "Throat culture (procedure)"
} ],
"text": "Throat culture (procedure)"
},
"servicedPeriod": {
"start": "2018-05-08T18:15:30+02:00",
"end": "2018-05-08T18:30:30+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"net": {
"value": 2435.36,
"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": 487.07200000000006,
"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": 1948.2880000000002,
"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": 2435.36,
"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": 2435.36,
"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": 2520.91,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 1948.2880000000002,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26",
"resource": {
"resourceType": "Encounter",
"id": "5165191d-c028-dabb-7b8f-f3e35663db26",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "5165191d-c028-dabb-7b8f-f3e35663db26"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "702927004",
"display": "Urgent care clinic (environment)"
} ],
"text": "Urgent care clinic (environment)"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498",
"display": "Dr. Rema399 McDermott739"
}
} ],
"period": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|f3a27424-c1f9-344d-a732-ded5d43323ed",
"display": "URGENT HELP CHELMSFORD PC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c05d73d0-b348-32ce-9fe5-13a720950f37",
"display": "URGENT HELP CHELMSFORD PC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:979a7c6c-6e85-6bd7-b48b-6d8fcc459bae",
"resource": {
"resourceType": "Condition",
"id": "979a7c6c-6e85-6bd7-b48b-6d8fcc459bae",
"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": "271737000",
"display": "Anemia (disorder)"
} ],
"text": "Anemia (disorder)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"onsetDateTime": "2018-05-17T18:15:30+02:00",
"recordedDate": "2018-05-17T18:15:30+02:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:393ad0d5-d8b9-cb90-2cd0-7d64f13abf22",
"resource": {
"resourceType": "Condition",
"id": "393ad0d5-d8b9-cb90-2cd0-7d64f13abf22",
"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": "423315002",
"display": "Limited social contact (finding)"
} ],
"text": "Limited social contact (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"onsetDateTime": "2018-05-17T18:48:10+02:00",
"abatementDateTime": "2019-03-14T17:50:25+01:00",
"recordedDate": "2018-05-17T18:48:10+02:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:a1bce00d-1732-7413-8132-ccd1deb9c75d",
"resource": {
"resourceType": "Observation",
"id": "a1bce00d-1732-7413-8132-ccd1deb9c75d",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "4548-4",
"display": "Hemoglobin A1c/Hemoglobin.total in Blood"
} ],
"text": "Hemoglobin A1c/Hemoglobin.total in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T18:15:30+02:00",
"issued": "2018-05-17T18:15:30.236+02:00",
"valueQuantity": {
"value": 6.15,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:6dcc4ab2-50fb-5ece-0f8e-89746d5d4de1",
"resource": {
"resourceType": "Observation",
"id": "6dcc4ab2-50fb-5ece-0f8e-89746d5d4de1",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T18:15:30+02:00",
"issued": "2018-05-17T18:15:30.236+02:00",
"valueQuantity": {
"value": 174.1,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:af45b1c5-a737-5f6b-0eb8-02647a60b225",
"resource": {
"resourceType": "Observation",
"id": "af45b1c5-a737-5f6b-0eb8-02647a60b225",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T18:15:30+02:00",
"issued": "2018-05-17T18:15:30.236+02:00",
"valueQuantity": {
"value": 1,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:ff77c6fa-2170-5606-dae3-a3002b34e55d",
"resource": {
"resourceType": "Observation",
"id": "ff77c6fa-2170-5606-dae3-a3002b34e55d",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T18:15:30+02:00",
"issued": "2018-05-17T18:15:30.236+02:00",
"valueQuantity": {
"value": 86.6,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:987a35c1-c8fa-f90d-1e80-5a5326e1c4c1",
"resource": {
"resourceType": "Observation",
"id": "987a35c1-c8fa-f90d-1e80-5a5326e1c4c1",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T18:15:30+02:00",
"issued": "2018-05-17T18:15:30.236+02:00",
"valueQuantity": {
"value": 28.58,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:03fc4d08-f8f1-3da7-a1f3-a64b206e73d2",
"resource": {
"resourceType": "Observation",
"id": "03fc4d08-f8f1-3da7-a1f3-a64b206e73d2",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T18:15:30+02:00",
"issued": "2018-05-17T18:15:30.236+02:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 76,
"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": 102,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:5b30ea26-d3aa-64ff-d146-1a9c2140a2a3",
"resource": {
"resourceType": "Observation",
"id": "5b30ea26-d3aa-64ff-d146-1a9c2140a2a3",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T18:15:30+02:00",
"issued": "2018-05-17T18:15:30.236+02:00",
"valueQuantity": {
"value": 93,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:319a550b-5049-b8f5-8a96-f705b8e3cb56",
"resource": {
"resourceType": "Observation",
"id": "319a550b-5049-b8f5-8a96-f705b8e3cb56",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T18:15:30+02:00",
"issued": "2018-05-17T18:15:30.236+02:00",
"valueQuantity": {
"value": 15,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:263e35ee-a771-5ee9-8f9b-55de0f17e2f1",
"resource": {
"resourceType": "Observation",
"id": "263e35ee-a771-5ee9-8f9b-55de0f17e2f1",
"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": "2339-0",
"display": "Glucose [Mass/volume] in Blood"
} ],
"text": "Glucose [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T18:15:30+02:00",
"issued": "2018-05-17T18:15:30.236+02:00",
"valueQuantity": {
"value": 65.72,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:3bb82130-3cbd-c3b3-cc6b-b3be4bfed133",
"resource": {
"resourceType": "Observation",
"id": "3bb82130-3cbd-c3b3-cc6b-b3be4bfed133",
"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": "6299-2",
"display": "Urea nitrogen [Mass/volume] in Blood"
} ],
"text": "Urea nitrogen [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T18:15:30+02:00",
"issued": "2018-05-17T18:15:30.236+02:00",
"valueQuantity": {
"value": 17.72,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:0af7d745-c419-b133-e16c-2a3b1253a27f",
"resource": {
"resourceType": "Observation",
"id": "0af7d745-c419-b133-e16c-2a3b1253a27f",
"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": "38483-4",
"display": "Creatinine [Mass/volume] in Blood"
} ],
"text": "Creatinine [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T18:15:30+02:00",
"issued": "2018-05-17T18:15:30.236+02:00",
"valueQuantity": {
"value": 1.33,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:a5711259-19f0-9ad3-93fb-1eb0256e5dd6",
"resource": {
"resourceType": "Observation",
"id": "a5711259-19f0-9ad3-93fb-1eb0256e5dd6",
"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": "49765-1",
"display": "Calcium [Mass/volume] in Blood"
} ],
"text": "Calcium [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T18:15:30+02:00",
"issued": "2018-05-17T18:15:30.236+02:00",
"valueQuantity": {
"value": 8.94,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:af0e8903-28d2-e2ff-cab9-0ca99fdb0968",
"resource": {
"resourceType": "Observation",
"id": "af0e8903-28d2-e2ff-cab9-0ca99fdb0968",
"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": "2947-0",
"display": "Sodium [Moles/volume] in Blood"
} ],
"text": "Sodium [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T18:15:30+02:00",
"issued": "2018-05-17T18:15:30.236+02:00",
"valueQuantity": {
"value": 139.2,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:db0bd959-fb14-83d4-3798-12853383e46e",
"resource": {
"resourceType": "Observation",
"id": "db0bd959-fb14-83d4-3798-12853383e46e",
"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": "6298-4",
"display": "Potassium [Moles/volume] in Blood"
} ],
"text": "Potassium [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T18:15:30+02:00",
"issued": "2018-05-17T18:15:30.236+02:00",
"valueQuantity": {
"value": 3.9,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:5554a02d-71e1-0f17-d045-24559464ea36",
"resource": {
"resourceType": "Observation",
"id": "5554a02d-71e1-0f17-d045-24559464ea36",
"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": "2069-3",
"display": "Chloride [Moles/volume] in Blood"
} ],
"text": "Chloride [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T18:15:30+02:00",
"issued": "2018-05-17T18:15:30.236+02:00",
"valueQuantity": {
"value": 106.26,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:a727408c-437b-3968-9237-090aff8bf27f",
"resource": {
"resourceType": "Observation",
"id": "a727408c-437b-3968-9237-090aff8bf27f",
"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": "20565-8",
"display": "Carbon dioxide, total [Moles/volume] in Blood"
} ],
"text": "Carbon dioxide, total [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T18:15:30+02:00",
"issued": "2018-05-17T18:15:30.236+02:00",
"valueQuantity": {
"value": 27.45,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:61aa584d-70d3-ddf5-55ad-5bb4fcafa660",
"resource": {
"resourceType": "Observation",
"id": "61aa584d-70d3-ddf5-55ad-5bb4fcafa660",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T18:15:30+02:00",
"issued": "2018-05-17T18:15:30.236+02:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "8517006",
"display": "Ex-smoker (finding)"
} ],
"text": "Ex-smoker (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:2ae41665-b6d6-b3a5-26d3-0002f8eee435",
"resource": {
"resourceType": "Observation",
"id": "2ae41665-b6d6-b3a5-26d3-0002f8eee435",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93025-5",
"display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
} ],
"text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T18:48:10+02:00",
"issued": "2018-05-17T18:48:10.236+02:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76501-6",
"display": "Within the last year, have you been afraid of your partner or ex-partner?"
} ],
"text": "Within the last year, have you been afraid of your partner or ex-partner?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93026-3",
"display": "Do you feel physically and emotionally safe where you currently live?"
} ],
"text": "Do you feel physically and emotionally safe where you currently live?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93027-1",
"display": "Are you a refugee?"
} ],
"text": "Are you a refugee?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93028-9",
"display": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
} ],
"text": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93038-8",
"display": "Stress level"
} ],
"text": "Stress level"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA6568-5",
"display": "Not at all"
} ],
"text": "Not at all"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93029-7",
"display": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
} ],
"text": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30130-1",
"display": "1 or 2 times a week"
} ],
"text": "1 or 2 times a week"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93030-5",
"display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
} ],
"text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93031-3",
"display": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
} ],
"text": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30122-8",
"display": "I choose not to answer this question"
} ],
"text": "I choose not to answer this question"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63586-2",
"display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
} ],
"text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
},
"valueQuantity": {
"value": 55950,
"unit": "/a",
"system": "http://unitsofmeasure.org",
"code": "/a"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76437-3",
"display": "Primary insurance"
} ],
"text": "Primary insurance"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30194-7",
"display": "None/uninsured"
} ],
"text": "None/uninsured"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "67875-5",
"display": "Employment status - current"
} ],
"text": "Employment status - current"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30136-8",
"display": "Full-time work"
} ],
"text": "Full-time work"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82589-3",
"display": "Highest level of education"
} ],
"text": "Highest level of education"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30193-9",
"display": "More than high school"
} ],
"text": "More than high school"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56799-0",
"display": "Address"
} ],
"text": "Address"
},
"valueString": "287 Treutel Neck"
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93033-9",
"display": "Are you worried about losing your housing?"
} ],
"text": "Are you worried about losing your housing?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "71802-3",
"display": "Housing status"
} ],
"text": "Housing status"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30189-7",
"display": "I have housing"
} ],
"text": "I have housing"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63512-8",
"display": "How many people are living or staying at this address?"
} ],
"text": "How many people are living or staying at this address?"
},
"valueQuantity": {
"value": 7,
"unit": "{#}",
"system": "http://unitsofmeasure.org",
"code": "{#}"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "54899-0",
"display": "Preferred language"
} ],
"text": "Preferred language"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA43-5",
"display": "English"
} ],
"text": "English"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93034-7",
"display": "Have you been discharged from the armed forces of the United States?"
} ],
"text": "Have you been discharged from the armed forces of the United States?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93035-4",
"display": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
} ],
"text": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "32624-9",
"display": "Race"
} ],
"text": "Race"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA4457-3",
"display": "White"
} ],
"text": "White"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56051-6",
"display": "Do you consider yourself Hispanic/Latino?"
} ],
"text": "Do you consider yourself Hispanic/Latino?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:33a1702f-abe6-4dd5-263f-64656c391258",
"resource": {
"resourceType": "Observation",
"id": "33a1702f-abe6-4dd5-263f-64656c391258",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "70274-6",
"display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T19:09:06+02:00",
"issued": "2018-05-17T19:09:06.236+02:00",
"valueQuantity": {
"value": 2,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:99d5a8a4-260b-3a0d-d222-2571c332c595",
"resource": {
"resourceType": "Observation",
"id": "99d5a8a4-260b-3a0d-d222-2571c332c595",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82667-7",
"display": "Total score [DAST-10]"
} ],
"text": "Total score [DAST-10]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T19:49:00+02:00",
"issued": "2018-05-17T19:49:00.236+02:00",
"valueQuantity": {
"value": 0,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:77005040-462b-24bb-b56e-6aec5fbb45a1",
"resource": {
"resourceType": "Procedure",
"id": "77005040-462b-24bb-b56e-6aec5fbb45a1",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"performedPeriod": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:30:30+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|f3a27424-c1f9-344d-a732-ded5d43323ed",
"display": "URGENT HELP CHELMSFORD PC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:9c372c35-48c0-c20e-232b-fb8d26b75c0a",
"resource": {
"resourceType": "Procedure",
"id": "9c372c35-48c0-c20e-232b-fb8d26b75c0a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"performedPeriod": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|f3a27424-c1f9-344d-a732-ded5d43323ed",
"display": "URGENT HELP CHELMSFORD PC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:97b2e564-6128-4153-4eb5-3975a6c5af95",
"resource": {
"resourceType": "Procedure",
"id": "97b2e564-6128-4153-4eb5-3975a6c5af95",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"performedPeriod": {
"start": "2018-05-17T18:48:10+02:00",
"end": "2018-05-17T19:09:06+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|f3a27424-c1f9-344d-a732-ded5d43323ed",
"display": "URGENT HELP CHELMSFORD PC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:6bee6a68-9989-0011-ad60-67e93e7a1ffb",
"resource": {
"resourceType": "Procedure",
"id": "6bee6a68-9989-0011-ad60-67e93e7a1ffb",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"performedPeriod": {
"start": "2018-05-17T19:09:06+02:00",
"end": "2018-05-17T19:21:46+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|f3a27424-c1f9-344d-a732-ded5d43323ed",
"display": "URGENT HELP CHELMSFORD PC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:1184c8d9-b5d3-9921-67ca-77d58415dca8",
"resource": {
"resourceType": "Procedure",
"id": "1184c8d9-b5d3-9921-67ca-77d58415dca8",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "713106006",
"display": "Screening for drug abuse (procedure)"
} ],
"text": "Screening for drug abuse (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"performedPeriod": {
"start": "2018-05-17T19:21:46+02:00",
"end": "2018-05-17T19:49:00+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|f3a27424-c1f9-344d-a732-ded5d43323ed",
"display": "URGENT HELP CHELMSFORD PC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:3c553657-6708-be71-6506-cfcbab7c7560",
"resource": {
"resourceType": "SupplyDelivery",
"id": "3c553657-6708-be71-6506-cfcbab7c7560",
"status": "completed",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/supply-item-type",
"code": "device",
"display": "Device"
} ]
},
"suppliedItem": {
"quantity": {
"value": 50
},
"itemCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
}
},
"occurrenceDateTime": "2018-05-17T18:15:30+02:00"
},
"request": {
"method": "POST",
"url": "SupplyDelivery"
}
}, {
"fullUrl": "urn:uuid:21309549-b87d-b070-f048-5fa018c5bcc0",
"resource": {
"resourceType": "MedicationRequest",
"id": "21309549-b87d-b070-f048-5fa018c5bcc0",
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"authoredOn": "2018-05-17T18:15:30+02:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498",
"display": "Dr. Rema399 McDermott739"
},
"dosageInstruction": [ {
"sequence": 1,
"text": "Every six hours (qualifier value)",
"additionalInstruction": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "307468000",
"display": "Every six hours (qualifier value)"
} ],
"text": "Every six hours (qualifier value)"
} ],
"timing": {
"repeat": {
"frequency": 4,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:405d709a-115b-5685-0e30-b318a123dc8d",
"resource": {
"resourceType": "Claim",
"id": "405d709a-115b-5685-0e30-b318a123dc8d",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"created": "2018-05-17T18:48:10+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c05d73d0-b348-32ce-9fe5-13a720950f37",
"display": "URGENT HELP CHELMSFORD PC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:21309549-b87d-b070-f048-5fa018c5bcc0"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"encounter": [ {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
} ]
} ],
"total": {
"value": 129.94,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:7fc408bd-f545-8b33-e663-3eaa1308cee6",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "7fc408bd-f545-8b33-e663-3eaa1308cee6",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "405d709a-115b-5685-0e30-b318a123dc8d"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-05-17T18:48:10+02:00",
"end": "2019-05-17T18:48:10+02:00"
},
"created": "2018-05-17T18:48:10+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|f3a27424-c1f9-344d-a732-ded5d43323ed",
"display": "URGENT HELP CHELMSFORD PC"
},
"claim": {
"reference": "urn:uuid:405d709a-115b-5685-0e30-b318a123dc8d"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"servicedPeriod": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
},
"encounter": [ {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
} ]
} ],
"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:c243a2d5-e0da-e081-be69-3a0ab7f2f0e5",
"resource": {
"resourceType": "MedicationRequest",
"id": "c243a2d5-e0da-e081-be69-3a0ab7f2f0e5",
"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": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"authoredOn": "2018-05-17T18:15:30+02:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498",
"display": "Dr. Rema399 McDermott739"
},
"reasonReference": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4",
"display": "Essential hypertension (disorder)"
} ],
"dosageInstruction": [ {
"sequence": 1,
"timing": {
"repeat": {
"frequency": 1,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:8cfbc363-4278-5f95-5fff-7b2677817981",
"resource": {
"resourceType": "Claim",
"id": "8cfbc363-4278-5f95-5fff-7b2677817981",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"created": "2018-05-17T18:48:10+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c05d73d0-b348-32ce-9fe5-13a720950f37",
"display": "URGENT HELP CHELMSFORD PC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:c243a2d5-e0da-e081-be69-3a0ab7f2f0e5"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
} ]
} ],
"total": {
"value": 0.55,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:43259541-5aa8-4ad6-00a9-4da9d1151ebc",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "43259541-5aa8-4ad6-00a9-4da9d1151ebc",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "8cfbc363-4278-5f95-5fff-7b2677817981"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-05-17T18:48:10+02:00",
"end": "2019-05-17T18:48:10+02:00"
},
"created": "2018-05-17T18:48:10+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|f3a27424-c1f9-344d-a732-ded5d43323ed",
"display": "URGENT HELP CHELMSFORD PC"
},
"claim": {
"reference": "urn:uuid:8cfbc363-4278-5f95-5fff-7b2677817981"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
},
"encounter": [ {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 0.55,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:52902248-3275-2522-b386-4ce22bca4110",
"resource": {
"resourceType": "MedicationRequest",
"id": "52902248-3275-2522-b386-4ce22bca4110",
"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": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"authoredOn": "2018-05-17T18:15:30+02:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498",
"display": "Dr. Rema399 McDermott739"
},
"reasonReference": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4",
"display": "Essential hypertension (disorder)"
} ],
"dosageInstruction": [ {
"sequence": 1,
"timing": {
"repeat": {
"frequency": 1,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:b0113b45-6461-ef0d-998e-0f2d46089859",
"resource": {
"resourceType": "Claim",
"id": "b0113b45-6461-ef0d-998e-0f2d46089859",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"created": "2018-05-17T18:48:10+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c05d73d0-b348-32ce-9fe5-13a720950f37",
"display": "URGENT HELP CHELMSFORD PC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:52902248-3275-2522-b386-4ce22bca4110"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
} ]
} ],
"total": {
"value": 0.91,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:3190ee21-4f55-24a9-668a-5d823d6f4244",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "3190ee21-4f55-24a9-668a-5d823d6f4244",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "b0113b45-6461-ef0d-998e-0f2d46089859"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-05-17T18:48:10+02:00",
"end": "2019-05-17T18:48:10+02:00"
},
"created": "2018-05-17T18:48:10+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|f3a27424-c1f9-344d-a732-ded5d43323ed",
"display": "URGENT HELP CHELMSFORD PC"
},
"claim": {
"reference": "urn:uuid:b0113b45-6461-ef0d-998e-0f2d46089859"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
},
"encounter": [ {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 0.91,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:b987e74e-67f2-2de8-91a4-fcf095247ab7",
"resource": {
"resourceType": "Immunization",
"id": "b987e74e-67f2-2de8-91a4-fcf095247ab7",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"occurrenceDateTime": "2018-05-17T18:15:30+02:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|f3a27424-c1f9-344d-a732-ded5d43323ed",
"display": "URGENT HELP CHELMSFORD PC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:f49e1f8c-8b0d-64b6-55cd-85d0d88a0306",
"resource": {
"resourceType": "DiagnosticReport",
"id": "f49e1f8c-8b0d-64b6-55cd-85d0d88a0306",
"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": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T18:15:30+02:00",
"issued": "2018-05-17T18:15:30.236+02:00",
"performer": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c05d73d0-b348-32ce-9fe5-13a720950f37",
"display": "URGENT HELP CHELMSFORD PC"
} ],
"result": [ {
"reference": "urn:uuid:263e35ee-a771-5ee9-8f9b-55de0f17e2f1",
"display": "Glucose [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:3bb82130-3cbd-c3b3-cc6b-b3be4bfed133",
"display": "Urea nitrogen [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:0af7d745-c419-b133-e16c-2a3b1253a27f",
"display": "Creatinine [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:a5711259-19f0-9ad3-93fb-1eb0256e5dd6",
"display": "Calcium [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:af0e8903-28d2-e2ff-cab9-0ca99fdb0968",
"display": "Sodium [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:db0bd959-fb14-83d4-3798-12853383e46e",
"display": "Potassium [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:5554a02d-71e1-0f17-d045-24559464ea36",
"display": "Chloride [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:a727408c-437b-3968-9237-090aff8bf27f",
"display": "Carbon dioxide, total [Moles/volume] in Blood"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:b9946e95-51c4-e626-41eb-47704f13388e",
"resource": {
"resourceType": "DiagnosticReport",
"id": "b9946e95-51c4-e626-41eb-47704f13388e",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T19:09:06+02:00",
"issued": "2018-05-17T19:09:06.236+02:00",
"result": [ {
"reference": "urn:uuid:33a1702f-abe6-4dd5-263f-64656c391258",
"display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:bd497c3a-5ced-a4d2-f861-a63d7f87200e",
"resource": {
"resourceType": "DiagnosticReport",
"id": "bd497c3a-5ced-a4d2-f861-a63d7f87200e",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82666-9",
"display": "Drug Abuse Screening Test-10 [DAST-10]"
} ],
"text": "Drug Abuse Screening Test-10 [DAST-10]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T19:49:00+02:00",
"issued": "2018-05-17T19:49:00.236+02:00",
"result": [ {
"reference": "urn:uuid:99d5a8a4-260b-3a0d-d222-2571c332c595",
"display": "Total score [DAST-10]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:29a2671c-eef9-045c-6b84-f9a75e59f21d",
"resource": {
"resourceType": "DiagnosticReport",
"id": "29a2671c-eef9-045c-6b84-f9a75e59f21d",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
},
"effectiveDateTime": "2018-05-17T18:15:30+02:00",
"issued": "2018-05-17T18:15:30.236+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498",
"display": "Dr. Rema399 McDermott739"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:3e701902-d9f5-bda6-45de-2311ee8a1121",
"resource": {
"resourceType": "DocumentReference",
"id": "3e701902-d9f5-bda6-45de-2311ee8a1121",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:29a2671c-eef9-045c-6b84-f9a75e59f21d"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2018-05-17T18:15:30.236+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498",
"display": "Dr. Rema399 McDermott739"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c05d73d0-b348-32ce-9fe5-13a720950f37",
"display": "URGENT HELP CHELMSFORD PC"
},
"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:5165191d-c028-dabb-7b8f-f3e35663db26"
} ],
"period": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:86c05e88-24eb-57eb-459d-b7714162eade",
"resource": {
"resourceType": "Claim",
"id": "86c05e88-24eb-57eb-459d-b7714162eade",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"created": "2018-05-17T18:48:10+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c05d73d0-b348-32ce-9fe5-13a720950f37",
"display": "URGENT HELP CHELMSFORD PC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|f3a27424-c1f9-344d-a732-ded5d43323ed",
"display": "URGENT HELP CHELMSFORD PC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:b987e74e-67f2-2de8-91a4-fcf095247ab7"
}
}, {
"sequence": 2,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 4,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 5,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:979a7c6c-6e85-6bd7-b48b-6d8fcc459bae"
}
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:393ad0d5-d8b9-cb90-2cd0-7d64f13abf22"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:77005040-462b-24bb-b56e-6aec5fbb45a1"
}
}, {
"sequence": 2,
"procedureReference": {
"reference": "urn:uuid:9c372c35-48c0-c20e-232b-fb8d26b75c0a"
}
}, {
"sequence": 3,
"procedureReference": {
"reference": "urn:uuid:97b2e564-6128-4153-4eb5-3975a6c5af95"
}
}, {
"sequence": 4,
"procedureReference": {
"reference": "urn:uuid:6bee6a68-9989-0011-ad60-67e93e7a1ffb"
}
}, {
"sequence": 5,
"procedureReference": {
"reference": "urn:uuid:1184c8d9-b5d3-9921-67ca-77d58415dca8"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "702927004",
"display": "Urgent care clinic (environment)"
} ],
"text": "Urgent care clinic (environment)"
},
"encounter": [ {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
} ]
}, {
"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": 599.46,
"currency": "USD"
}
}, {
"sequence": 4,
"informationSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
},
"net": {
"value": 6.80,
"currency": "USD"
}
}, {
"sequence": 5,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "271737000",
"display": "Anemia (disorder)"
} ],
"text": "Anemia (disorder)"
}
}, {
"sequence": 6,
"informationSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 7,
"procedureSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 8,
"diagnosisSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "423315002",
"display": "Limited social contact (finding)"
} ],
"text": "Limited social contact (finding)"
}
}, {
"sequence": 9,
"procedureSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 10,
"informationSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 11,
"procedureSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 12,
"procedureSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "713106006",
"display": "Screening for drug abuse (procedure)"
} ],
"text": "Screening for drug abuse (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 13,
"informationSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "82666-9",
"display": "Drug Abuse Screening Test-10 [DAST-10]"
} ],
"text": "Drug Abuse Screening Test-10 [DAST-10]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
} ],
"total": {
"value": 1390.82,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:5bc3f776-47fe-bbc1-d230-cb5c05827429",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "5bc3f776-47fe-bbc1-d230-cb5c05827429",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "86c05e88-24eb-57eb-459d-b7714162eade"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-05-17T18:48:10+02:00",
"end": "2019-05-17T18:48:10+02:00"
},
"created": "2018-05-17T18:48:10+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|f3a27424-c1f9-344d-a732-ded5d43323ed",
"display": "URGENT HELP CHELMSFORD PC"
},
"claim": {
"reference": "urn:uuid:86c05e88-24eb-57eb-459d-b7714162eade"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:979a7c6c-6e85-6bd7-b48b-6d8fcc459bae"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:393ad0d5-d8b9-cb90-2cd0-7d64f13abf22"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "702927004",
"display": "Urgent care clinic (environment)"
} ],
"text": "Urgent care clinic (environment)"
},
"servicedPeriod": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
},
"encounter": [ {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
} ]
}, {
"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": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
},
"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": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
},
"net": {
"value": 599.46,
"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": 119.89200000000001,
"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": 479.56800000000004,
"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": 599.46,
"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": 599.46,
"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": [ 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": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
},
"servicedPeriod": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
},
"net": {
"value": 6.80,
"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": 1.36,
"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": 5.44,
"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": 6.80,
"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": 6.80,
"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,
"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": "271737000",
"display": "Anemia (disorder)"
} ],
"text": "Anemia (disorder)"
},
"servicedPeriod": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
}
}, {
"sequence": 6,
"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://loinc.org",
"code": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"servicedPeriod": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
},
"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"
} ]
}
} ]
}, {
"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": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"servicedPeriod": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"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"
} ]
}
} ]
}, {
"sequence": 8,
"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": "423315002",
"display": "Limited social contact (finding)"
} ],
"text": "Limited social contact (finding)"
},
"servicedPeriod": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
}
}, {
"sequence": 9,
"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": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"servicedPeriod": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"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"
} ]
}
} ]
}, {
"sequence": 10,
"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://loinc.org",
"code": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"servicedPeriod": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
},
"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"
} ]
}
} ]
}, {
"sequence": 11,
"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": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"servicedPeriod": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"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"
} ]
}
} ]
}, {
"sequence": 12,
"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": "713106006",
"display": "Screening for drug abuse (procedure)"
} ],
"text": "Screening for drug abuse (procedure)"
},
"servicedPeriod": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"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"
} ]
}
} ]
}, {
"sequence": 13,
"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://loinc.org",
"code": "82666-9",
"display": "Drug Abuse Screening Test-10 [DAST-10]"
} ],
"text": "Drug Abuse Screening Test-10 [DAST-10]"
},
"servicedPeriod": {
"start": "2018-05-17T18:15:30+02:00",
"end": "2018-05-17T18:48:10+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "20",
"display": "Urgent Care Facility"
} ]
},
"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": 1390.82,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 2153.28,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081",
"resource": {
"resourceType": "Encounter",
"id": "e3aa3c41-0d55-26c3-446c-a510a3aa9081",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "e3aa3c41-0d55-26c3-446c-a510a3aa9081"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2018-05-24T18:15:30+02:00",
"end": "2018-05-24T19:29:17+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
}
} ],
"period": {
"start": "2018-05-24T18:15:30+02:00",
"end": "2018-05-24T19:29:17+02:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "271737000",
"display": "Anemia (disorder)"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:29b46b86-5c17-fe14-31d6-e4db0b6ff73d",
"resource": {
"resourceType": "Observation",
"id": "29b46b86-5c17-fe14-31d6-e4db0b6ff73d",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
},
"effectiveDateTime": "2018-05-24T18:15:30+02:00",
"issued": "2018-05-24T18:15:30.236+02:00",
"valueQuantity": {
"value": 10.638,
"unit": "g/dL",
"system": "http://unitsofmeasure.org",
"code": "g/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:2446d071-1abd-a2ab-ac98-d410a4519816",
"resource": {
"resourceType": "Observation",
"id": "2446d071-1abd-a2ab-ac98-d410a4519816",
"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": "20570-8",
"display": "Hematocrit [Volume Fraction] of Blood"
} ],
"text": "Hematocrit [Volume Fraction] of Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
},
"effectiveDateTime": "2018-05-24T18:15:30+02:00",
"issued": "2018-05-24T18:15:30.236+02:00",
"valueQuantity": {
"value": 31.312,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:43d6726a-df9e-37b3-2a4a-a6d4d57c7187",
"resource": {
"resourceType": "Observation",
"id": "43d6726a-df9e-37b3-2a4a-a6d4d57c7187",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
},
"effectiveDateTime": "2018-05-24T18:15:30+02:00",
"issued": "2018-05-24T18:15:30.236+02:00",
"valueQuantity": {
"value": 9.8034,
"unit": "10*3/uL",
"system": "http://unitsofmeasure.org",
"code": "10*3/uL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:81eae32b-e649-9fe5-02ed-f0520f7e1f6e",
"resource": {
"resourceType": "Observation",
"id": "81eae32b-e649-9fe5-02ed-f0520f7e1f6e",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
},
"effectiveDateTime": "2018-05-24T18:15:30+02:00",
"issued": "2018-05-24T18:15:30.236+02:00",
"valueQuantity": {
"value": 5.1247,
"unit": "10*6/uL",
"system": "http://unitsofmeasure.org",
"code": "10*6/uL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:817a695e-1300-fa33-f8d1-6175f6fd7da8",
"resource": {
"resourceType": "Observation",
"id": "817a695e-1300-fa33-f8d1-6175f6fd7da8",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
},
"effectiveDateTime": "2018-05-24T18:15:30+02:00",
"issued": "2018-05-24T18:15:30.236+02:00",
"valueQuantity": {
"value": 92.017,
"unit": "fL",
"system": "http://unitsofmeasure.org",
"code": "fL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:6581a337-32ee-0fbb-ae80-8200895690b8",
"resource": {
"resourceType": "Observation",
"id": "6581a337-32ee-0fbb-ae80-8200895690b8",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
},
"effectiveDateTime": "2018-05-24T18:15:30+02:00",
"issued": "2018-05-24T18:15:30.236+02:00",
"valueQuantity": {
"value": 30.14,
"unit": "pg",
"system": "http://unitsofmeasure.org",
"code": "pg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:9e38c33d-fd75-d4ef-e03d-680b8770e43a",
"resource": {
"resourceType": "Observation",
"id": "9e38c33d-fd75-d4ef-e03d-680b8770e43a",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
},
"effectiveDateTime": "2018-05-24T18:15:30+02:00",
"issued": "2018-05-24T18:15:30.236+02:00",
"valueQuantity": {
"value": 34.075,
"unit": "g/dL",
"system": "http://unitsofmeasure.org",
"code": "g/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:06fc1dd9-d811-4c9a-860e-425ed1e6d8a9",
"resource": {
"resourceType": "Observation",
"id": "06fc1dd9-d811-4c9a-860e-425ed1e6d8a9",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
},
"effectiveDateTime": "2018-05-24T18:15:30+02:00",
"issued": "2018-05-24T18:15:30.236+02:00",
"valueQuantity": {
"value": 40.932,
"unit": "fL",
"system": "http://unitsofmeasure.org",
"code": "fL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d77bc978-b8de-65be-c38b-a72633cf4e1c",
"resource": {
"resourceType": "Observation",
"id": "d77bc978-b8de-65be-c38b-a72633cf4e1c",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
},
"effectiveDateTime": "2018-05-24T18:15:30+02:00",
"issued": "2018-05-24T18:15:30.236+02:00",
"valueQuantity": {
"value": 384.03,
"unit": "10*3/uL",
"system": "http://unitsofmeasure.org",
"code": "10*3/uL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:7bf5c471-15a8-657f-6c18-cbe770686c00",
"resource": {
"resourceType": "Observation",
"id": "7bf5c471-15a8-657f-6c18-cbe770686c00",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
},
"effectiveDateTime": "2018-05-24T18:15:30+02:00",
"issued": "2018-05-24T18:15:30.236+02:00",
"valueQuantity": {
"value": 329.37,
"unit": "fL",
"system": "http://unitsofmeasure.org",
"code": "fL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:07823ae7-876f-a4a2-96ab-64cef99f0604",
"resource": {
"resourceType": "Observation",
"id": "07823ae7-876f-a4a2-96ab-64cef99f0604",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
},
"effectiveDateTime": "2018-05-24T18:15:30+02:00",
"issued": "2018-05-24T18:15:30.236+02:00",
"valueQuantity": {
"value": 9.558,
"unit": "fL",
"system": "http://unitsofmeasure.org",
"code": "fL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:04b2b8a6-29ae-dcac-9a31-d92169d27c50",
"resource": {
"resourceType": "Procedure",
"id": "04b2b8a6-29ae-dcac-9a31-d92169d27c50",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "14768001",
"display": "Peripheral blood smear interpretation"
} ],
"text": "Peripheral blood smear interpretation"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
},
"performedPeriod": {
"start": "2018-05-24T18:15:30+02:00",
"end": "2018-05-24T18:45:30+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:28e4c333-eda6-3f70-d078-71d3425b888e",
"resource": {
"resourceType": "Procedure",
"id": "28e4c333-eda6-3f70-d078-71d3425b888e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "415300000",
"display": "Review of systems (procedure)"
} ],
"text": "Review of systems (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
},
"performedPeriod": {
"start": "2018-05-24T18:45:30+02:00",
"end": "2018-05-24T19:01:23+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:90e90893-1bd8-5674-c5ff-a5c55a10d5f7",
"resource": {
"resourceType": "Procedure",
"id": "90e90893-1bd8-5674-c5ff-a5c55a10d5f7",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
},
"performedPeriod": {
"start": "2018-05-24T19:01:23+02:00",
"end": "2018-05-24T19:12:20+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:5eb607c5-4fdd-59be-b7de-ef2401e81445",
"resource": {
"resourceType": "Procedure",
"id": "5eb607c5-4fdd-59be-b7de-ef2401e81445",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162676008",
"display": "Brief general examination (procedure)"
} ],
"text": "Brief general examination (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
},
"performedPeriod": {
"start": "2018-05-24T19:12:20+02:00",
"end": "2018-05-24T19:29:17+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:a7567733-c4b5-dc7e-439e-746a4e58ec3d",
"resource": {
"resourceType": "DiagnosticReport",
"id": "a7567733-c4b5-dc7e-439e-746a4e58ec3d",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
},
"effectiveDateTime": "2018-05-24T18:15:30+02:00",
"issued": "2018-05-24T18:15:30.236+02:00",
"performer": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
} ],
"result": [ {
"reference": "urn:uuid:29b46b86-5c17-fe14-31d6-e4db0b6ff73d",
"display": "Hemoglobin [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:2446d071-1abd-a2ab-ac98-d410a4519816",
"display": "Hematocrit [Volume Fraction] of Blood"
}, {
"reference": "urn:uuid:43d6726a-df9e-37b3-2a4a-a6d4d57c7187",
"display": "Leukocytes [#/volume] in Blood by Automated count"
}, {
"reference": "urn:uuid:81eae32b-e649-9fe5-02ed-f0520f7e1f6e",
"display": "Erythrocytes [#/volume] in Blood by Automated count"
}, {
"reference": "urn:uuid:817a695e-1300-fa33-f8d1-6175f6fd7da8",
"display": "MCV [Entitic volume] by Automated count"
}, {
"reference": "urn:uuid:6581a337-32ee-0fbb-ae80-8200895690b8",
"display": "MCH [Entitic mass] by Automated count"
}, {
"reference": "urn:uuid:9e38c33d-fd75-d4ef-e03d-680b8770e43a",
"display": "MCHC [Mass/volume] by Automated count"
}, {
"reference": "urn:uuid:06fc1dd9-d811-4c9a-860e-425ed1e6d8a9",
"display": "Erythrocyte distribution width [Entitic volume] by Automated count"
}, {
"reference": "urn:uuid:d77bc978-b8de-65be-c38b-a72633cf4e1c",
"display": "Platelets [#/volume] in Blood by Automated count"
}, {
"reference": "urn:uuid:7bf5c471-15a8-657f-6c18-cbe770686c00",
"display": "Platelet distribution width [Entitic volume] in Blood by Automated count"
}, {
"reference": "urn:uuid:07823ae7-876f-a4a2-96ab-64cef99f0604",
"display": "Platelet mean volume [Entitic volume] in Blood by Automated count"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:9ffadb59-8b16-2a4a-febc-b6dc0edb4f5f",
"resource": {
"resourceType": "DiagnosticReport",
"id": "9ffadb59-8b16-2a4a-febc-b6dc0edb4f5f",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
},
"effectiveDateTime": "2018-05-24T18:15:30+02:00",
"issued": "2018-05-24T18:15:30.236+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:3ecbfe5c-ef88-6bc4-67f4-a552fe647fe2",
"resource": {
"resourceType": "DocumentReference",
"id": "3ecbfe5c-ef88-6bc4-67f4-a552fe647fe2",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:9ffadb59-8b16-2a4a-febc-b6dc0edb4f5f"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2018-05-24T18:15:30.236+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"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:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
} ],
"period": {
"start": "2018-05-24T18:15:30+02:00",
"end": "2018-05-24T19:29:17+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:1482c330-777a-e7a2-df53-e8e83d105d1a",
"resource": {
"resourceType": "Claim",
"id": "1482c330-777a-e7a2-df53-e8e83d105d1a",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2018-05-24T18:15:30+02:00",
"end": "2018-05-24T19:29:17+02:00"
},
"created": "2018-05-24T19:29:17+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:04b2b8a6-29ae-dcac-9a31-d92169d27c50"
}
}, {
"sequence": 2,
"procedureReference": {
"reference": "urn:uuid:28e4c333-eda6-3f70-d078-71d3425b888e"
}
}, {
"sequence": 3,
"procedureReference": {
"reference": "urn:uuid:90e90893-1bd8-5674-c5ff-a5c55a10d5f7"
}
}, {
"sequence": 4,
"procedureReference": {
"reference": "urn:uuid:5eb607c5-4fdd-59be-b7de-ef2401e81445"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185347001",
"display": "Encounter for problem"
} ],
"text": "Encounter for problem"
},
"encounter": [ {
"reference": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"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"
}
}, {
"sequence": 3,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "14768001",
"display": "Peripheral blood smear interpretation"
} ],
"text": "Peripheral blood smear interpretation"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 4,
"procedureSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "415300000",
"display": "Review of systems (procedure)"
} ],
"text": "Review of systems (procedure)"
},
"net": {
"value": 66.51,
"currency": "USD"
}
}, {
"sequence": 5,
"procedureSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"net": {
"value": 745.69,
"currency": "USD"
}
}, {
"sequence": 6,
"procedureSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162676008",
"display": "Brief general examination (procedure)"
} ],
"text": "Brief general examination (procedure)"
},
"net": {
"value": 176.48,
"currency": "USD"
}
} ],
"total": {
"value": 1580.21,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:143ccba6-9e4b-c0b0-bbd2-4a0276874739",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "143ccba6-9e4b-c0b0-bbd2-4a0276874739",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "1482c330-777a-e7a2-df53-e8e83d105d1a"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-05-24T19:29:17+02:00",
"end": "2019-05-24T19:29:17+02:00"
},
"created": "2018-05-24T19:29:17+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"claim": {
"reference": "urn:uuid:1482c330-777a-e7a2-df53-e8e83d105d1a"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "2018-05-24T18:15:30+02:00",
"end": "2018-05-24T19:29:17+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
} ]
}, {
"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://loinc.org",
"code": "58410-2",
"display": "CBC panel - Blood by Automated count"
} ],
"text": "CBC panel - Blood by Automated count"
},
"servicedPeriod": {
"start": "2018-05-24T18:15:30+02:00",
"end": "2018-05-24T19:29:17+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient 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"
} ]
}
} ]
}, {
"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": "14768001",
"display": "Peripheral blood smear interpretation"
} ],
"text": "Peripheral blood smear interpretation"
},
"servicedPeriod": {
"start": "2018-05-24T18:15:30+02:00",
"end": "2018-05-24T19:29:17+02:00"
},
"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"
} ]
}
} ]
}, {
"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": "415300000",
"display": "Review of systems (procedure)"
} ],
"text": "Review of systems (procedure)"
},
"servicedPeriod": {
"start": "2018-05-24T18:15:30+02:00",
"end": "2018-05-24T19:29:17+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"net": {
"value": 66.51,
"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": 13.302000000000001,
"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": 53.208000000000006,
"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": 66.51,
"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": 66.51,
"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": "430193006",
"display": "Medication Reconciliation (procedure)"
} ],
"text": "Medication Reconciliation (procedure)"
},
"servicedPeriod": {
"start": "2018-05-24T18:15:30+02:00",
"end": "2018-05-24T19:29:17+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"net": {
"value": 745.69,
"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": 149.138,
"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": 596.552,
"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": 745.69,
"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": 745.69,
"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,
"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": "162676008",
"display": "Brief general examination (procedure)"
} ],
"text": "Brief general examination (procedure)"
},
"servicedPeriod": {
"start": "2018-05-24T18:15:30+02:00",
"end": "2018-05-24T19:29:17+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"net": {
"value": 176.48,
"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": 35.296,
"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": 141.184,
"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": 176.48,
"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": 176.48,
"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": 1580.21,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 1195.728,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:874a185b-2414-ec0d-d0b1-c689449b91ed",
"resource": {
"resourceType": "Encounter",
"id": "874a185b-2414-ec0d-d0b1-c689449b91ed",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "874a185b-2414-ec0d-d0b1-c689449b91ed"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2018-06-04T20:15:30+02:00",
"end": "2018-06-04T20:30:30+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
}
} ],
"period": {
"start": "2018-06-04T20:15:30+02:00",
"end": "2018-06-04T20:30:30+02:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "36971009",
"display": "Sinusitis (disorder)"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:046c846c-ea6b-00cb-40ef-fc9025d2a2dc",
"resource": {
"resourceType": "Condition",
"id": "046c846c-ea6b-00cb-40ef-fc9025d2a2dc",
"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": "40055000",
"display": "Chronic sinusitis (disorder)"
} ],
"text": "Chronic sinusitis (disorder)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:874a185b-2414-ec0d-d0b1-c689449b91ed"
},
"onsetDateTime": "2018-06-04T20:15:30+02:00",
"abatementDateTime": "2018-08-27T20:15:30+02:00",
"recordedDate": "2018-06-04T20:15:30+02:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:5acad755-4fd0-0004-1463-a3ad8ed62f8d",
"resource": {
"resourceType": "Device",
"id": "5acad755-4fd0-0004-1463-a3ad8ed62f8d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-implantable-device" ]
},
"udiCarrier": [ {
"deviceIdentifier": "35882145861505",
"carrierHRF": "(01)35882145861505(11)180514(17)430529(10)678653505033274349(21)598072288762804"
} ],
"status": "active",
"distinctIdentifier": "35882145861505",
"manufactureDate": "2018-05-14T20:15:30+02:00",
"expirationDate": "2043-05-29T20:15:30+02:00",
"lotNumber": "678653505033274349",
"serialNumber": "598072288762804",
"deviceName": [ {
"name": "Home nebulizer (physical object)",
"type": "user-friendly-name"
} ],
"type": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "170615005",
"display": "Home nebulizer (physical object)"
} ],
"text": "Home nebulizer (physical object)"
},
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
}
},
"request": {
"method": "POST",
"url": "Device"
}
}, {
"fullUrl": "urn:uuid:197b59b5-1c9b-f662-0f8a-35c93ac51f09",
"resource": {
"resourceType": "DiagnosticReport",
"id": "197b59b5-1c9b-f662-0f8a-35c93ac51f09",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:874a185b-2414-ec0d-d0b1-c689449b91ed"
},
"effectiveDateTime": "2018-06-04T20:15:30+02:00",
"issued": "2018-06-04T20:15:30.236+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "CjIwMTgtMDYtMDQKCiMgQ2hpZWYgQ29tcGxhaW50Ck5vIGNvbXBsYWludHMuCgojIEhpc3Rvcnkgb2YgUHJlc2VudCBJbGxuZXNzCk11cnJheTg1NgogaXMgYSAzMCB5ZWFyLW9sZCBub25oaXNwYW5pYyB3aGl0ZSBtYWxlLiBQYXRpZW50IGhhcyBhIGhpc3Rvcnkgb2YgcGFydC10aW1lIGVtcGxveW1lbnQgKGZpbmRpbmcpLCBtZWRpY2F0aW9uIHJldmlldyBkdWUgKHNpdHVhdGlvbiksIGxpbWl0ZWQgc29jaWFsIGNvbnRhY3QgKGZpbmRpbmcpLCB1bmhlYWx0aHkgYWxjb2hvbCBkcmlua2luZyBiZWhhdmlvciAoZmluZGluZyksIHJlcG9ydHMgb2YgdmlvbGVuY2UgaW4gdGhlIGVudmlyb25tZW50IChmaW5kaW5nKSwgc2ludXNpdGlzIChkaXNvcmRlciksIGZ1bGwtdGltZSBlbXBsb3ltZW50IChmaW5kaW5nKSwgYWN1dGUgdmlyYWwgcGhhcnluZ2l0aXMgKGRpc29yZGVyKSwgc3RyZXNzIChmaW5kaW5nKS4KCiMgU29jaWFsIEhpc3RvcnkKUGF0aWVudCBpcyBtYXJyaWVkLiBQYXRpZW50IHF1aXQgc21va2luZyBhdCBhZ2UgMTYuCiBQYXRpZW50IGlkZW50aWZpZXMgYXMgaGV0ZXJvc2V4dWFsLgoKUGF0aWVudCBjb21lcyBmcm9tIGEgaGlnaCBzb2Npb2Vjb25vbWljIGJhY2tncm91bmQuCiBQYXRpZW50IGlzIGEgY29sbGVnZSBncmFkdWF0ZS4KUGF0aWVudCBjdXJyZW50bHkgaGFzIE5PIElOU1VSQU5DRS4KCiMgQWxsZXJnaWVzCk5vIEtub3duIEFsbGVyZ2llcy4KCiMgTWVkaWNhdGlvbnMKbGlzaW5vcHJpbCAxMCBtZyBvcmFsIHRhYmxldDsgYWNldGFtaW5vcGhlbiAzMjUgbWcgLyBveHljb2RvbmUgaHlkcm9jaGxvcmlkZSAxMCBtZyBvcmFsIHRhYmxldCBbcGVyY29jZXRdOyBoeWRyb2NobG9yb3RoaWF6aWRlIDI1IG1nIG9yYWwgdGFibGV0CgojIEFzc2Vzc21lbnQgYW5kIFBsYW4KUGF0aWVudCBpcyBwcmVzZW50aW5nIHdpdGggY2hyb25pYyBzaW51c2l0aXMgKGRpc29yZGVyKS4gCgojIyBQbGFuCgo="
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:4b807edc-2e51-e441-94c5-b68ca5328532",
"resource": {
"resourceType": "DocumentReference",
"id": "4b807edc-2e51-e441-94c5-b68ca5328532",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:197b59b5-1c9b-f662-0f8a-35c93ac51f09"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2018-06-04T20:15:30.236+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"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:874a185b-2414-ec0d-d0b1-c689449b91ed"
} ],
"period": {
"start": "2018-06-04T20:15:30+02:00",
"end": "2018-06-04T20:30:30+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:5454974a-ad03-e3b6-7b77-f25106044963",
"resource": {
"resourceType": "Claim",
"id": "5454974a-ad03-e3b6-7b77-f25106044963",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2018-06-04T20:15:30+02:00",
"end": "2018-06-04T20:30:30+02:00"
},
"created": "2018-06-04T20:30:30+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:046c846c-ea6b-00cb-40ef-fc9025d2a2dc"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
},
"encounter": [ {
"reference": "urn:uuid:874a185b-2414-ec0d-d0b1-c689449b91ed"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "40055000",
"display": "Chronic sinusitis (disorder)"
} ],
"text": "Chronic sinusitis (disorder)"
}
}, {
"sequence": 3,
"informationSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "170615005",
"display": "Home nebulizer (physical object)"
} ],
"text": "Home nebulizer (physical object)"
},
"net": {
"value": 7.38,
"currency": "USD"
}
} ],
"total": {
"value": 92.93,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:427b7bd1-dcdd-2bf0-d971-8ab3802b6093",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "427b7bd1-dcdd-2bf0-d971-8ab3802b6093",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "5454974a-ad03-e3b6-7b77-f25106044963"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-06-04T20:30:30+02:00",
"end": "2019-06-04T20:30:30+02:00"
},
"created": "2018-06-04T20:30:30+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"claim": {
"reference": "urn:uuid:5454974a-ad03-e3b6-7b77-f25106044963"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:046c846c-ea6b-00cb-40ef-fc9025d2a2dc"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "2018-06-04T20:15:30+02:00",
"end": "2018-06-04T20:30:30+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:874a185b-2414-ec0d-d0b1-c689449b91ed"
} ]
}, {
"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": "40055000",
"display": "Chronic sinusitis (disorder)"
} ],
"text": "Chronic sinusitis (disorder)"
},
"servicedPeriod": {
"start": "2018-06-04T20:15:30+02:00",
"end": "2018-06-04T20:30:30+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
}
}, {
"sequence": 3,
"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://snomed.info/sct",
"code": "170615005",
"display": "Home nebulizer (physical object)"
} ],
"text": "Home nebulizer (physical object)"
},
"servicedPeriod": {
"start": "2018-06-04T20:15:30+02:00",
"end": "2018-06-04T20:30:30+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"net": {
"value": 7.38,
"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": 1.476,
"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": 5.904,
"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": 7.38,
"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": 7.38,
"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": 92.93,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 5.904,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:5c7cfa27-c15a-cd94-4ec3-034e4daed6bc",
"resource": {
"resourceType": "Encounter",
"id": "5c7cfa27-c15a-cd94-4ec3-034e4daed6bc",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "5c7cfa27-c15a-cd94-4ec3-034e4daed6bc"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2018-07-02T20:15:30+02:00",
"end": "2018-07-02T20:30:30+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
}
} ],
"period": {
"start": "2018-07-02T20:15:30+02:00",
"end": "2018-07-02T20:30:30+02:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "36971009",
"display": "Sinusitis (disorder)"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:6b0c2ffa-8ca2-34cd-4720-4e23b5492adc",
"resource": {
"resourceType": "DiagnosticReport",
"id": "6b0c2ffa-8ca2-34cd-4720-4e23b5492adc",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:5c7cfa27-c15a-cd94-4ec3-034e4daed6bc"
},
"effectiveDateTime": "2018-07-02T20:15:30+02:00",
"issued": "2018-07-02T20:15:30.236+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:4009cfee-5cdc-4032-97ba-46cefdcd8977",
"resource": {
"resourceType": "DocumentReference",
"id": "4009cfee-5cdc-4032-97ba-46cefdcd8977",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:6b0c2ffa-8ca2-34cd-4720-4e23b5492adc"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2018-07-02T20:15:30.236+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"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:5c7cfa27-c15a-cd94-4ec3-034e4daed6bc"
} ],
"period": {
"start": "2018-07-02T20:15:30+02:00",
"end": "2018-07-02T20:30:30+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:f69ebf8f-d700-3528-0b6c-9a97812e0e17",
"resource": {
"resourceType": "Claim",
"id": "f69ebf8f-d700-3528-0b6c-9a97812e0e17",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2018-07-02T20:15:30+02:00",
"end": "2018-07-02T20:30:30+02:00"
},
"created": "2018-07-02T20:30:30+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
},
"encounter": [ {
"reference": "urn:uuid:5c7cfa27-c15a-cd94-4ec3-034e4daed6bc"
} ]
} ],
"total": {
"value": 85.55,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:5e655e9e-5f6f-1ecb-8add-45bb171f95d8",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "5e655e9e-5f6f-1ecb-8add-45bb171f95d8",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "f69ebf8f-d700-3528-0b6c-9a97812e0e17"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-07-02T20:30:30+02:00",
"end": "2019-07-02T20:30:30+02:00"
},
"created": "2018-07-02T20:30:30+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"claim": {
"reference": "urn:uuid:f69ebf8f-d700-3528-0b6c-9a97812e0e17"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "2018-07-02T20:15:30+02:00",
"end": "2018-07-02T20:30:30+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:5c7cfa27-c15a-cd94-4ec3-034e4daed6bc"
} ]
} ],
"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:54a39803-576e-2e43-bfc4-302534711c0c",
"resource": {
"resourceType": "Encounter",
"id": "54a39803-576e-2e43-bfc4-302534711c0c",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "54a39803-576e-2e43-bfc4-302534711c0c"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2018-08-06T20:15:30+02:00",
"end": "2018-08-06T20:30:30+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
}
} ],
"period": {
"start": "2018-08-06T20:15:30+02:00",
"end": "2018-08-06T20:30:30+02:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "36971009",
"display": "Sinusitis (disorder)"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:f8de6eab-88e3-a31d-211a-c0fcdecfc0d6",
"resource": {
"resourceType": "DiagnosticReport",
"id": "f8de6eab-88e3-a31d-211a-c0fcdecfc0d6",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:54a39803-576e-2e43-bfc4-302534711c0c"
},
"effectiveDateTime": "2018-08-06T20:15:30+02:00",
"issued": "2018-08-06T20:15:30.236+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:bec95ebd-ac4c-f6e8-1fb7-1fff8edf8158",
"resource": {
"resourceType": "DocumentReference",
"id": "bec95ebd-ac4c-f6e8-1fb7-1fff8edf8158",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:f8de6eab-88e3-a31d-211a-c0fcdecfc0d6"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2018-08-06T20:15:30.236+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"content": [ {
"attachment": {
"contentType": "text/plain; charset=utf-8",
"data": "CjIwMTgtMDgtMDYKCiMgQ2hpZWYgQ29tcGxhaW50Ck5vIGNvbXBsYWludHMuCgojIEhpc3Rvcnkgb2YgUHJlc2VudCBJbGxuZXNzCk11cnJheTg1NgogaXMgYSAzMCB5ZWFyLW9sZCBub25oaXNwYW5pYyB3aGl0ZSBtYWxlLiBQYXRpZW50IGhhcyBhIGhpc3Rvcnkgb2YgcGFydC10aW1lIGVtcGxveW1lbnQgKGZpbmRpbmcpLCBtZWRpY2F0aW9uIHJldmlldyBkdWUgKHNpdHVhdGlvbiksIGxpbWl0ZWQgc29jaWFsIGNvbnRhY3QgKGZpbmRpbmcpLCB1bmhlYWx0aHkgYWxjb2hvbCBkcmlua2luZyBiZWhhdmlvciAoZmluZGluZyksIHJlcG9ydHMgb2YgdmlvbGVuY2UgaW4gdGhlIGVudmlyb25tZW50IChmaW5kaW5nKSwgc2ludXNpdGlzIChkaXNvcmRlciksIGZ1bGwtdGltZSBlbXBsb3ltZW50IChmaW5kaW5nKSwgYWN1dGUgdmlyYWwgcGhhcnluZ2l0aXMgKGRpc29yZGVyKSwgY2hyb25pYyBzaW51c2l0aXMgKGRpc29yZGVyKSwgc3RyZXNzIChmaW5kaW5nKS4KCiMgU29jaWFsIEhpc3RvcnkKUGF0aWVudCBpcyBtYXJyaWVkLiBQYXRpZW50IHF1aXQgc21va2luZyBhdCBhZ2UgMTYuCiBQYXRpZW50IGlkZW50aWZpZXMgYXMgaGV0ZXJvc2V4dWFsLgoKUGF0aWVudCBjb21lcyBmcm9tIGEgaGlnaCBzb2Npb2Vjb25vbWljIGJhY2tncm91bmQuCiBQYXRpZW50IGlzIGEgY29sbGVnZSBncmFkdWF0ZS4KUGF0aWVudCBjdXJyZW50bHkgaGFzIE5PIElOU1VSQU5DRS4KCiMgQWxsZXJnaWVzCk5vIEtub3duIEFsbGVyZ2llcy4KCiMgTWVkaWNhdGlvbnMKbGlzaW5vcHJpbCAxMCBtZyBvcmFsIHRhYmxldDsgYWNldGFtaW5vcGhlbiAzMjUgbWcgLyBveHljb2RvbmUgaHlkcm9jaGxvcmlkZSAxMCBtZyBvcmFsIHRhYmxldCBbcGVyY29jZXRdOyBoeWRyb2NobG9yb3RoaWF6aWRlIDI1IG1nIG9yYWwgdGFibGV0CgojIEFzc2Vzc21lbnQgYW5kIFBsYW4KCgojIyBQbGFuCgo="
},
"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:54a39803-576e-2e43-bfc4-302534711c0c"
} ],
"period": {
"start": "2018-08-06T20:15:30+02:00",
"end": "2018-08-06T20:30:30+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:fd914d7c-31d6-e6c6-1a35-8b3216cd9164",
"resource": {
"resourceType": "Claim",
"id": "fd914d7c-31d6-e6c6-1a35-8b3216cd9164",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2018-08-06T20:15:30+02:00",
"end": "2018-08-06T20:30:30+02:00"
},
"created": "2018-08-06T20:30:30+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
},
"encounter": [ {
"reference": "urn:uuid:54a39803-576e-2e43-bfc4-302534711c0c"
} ]
} ],
"total": {
"value": 85.55,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:30979f5c-eba7-30d9-3051-3c149c1e3e1c",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "30979f5c-eba7-30d9-3051-3c149c1e3e1c",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "fd914d7c-31d6-e6c6-1a35-8b3216cd9164"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-08-06T20:30:30+02:00",
"end": "2019-08-06T20:30:30+02:00"
},
"created": "2018-08-06T20:30:30+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"claim": {
"reference": "urn:uuid:fd914d7c-31d6-e6c6-1a35-8b3216cd9164"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "2018-08-06T20:15:30+02:00",
"end": "2018-08-06T20:30:30+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:54a39803-576e-2e43-bfc4-302534711c0c"
} ]
} ],
"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:0c02e7f6-0df9-ac8c-823e-0bdd3904bd74",
"resource": {
"resourceType": "Encounter",
"id": "0c02e7f6-0df9-ac8c-823e-0bdd3904bd74",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "0c02e7f6-0df9-ac8c-823e-0bdd3904bd74"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2018-08-27T20:15:30+02:00",
"end": "2018-08-27T20:30:30+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
}
} ],
"period": {
"start": "2018-08-27T20:15:30+02:00",
"end": "2018-08-27T20:30:30+02:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "36971009",
"display": "Sinusitis (disorder)"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:dff9057c-5163-c21a-35ce-6c8ad8a0b52d",
"resource": {
"resourceType": "Procedure",
"id": "dff9057c-5163-c21a-35ce-6c8ad8a0b52d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "112790001",
"display": "Nasal sinus endoscopy (procedure)"
} ],
"text": "Nasal sinus endoscopy (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:0c02e7f6-0df9-ac8c-823e-0bdd3904bd74"
},
"performedPeriod": {
"start": "2018-08-27T20:15:30+02:00",
"end": "2018-08-27T20:30:30+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:885b3e59-2191-672e-12a5-6816a5486c36",
"resource": {
"resourceType": "DiagnosticReport",
"id": "885b3e59-2191-672e-12a5-6816a5486c36",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:0c02e7f6-0df9-ac8c-823e-0bdd3904bd74"
},
"effectiveDateTime": "2018-08-27T20:15:30+02:00",
"issued": "2018-08-27T20:15:30.236+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:c0184b5d-cd48-71e5-7840-87b01e9e5e03",
"resource": {
"resourceType": "DocumentReference",
"id": "c0184b5d-cd48-71e5-7840-87b01e9e5e03",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:885b3e59-2191-672e-12a5-6816a5486c36"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2018-08-27T20:15:30.236+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"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:0c02e7f6-0df9-ac8c-823e-0bdd3904bd74"
} ],
"period": {
"start": "2018-08-27T20:15:30+02:00",
"end": "2018-08-27T20:30:30+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:b06dab2a-cd44-f00f-01ff-df06dd22b36a",
"resource": {
"resourceType": "Claim",
"id": "b06dab2a-cd44-f00f-01ff-df06dd22b36a",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2018-08-27T20:15:30+02:00",
"end": "2018-08-27T20:30:30+02:00"
},
"created": "2018-08-27T20:30:30+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:dff9057c-5163-c21a-35ce-6c8ad8a0b52d"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
},
"encounter": [ {
"reference": "urn:uuid:0c02e7f6-0df9-ac8c-823e-0bdd3904bd74"
} ]
}, {
"sequence": 2,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "112790001",
"display": "Nasal sinus endoscopy (procedure)"
} ],
"text": "Nasal sinus endoscopy (procedure)"
},
"net": {
"value": 3972.61,
"currency": "USD"
}
} ],
"total": {
"value": 4058.16,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:857cf9cb-c26c-e571-2f8d-872f5962f453",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "857cf9cb-c26c-e571-2f8d-872f5962f453",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "b06dab2a-cd44-f00f-01ff-df06dd22b36a"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2018-08-27T20:30:30+02:00",
"end": "2019-08-27T20:30:30+02:00"
},
"created": "2018-08-27T20:30:30+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"claim": {
"reference": "urn:uuid:b06dab2a-cd44-f00f-01ff-df06dd22b36a"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "2018-08-27T20:15:30+02:00",
"end": "2018-08-27T20:30:30+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:0c02e7f6-0df9-ac8c-823e-0bdd3904bd74"
} ]
}, {
"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": "112790001",
"display": "Nasal sinus endoscopy (procedure)"
} ],
"text": "Nasal sinus endoscopy (procedure)"
},
"servicedPeriod": {
"start": "2018-08-27T20:15:30+02:00",
"end": "2018-08-27T20:30:30+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"net": {
"value": 3972.61,
"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": 794.522,
"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": 3178.088,
"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": 3972.61,
"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": 3972.61,
"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"
} ]
}
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 4058.16,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 3178.088,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:49248bb8-359b-8420-0253-682d67d98736",
"resource": {
"resourceType": "Encounter",
"id": "49248bb8-359b-8420-0253-682d67d98736",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "49248bb8-359b-8420-0253-682d67d98736"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2019-02-12T12:15:30+01:00",
"end": "2019-02-12T12:30:30+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
}
} ],
"period": {
"start": "2019-02-12T12:15:30+01:00",
"end": "2019-02-12T12:30:30+01:00"
},
"reasonCode": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "195662009",
"display": "Acute viral pharyngitis (disorder)"
} ]
} ],
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:3de73043-5073-2fbc-6ca8-53e40e56b64f",
"resource": {
"resourceType": "Condition",
"id": "3de73043-5073-2fbc-6ca8-53e40e56b64f",
"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": "195662009",
"display": "Acute viral pharyngitis (disorder)"
} ],
"text": "Acute viral pharyngitis (disorder)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:49248bb8-359b-8420-0253-682d67d98736"
},
"onsetDateTime": "2019-02-12T12:15:30+01:00",
"abatementDateTime": "2019-02-23T04:15:30+01:00",
"recordedDate": "2019-02-12T12:15:30+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:dc49bb66-4d0b-4995-501a-5da69f9146db",
"resource": {
"resourceType": "Observation",
"id": "dc49bb66-4d0b-4995-501a-5da69f9146db",
"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": "8310-5",
"display": "Body temperature"
}, {
"system": "http://loinc.org",
"code": "8331-1",
"display": "Oral temperature"
} ],
"text": "Body temperature"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:49248bb8-359b-8420-0253-682d67d98736"
},
"effectiveDateTime": "2019-02-12T12:15:30+01:00",
"issued": "2019-02-12T12:15:30.236+01:00",
"valueQuantity": {
"value": 37.85,
"unit": "Cel",
"system": "http://unitsofmeasure.org",
"code": "Cel"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:84ff0963-be14-22e2-5d88-c789f96085a0",
"resource": {
"resourceType": "Procedure",
"id": "84ff0963-be14-22e2-5d88-c789f96085a0",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "117015009",
"display": "Throat culture (procedure)"
} ],
"text": "Throat culture (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:49248bb8-359b-8420-0253-682d67d98736"
},
"performedPeriod": {
"start": "2019-02-12T12:15:30+01:00",
"end": "2019-02-12T12:30:30+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"reasonReference": [ {
"reference": "urn:uuid:a0cb3230-cfef-9ddd-cffc-991f4a474332",
"display": "Acute viral pharyngitis (disorder)"
} ]
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:bb4af66c-ef90-2d8a-fd2d-88f75ef11b4b",
"resource": {
"resourceType": "DiagnosticReport",
"id": "bb4af66c-ef90-2d8a-fd2d-88f75ef11b4b",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:49248bb8-359b-8420-0253-682d67d98736"
},
"effectiveDateTime": "2019-02-12T12:15:30+01:00",
"issued": "2019-02-12T12:15:30.236+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:7bc5dd90-1e70-3da9-8333-e79f33049124",
"resource": {
"resourceType": "DocumentReference",
"id": "7bc5dd90-1e70-3da9-8333-e79f33049124",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:bb4af66c-ef90-2d8a-fd2d-88f75ef11b4b"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2019-02-12T12:15:30.236+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"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:49248bb8-359b-8420-0253-682d67d98736"
} ],
"period": {
"start": "2019-02-12T12:15:30+01:00",
"end": "2019-02-12T12:30:30+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:a7e76f40-e09b-25db-62ff-4f65d12ae43a",
"resource": {
"resourceType": "Claim",
"id": "a7e76f40-e09b-25db-62ff-4f65d12ae43a",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2019-02-12T12:15:30+01:00",
"end": "2019-02-12T12:30:30+01:00"
},
"created": "2019-02-12T12:30:30+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:3de73043-5073-2fbc-6ca8-53e40e56b64f"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:84ff0963-be14-22e2-5d88-c789f96085a0"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
},
"encounter": [ {
"reference": "urn:uuid:49248bb8-359b-8420-0253-682d67d98736"
} ]
}, {
"sequence": 2,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "195662009",
"display": "Acute viral pharyngitis (disorder)"
} ],
"text": "Acute viral pharyngitis (disorder)"
}
}, {
"sequence": 3,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "117015009",
"display": "Throat culture (procedure)"
} ],
"text": "Throat culture (procedure)"
},
"net": {
"value": 2376.80,
"currency": "USD"
}
} ],
"total": {
"value": 2462.35,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:8904c46d-582c-bf72-bef0-e230c7746bed",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "8904c46d-582c-bf72-bef0-e230c7746bed",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "a7e76f40-e09b-25db-62ff-4f65d12ae43a"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2019-02-12T12:30:30+01:00",
"end": "2020-02-12T12:30:30+01:00"
},
"created": "2019-02-12T12:30:30+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"claim": {
"reference": "urn:uuid:a7e76f40-e09b-25db-62ff-4f65d12ae43a"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:3de73043-5073-2fbc-6ca8-53e40e56b64f"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "2019-02-12T12:15:30+01:00",
"end": "2019-02-12T12:30:30+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:49248bb8-359b-8420-0253-682d67d98736"
} ]
}, {
"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": "195662009",
"display": "Acute viral pharyngitis (disorder)"
} ],
"text": "Acute viral pharyngitis (disorder)"
},
"servicedPeriod": {
"start": "2019-02-12T12:15:30+01:00",
"end": "2019-02-12T12:30:30+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient 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": "117015009",
"display": "Throat culture (procedure)"
} ],
"text": "Throat culture (procedure)"
},
"servicedPeriod": {
"start": "2019-02-12T12:15:30+01:00",
"end": "2019-02-12T12:30:30+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"net": {
"value": 2376.80,
"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": 475.36000000000007,
"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": 1901.4400000000003,
"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": 2376.80,
"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": 2376.80,
"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": 2462.35,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 1901.4400000000003,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210",
"resource": {
"resourceType": "Encounter",
"id": "3e023371-4077-7c02-0c19-23d5f89f3210",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "3e023371-4077-7c02-0c19-23d5f89f3210"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
}
} ],
"period": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:db6175db-b452-58c3-eaf6-0d119de07d50",
"resource": {
"resourceType": "Condition",
"id": "db6175db-b452-58c3-eaf6-0d119de07d50",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"onsetDateTime": "2019-03-14T17:15:30+01:00",
"abatementDateTime": "2019-03-14T17:15:30+01:00",
"recordedDate": "2019-03-14T17:15:30+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:aa03cf1d-ea75-63d8-882b-b6ed14d2525b",
"resource": {
"resourceType": "Condition",
"id": "aa03cf1d-ea75-63d8-882b-b6ed14d2525b",
"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": "73595000",
"display": "Stress (finding)"
} ],
"text": "Stress (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"onsetDateTime": "2019-03-14T17:50:25+01:00",
"abatementDateTime": "2020-12-24T17:56:50+01:00",
"recordedDate": "2019-03-14T17:50:25+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:ed686b5f-beaa-cf1f-7a0c-1e1a4f3dd901",
"resource": {
"resourceType": "Observation",
"id": "ed686b5f-beaa-cf1f-7a0c-1e1a4f3dd901",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "4548-4",
"display": "Hemoglobin A1c/Hemoglobin.total in Blood"
} ],
"text": "Hemoglobin A1c/Hemoglobin.total in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T17:15:30+01:00",
"issued": "2019-03-14T17:15:30.236+01:00",
"valueQuantity": {
"value": 5.95,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:f67f2f00-4c1e-ca31-5163-efe0f906b400",
"resource": {
"resourceType": "Observation",
"id": "f67f2f00-4c1e-ca31-5163-efe0f906b400",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T17:15:30+01:00",
"issued": "2019-03-14T17:15:30.236+01:00",
"valueQuantity": {
"value": 174.1,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:39bbdd07-213b-bcbb-8d26-1754fa79b006",
"resource": {
"resourceType": "Observation",
"id": "39bbdd07-213b-bcbb-8d26-1754fa79b006",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T17:15:30+01:00",
"issued": "2019-03-14T17:15:30.236+01:00",
"valueQuantity": {
"value": 3,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:c0389331-1ef2-41b7-107f-c06a4f6e37c8",
"resource": {
"resourceType": "Observation",
"id": "c0389331-1ef2-41b7-107f-c06a4f6e37c8",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T17:15:30+01:00",
"issued": "2019-03-14T17:15:30.236+01:00",
"valueQuantity": {
"value": 84,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:c148b970-4b67-e392-af0c-6ddde033241e",
"resource": {
"resourceType": "Observation",
"id": "c148b970-4b67-e392-af0c-6ddde033241e",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T17:15:30+01:00",
"issued": "2019-03-14T17:15:30.236+01:00",
"valueQuantity": {
"value": 27.73,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:8690ed6b-8174-2f47-ee3f-7287fce84ca0",
"resource": {
"resourceType": "Observation",
"id": "8690ed6b-8174-2f47-ee3f-7287fce84ca0",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T17:15:30+01:00",
"issued": "2019-03-14T17:15:30.236+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 77,
"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": 110,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:dc0c7ddf-68b1-59c4-2da8-94434594f819",
"resource": {
"resourceType": "Observation",
"id": "dc0c7ddf-68b1-59c4-2da8-94434594f819",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T17:15:30+01:00",
"issued": "2019-03-14T17:15:30.236+01:00",
"valueQuantity": {
"value": 67,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:c759f180-4265-0fd4-faaa-c58efd6f6980",
"resource": {
"resourceType": "Observation",
"id": "c759f180-4265-0fd4-faaa-c58efd6f6980",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T17:15:30+01:00",
"issued": "2019-03-14T17:15:30.236+01:00",
"valueQuantity": {
"value": 13,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:103de47d-b72c-e399-6c1d-9fdb32aab6cc",
"resource": {
"resourceType": "Observation",
"id": "103de47d-b72c-e399-6c1d-9fdb32aab6cc",
"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": "2339-0",
"display": "Glucose [Mass/volume] in Blood"
} ],
"text": "Glucose [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T17:15:30+01:00",
"issued": "2019-03-14T17:15:30.236+01:00",
"valueQuantity": {
"value": 64.18,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:780517f1-d3d0-4f1e-adbb-36b6de3313eb",
"resource": {
"resourceType": "Observation",
"id": "780517f1-d3d0-4f1e-adbb-36b6de3313eb",
"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": "6299-2",
"display": "Urea nitrogen [Mass/volume] in Blood"
} ],
"text": "Urea nitrogen [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T17:15:30+01:00",
"issued": "2019-03-14T17:15:30.236+01:00",
"valueQuantity": {
"value": 15.79,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:661cb4a7-593f-8b42-2a34-c5204c561b69",
"resource": {
"resourceType": "Observation",
"id": "661cb4a7-593f-8b42-2a34-c5204c561b69",
"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": "38483-4",
"display": "Creatinine [Mass/volume] in Blood"
} ],
"text": "Creatinine [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T17:15:30+01:00",
"issued": "2019-03-14T17:15:30.236+01:00",
"valueQuantity": {
"value": 1.27,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:a1c35701-fb61-ebce-795f-d79d13206ec0",
"resource": {
"resourceType": "Observation",
"id": "a1c35701-fb61-ebce-795f-d79d13206ec0",
"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": "49765-1",
"display": "Calcium [Mass/volume] in Blood"
} ],
"text": "Calcium [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T17:15:30+01:00",
"issued": "2019-03-14T17:15:30.236+01:00",
"valueQuantity": {
"value": 9.04,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:f5c46931-aad5-ff92-3d14-539330ec4d20",
"resource": {
"resourceType": "Observation",
"id": "f5c46931-aad5-ff92-3d14-539330ec4d20",
"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": "2947-0",
"display": "Sodium [Moles/volume] in Blood"
} ],
"text": "Sodium [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T17:15:30+01:00",
"issued": "2019-03-14T17:15:30.236+01:00",
"valueQuantity": {
"value": 143.99,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:43526ca6-08d1-0ecd-7f13-1fd8037c5271",
"resource": {
"resourceType": "Observation",
"id": "43526ca6-08d1-0ecd-7f13-1fd8037c5271",
"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": "6298-4",
"display": "Potassium [Moles/volume] in Blood"
} ],
"text": "Potassium [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T17:15:30+01:00",
"issued": "2019-03-14T17:15:30.236+01:00",
"valueQuantity": {
"value": 3.7,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:4fb7e6bf-3e0d-9bd1-4b56-42854e54a298",
"resource": {
"resourceType": "Observation",
"id": "4fb7e6bf-3e0d-9bd1-4b56-42854e54a298",
"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": "2069-3",
"display": "Chloride [Moles/volume] in Blood"
} ],
"text": "Chloride [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T17:15:30+01:00",
"issued": "2019-03-14T17:15:30.236+01:00",
"valueQuantity": {
"value": 105.44,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:6fdde4c7-1a8e-c9e7-56e4-880ec96504f9",
"resource": {
"resourceType": "Observation",
"id": "6fdde4c7-1a8e-c9e7-56e4-880ec96504f9",
"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": "20565-8",
"display": "Carbon dioxide, total [Moles/volume] in Blood"
} ],
"text": "Carbon dioxide, total [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T17:15:30+01:00",
"issued": "2019-03-14T17:15:30.236+01:00",
"valueQuantity": {
"value": 22.57,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:5fe763bf-b19c-d04b-01a8-18826818e654",
"resource": {
"resourceType": "Observation",
"id": "5fe763bf-b19c-d04b-01a8-18826818e654",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T17:15:30+01:00",
"issued": "2019-03-14T17:15:30.236+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "8517006",
"display": "Ex-smoker (finding)"
} ],
"text": "Ex-smoker (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:73349095-3123-3318-b2b7-296d67573d8f",
"resource": {
"resourceType": "Observation",
"id": "73349095-3123-3318-b2b7-296d67573d8f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93025-5",
"display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
} ],
"text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T17:50:25+01:00",
"issued": "2019-03-14T17:50:25.236+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76501-6",
"display": "Within the last year, have you been afraid of your partner or ex-partner?"
} ],
"text": "Within the last year, have you been afraid of your partner or ex-partner?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93026-3",
"display": "Do you feel physically and emotionally safe where you currently live?"
} ],
"text": "Do you feel physically and emotionally safe where you currently live?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93027-1",
"display": "Are you a refugee?"
} ],
"text": "Are you a refugee?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93028-9",
"display": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
} ],
"text": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93038-8",
"display": "Stress level"
} ],
"text": "Stress level"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA13909-9",
"display": "Somewhat"
} ],
"text": "Somewhat"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93029-7",
"display": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
} ],
"text": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30132-7",
"display": "5 or more times a week"
} ],
"text": "5 or more times a week"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93030-5",
"display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
} ],
"text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93031-3",
"display": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
} ],
"text": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30128-5",
"display": "Medicine or Any Health Care (Medical, Dental, Mental Health, Vision)"
} ],
"text": "Medicine or Any Health Care (Medical, Dental, Mental Health, Vision)"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63586-2",
"display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
} ],
"text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
},
"valueQuantity": {
"value": 55950,
"unit": "/a",
"system": "http://unitsofmeasure.org",
"code": "/a"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76437-3",
"display": "Primary insurance"
} ],
"text": "Primary insurance"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30194-7",
"display": "None/uninsured"
} ],
"text": "None/uninsured"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "67875-5",
"display": "Employment status - current"
} ],
"text": "Employment status - current"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30136-8",
"display": "Full-time work"
} ],
"text": "Full-time work"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82589-3",
"display": "Highest level of education"
} ],
"text": "Highest level of education"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30193-9",
"display": "More than high school"
} ],
"text": "More than high school"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56799-0",
"display": "Address"
} ],
"text": "Address"
},
"valueString": "287 Treutel Neck"
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93033-9",
"display": "Are you worried about losing your housing?"
} ],
"text": "Are you worried about losing your housing?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "71802-3",
"display": "Housing status"
} ],
"text": "Housing status"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30189-7",
"display": "I have housing"
} ],
"text": "I have housing"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63512-8",
"display": "How many people are living or staying at this address?"
} ],
"text": "How many people are living or staying at this address?"
},
"valueQuantity": {
"value": 7,
"unit": "{#}",
"system": "http://unitsofmeasure.org",
"code": "{#}"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "54899-0",
"display": "Preferred language"
} ],
"text": "Preferred language"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA43-5",
"display": "English"
} ],
"text": "English"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93034-7",
"display": "Have you been discharged from the armed forces of the United States?"
} ],
"text": "Have you been discharged from the armed forces of the United States?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93035-4",
"display": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
} ],
"text": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "32624-9",
"display": "Race"
} ],
"text": "Race"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA4457-3",
"display": "White"
} ],
"text": "White"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56051-6",
"display": "Do you consider yourself Hispanic/Latino?"
} ],
"text": "Do you consider yourself Hispanic/Latino?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:6d73d9ee-ad17-d67a-214f-f709d2d905a4",
"resource": {
"resourceType": "Observation",
"id": "6d73d9ee-ad17-d67a-214f-f709d2d905a4",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76504-0",
"display": "Total score [HARK]"
} ],
"text": "Total score [HARK]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T18:32:42+01:00",
"issued": "2019-03-14T18:32:42.236+01:00",
"valueQuantity": {
"value": 0,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:6504e999-96ca-975c-9d8e-aa06de5d87e6",
"resource": {
"resourceType": "Observation",
"id": "6504e999-96ca-975c-9d8e-aa06de5d87e6",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "55758-7",
"display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T19:09:40+01:00",
"issued": "2019-03-14T19:09:40.236+01:00",
"valueQuantity": {
"value": 1,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e8c46bb9-7c06-be12-c19d-3d4c8368bcc8",
"resource": {
"resourceType": "Observation",
"id": "e8c46bb9-7c06-be12-c19d-3d4c8368bcc8",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "75626-2",
"display": "Total score [AUDIT-C]"
} ],
"text": "Total score [AUDIT-C]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T19:50:00+01:00",
"issued": "2019-03-14T19:50:00.236+01:00",
"valueQuantity": {
"value": 0,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:12728529-a027-51b0-c2bc-4311179c3784",
"resource": {
"resourceType": "Procedure",
"id": "12728529-a027-51b0-c2bc-4311179c3784",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"performedPeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:30:30+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:e4e95fdb-ce58-d97e-ef1c-8d449fc350bd",
"resource": {
"resourceType": "Procedure",
"id": "e4e95fdb-ce58-d97e-ef1c-8d449fc350bd",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"performedPeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:b00ebd8d-ff38-be89-24e3-c265ccbf0fc2",
"resource": {
"resourceType": "Procedure",
"id": "b00ebd8d-ff38-be89-24e3-c265ccbf0fc2",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "866148006",
"display": "Screening for domestic abuse (procedure)"
} ],
"text": "Screening for domestic abuse (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"performedPeriod": {
"start": "2019-03-14T17:50:25+01:00",
"end": "2019-03-14T18:32:42+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:3d6b78fa-e735-b7d1-bb53-9f0772da1f01",
"resource": {
"resourceType": "Procedure",
"id": "3d6b78fa-e735-b7d1-bb53-9f0772da1f01",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"performedPeriod": {
"start": "2019-03-14T18:32:42+01:00",
"end": "2019-03-14T18:43:33+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:2a7427f4-bbb8-0dd0-133d-61d1134dac03",
"resource": {
"resourceType": "Procedure",
"id": "2a7427f4-bbb8-0dd0-133d-61d1134dac03",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"performedPeriod": {
"start": "2019-03-14T18:43:33+01:00",
"end": "2019-03-14T19:09:40+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:12781d92-0d5b-fa92-f309-8e83f45bee5e",
"resource": {
"resourceType": "Procedure",
"id": "12781d92-0d5b-fa92-f309-8e83f45bee5e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"performedPeriod": {
"start": "2019-03-14T19:09:40+01:00",
"end": "2019-03-14T19:23:14+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:5a09ec64-85d7-ccff-cc40-36ea690bcf07",
"resource": {
"resourceType": "Procedure",
"id": "5a09ec64-85d7-ccff-cc40-36ea690bcf07",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "763302001",
"display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
} ],
"text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"performedPeriod": {
"start": "2019-03-14T19:23:14+01:00",
"end": "2019-03-14T19:50:00+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:cd574841-155d-902d-3b42-de3e53950bad",
"resource": {
"resourceType": "SupplyDelivery",
"id": "cd574841-155d-902d-3b42-de3e53950bad",
"status": "completed",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/supply-item-type",
"code": "device",
"display": "Device"
} ]
},
"suppliedItem": {
"quantity": {
"value": 50
},
"itemCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
}
},
"occurrenceDateTime": "2019-03-14T17:15:30+01:00"
},
"request": {
"method": "POST",
"url": "SupplyDelivery"
}
}, {
"fullUrl": "urn:uuid:775217cd-ed3e-0353-466d-cf3a6daf65ea",
"resource": {
"resourceType": "SupplyDelivery",
"id": "775217cd-ed3e-0353-466d-cf3a6daf65ea",
"status": "completed",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/supply-item-type",
"code": "device",
"display": "Device"
} ]
},
"suppliedItem": {
"quantity": {
"value": 100
},
"itemCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "1137596000",
"display": "Blood lancet (physical object)"
} ],
"text": "Blood lancet (physical object)"
}
},
"occurrenceDateTime": "2019-03-14T17:15:30+01:00"
},
"request": {
"method": "POST",
"url": "SupplyDelivery"
}
}, {
"fullUrl": "urn:uuid:5a7c7745-05eb-ed01-6706-e4fcfe5fd69b",
"resource": {
"resourceType": "MedicationRequest",
"id": "5a7c7745-05eb-ed01-6706-e4fcfe5fd69b",
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"authoredOn": "2019-03-14T17:15:30+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"dosageInstruction": [ {
"sequence": 1,
"text": "Every six hours (qualifier value)",
"additionalInstruction": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "307468000",
"display": "Every six hours (qualifier value)"
} ],
"text": "Every six hours (qualifier value)"
} ],
"timing": {
"repeat": {
"frequency": 4,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:b24cc530-3de6-96e6-f18f-e06fb8edef53",
"resource": {
"resourceType": "Claim",
"id": "b24cc530-3de6-96e6-f18f-e06fb8edef53",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"created": "2019-03-14T17:50:25+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:5a7c7745-05eb-ed01-6706-e4fcfe5fd69b"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"encounter": [ {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
} ]
} ],
"total": {
"value": 129.94,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:17f029cf-8b84-0171-73c8-655673cc716f",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "17f029cf-8b84-0171-73c8-655673cc716f",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "b24cc530-3de6-96e6-f18f-e06fb8edef53"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2019-03-14T17:50:25+01:00",
"end": "2020-03-14T17:50:25+01:00"
},
"created": "2019-03-14T17:50:25+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:b24cc530-3de6-96e6-f18f-e06fb8edef53"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"servicedPeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
} ]
} ],
"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:59906b55-0700-1c3c-232c-8f9db2084794",
"resource": {
"resourceType": "MedicationRequest",
"id": "59906b55-0700-1c3c-232c-8f9db2084794",
"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": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"authoredOn": "2019-03-14T17:15:30+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"reasonReference": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4",
"display": "Essential hypertension (disorder)"
} ],
"dosageInstruction": [ {
"sequence": 1,
"timing": {
"repeat": {
"frequency": 1,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:4bd70ad6-6a1c-a342-ddfc-d2923d068e7b",
"resource": {
"resourceType": "Claim",
"id": "4bd70ad6-6a1c-a342-ddfc-d2923d068e7b",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"created": "2019-03-14T17:50:25+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:59906b55-0700-1c3c-232c-8f9db2084794"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
} ]
} ],
"total": {
"value": 0.60,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:d44d8d2b-27db-50f2-bc95-fd2983b38c79",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "d44d8d2b-27db-50f2-bc95-fd2983b38c79",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "4bd70ad6-6a1c-a342-ddfc-d2923d068e7b"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2019-03-14T17:50:25+01:00",
"end": "2020-03-14T17:50:25+01:00"
},
"created": "2019-03-14T17:50:25+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:4bd70ad6-6a1c-a342-ddfc-d2923d068e7b"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 0.60,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:75a27585-f2f9-a9e8-1694-4feba74f96c7",
"resource": {
"resourceType": "MedicationRequest",
"id": "75a27585-f2f9-a9e8-1694-4feba74f96c7",
"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": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"authoredOn": "2019-03-14T17:15:30+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"reasonReference": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4",
"display": "Essential hypertension (disorder)"
} ],
"dosageInstruction": [ {
"sequence": 1,
"timing": {
"repeat": {
"frequency": 1,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:5e8bbe74-2d0c-f684-f0ef-73da0b01af99",
"resource": {
"resourceType": "Claim",
"id": "5e8bbe74-2d0c-f684-f0ef-73da0b01af99",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"created": "2019-03-14T17:50:25+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:75a27585-f2f9-a9e8-1694-4feba74f96c7"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
} ]
} ],
"total": {
"value": 0.91,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:6104e9bd-7f40-56de-2479-0df57e7642fc",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "6104e9bd-7f40-56de-2479-0df57e7642fc",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "5e8bbe74-2d0c-f684-f0ef-73da0b01af99"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2019-03-14T17:50:25+01:00",
"end": "2020-03-14T17:50:25+01:00"
},
"created": "2019-03-14T17:50:25+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:5e8bbe74-2d0c-f684-f0ef-73da0b01af99"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 0.91,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:4c61d21c-ab31-f00e-4bad-a24c76d1001d",
"resource": {
"resourceType": "Immunization",
"id": "4c61d21c-ab31-f00e-4bad-a24c76d1001d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization" ]
},
"status": "completed",
"vaccineCode": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "113",
"display": "Td (adult), 5 Lf tetanus toxoid, preservative free, adsorbed"
} ],
"text": "Td (adult), 5 Lf tetanus toxoid, preservative free, adsorbed"
},
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"occurrenceDateTime": "2019-03-14T17:15:30+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:f1224b20-5ff8-ce6f-a250-0797d13ab43c",
"resource": {
"resourceType": "DiagnosticReport",
"id": "f1224b20-5ff8-ce6f-a250-0797d13ab43c",
"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": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T17:15:30+01:00",
"issued": "2019-03-14T17:15:30.236+01:00",
"performer": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
} ],
"result": [ {
"reference": "urn:uuid:103de47d-b72c-e399-6c1d-9fdb32aab6cc",
"display": "Glucose [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:780517f1-d3d0-4f1e-adbb-36b6de3313eb",
"display": "Urea nitrogen [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:661cb4a7-593f-8b42-2a34-c5204c561b69",
"display": "Creatinine [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:a1c35701-fb61-ebce-795f-d79d13206ec0",
"display": "Calcium [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:f5c46931-aad5-ff92-3d14-539330ec4d20",
"display": "Sodium [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:43526ca6-08d1-0ecd-7f13-1fd8037c5271",
"display": "Potassium [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:4fb7e6bf-3e0d-9bd1-4b56-42854e54a298",
"display": "Chloride [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:6fdde4c7-1a8e-c9e7-56e4-880ec96504f9",
"display": "Carbon dioxide, total [Moles/volume] in Blood"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:f01c6ca2-6450-3d6a-6d18-fd92182e5d14",
"resource": {
"resourceType": "DiagnosticReport",
"id": "f01c6ca2-6450-3d6a-6d18-fd92182e5d14",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76499-3",
"display": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
} ],
"text": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T18:32:42+01:00",
"issued": "2019-03-14T18:32:42.236+01:00",
"result": [ {
"reference": "urn:uuid:6d73d9ee-ad17-d67a-214f-f709d2d905a4",
"display": "Total score [HARK]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:87b10633-7f48-412a-416d-8dcc7c5a245a",
"resource": {
"resourceType": "DiagnosticReport",
"id": "87b10633-7f48-412a-416d-8dcc7c5a245a",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T19:09:40+01:00",
"issued": "2019-03-14T19:09:40.236+01:00",
"result": [ {
"reference": "urn:uuid:6504e999-96ca-975c-9d8e-aa06de5d87e6",
"display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:b926550f-5265-296f-bf0c-081d6e213507",
"resource": {
"resourceType": "DiagnosticReport",
"id": "b926550f-5265-296f-bf0c-081d6e213507",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72109-2",
"display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
} ],
"text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T19:50:00+01:00",
"issued": "2019-03-14T19:50:00.236+01:00",
"result": [ {
"reference": "urn:uuid:e8c46bb9-7c06-be12-c19d-3d4c8368bcc8",
"display": "Total score [AUDIT-C]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:9f454adf-fd66-4c5e-564a-526a479009e2",
"resource": {
"resourceType": "DiagnosticReport",
"id": "9f454adf-fd66-4c5e-564a-526a479009e2",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
},
"effectiveDateTime": "2019-03-14T17:15:30+01:00",
"issued": "2019-03-14T17:15:30.236+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:89110fdd-792e-1ade-defd-2d95a16a6d2f",
"resource": {
"resourceType": "DocumentReference",
"id": "89110fdd-792e-1ade-defd-2d95a16a6d2f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:9f454adf-fd66-4c5e-564a-526a479009e2"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2019-03-14T17:15:30.236+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE 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:3e023371-4077-7c02-0c19-23d5f89f3210"
} ],
"period": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:7d26ae9d-fb12-3be9-5388-5afbbd4b5888",
"resource": {
"resourceType": "Claim",
"id": "7d26ae9d-fb12-3be9-5388-5afbbd4b5888",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"created": "2019-03-14T17:50:25+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:4c61d21c-ab31-f00e-4bad-a24c76d1001d"
}
}, {
"sequence": 2,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 4,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 5,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 6,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 7,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:db6175db-b452-58c3-eaf6-0d119de07d50"
}
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:aa03cf1d-ea75-63d8-882b-b6ed14d2525b"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:12728529-a027-51b0-c2bc-4311179c3784"
}
}, {
"sequence": 2,
"procedureReference": {
"reference": "urn:uuid:e4e95fdb-ce58-d97e-ef1c-8d449fc350bd"
}
}, {
"sequence": 3,
"procedureReference": {
"reference": "urn:uuid:b00ebd8d-ff38-be89-24e3-c265ccbf0fc2"
}
}, {
"sequence": 4,
"procedureReference": {
"reference": "urn:uuid:3d6b78fa-e735-b7d1-bb53-9f0772da1f01"
}
}, {
"sequence": 5,
"procedureReference": {
"reference": "urn:uuid:2a7427f4-bbb8-0dd0-133d-61d1134dac03"
}
}, {
"sequence": 6,
"procedureReference": {
"reference": "urn:uuid:12781d92-0d5b-fa92-f309-8e83f45bee5e"
}
}, {
"sequence": 7,
"procedureReference": {
"reference": "urn:uuid:5a09ec64-85d7-ccff-cc40-36ea690bcf07"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
} ]
}, {
"sequence": 2,
"informationSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://hl7.org/fhir/sid/cvx",
"code": "113",
"display": "Td (adult), 5 Lf tetanus toxoid, preservative free, adsorbed"
} ],
"text": "Td (adult), 5 Lf tetanus toxoid, preservative free, adsorbed"
},
"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": 605.09,
"currency": "USD"
}
}, {
"sequence": 5,
"informationSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
},
"net": {
"value": 6.80,
"currency": "USD"
}
}, {
"sequence": 6,
"informationSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "1137596000",
"display": "Blood lancet (physical object)"
} ],
"text": "Blood lancet (physical object)"
},
"net": {
"value": 0.00,
"currency": "USD"
}
}, {
"sequence": 7,
"informationSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 8,
"procedureSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 9,
"diagnosisSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "73595000",
"display": "Stress (finding)"
} ],
"text": "Stress (finding)"
}
}, {
"sequence": 10,
"procedureSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "866148006",
"display": "Screening for domestic abuse (procedure)"
} ],
"text": "Screening for domestic abuse (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 11,
"informationSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "76499-3",
"display": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
} ],
"text": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 12,
"procedureSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 13,
"procedureSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 14,
"informationSequence": [ 6 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 15,
"procedureSequence": [ 6 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 16,
"procedureSequence": [ 7 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "763302001",
"display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
} ],
"text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 17,
"informationSequence": [ 7 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "72109-2",
"display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
} ],
"text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
} ],
"total": {
"value": 1390.67,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:40429be7-b1f5-83e7-c035-faa98e2cc62a",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "40429be7-b1f5-83e7-c035-faa98e2cc62a",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "7d26ae9d-fb12-3be9-5388-5afbbd4b5888"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2019-03-14T17:50:25+01:00",
"end": "2020-03-14T17:50:25+01:00"
},
"created": "2019-03-14T17:50:25+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:7d26ae9d-fb12-3be9-5388-5afbbd4b5888"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:db6175db-b452-58c3-eaf6-0d119de07d50"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:aa03cf1d-ea75-63d8-882b-b6ed14d2525b"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"servicedPeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
} ]
}, {
"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": "113",
"display": "Td (adult), 5 Lf tetanus toxoid, preservative free, adsorbed"
} ],
"text": "Td (adult), 5 Lf tetanus toxoid, preservative free, adsorbed"
},
"servicedPeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+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": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+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": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 605.09,
"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": 121.01800000000001,
"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": 484.07200000000006,
"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": 605.09,
"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": 605.09,
"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://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
},
"servicedPeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 6.80,
"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": 1.36,
"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": 5.44,
"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": 6.80,
"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": 6.80,
"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": [ 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": "1137596000",
"display": "Blood lancet (physical object)"
} ],
"text": "Blood lancet (physical object)"
},
"servicedPeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 0.00,
"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": 0.0,
"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": 0.0,
"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": 0.00,
"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": 0.00,
"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,
"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://loinc.org",
"code": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"servicedPeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+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"
} ]
}
} ]
}, {
"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": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"servicedPeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 9,
"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": "73595000",
"display": "Stress (finding)"
} ],
"text": "Stress (finding)"
},
"servicedPeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 10,
"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": "866148006",
"display": "Screening for domestic abuse (procedure)"
} ],
"text": "Screening for domestic abuse (procedure)"
},
"servicedPeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 11,
"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://loinc.org",
"code": "76499-3",
"display": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
} ],
"text": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
},
"servicedPeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+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"
} ]
}
} ]
}, {
"sequence": 12,
"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": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"servicedPeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 13,
"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": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"servicedPeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 14,
"informationSequence": [ 6 ],
"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": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"servicedPeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+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"
} ]
}
} ]
}, {
"sequence": 15,
"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": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"servicedPeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 16,
"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": "763302001",
"display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
} ],
"text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
},
"servicedPeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 17,
"informationSequence": [ 7 ],
"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": "72109-2",
"display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
} ],
"text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
},
"servicedPeriod": {
"start": "2019-03-14T17:15:30+01:00",
"end": "2019-03-14T17:50:25+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": 1390.67,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 2907.688,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de",
"resource": {
"resourceType": "Encounter",
"id": "453daa6d-b332-83be-fe0e-7643b2a5d1de",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "453daa6d-b332-83be-fe0e-7643b2a5d1de"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
}
} ],
"period": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:cbd82f1a-137c-2447-b31e-3c0ab0656971",
"resource": {
"resourceType": "Condition",
"id": "cbd82f1a-137c-2447-b31e-3c0ab0656971",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"onsetDateTime": "2020-03-19T17:15:30+01:00",
"abatementDateTime": "2020-12-24T17:15:30+01:00",
"recordedDate": "2020-03-19T17:15:30+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:fb2cab63-7b3c-e2f2-08cd-93e1d83f5b85",
"resource": {
"resourceType": "Observation",
"id": "fb2cab63-7b3c-e2f2-08cd-93e1d83f5b85",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "4548-4",
"display": "Hemoglobin A1c/Hemoglobin.total in Blood"
} ],
"text": "Hemoglobin A1c/Hemoglobin.total in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 6.22,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:8842a1cf-e239-385c-388e-cfa3cd93beb7",
"resource": {
"resourceType": "Observation",
"id": "8842a1cf-e239-385c-388e-cfa3cd93beb7",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 174.1,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:4b882e74-0c62-df6a-c79c-5077f98780af",
"resource": {
"resourceType": "Observation",
"id": "4b882e74-0c62-df6a-c79c-5077f98780af",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 2,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:2af461b9-aba0-cf9b-22bd-b1c6e5ce4a43",
"resource": {
"resourceType": "Observation",
"id": "2af461b9-aba0-cf9b-22bd-b1c6e5ce4a43",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 86.2,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:7907567b-7186-c598-3bc3-54df0403a4a4",
"resource": {
"resourceType": "Observation",
"id": "7907567b-7186-c598-3bc3-54df0403a4a4",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 28.44,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:620b9f29-9cdc-cba5-2c22-98a9e2e7ab51",
"resource": {
"resourceType": "Observation",
"id": "620b9f29-9cdc-cba5-2c22-98a9e2e7ab51",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 78,
"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": 111,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:1c542cef-b03c-f478-f86d-93c6c5441c53",
"resource": {
"resourceType": "Observation",
"id": "1c542cef-b03c-f478-f86d-93c6c5441c53",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 76,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:037ef59b-e0ea-572b-ff7f-004fe6a22711",
"resource": {
"resourceType": "Observation",
"id": "037ef59b-e0ea-572b-ff7f-004fe6a22711",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 14,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:684c3d67-d88a-3a35-cd89-c568a5e5c373",
"resource": {
"resourceType": "Observation",
"id": "684c3d67-d88a-3a35-cd89-c568a5e5c373",
"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": "2339-0",
"display": "Glucose [Mass/volume] in Blood"
} ],
"text": "Glucose [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 77.87,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:ab27c417-c738-7b8d-07bd-57a91a035877",
"resource": {
"resourceType": "Observation",
"id": "ab27c417-c738-7b8d-07bd-57a91a035877",
"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": "6299-2",
"display": "Urea nitrogen [Mass/volume] in Blood"
} ],
"text": "Urea nitrogen [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 11.33,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:46f8cdde-9200-fdb3-8a48-26565edf41b6",
"resource": {
"resourceType": "Observation",
"id": "46f8cdde-9200-fdb3-8a48-26565edf41b6",
"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": "38483-4",
"display": "Creatinine [Mass/volume] in Blood"
} ],
"text": "Creatinine [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 1.35,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:b9a9394e-c4f8-d7a1-1889-b4afc66931d8",
"resource": {
"resourceType": "Observation",
"id": "b9a9394e-c4f8-d7a1-1889-b4afc66931d8",
"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": "49765-1",
"display": "Calcium [Mass/volume] in Blood"
} ],
"text": "Calcium [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 9.83,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:b1e3dd1e-7e3a-5940-8950-b7554da68e26",
"resource": {
"resourceType": "Observation",
"id": "b1e3dd1e-7e3a-5940-8950-b7554da68e26",
"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": "2947-0",
"display": "Sodium [Moles/volume] in Blood"
} ],
"text": "Sodium [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 137.23,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:f7347e2c-3e38-631d-4d13-23e6c3ce6f5c",
"resource": {
"resourceType": "Observation",
"id": "f7347e2c-3e38-631d-4d13-23e6c3ce6f5c",
"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": "6298-4",
"display": "Potassium [Moles/volume] in Blood"
} ],
"text": "Potassium [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 3.83,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d522a1c4-69c3-055c-11a5-16eb77e45bc3",
"resource": {
"resourceType": "Observation",
"id": "d522a1c4-69c3-055c-11a5-16eb77e45bc3",
"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": "2069-3",
"display": "Chloride [Moles/volume] in Blood"
} ],
"text": "Chloride [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 106.35,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:ebb0c021-6142-99ec-ffdd-b3f3727c0e7f",
"resource": {
"resourceType": "Observation",
"id": "ebb0c021-6142-99ec-ffdd-b3f3727c0e7f",
"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": "20565-8",
"display": "Carbon dioxide, total [Moles/volume] in Blood"
} ],
"text": "Carbon dioxide, total [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 28.21,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:2ceb1620-fc88-a490-0d1f-6616564f0d07",
"resource": {
"resourceType": "Observation",
"id": "2ceb1620-fc88-a490-0d1f-6616564f0d07",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 7.1467,
"unit": "10*3/uL",
"system": "http://unitsofmeasure.org",
"code": "10*3/uL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:578b62ad-d31a-4d31-0726-cedbde7c0533",
"resource": {
"resourceType": "Observation",
"id": "578b62ad-d31a-4d31-0726-cedbde7c0533",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 5.1851,
"unit": "10*6/uL",
"system": "http://unitsofmeasure.org",
"code": "10*6/uL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:c75a4738-da92-376f-d8f8-753a788fcd00",
"resource": {
"resourceType": "Observation",
"id": "c75a4738-da92-376f-d8f8-753a788fcd00",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 13.877,
"unit": "g/dL",
"system": "http://unitsofmeasure.org",
"code": "g/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e471e01d-8ade-aacb-dbe5-d9a26f92c4e6",
"resource": {
"resourceType": "Observation",
"id": "e471e01d-8ade-aacb-dbe5-d9a26f92c4e6",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 49.061,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:3a1a886a-bd50-c361-9e28-b3666ad43197",
"resource": {
"resourceType": "Observation",
"id": "3a1a886a-bd50-c361-9e28-b3666ad43197",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 89.941,
"unit": "fL",
"system": "http://unitsofmeasure.org",
"code": "fL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:504fb7e6-ae3f-a81d-6322-464db27d3a58",
"resource": {
"resourceType": "Observation",
"id": "504fb7e6-ae3f-a81d-6322-464db27d3a58",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 28.09,
"unit": "pg",
"system": "http://unitsofmeasure.org",
"code": "pg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d4e853e5-dfb0-3676-0f80-a695c76ff37d",
"resource": {
"resourceType": "Observation",
"id": "d4e853e5-dfb0-3676-0f80-a695c76ff37d",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 34.452,
"unit": "g/dL",
"system": "http://unitsofmeasure.org",
"code": "g/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:c4ebc494-4c84-3f21-4bcd-9fdd4b4a1c16",
"resource": {
"resourceType": "Observation",
"id": "c4ebc494-4c84-3f21-4bcd-9fdd4b4a1c16",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 44.066,
"unit": "fL",
"system": "http://unitsofmeasure.org",
"code": "fL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:b56b52c2-9da5-5445-0074-0fb3a225bd2c",
"resource": {
"resourceType": "Observation",
"id": "b56b52c2-9da5-5445-0074-0fb3a225bd2c",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 275.89,
"unit": "10*3/uL",
"system": "http://unitsofmeasure.org",
"code": "10*3/uL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:b8cdf264-7aba-e50d-ab52-bebcb8622620",
"resource": {
"resourceType": "Observation",
"id": "b8cdf264-7aba-e50d-ab52-bebcb8622620",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 350.53,
"unit": "fL",
"system": "http://unitsofmeasure.org",
"code": "fL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:19c83c29-8f5b-43ad-9626-2ba8cbdfa508",
"resource": {
"resourceType": "Observation",
"id": "19c83c29-8f5b-43ad-9626-2ba8cbdfa508",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueQuantity": {
"value": 10.585,
"unit": "fL",
"system": "http://unitsofmeasure.org",
"code": "fL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d15be174-5e9b-2323-80ac-ceceffe064ac",
"resource": {
"resourceType": "Observation",
"id": "d15be174-5e9b-2323-80ac-ceceffe064ac",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "8517006",
"display": "Ex-smoker (finding)"
} ],
"text": "Ex-smoker (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:1c3cfd70-3463-286a-13f3-ff8fc81d7d3f",
"resource": {
"resourceType": "Observation",
"id": "1c3cfd70-3463-286a-13f3-ff8fc81d7d3f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93025-5",
"display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
} ],
"text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T18:07:25+01:00",
"issued": "2020-03-19T18:07:25.236+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76501-6",
"display": "Within the last year, have you been afraid of your partner or ex-partner?"
} ],
"text": "Within the last year, have you been afraid of your partner or ex-partner?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93026-3",
"display": "Do you feel physically and emotionally safe where you currently live?"
} ],
"text": "Do you feel physically and emotionally safe where you currently live?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93027-1",
"display": "Are you a refugee?"
} ],
"text": "Are you a refugee?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93028-9",
"display": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
} ],
"text": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93038-8",
"display": "Stress level"
} ],
"text": "Stress level"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA13909-9",
"display": "Somewhat"
} ],
"text": "Somewhat"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93029-7",
"display": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
} ],
"text": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30132-7",
"display": "5 or more times a week"
} ],
"text": "5 or more times a week"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93030-5",
"display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
} ],
"text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93031-3",
"display": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
} ],
"text": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30128-5",
"display": "Medicine or Any Health Care (Medical, Dental, Mental Health, Vision)"
} ],
"text": "Medicine or Any Health Care (Medical, Dental, Mental Health, Vision)"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63586-2",
"display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
} ],
"text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
},
"valueQuantity": {
"value": 55950,
"unit": "/a",
"system": "http://unitsofmeasure.org",
"code": "/a"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76437-3",
"display": "Primary insurance"
} ],
"text": "Primary insurance"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30194-7",
"display": "None/uninsured"
} ],
"text": "None/uninsured"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "67875-5",
"display": "Employment status - current"
} ],
"text": "Employment status - current"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30136-8",
"display": "Full-time work"
} ],
"text": "Full-time work"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82589-3",
"display": "Highest level of education"
} ],
"text": "Highest level of education"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30193-9",
"display": "More than high school"
} ],
"text": "More than high school"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56799-0",
"display": "Address"
} ],
"text": "Address"
},
"valueString": "287 Treutel Neck"
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93033-9",
"display": "Are you worried about losing your housing?"
} ],
"text": "Are you worried about losing your housing?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "71802-3",
"display": "Housing status"
} ],
"text": "Housing status"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30189-7",
"display": "I have housing"
} ],
"text": "I have housing"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63512-8",
"display": "How many people are living or staying at this address?"
} ],
"text": "How many people are living or staying at this address?"
},
"valueQuantity": {
"value": 7,
"unit": "{#}",
"system": "http://unitsofmeasure.org",
"code": "{#}"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "54899-0",
"display": "Preferred language"
} ],
"text": "Preferred language"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA43-5",
"display": "English"
} ],
"text": "English"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93034-7",
"display": "Have you been discharged from the armed forces of the United States?"
} ],
"text": "Have you been discharged from the armed forces of the United States?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93035-4",
"display": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
} ],
"text": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "32624-9",
"display": "Race"
} ],
"text": "Race"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA4457-3",
"display": "White"
} ],
"text": "White"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56051-6",
"display": "Do you consider yourself Hispanic/Latino?"
} ],
"text": "Do you consider yourself Hispanic/Latino?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:76da252f-7fb8-13d7-1061-a790554c409b",
"resource": {
"resourceType": "Observation",
"id": "76da252f-7fb8-13d7-1061-a790554c409b",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "70274-6",
"display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T18:27:45+01:00",
"issued": "2020-03-19T18:27:45.236+01:00",
"valueQuantity": {
"value": 3,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:cd655edd-0bce-eb04-a1b6-e0100522da3d",
"resource": {
"resourceType": "Observation",
"id": "cd655edd-0bce-eb04-a1b6-e0100522da3d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "55758-7",
"display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T19:06:17+01:00",
"issued": "2020-03-19T19:06:17.236+01:00",
"valueQuantity": {
"value": 0,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:ccf8b1cf-1a12-80b9-1044-6690f1cecb63",
"resource": {
"resourceType": "Observation",
"id": "ccf8b1cf-1a12-80b9-1044-6690f1cecb63",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "75626-2",
"display": "Total score [AUDIT-C]"
} ],
"text": "Total score [AUDIT-C]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T19:46:55+01:00",
"issued": "2020-03-19T19:46:55.236+01:00",
"valueQuantity": {
"value": 1,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:25804cc2-e134-6fca-7a3b-e6a682554cb7",
"resource": {
"resourceType": "Procedure",
"id": "25804cc2-e134-6fca-7a3b-e6a682554cb7",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"performedPeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:937b3d63-611f-f447-f0b1-4a075e857ffe",
"resource": {
"resourceType": "Procedure",
"id": "937b3d63-611f-f447-f0b1-4a075e857ffe",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"performedPeriod": {
"start": "2020-03-19T18:07:25+01:00",
"end": "2020-03-19T18:27:45+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:ed42ce16-d69a-7f75-2353-cda398f9678f",
"resource": {
"resourceType": "Procedure",
"id": "ed42ce16-d69a-7f75-2353-cda398f9678f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"performedPeriod": {
"start": "2020-03-19T18:27:45+01:00",
"end": "2020-03-19T18:42:14+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:d17f3cef-b57d-cfa9-99eb-897dea34a9e7",
"resource": {
"resourceType": "Procedure",
"id": "d17f3cef-b57d-cfa9-99eb-897dea34a9e7",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"performedPeriod": {
"start": "2020-03-19T18:42:14+01:00",
"end": "2020-03-19T19:06:17+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:0e22d2f4-1c53-d407-fd6f-ea96e69c911d",
"resource": {
"resourceType": "Procedure",
"id": "0e22d2f4-1c53-d407-fd6f-ea96e69c911d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"performedPeriod": {
"start": "2020-03-19T19:06:17+01:00",
"end": "2020-03-19T19:19:39+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:a09117f3-25ef-27d0-d9c8-938361aff0c0",
"resource": {
"resourceType": "Procedure",
"id": "a09117f3-25ef-27d0-d9c8-938361aff0c0",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "763302001",
"display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
} ],
"text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"performedPeriod": {
"start": "2020-03-19T19:19:39+01:00",
"end": "2020-03-19T19:46:55+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:db860404-8ddb-77a4-4200-fbba39a2abaf",
"resource": {
"resourceType": "SupplyDelivery",
"id": "db860404-8ddb-77a4-4200-fbba39a2abaf",
"status": "completed",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/supply-item-type",
"code": "device",
"display": "Device"
} ]
},
"suppliedItem": {
"quantity": {
"value": 50
},
"itemCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
}
},
"occurrenceDateTime": "2020-03-19T17:15:30+01:00"
},
"request": {
"method": "POST",
"url": "SupplyDelivery"
}
}, {
"fullUrl": "urn:uuid:06352398-1d60-1f4d-d115-8941772b7ac6",
"resource": {
"resourceType": "MedicationRequest",
"id": "06352398-1d60-1f4d-d115-8941772b7ac6",
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"authoredOn": "2020-03-19T17:15:30+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"dosageInstruction": [ {
"sequence": 1,
"text": "Every six hours (qualifier value)",
"additionalInstruction": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "307468000",
"display": "Every six hours (qualifier value)"
} ],
"text": "Every six hours (qualifier value)"
} ],
"timing": {
"repeat": {
"frequency": 4,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:f90b5fee-cc34-908a-7bb1-de3347026431",
"resource": {
"resourceType": "Claim",
"id": "f90b5fee-cc34-908a-7bb1-de3347026431",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+01:00"
},
"created": "2020-03-19T18:07:25+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:06352398-1d60-1f4d-d115-8941772b7ac6"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"encounter": [ {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
} ]
} ],
"total": {
"value": 129.94,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:9a757fb3-3c67-7e37-d71d-4b2e43d86a2d",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "9a757fb3-3c67-7e37-d71d-4b2e43d86a2d",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "f90b5fee-cc34-908a-7bb1-de3347026431"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2020-03-19T18:07:25+01:00",
"end": "2021-03-19T18:07:25+01:00"
},
"created": "2020-03-19T18:07:25+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:f90b5fee-cc34-908a-7bb1-de3347026431"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"servicedPeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
} ]
} ],
"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:9eb0fefa-2ccb-7cdf-2fba-59e2162a6f7f",
"resource": {
"resourceType": "MedicationRequest",
"id": "9eb0fefa-2ccb-7cdf-2fba-59e2162a6f7f",
"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": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"authoredOn": "2020-03-19T17:15:30+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"reasonReference": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4",
"display": "Essential hypertension (disorder)"
} ],
"dosageInstruction": [ {
"sequence": 1,
"timing": {
"repeat": {
"frequency": 1,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:f84d3698-6cfc-a1c8-ade0-30e802aaaea9",
"resource": {
"resourceType": "Claim",
"id": "f84d3698-6cfc-a1c8-ade0-30e802aaaea9",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+01:00"
},
"created": "2020-03-19T18:07:25+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:9eb0fefa-2ccb-7cdf-2fba-59e2162a6f7f"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
} ]
} ],
"total": {
"value": 0.62,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:fe9008b5-a4d8-5805-f12f-3ea1c29c07de",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "fe9008b5-a4d8-5805-f12f-3ea1c29c07de",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "f84d3698-6cfc-a1c8-ade0-30e802aaaea9"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2020-03-19T18:07:25+01:00",
"end": "2021-03-19T18:07:25+01:00"
},
"created": "2020-03-19T18:07:25+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:f84d3698-6cfc-a1c8-ade0-30e802aaaea9"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 0.62,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:41a744dc-c38d-4969-d654-b4d307698046",
"resource": {
"resourceType": "MedicationRequest",
"id": "41a744dc-c38d-4969-d654-b4d307698046",
"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": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"authoredOn": "2020-03-19T17:15:30+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"reasonReference": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4",
"display": "Essential hypertension (disorder)"
} ],
"dosageInstruction": [ {
"sequence": 1,
"timing": {
"repeat": {
"frequency": 1,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:48364dfa-b01a-9010-437e-514dcf2fde31",
"resource": {
"resourceType": "Claim",
"id": "48364dfa-b01a-9010-437e-514dcf2fde31",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+01:00"
},
"created": "2020-03-19T18:07:25+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:41a744dc-c38d-4969-d654-b4d307698046"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
} ]
} ],
"total": {
"value": 0.91,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:387800b8-b6a2-851a-2b17-36a4d46634f3",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "387800b8-b6a2-851a-2b17-36a4d46634f3",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "48364dfa-b01a-9010-437e-514dcf2fde31"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2020-03-19T18:07:25+01:00",
"end": "2021-03-19T18:07:25+01:00"
},
"created": "2020-03-19T18:07:25+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:48364dfa-b01a-9010-437e-514dcf2fde31"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 0.91,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:faa07a23-187b-8b5a-4907-805b76723c35",
"resource": {
"resourceType": "Immunization",
"id": "faa07a23-187b-8b5a-4907-805b76723c35",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"occurrenceDateTime": "2020-03-19T17:15:30+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:463d9b33-a74d-cdfb-44e7-63ff4121e025",
"resource": {
"resourceType": "DiagnosticReport",
"id": "463d9b33-a74d-cdfb-44e7-63ff4121e025",
"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": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"performer": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
} ],
"result": [ {
"reference": "urn:uuid:684c3d67-d88a-3a35-cd89-c568a5e5c373",
"display": "Glucose [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:ab27c417-c738-7b8d-07bd-57a91a035877",
"display": "Urea nitrogen [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:46f8cdde-9200-fdb3-8a48-26565edf41b6",
"display": "Creatinine [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:b9a9394e-c4f8-d7a1-1889-b4afc66931d8",
"display": "Calcium [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:b1e3dd1e-7e3a-5940-8950-b7554da68e26",
"display": "Sodium [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:f7347e2c-3e38-631d-4d13-23e6c3ce6f5c",
"display": "Potassium [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:d522a1c4-69c3-055c-11a5-16eb77e45bc3",
"display": "Chloride [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:ebb0c021-6142-99ec-ffdd-b3f3727c0e7f",
"display": "Carbon dioxide, total [Moles/volume] in Blood"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:d4b44239-46c7-9f36-7f43-0514491a0a34",
"resource": {
"resourceType": "DiagnosticReport",
"id": "d4b44239-46c7-9f36-7f43-0514491a0a34",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"performer": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
} ],
"result": [ {
"reference": "urn:uuid:2ceb1620-fc88-a490-0d1f-6616564f0d07",
"display": "Leukocytes [#/volume] in Blood by Automated count"
}, {
"reference": "urn:uuid:578b62ad-d31a-4d31-0726-cedbde7c0533",
"display": "Erythrocytes [#/volume] in Blood by Automated count"
}, {
"reference": "urn:uuid:c75a4738-da92-376f-d8f8-753a788fcd00",
"display": "Hemoglobin [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:e471e01d-8ade-aacb-dbe5-d9a26f92c4e6",
"display": "Hematocrit [Volume Fraction] of Blood by Automated count"
}, {
"reference": "urn:uuid:3a1a886a-bd50-c361-9e28-b3666ad43197",
"display": "MCV [Entitic volume] by Automated count"
}, {
"reference": "urn:uuid:504fb7e6-ae3f-a81d-6322-464db27d3a58",
"display": "MCH [Entitic mass] by Automated count"
}, {
"reference": "urn:uuid:d4e853e5-dfb0-3676-0f80-a695c76ff37d",
"display": "MCHC [Mass/volume] by Automated count"
}, {
"reference": "urn:uuid:c4ebc494-4c84-3f21-4bcd-9fdd4b4a1c16",
"display": "Erythrocyte distribution width [Entitic volume] by Automated count"
}, {
"reference": "urn:uuid:b56b52c2-9da5-5445-0074-0fb3a225bd2c",
"display": "Platelets [#/volume] in Blood by Automated count"
}, {
"reference": "urn:uuid:b8cdf264-7aba-e50d-ab52-bebcb8622620",
"display": "Platelet distribution width [Entitic volume] in Blood by Automated count"
}, {
"reference": "urn:uuid:19c83c29-8f5b-43ad-9626-2ba8cbdfa508",
"display": "Platelet mean volume [Entitic volume] in Blood by Automated count"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:cd79c20b-b493-9efa-390e-751d2a77938a",
"resource": {
"resourceType": "DiagnosticReport",
"id": "cd79c20b-b493-9efa-390e-751d2a77938a",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T18:27:45+01:00",
"issued": "2020-03-19T18:27:45.236+01:00",
"result": [ {
"reference": "urn:uuid:76da252f-7fb8-13d7-1061-a790554c409b",
"display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:c6fd5dc1-208d-f7c7-aac2-8fd4e4132f2b",
"resource": {
"resourceType": "DiagnosticReport",
"id": "c6fd5dc1-208d-f7c7-aac2-8fd4e4132f2b",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T19:06:17+01:00",
"issued": "2020-03-19T19:06:17.236+01:00",
"result": [ {
"reference": "urn:uuid:cd655edd-0bce-eb04-a1b6-e0100522da3d",
"display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:d2d2e9bd-b50f-c0f2-e3ca-131048a3e174",
"resource": {
"resourceType": "DiagnosticReport",
"id": "d2d2e9bd-b50f-c0f2-e3ca-131048a3e174",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72109-2",
"display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
} ],
"text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T19:46:55+01:00",
"issued": "2020-03-19T19:46:55.236+01:00",
"result": [ {
"reference": "urn:uuid:ccf8b1cf-1a12-80b9-1044-6690f1cecb63",
"display": "Total score [AUDIT-C]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:1ebf171f-d0cd-56e9-7fac-d861b35fe158",
"resource": {
"resourceType": "DiagnosticReport",
"id": "1ebf171f-d0cd-56e9-7fac-d861b35fe158",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
},
"effectiveDateTime": "2020-03-19T17:15:30+01:00",
"issued": "2020-03-19T17:15:30.236+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:278fa46e-ad02-b44d-bbe3-1f761b0cc361",
"resource": {
"resourceType": "DocumentReference",
"id": "278fa46e-ad02-b44d-bbe3-1f761b0cc361",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:1ebf171f-d0cd-56e9-7fac-d861b35fe158"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2020-03-19T17:15:30.236+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE 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:453daa6d-b332-83be-fe0e-7643b2a5d1de"
} ],
"period": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:a7dbe7f6-c365-025d-8764-8f64620c3ffb",
"resource": {
"resourceType": "Claim",
"id": "a7dbe7f6-c365-025d-8764-8f64620c3ffb",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+01:00"
},
"created": "2020-03-19T18:07:25+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:faa07a23-187b-8b5a-4907-805b76723c35"
}
}, {
"sequence": 2,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 4,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 5,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 6,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 7,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:cbd82f1a-137c-2447-b31e-3c0ab0656971"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:25804cc2-e134-6fca-7a3b-e6a682554cb7"
}
}, {
"sequence": 2,
"procedureReference": {
"reference": "urn:uuid:937b3d63-611f-f447-f0b1-4a075e857ffe"
}
}, {
"sequence": 3,
"procedureReference": {
"reference": "urn:uuid:ed42ce16-d69a-7f75-2353-cda398f9678f"
}
}, {
"sequence": 4,
"procedureReference": {
"reference": "urn:uuid:d17f3cef-b57d-cfa9-99eb-897dea34a9e7"
}
}, {
"sequence": 5,
"procedureReference": {
"reference": "urn:uuid:0e22d2f4-1c53-d407-fd6f-ea96e69c911d"
}
}, {
"sequence": 6,
"procedureReference": {
"reference": "urn:uuid:a09117f3-25ef-27d0-d9c8-938361aff0c0"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
} ]
}, {
"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://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
},
"net": {
"value": 6.80,
"currency": "USD"
}
}, {
"sequence": 5,
"informationSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 6,
"informationSequence": [ 4 ],
"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"
}
}, {
"sequence": 7,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 8,
"procedureSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 9,
"informationSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 10,
"procedureSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 11,
"procedureSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 12,
"informationSequence": [ 6 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 13,
"procedureSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 14,
"procedureSequence": [ 6 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "763302001",
"display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
} ],
"text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 15,
"informationSequence": [ 7 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "72109-2",
"display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
} ],
"text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
} ],
"total": {
"value": 860.16,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:2a8da2ec-c3d5-df1c-d259-1df434c1d558",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "2a8da2ec-c3d5-df1c-d259-1df434c1d558",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "a7dbe7f6-c365-025d-8764-8f64620c3ffb"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2020-03-19T18:07:25+01:00",
"end": "2021-03-19T18:07:25+01:00"
},
"created": "2020-03-19T18:07:25+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:a7dbe7f6-c365-025d-8764-8f64620c3ffb"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:cbd82f1a-137c-2447-b31e-3c0ab0656971"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"servicedPeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
} ]
}, {
"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": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+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": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+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://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
},
"servicedPeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 6.80,
"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": 1.36,
"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": 5.44,
"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": 6.80,
"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": 6.80,
"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": [ 3 ],
"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": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"servicedPeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+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"
} ]
}
} ]
}, {
"sequence": 6,
"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://loinc.org",
"code": "58410-2",
"display": "CBC panel - Blood by Automated count"
} ],
"text": "CBC panel - Blood by Automated count"
},
"servicedPeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+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"
} ]
}
} ]
}, {
"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": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"servicedPeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"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": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"servicedPeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 9,
"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://loinc.org",
"code": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"servicedPeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+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"
} ]
}
} ]
}, {
"sequence": 10,
"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": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"servicedPeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 11,
"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": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"servicedPeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 12,
"informationSequence": [ 6 ],
"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": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"servicedPeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+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"
} ]
}
} ]
}, {
"sequence": 13,
"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": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"servicedPeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 14,
"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": "763302001",
"display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
} ],
"text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
},
"servicedPeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 15,
"informationSequence": [ 7 ],
"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": "72109-2",
"display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
} ],
"text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
},
"servicedPeriod": {
"start": "2020-03-19T17:15:30+01:00",
"end": "2020-03-19T18:07:25+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": 860.16,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 2483.28,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:a398e9a2-4a4e-d575-1965-12210e25be08",
"resource": {
"resourceType": "Encounter",
"id": "a398e9a2-4a4e-d575-1965-12210e25be08",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "a398e9a2-4a4e-d575-1965-12210e25be08"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2020-09-23T17:15:30+02:00",
"end": "2020-09-23T17:30:30+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
}
} ],
"period": {
"start": "2020-09-23T17:15:30+02:00",
"end": "2020-09-23T17:30:30+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|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:942bdfc4-567b-abfb-a895-3dc3d796479c",
"resource": {
"resourceType": "Condition",
"id": "942bdfc4-567b-abfb-a895-3dc3d796479c",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:a398e9a2-4a4e-d575-1965-12210e25be08"
},
"onsetDateTime": "2020-09-23T17:15:30+02:00",
"abatementDateTime": "2020-10-14T17:15:30+02:00",
"recordedDate": "2020-09-23T17:15:30+02:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:306c2577-c20d-5360-89ce-4fcd56014e87",
"resource": {
"resourceType": "MedicationRequest",
"id": "306c2577-c20d-5360-89ce-4fcd56014e87",
"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": "562251",
"display": "Amoxicillin 250 MG / Clavulanate 125 MG Oral Tablet"
} ],
"text": "Amoxicillin 250 MG / Clavulanate 125 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:a398e9a2-4a4e-d575-1965-12210e25be08"
},
"authoredOn": "2020-09-23T17:15:30+02:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
},
"reasonReference": [ {
"reference": "urn:uuid:942bdfc4-567b-abfb-a895-3dc3d796479c",
"display": "Viral sinusitis (disorder)"
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:e20b995d-027d-c8e9-1d39-da1d90527aaa",
"resource": {
"resourceType": "Claim",
"id": "e20b995d-027d-c8e9-1d39-da1d90527aaa",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2020-09-23T17:15:30+02:00",
"end": "2020-09-23T17:30:30+02:00"
},
"created": "2020-09-23T17:30:30+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:306c2577-c20d-5360-89ce-4fcd56014e87"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "562251",
"display": "Amoxicillin 250 MG / Clavulanate 125 MG Oral Tablet"
} ],
"text": "Amoxicillin 250 MG / Clavulanate 125 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:a398e9a2-4a4e-d575-1965-12210e25be08"
} ]
} ],
"total": {
"value": 339.37,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:73750d94-08e6-bda8-7ae6-011a2ed18923",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "73750d94-08e6-bda8-7ae6-011a2ed18923",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "e20b995d-027d-c8e9-1d39-da1d90527aaa"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2020-09-23T17:30:30+02:00",
"end": "2021-09-23T17:30:30+02:00"
},
"created": "2020-09-23T17:30:30+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"claim": {
"reference": "urn:uuid:e20b995d-027d-c8e9-1d39-da1d90527aaa"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "562251",
"display": "Amoxicillin 250 MG / Clavulanate 125 MG Oral Tablet"
} ],
"text": "Amoxicillin 250 MG / Clavulanate 125 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2020-09-23T17:15:30+02:00",
"end": "2020-09-23T17:30:30+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:a398e9a2-4a4e-d575-1965-12210e25be08"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 339.37,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:a075120d-7ea8-b62a-ff36-ed90026ddb3f",
"resource": {
"resourceType": "DiagnosticReport",
"id": "a075120d-7ea8-b62a-ff36-ed90026ddb3f",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:a398e9a2-4a4e-d575-1965-12210e25be08"
},
"effectiveDateTime": "2020-09-23T17:15:30+02:00",
"issued": "2020-09-23T17:15:30.236+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:d32afe66-951b-db60-fc53-a55ca3f7ef7e",
"resource": {
"resourceType": "DocumentReference",
"id": "d32afe66-951b-db60-fc53-a55ca3f7ef7e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:a075120d-7ea8-b62a-ff36-ed90026ddb3f"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2020-09-23T17:15:30.236+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"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:a398e9a2-4a4e-d575-1965-12210e25be08"
} ],
"period": {
"start": "2020-09-23T17:15:30+02:00",
"end": "2020-09-23T17:30:30+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:aa8da1ed-387f-1f77-e60f-cee999d1a4df",
"resource": {
"resourceType": "Claim",
"id": "aa8da1ed-387f-1f77-e60f-cee999d1a4df",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2020-09-23T17:15:30+02:00",
"end": "2020-09-23T17:30:30+02:00"
},
"created": "2020-09-23T17:30:30+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:942bdfc4-567b-abfb-a895-3dc3d796479c"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
},
"encounter": [ {
"reference": "urn:uuid:a398e9a2-4a4e-d575-1965-12210e25be08"
} ]
}, {
"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:9dc25cd2-a144-f406-693d-644394cb19f1",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "9dc25cd2-a144-f406-693d-644394cb19f1",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "aa8da1ed-387f-1f77-e60f-cee999d1a4df"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2020-09-23T17:30:30+02:00",
"end": "2021-09-23T17:30:30+02:00"
},
"created": "2020-09-23T17:30:30+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"claim": {
"reference": "urn:uuid:aa8da1ed-387f-1f77-e60f-cee999d1a4df"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:942bdfc4-567b-abfb-a895-3dc3d796479c"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "2020-09-23T17:15:30+02:00",
"end": "2020-09-23T17:30:30+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:a398e9a2-4a4e-d575-1965-12210e25be08"
} ]
}, {
"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": "2020-09-23T17:15:30+02:00",
"end": "2020-09-23T17:30:30+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:cf69e400-18aa-1360-e0c4-7df05ae783f1",
"resource": {
"resourceType": "Encounter",
"id": "cf69e400-18aa-1360-e0c4-7df05ae783f1",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "cf69e400-18aa-1360-e0c4-7df05ae783f1"
} ],
"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 (procedure)"
} ],
"text": "Encounter for check up (procedure)"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798",
"display": "Dr. Marcus77 Schamberger479"
}
} ],
"period": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2d8335a7-e37a-3004-9254-6f7de59ab66a",
"display": "THE LOWELL GENERAL HOSPITAL"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|5fcff9db-16e4-3e56-aa78-abbc16338097",
"display": "THE LOWELL GENERAL HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:dcbb8c55-d92a-e410-d239-0c94c0bf4801",
"resource": {
"resourceType": "Condition",
"id": "dcbb8c55-d92a-e410-d239-0c94c0bf4801",
"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": "741062008",
"display": "Not in labor force (finding)"
} ],
"text": "Not in labor force (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"onsetDateTime": "2020-12-24T17:56:50+01:00",
"abatementDateTime": "2021-03-25T17:52:02+01:00",
"recordedDate": "2020-12-24T17:56:50+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:a9b2184f-3bd4-9401-13b8-010daf2b8773",
"resource": {
"resourceType": "Condition",
"id": "a9b2184f-3bd4-9401-13b8-010daf2b8773",
"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": "706893006",
"display": "Victim of intimate partner abuse (finding)"
} ],
"text": "Victim of intimate partner abuse (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"onsetDateTime": "2020-12-24T17:56:50+01:00",
"abatementDateTime": "2021-03-25T17:52:02+01:00",
"recordedDate": "2020-12-24T17:56:50+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:9e98eeba-47e7-971f-a768-91f46ed0a3e8",
"resource": {
"resourceType": "Observation",
"id": "9e98eeba-47e7-971f-a768-91f46ed0a3e8",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "4548-4",
"display": "Hemoglobin A1c/Hemoglobin.total in Blood"
} ],
"text": "Hemoglobin A1c/Hemoglobin.total in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T17:15:30+01:00",
"issued": "2020-12-24T17:15:30.236+01:00",
"valueQuantity": {
"value": 6.14,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:45d3d95c-e38b-2b64-2a5b-f34754b7cf1e",
"resource": {
"resourceType": "Observation",
"id": "45d3d95c-e38b-2b64-2a5b-f34754b7cf1e",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T17:15:30+01:00",
"issued": "2020-12-24T17:15:30.236+01:00",
"valueQuantity": {
"value": 174.1,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d278fe67-7b22-deaa-86fa-1c8c60be40bd",
"resource": {
"resourceType": "Observation",
"id": "d278fe67-7b22-deaa-86fa-1c8c60be40bd",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T17:15:30+01:00",
"issued": "2020-12-24T17:15:30.236+01:00",
"valueQuantity": {
"value": 1,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:93ef7589-5be8-8878-a9b1-ff0631563caf",
"resource": {
"resourceType": "Observation",
"id": "93ef7589-5be8-8878-a9b1-ff0631563caf",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T17:15:30+01:00",
"issued": "2020-12-24T17:15:30.236+01:00",
"valueQuantity": {
"value": 87.9,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:6b368dbb-3e19-a18a-493c-7390591475e0",
"resource": {
"resourceType": "Observation",
"id": "6b368dbb-3e19-a18a-493c-7390591475e0",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T17:15:30+01:00",
"issued": "2020-12-24T17:15:30.236+01:00",
"valueQuantity": {
"value": 28.99,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:82aa36fb-34e9-866f-c64a-1843c15bd857",
"resource": {
"resourceType": "Observation",
"id": "82aa36fb-34e9-866f-c64a-1843c15bd857",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T17:15:30+01:00",
"issued": "2020-12-24T17:15:30.236+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 78,
"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": 102,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:3d5e0b67-2774-8b7c-05c6-5ec7cfc28aa9",
"resource": {
"resourceType": "Observation",
"id": "3d5e0b67-2774-8b7c-05c6-5ec7cfc28aa9",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T17:15:30+01:00",
"issued": "2020-12-24T17:15:30.236+01:00",
"valueQuantity": {
"value": 66,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d6466ee7-bc8d-be31-5797-92fcef0890c5",
"resource": {
"resourceType": "Observation",
"id": "d6466ee7-bc8d-be31-5797-92fcef0890c5",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T17:15:30+01:00",
"issued": "2020-12-24T17:15:30.236+01:00",
"valueQuantity": {
"value": 12,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:8eb9a1cc-1522-65d3-6dd6-d6875e2aaf1f",
"resource": {
"resourceType": "Observation",
"id": "8eb9a1cc-1522-65d3-6dd6-d6875e2aaf1f",
"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": "2339-0",
"display": "Glucose [Mass/volume] in Blood"
} ],
"text": "Glucose [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T17:15:30+01:00",
"issued": "2020-12-24T17:15:30.236+01:00",
"valueQuantity": {
"value": 88.71,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:57e8e7af-f503-6fdc-45b9-b40c11122895",
"resource": {
"resourceType": "Observation",
"id": "57e8e7af-f503-6fdc-45b9-b40c11122895",
"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": "6299-2",
"display": "Urea nitrogen [Mass/volume] in Blood"
} ],
"text": "Urea nitrogen [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T17:15:30+01:00",
"issued": "2020-12-24T17:15:30.236+01:00",
"valueQuantity": {
"value": 15.6,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d627c13a-ffd3-aaa1-53cb-ff527f2c666c",
"resource": {
"resourceType": "Observation",
"id": "d627c13a-ffd3-aaa1-53cb-ff527f2c666c",
"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": "38483-4",
"display": "Creatinine [Mass/volume] in Blood"
} ],
"text": "Creatinine [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T17:15:30+01:00",
"issued": "2020-12-24T17:15:30.236+01:00",
"valueQuantity": {
"value": 1.3,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:6397372f-65b3-6d22-240f-655fb8b2a576",
"resource": {
"resourceType": "Observation",
"id": "6397372f-65b3-6d22-240f-655fb8b2a576",
"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": "49765-1",
"display": "Calcium [Mass/volume] in Blood"
} ],
"text": "Calcium [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T17:15:30+01:00",
"issued": "2020-12-24T17:15:30.236+01:00",
"valueQuantity": {
"value": 9.89,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:0ac319cc-0758-6ca2-5e74-54884a4857cb",
"resource": {
"resourceType": "Observation",
"id": "0ac319cc-0758-6ca2-5e74-54884a4857cb",
"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": "2947-0",
"display": "Sodium [Moles/volume] in Blood"
} ],
"text": "Sodium [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T17:15:30+01:00",
"issued": "2020-12-24T17:15:30.236+01:00",
"valueQuantity": {
"value": 138.36,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e6c95276-3554-d778-adaa-e0a697b16db9",
"resource": {
"resourceType": "Observation",
"id": "e6c95276-3554-d778-adaa-e0a697b16db9",
"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": "6298-4",
"display": "Potassium [Moles/volume] in Blood"
} ],
"text": "Potassium [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T17:15:30+01:00",
"issued": "2020-12-24T17:15:30.236+01:00",
"valueQuantity": {
"value": 4.63,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:61722b94-ef34-c927-6f67-27ab7cefb9f8",
"resource": {
"resourceType": "Observation",
"id": "61722b94-ef34-c927-6f67-27ab7cefb9f8",
"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": "2069-3",
"display": "Chloride [Moles/volume] in Blood"
} ],
"text": "Chloride [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T17:15:30+01:00",
"issued": "2020-12-24T17:15:30.236+01:00",
"valueQuantity": {
"value": 106.27,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:acaab2bc-41f6-6bac-6ce8-fa554e55e522",
"resource": {
"resourceType": "Observation",
"id": "acaab2bc-41f6-6bac-6ce8-fa554e55e522",
"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": "20565-8",
"display": "Carbon dioxide, total [Moles/volume] in Blood"
} ],
"text": "Carbon dioxide, total [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T17:15:30+01:00",
"issued": "2020-12-24T17:15:30.236+01:00",
"valueQuantity": {
"value": 20.26,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:08d135da-148f-185d-1538-362067962769",
"resource": {
"resourceType": "Observation",
"id": "08d135da-148f-185d-1538-362067962769",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T17:15:30+01:00",
"issued": "2020-12-24T17:15:30.236+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "8517006",
"display": "Ex-smoker (finding)"
} ],
"text": "Ex-smoker (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:be85aae4-4a37-6681-a9fa-84116003e80d",
"resource": {
"resourceType": "Observation",
"id": "be85aae4-4a37-6681-a9fa-84116003e80d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93025-5",
"display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
} ],
"text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T17:56:50+01:00",
"issued": "2020-12-24T17:56:50.236+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76501-6",
"display": "Within the last year, have you been afraid of your partner or ex-partner?"
} ],
"text": "Within the last year, have you been afraid of your partner or ex-partner?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93026-3",
"display": "Do you feel physically and emotionally safe where you currently live?"
} ],
"text": "Do you feel physically and emotionally safe where you currently live?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93027-1",
"display": "Are you a refugee?"
} ],
"text": "Are you a refugee?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93028-9",
"display": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
} ],
"text": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93038-8",
"display": "Stress level"
} ],
"text": "Stress level"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA6568-5",
"display": "Not at all"
} ],
"text": "Not at all"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93029-7",
"display": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
} ],
"text": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30131-9",
"display": "3 to 5 times a week"
} ],
"text": "3 to 5 times a week"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93030-5",
"display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
} ],
"text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93031-3",
"display": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
} ],
"text": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30122-8",
"display": "I choose not to answer this question"
} ],
"text": "I choose not to answer this question"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63586-2",
"display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
} ],
"text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
},
"valueQuantity": {
"value": 55950,
"unit": "/a",
"system": "http://unitsofmeasure.org",
"code": "/a"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76437-3",
"display": "Primary insurance"
} ],
"text": "Primary insurance"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30194-7",
"display": "None/uninsured"
} ],
"text": "None/uninsured"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "67875-5",
"display": "Employment status - current"
} ],
"text": "Employment status - current"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30137-6",
"display": "Otherwise unemployed but not seeking work (ex: student, retired, disabled, unpaid primary care giver)"
} ],
"text": "Otherwise unemployed but not seeking work (ex: student, retired, disabled, unpaid primary care giver)"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82589-3",
"display": "Highest level of education"
} ],
"text": "Highest level of education"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30193-9",
"display": "More than high school"
} ],
"text": "More than high school"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56799-0",
"display": "Address"
} ],
"text": "Address"
},
"valueString": "287 Treutel Neck"
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93033-9",
"display": "Are you worried about losing your housing?"
} ],
"text": "Are you worried about losing your housing?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "71802-3",
"display": "Housing status"
} ],
"text": "Housing status"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30189-7",
"display": "I have housing"
} ],
"text": "I have housing"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63512-8",
"display": "How many people are living or staying at this address?"
} ],
"text": "How many people are living or staying at this address?"
},
"valueQuantity": {
"value": 7,
"unit": "{#}",
"system": "http://unitsofmeasure.org",
"code": "{#}"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "54899-0",
"display": "Preferred language"
} ],
"text": "Preferred language"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA43-5",
"display": "English"
} ],
"text": "English"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93034-7",
"display": "Have you been discharged from the armed forces of the United States?"
} ],
"text": "Have you been discharged from the armed forces of the United States?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93035-4",
"display": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
} ],
"text": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "32624-9",
"display": "Race"
} ],
"text": "Race"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA4457-3",
"display": "White"
} ],
"text": "White"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56051-6",
"display": "Do you consider yourself Hispanic/Latino?"
} ],
"text": "Do you consider yourself Hispanic/Latino?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:ef7a908e-6d5a-f544-063d-473d6ef16607",
"resource": {
"resourceType": "Observation",
"id": "ef7a908e-6d5a-f544-063d-473d6ef16607",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "70274-6",
"display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T18:12:52+01:00",
"issued": "2020-12-24T18:12:52.236+01:00",
"valueQuantity": {
"value": 3,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:f6aa19c8-66b0-cc7e-394d-06b35edaba75",
"resource": {
"resourceType": "Observation",
"id": "f6aa19c8-66b0-cc7e-394d-06b35edaba75",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76504-0",
"display": "Total score [HARK]"
} ],
"text": "Total score [HARK]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T18:51:07+01:00",
"issued": "2020-12-24T18:51:07.236+01:00",
"valueQuantity": {
"value": 0,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:a73635a8-483b-cd09-e32a-e3fc07b7773f",
"resource": {
"resourceType": "Observation",
"id": "a73635a8-483b-cd09-e32a-e3fc07b7773f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "55758-7",
"display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T19:33:23+01:00",
"issued": "2020-12-24T19:33:23.236+01:00",
"valueQuantity": {
"value": 1,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:6e0f2547-9b59-53b4-bc1f-054a46334efd",
"resource": {
"resourceType": "Observation",
"id": "6e0f2547-9b59-53b4-bc1f-054a46334efd",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "75626-2",
"display": "Total score [AUDIT-C]"
} ],
"text": "Total score [AUDIT-C]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T20:12:50+01:00",
"issued": "2020-12-24T20:12:50.236+01:00",
"valueQuantity": {
"value": 2,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:dbb50431-ab90-00af-eb73-1eb930fa0e62",
"resource": {
"resourceType": "Procedure",
"id": "dbb50431-ab90-00af-eb73-1eb930fa0e62",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"performedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:30:30+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2d8335a7-e37a-3004-9254-6f7de59ab66a",
"display": "THE LOWELL GENERAL HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:7fd38f8e-c5f3-b46b-d4bc-794eca6af1a9",
"resource": {
"resourceType": "Procedure",
"id": "7fd38f8e-c5f3-b46b-d4bc-794eca6af1a9",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"performedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2d8335a7-e37a-3004-9254-6f7de59ab66a",
"display": "THE LOWELL GENERAL HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:721dd141-94a7-517e-bafd-af123aa384ee",
"resource": {
"resourceType": "Procedure",
"id": "721dd141-94a7-517e-bafd-af123aa384ee",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"performedPeriod": {
"start": "2020-12-24T17:56:50+01:00",
"end": "2020-12-24T18:12:52+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2d8335a7-e37a-3004-9254-6f7de59ab66a",
"display": "THE LOWELL GENERAL HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:b41fda6e-f01d-649d-f08b-7d202f9e8cdd",
"resource": {
"resourceType": "Procedure",
"id": "b41fda6e-f01d-649d-f08b-7d202f9e8cdd",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "866148006",
"display": "Screening for domestic abuse (procedure)"
} ],
"text": "Screening for domestic abuse (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"performedPeriod": {
"start": "2020-12-24T18:12:52+01:00",
"end": "2020-12-24T18:51:07+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2d8335a7-e37a-3004-9254-6f7de59ab66a",
"display": "THE LOWELL GENERAL HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:7078d2b8-3fd6-e7e7-b20e-abccb6d6c1da",
"resource": {
"resourceType": "Procedure",
"id": "7078d2b8-3fd6-e7e7-b20e-abccb6d6c1da",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"performedPeriod": {
"start": "2020-12-24T18:51:07+01:00",
"end": "2020-12-24T19:05:41+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2d8335a7-e37a-3004-9254-6f7de59ab66a",
"display": "THE LOWELL GENERAL HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:83b3270f-339e-8c69-54b0-100639e45a57",
"resource": {
"resourceType": "Procedure",
"id": "83b3270f-339e-8c69-54b0-100639e45a57",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"performedPeriod": {
"start": "2020-12-24T19:05:41+01:00",
"end": "2020-12-24T19:33:23+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2d8335a7-e37a-3004-9254-6f7de59ab66a",
"display": "THE LOWELL GENERAL HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:30dbe30d-9b4a-b7f7-cda3-f590e91c41ef",
"resource": {
"resourceType": "Procedure",
"id": "30dbe30d-9b4a-b7f7-cda3-f590e91c41ef",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"performedPeriod": {
"start": "2020-12-24T19:33:23+01:00",
"end": "2020-12-24T19:44:17+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2d8335a7-e37a-3004-9254-6f7de59ab66a",
"display": "THE LOWELL GENERAL HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:c8e9685c-42bd-2581-17ac-90a6bc79ef7c",
"resource": {
"resourceType": "Procedure",
"id": "c8e9685c-42bd-2581-17ac-90a6bc79ef7c",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "763302001",
"display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
} ],
"text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"performedPeriod": {
"start": "2020-12-24T19:44:17+01:00",
"end": "2020-12-24T20:12:50+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2d8335a7-e37a-3004-9254-6f7de59ab66a",
"display": "THE LOWELL GENERAL HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:34573b65-3bf8-fba2-1278-5e057b183d6d",
"resource": {
"resourceType": "SupplyDelivery",
"id": "34573b65-3bf8-fba2-1278-5e057b183d6d",
"status": "completed",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/supply-item-type",
"code": "device",
"display": "Device"
} ]
},
"suppliedItem": {
"quantity": {
"value": 50
},
"itemCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
}
},
"occurrenceDateTime": "2020-12-24T17:15:30+01:00"
},
"request": {
"method": "POST",
"url": "SupplyDelivery"
}
}, {
"fullUrl": "urn:uuid:a0fce53b-86f5-870c-b454-4bd7103ffadf",
"resource": {
"resourceType": "MedicationRequest",
"id": "a0fce53b-86f5-870c-b454-4bd7103ffadf",
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"authoredOn": "2020-12-24T17:15:30+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798",
"display": "Dr. Marcus77 Schamberger479"
},
"dosageInstruction": [ {
"sequence": 1,
"text": "Every six hours (qualifier value)",
"additionalInstruction": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "307468000",
"display": "Every six hours (qualifier value)"
} ],
"text": "Every six hours (qualifier value)"
} ],
"timing": {
"repeat": {
"frequency": 4,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:b052de89-3fff-efa4-7149-8252d6dea1d0",
"resource": {
"resourceType": "Claim",
"id": "b052de89-3fff-efa4-7149-8252d6dea1d0",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"created": "2020-12-24T17:56:50+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|5fcff9db-16e4-3e56-aa78-abbc16338097",
"display": "THE LOWELL GENERAL HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:a0fce53b-86f5-870c-b454-4bd7103ffadf"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"encounter": [ {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
} ]
} ],
"total": {
"value": 129.94,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:7aeaa6ef-906c-903a-b510-8ebb0b740131",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "7aeaa6ef-906c-903a-b510-8ebb0b740131",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "b052de89-3fff-efa4-7149-8252d6dea1d0"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2020-12-24T17:56:50+01:00",
"end": "2021-12-24T17:56:50+01:00"
},
"created": "2020-12-24T17:56:50+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2d8335a7-e37a-3004-9254-6f7de59ab66a",
"display": "THE LOWELL GENERAL HOSPITAL"
},
"claim": {
"reference": "urn:uuid:b052de89-3fff-efa4-7149-8252d6dea1d0"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"servicedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
} ]
} ],
"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:50ed1640-9cac-9a32-c49a-1014ab57ae34",
"resource": {
"resourceType": "MedicationRequest",
"id": "50ed1640-9cac-9a32-c49a-1014ab57ae34",
"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": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"authoredOn": "2020-12-24T17:15:30+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798",
"display": "Dr. Marcus77 Schamberger479"
},
"reasonReference": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4",
"display": "Essential hypertension (disorder)"
} ],
"dosageInstruction": [ {
"sequence": 1,
"timing": {
"repeat": {
"frequency": 1,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:1dca3471-7e3f-cf7d-ed8a-f438c468375e",
"resource": {
"resourceType": "Claim",
"id": "1dca3471-7e3f-cf7d-ed8a-f438c468375e",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"created": "2020-12-24T17:56:50+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|5fcff9db-16e4-3e56-aa78-abbc16338097",
"display": "THE LOWELL GENERAL HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:50ed1640-9cac-9a32-c49a-1014ab57ae34"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
} ]
} ],
"total": {
"value": 0.66,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:5d8b1b71-5dbb-78c3-54c5-415929368034",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "5d8b1b71-5dbb-78c3-54c5-415929368034",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "1dca3471-7e3f-cf7d-ed8a-f438c468375e"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2020-12-24T17:56:50+01:00",
"end": "2021-12-24T17:56:50+01:00"
},
"created": "2020-12-24T17:56:50+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2d8335a7-e37a-3004-9254-6f7de59ab66a",
"display": "THE LOWELL GENERAL HOSPITAL"
},
"claim": {
"reference": "urn:uuid:1dca3471-7e3f-cf7d-ed8a-f438c468375e"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 0.66,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:b3eec0fa-caa5-2602-9afa-99ed8861d180",
"resource": {
"resourceType": "MedicationRequest",
"id": "b3eec0fa-caa5-2602-9afa-99ed8861d180",
"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": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"authoredOn": "2020-12-24T17:15:30+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798",
"display": "Dr. Marcus77 Schamberger479"
},
"reasonReference": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4",
"display": "Essential hypertension (disorder)"
} ],
"dosageInstruction": [ {
"sequence": 1,
"timing": {
"repeat": {
"frequency": 1,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:938a0756-fe22-610a-d1ee-791df2d0f642",
"resource": {
"resourceType": "Claim",
"id": "938a0756-fe22-610a-d1ee-791df2d0f642",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"created": "2020-12-24T17:56:50+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|5fcff9db-16e4-3e56-aa78-abbc16338097",
"display": "THE LOWELL GENERAL HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:b3eec0fa-caa5-2602-9afa-99ed8861d180"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
} ]
} ],
"total": {
"value": 0.91,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:b72249ac-17eb-e4cc-86b9-3fbaf9da5918",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "b72249ac-17eb-e4cc-86b9-3fbaf9da5918",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "938a0756-fe22-610a-d1ee-791df2d0f642"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2020-12-24T17:56:50+01:00",
"end": "2021-12-24T17:56:50+01:00"
},
"created": "2020-12-24T17:56:50+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2d8335a7-e37a-3004-9254-6f7de59ab66a",
"display": "THE LOWELL GENERAL HOSPITAL"
},
"claim": {
"reference": "urn:uuid:938a0756-fe22-610a-d1ee-791df2d0f642"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 0.91,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:a4dd568b-f531-8b10-8186-671c495a715c",
"resource": {
"resourceType": "Immunization",
"id": "a4dd568b-f531-8b10-8186-671c495a715c",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"occurrenceDateTime": "2020-12-24T17:15:30+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2d8335a7-e37a-3004-9254-6f7de59ab66a",
"display": "THE LOWELL GENERAL HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:d840990b-e8d2-5a17-914e-cd3ea611a461",
"resource": {
"resourceType": "DiagnosticReport",
"id": "d840990b-e8d2-5a17-914e-cd3ea611a461",
"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": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T17:15:30+01:00",
"issued": "2020-12-24T17:15:30.236+01:00",
"performer": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|5fcff9db-16e4-3e56-aa78-abbc16338097",
"display": "THE LOWELL GENERAL HOSPITAL"
} ],
"result": [ {
"reference": "urn:uuid:8eb9a1cc-1522-65d3-6dd6-d6875e2aaf1f",
"display": "Glucose [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:57e8e7af-f503-6fdc-45b9-b40c11122895",
"display": "Urea nitrogen [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:d627c13a-ffd3-aaa1-53cb-ff527f2c666c",
"display": "Creatinine [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:6397372f-65b3-6d22-240f-655fb8b2a576",
"display": "Calcium [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:0ac319cc-0758-6ca2-5e74-54884a4857cb",
"display": "Sodium [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:e6c95276-3554-d778-adaa-e0a697b16db9",
"display": "Potassium [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:61722b94-ef34-c927-6f67-27ab7cefb9f8",
"display": "Chloride [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:acaab2bc-41f6-6bac-6ce8-fa554e55e522",
"display": "Carbon dioxide, total [Moles/volume] in Blood"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:79ac6d74-8dcc-4812-cb0d-ccdd9da6ffa2",
"resource": {
"resourceType": "DiagnosticReport",
"id": "79ac6d74-8dcc-4812-cb0d-ccdd9da6ffa2",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T18:12:52+01:00",
"issued": "2020-12-24T18:12:52.236+01:00",
"result": [ {
"reference": "urn:uuid:ef7a908e-6d5a-f544-063d-473d6ef16607",
"display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:a51d7ba5-2fac-01e3-d14c-911f0ebd19c0",
"resource": {
"resourceType": "DiagnosticReport",
"id": "a51d7ba5-2fac-01e3-d14c-911f0ebd19c0",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76499-3",
"display": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
} ],
"text": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T18:51:07+01:00",
"issued": "2020-12-24T18:51:07.236+01:00",
"result": [ {
"reference": "urn:uuid:f6aa19c8-66b0-cc7e-394d-06b35edaba75",
"display": "Total score [HARK]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:ffe69594-314c-855b-7097-cb0870c0374e",
"resource": {
"resourceType": "DiagnosticReport",
"id": "ffe69594-314c-855b-7097-cb0870c0374e",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T19:33:23+01:00",
"issued": "2020-12-24T19:33:23.236+01:00",
"result": [ {
"reference": "urn:uuid:a73635a8-483b-cd09-e32a-e3fc07b7773f",
"display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:6dedd768-45b4-3ed9-e632-b75a18f78f0b",
"resource": {
"resourceType": "DiagnosticReport",
"id": "6dedd768-45b4-3ed9-e632-b75a18f78f0b",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72109-2",
"display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
} ],
"text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T20:12:50+01:00",
"issued": "2020-12-24T20:12:50.236+01:00",
"result": [ {
"reference": "urn:uuid:6e0f2547-9b59-53b4-bc1f-054a46334efd",
"display": "Total score [AUDIT-C]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:d27d377d-4918-2d60-c3c6-7cb4f98f0e01",
"resource": {
"resourceType": "DiagnosticReport",
"id": "d27d377d-4918-2d60-c3c6-7cb4f98f0e01",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
},
"effectiveDateTime": "2020-12-24T17:15:30+01:00",
"issued": "2020-12-24T17:15:30.236+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798",
"display": "Dr. Marcus77 Schamberger479"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:c992e177-4825-4cc5-8097-e901924f0a49",
"resource": {
"resourceType": "DocumentReference",
"id": "c992e177-4825-4cc5-8097-e901924f0a49",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:d27d377d-4918-2d60-c3c6-7cb4f98f0e01"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2020-12-24T17:15:30.236+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798",
"display": "Dr. Marcus77 Schamberger479"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|5fcff9db-16e4-3e56-aa78-abbc16338097",
"display": "THE LOWELL GENERAL HOSPITAL"
},
"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:cf69e400-18aa-1360-e0c4-7df05ae783f1"
} ],
"period": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:c1cd671f-5fa8-9adf-ddfa-86fc93bfed48",
"resource": {
"resourceType": "Claim",
"id": "c1cd671f-5fa8-9adf-ddfa-86fc93bfed48",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"created": "2020-12-24T17:56:50+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|5fcff9db-16e4-3e56-aa78-abbc16338097",
"display": "THE LOWELL GENERAL HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2d8335a7-e37a-3004-9254-6f7de59ab66a",
"display": "THE LOWELL GENERAL HOSPITAL"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:a4dd568b-f531-8b10-8186-671c495a715c"
}
}, {
"sequence": 2,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 4,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 5,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 6,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 7,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:dcbb8c55-d92a-e410-d239-0c94c0bf4801"
}
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:a9b2184f-3bd4-9401-13b8-010daf2b8773"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:dbb50431-ab90-00af-eb73-1eb930fa0e62"
}
}, {
"sequence": 2,
"procedureReference": {
"reference": "urn:uuid:7fd38f8e-c5f3-b46b-d4bc-794eca6af1a9"
}
}, {
"sequence": 3,
"procedureReference": {
"reference": "urn:uuid:721dd141-94a7-517e-bafd-af123aa384ee"
}
}, {
"sequence": 4,
"procedureReference": {
"reference": "urn:uuid:b41fda6e-f01d-649d-f08b-7d202f9e8cdd"
}
}, {
"sequence": 5,
"procedureReference": {
"reference": "urn:uuid:7078d2b8-3fd6-e7e7-b20e-abccb6d6c1da"
}
}, {
"sequence": 6,
"procedureReference": {
"reference": "urn:uuid:83b3270f-339e-8c69-54b0-100639e45a57"
}
}, {
"sequence": 7,
"procedureReference": {
"reference": "urn:uuid:30dbe30d-9b4a-b7f7-cda3-f590e91c41ef"
}
}, {
"sequence": 8,
"procedureReference": {
"reference": "urn:uuid:c8e9685c-42bd-2581-17ac-90a6bc79ef7c"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185349003",
"display": "Encounter for check up (procedure)"
} ],
"text": "Encounter for check up (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
} ]
}, {
"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": 661.45,
"currency": "USD"
}
}, {
"sequence": 4,
"informationSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
},
"net": {
"value": 6.80,
"currency": "USD"
}
}, {
"sequence": 5,
"informationSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 6,
"procedureSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 7,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "741062008",
"display": "Not in labor force (finding)"
} ],
"text": "Not in labor force (finding)"
}
}, {
"sequence": 8,
"diagnosisSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "706893006",
"display": "Victim of intimate partner abuse (finding)"
} ],
"text": "Victim of intimate partner abuse (finding)"
}
}, {
"sequence": 9,
"procedureSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 10,
"informationSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 11,
"procedureSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "866148006",
"display": "Screening for domestic abuse (procedure)"
} ],
"text": "Screening for domestic abuse (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 12,
"informationSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "76499-3",
"display": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
} ],
"text": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 13,
"procedureSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 14,
"procedureSequence": [ 6 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 15,
"informationSequence": [ 6 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 16,
"procedureSequence": [ 7 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 17,
"procedureSequence": [ 8 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "763302001",
"display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
} ],
"text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 18,
"informationSequence": [ 7 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "72109-2",
"display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
} ],
"text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
} ],
"total": {
"value": 1395.78,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:7ca7200d-e1f1-d1ed-bb02-f84969aba31c",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "7ca7200d-e1f1-d1ed-bb02-f84969aba31c",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "c1cd671f-5fa8-9adf-ddfa-86fc93bfed48"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2020-12-24T17:56:50+01:00",
"end": "2021-12-24T17:56:50+01:00"
},
"created": "2020-12-24T17:56:50+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|2d8335a7-e37a-3004-9254-6f7de59ab66a",
"display": "THE LOWELL GENERAL HOSPITAL"
},
"claim": {
"reference": "urn:uuid:c1cd671f-5fa8-9adf-ddfa-86fc93bfed48"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994798"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:dcbb8c55-d92a-e410-d239-0c94c0bf4801"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:a9b2184f-3bd4-9401-13b8-010daf2b8773"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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 (procedure)"
} ],
"text": "Encounter for check up (procedure)"
},
"servicedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
} ]
}, {
"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": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient 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": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"net": {
"value": 661.45,
"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": 132.29000000000002,
"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": 529.1600000000001,
"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": 661.45,
"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": 661.45,
"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": 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://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
},
"servicedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"net": {
"value": 6.80,
"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": 1.36,
"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": 5.44,
"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": 6.80,
"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": 6.80,
"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": [ 3 ],
"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": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"servicedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient 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"
} ]
}
} ]
}, {
"sequence": 6,
"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": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"servicedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+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"
} ]
}
} ]
}, {
"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": "741062008",
"display": "Not in labor force (finding)"
} ],
"text": "Not in labor force (finding)"
},
"servicedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
}
}, {
"sequence": 8,
"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": "706893006",
"display": "Victim of intimate partner abuse (finding)"
} ],
"text": "Victim of intimate partner abuse (finding)"
},
"servicedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
}
}, {
"sequence": 9,
"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": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"servicedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+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"
} ]
}
} ]
}, {
"sequence": 10,
"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://loinc.org",
"code": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"servicedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient 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"
} ]
}
} ]
}, {
"sequence": 11,
"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": "866148006",
"display": "Screening for domestic abuse (procedure)"
} ],
"text": "Screening for domestic abuse (procedure)"
},
"servicedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+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"
} ]
}
} ]
}, {
"sequence": 12,
"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://loinc.org",
"code": "76499-3",
"display": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
} ],
"text": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
},
"servicedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient 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"
} ]
}
} ]
}, {
"sequence": 13,
"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": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"servicedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+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"
} ]
}
} ]
}, {
"sequence": 14,
"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": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"servicedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+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"
} ]
}
} ]
}, {
"sequence": 15,
"informationSequence": [ 6 ],
"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": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"servicedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient 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"
} ]
}
} ]
}, {
"sequence": 16,
"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": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"servicedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+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"
} ]
}
} ]
}, {
"sequence": 17,
"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": "763302001",
"display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
} ],
"text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
},
"servicedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+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"
} ]
}
} ]
}, {
"sequence": 18,
"informationSequence": [ 7 ],
"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": "72109-2",
"display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
} ],
"text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
},
"servicedPeriod": {
"start": "2020-12-24T17:15:30+01:00",
"end": "2020-12-24T17:56:50+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient 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": 1395.78,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 3357.5600000000004,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:cc13baf0-4285-e189-e307-383109d21c0e",
"resource": {
"resourceType": "Encounter",
"id": "cc13baf0-4285-e189-e307-383109d21c0e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "cc13baf0-4285-e189-e307-383109d21c0e"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2020-12-31T17:15:30+01:00",
"end": "2020-12-31T17:30:30+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
}
} ],
"period": {
"start": "2020-12-31T17:15:30+01:00",
"end": "2020-12-31T17:30:30+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|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:521fabd0-2bfe-d88e-6d18-3d62ff82a7e2",
"resource": {
"resourceType": "Condition",
"id": "521fabd0-2bfe-d88e-6d18-3d62ff82a7e2",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cc13baf0-4285-e189-e307-383109d21c0e"
},
"onsetDateTime": "2020-12-31T17:15:30+01:00",
"abatementDateTime": "2021-01-12T17:15:30+01:00",
"recordedDate": "2020-12-31T17:15:30+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:7bd34013-1fff-8b5c-2c4a-20b41148d094",
"resource": {
"resourceType": "DiagnosticReport",
"id": "7bd34013-1fff-8b5c-2c4a-20b41148d094",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:cc13baf0-4285-e189-e307-383109d21c0e"
},
"effectiveDateTime": "2020-12-31T17:15:30+01:00",
"issued": "2020-12-31T17:15:30.236+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:5ac651a1-ffd9-73e3-a4f0-0f25b6de7b6d",
"resource": {
"resourceType": "DocumentReference",
"id": "5ac651a1-ffd9-73e3-a4f0-0f25b6de7b6d",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:7bd34013-1fff-8b5c-2c4a-20b41148d094"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2020-12-31T17:15:30.236+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598",
"display": "Dr. Kai187 Mann644"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"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:cc13baf0-4285-e189-e307-383109d21c0e"
} ],
"period": {
"start": "2020-12-31T17:15:30+01:00",
"end": "2020-12-31T17:30:30+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:b4096254-0993-f1eb-8200-b3838d765c76",
"resource": {
"resourceType": "Claim",
"id": "b4096254-0993-f1eb-8200-b3838d765c76",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2020-12-31T17:15:30+01:00",
"end": "2020-12-31T17:30:30+01:00"
},
"created": "2020-12-31T17:30:30+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|06cc2462-430f-3322-9c87-7e971125f510",
"display": "EMERSON HOSPITAL"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:521fabd0-2bfe-d88e-6d18-3d62ff82a7e2"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "185345009",
"display": "Encounter for symptom"
} ],
"text": "Encounter for symptom"
},
"encounter": [ {
"reference": "urn:uuid:cc13baf0-4285-e189-e307-383109d21c0e"
} ]
}, {
"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:ce4e59dd-3fcf-95a6-3f45-dc1c2f9b10ae",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "ce4e59dd-3fcf-95a6-3f45-dc1c2f9b10ae",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "b4096254-0993-f1eb-8200-b3838d765c76"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2020-12-31T17:30:30+01:00",
"end": "2021-12-31T17:30:30+01:00"
},
"created": "2020-12-31T17:30:30+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|ab557804-9cef-3574-92f3-faccf764e1c9",
"display": "EMERSON HOSPITAL"
},
"claim": {
"reference": "urn:uuid:b4096254-0993-f1eb-8200-b3838d765c76"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999990598"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:521fabd0-2bfe-d88e-6d18-3d62ff82a7e2"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "2020-12-31T17:15:30+01:00",
"end": "2020-12-31T17:30:30+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "21",
"display": "Inpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:cc13baf0-4285-e189-e307-383109d21c0e"
} ]
}, {
"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": "2020-12-31T17:15:30+01:00",
"end": "2020-12-31T17:30:30+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:b705a224-c1fe-cd7d-b361-92f073340294",
"resource": {
"resourceType": "Encounter",
"id": "b705a224-c1fe-cd7d-b361-92f073340294",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "b705a224-c1fe-cd7d-b361-92f073340294"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
}
} ],
"period": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:bc6dd251-ff50-c6de-3187-6cd5580b4839",
"resource": {
"resourceType": "Condition",
"id": "bc6dd251-ff50-c6de-3187-6cd5580b4839",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"onsetDateTime": "2021-03-25T17:15:30+01:00",
"abatementDateTime": "2023-04-06T18:15:30+02:00",
"recordedDate": "2021-03-25T17:15:30+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:534fb2c6-0c93-35f0-3f5e-99bb77a82334",
"resource": {
"resourceType": "Condition",
"id": "534fb2c6-0c93-35f0-3f5e-99bb77a82334",
"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": "160904001",
"display": "Part-time employment (finding)"
} ],
"text": "Part-time employment (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"onsetDateTime": "2021-03-25T17:52:02+01:00",
"abatementDateTime": "2022-03-31T19:04:54+02:00",
"recordedDate": "2021-03-25T17:52:02+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:8679ea5e-b099-8f49-6246-25b3211a8d3e",
"resource": {
"resourceType": "Condition",
"id": "8679ea5e-b099-8f49-6246-25b3211a8d3e",
"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": "422650009",
"display": "Social isolation (finding)"
} ],
"text": "Social isolation (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"onsetDateTime": "2021-03-25T17:52:02+01:00",
"abatementDateTime": "2022-03-31T19:04:54+02:00",
"recordedDate": "2021-03-25T17:52:02+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:1c50ecff-48e1-e3d4-af64-ccb255df1399",
"resource": {
"resourceType": "Condition",
"id": "1c50ecff-48e1-e3d4-af64-ccb255df1399",
"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": "73595000",
"display": "Stress (finding)"
} ],
"text": "Stress (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"onsetDateTime": "2021-03-25T17:52:02+01:00",
"recordedDate": "2021-03-25T17:52:02+01:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:8023aeb7-d1a4-1263-f99c-ff3fd45d522b",
"resource": {
"resourceType": "Observation",
"id": "8023aeb7-d1a4-1263-f99c-ff3fd45d522b",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "4548-4",
"display": "Hemoglobin A1c/Hemoglobin.total in Blood"
} ],
"text": "Hemoglobin A1c/Hemoglobin.total in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 5.94,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:a2f0c498-becb-81fa-f322-72bd816696a3",
"resource": {
"resourceType": "Observation",
"id": "a2f0c498-becb-81fa-f322-72bd816696a3",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 174.1,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:8ed1e8d2-1a87-c45f-6f28-c49bc8b1a6f5",
"resource": {
"resourceType": "Observation",
"id": "8ed1e8d2-1a87-c45f-6f28-c49bc8b1a6f5",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 2,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:c12ed541-ce10-1879-5107-a2296b49af97",
"resource": {
"resourceType": "Observation",
"id": "c12ed541-ce10-1879-5107-a2296b49af97",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 88.4,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:70639ea2-6172-2b9d-0e70-a285efb4ba31",
"resource": {
"resourceType": "Observation",
"id": "70639ea2-6172-2b9d-0e70-a285efb4ba31",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 29.16,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:c9c97483-8baf-8658-84ef-a3bef6b9d50b",
"resource": {
"resourceType": "Observation",
"id": "c9c97483-8baf-8658-84ef-a3bef6b9d50b",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 73,
"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": 110,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:41651f1b-aae3-9f34-a9c2-88ba9e7a3fdc",
"resource": {
"resourceType": "Observation",
"id": "41651f1b-aae3-9f34-a9c2-88ba9e7a3fdc",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 68,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:5665d6b7-dedb-2e6e-005f-84561e077df7",
"resource": {
"resourceType": "Observation",
"id": "5665d6b7-dedb-2e6e-005f-84561e077df7",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 12,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:b424b212-9752-2d38-8b8c-68f7c2e36828",
"resource": {
"resourceType": "Observation",
"id": "b424b212-9752-2d38-8b8c-68f7c2e36828",
"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": "2339-0",
"display": "Glucose [Mass/volume] in Blood"
} ],
"text": "Glucose [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 95.55,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:597ec9a8-6c45-105b-ee23-e89fe0e02e1f",
"resource": {
"resourceType": "Observation",
"id": "597ec9a8-6c45-105b-ee23-e89fe0e02e1f",
"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": "6299-2",
"display": "Urea nitrogen [Mass/volume] in Blood"
} ],
"text": "Urea nitrogen [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 19.99,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:42d308ad-fbc7-4f02-5af6-0e344734db68",
"resource": {
"resourceType": "Observation",
"id": "42d308ad-fbc7-4f02-5af6-0e344734db68",
"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": "38483-4",
"display": "Creatinine [Mass/volume] in Blood"
} ],
"text": "Creatinine [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 1.31,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:29b06a24-8f5f-9bcf-07bf-59e1bd6687f8",
"resource": {
"resourceType": "Observation",
"id": "29b06a24-8f5f-9bcf-07bf-59e1bd6687f8",
"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": "49765-1",
"display": "Calcium [Mass/volume] in Blood"
} ],
"text": "Calcium [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 8.79,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:968ec15f-fd8b-dd0f-ab48-27404d9b2d82",
"resource": {
"resourceType": "Observation",
"id": "968ec15f-fd8b-dd0f-ab48-27404d9b2d82",
"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": "2947-0",
"display": "Sodium [Moles/volume] in Blood"
} ],
"text": "Sodium [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 141.74,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:732d06c2-718f-f42f-ce91-d1b3a7b3fe09",
"resource": {
"resourceType": "Observation",
"id": "732d06c2-718f-f42f-ce91-d1b3a7b3fe09",
"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": "6298-4",
"display": "Potassium [Moles/volume] in Blood"
} ],
"text": "Potassium [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 4.42,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:0f012ccb-a025-086d-ae87-3b15299e0fb6",
"resource": {
"resourceType": "Observation",
"id": "0f012ccb-a025-086d-ae87-3b15299e0fb6",
"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": "2069-3",
"display": "Chloride [Moles/volume] in Blood"
} ],
"text": "Chloride [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 102.53,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:6361c155-d6c6-48d2-1adc-989270e171ea",
"resource": {
"resourceType": "Observation",
"id": "6361c155-d6c6-48d2-1adc-989270e171ea",
"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": "20565-8",
"display": "Carbon dioxide, total [Moles/volume] in Blood"
} ],
"text": "Carbon dioxide, total [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 27.87,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:1e5c337c-118f-df85-eadf-be5c86d682cb",
"resource": {
"resourceType": "Observation",
"id": "1e5c337c-118f-df85-eadf-be5c86d682cb",
"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": "2093-3",
"display": "Cholesterol [Mass/volume] in Serum or Plasma"
} ],
"text": "Cholesterol [Mass/volume] in Serum or Plasma"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 166.24,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:df721c7c-bc0a-e1da-1aab-2d399e97fd8d",
"resource": {
"resourceType": "Observation",
"id": "df721c7c-bc0a-e1da-1aab-2d399e97fd8d",
"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": "2571-8",
"display": "Triglycerides"
} ],
"text": "Triglycerides"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 100.06,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:48902312-b26f-ef09-4dfe-22d848442bec",
"resource": {
"resourceType": "Observation",
"id": "48902312-b26f-ef09-4dfe-22d848442bec",
"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": "18262-6",
"display": "Low Density Lipoprotein Cholesterol"
} ],
"text": "Low Density Lipoprotein Cholesterol"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 84.81,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:873955a0-38af-400b-2c4a-e93170df9354",
"resource": {
"resourceType": "Observation",
"id": "873955a0-38af-400b-2c4a-e93170df9354",
"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": "2085-9",
"display": "Cholesterol in HDL [Mass/volume] in Serum or Plasma"
} ],
"text": "Cholesterol in HDL [Mass/volume] in Serum or Plasma"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"valueQuantity": {
"value": 61.41,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:7ae4b43a-965d-70ce-59a7-0c423d9b2a7b",
"resource": {
"resourceType": "Observation",
"id": "7ae4b43a-965d-70ce-59a7-0c423d9b2a7b",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "8517006",
"display": "Ex-smoker (finding)"
} ],
"text": "Ex-smoker (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:75b7dfaa-fde1-38ca-4904-0c6a8d9339cf",
"resource": {
"resourceType": "Observation",
"id": "75b7dfaa-fde1-38ca-4904-0c6a8d9339cf",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93025-5",
"display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
} ],
"text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:52:02+01:00",
"issued": "2021-03-25T17:52:02.236+01:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76501-6",
"display": "Within the last year, have you been afraid of your partner or ex-partner?"
} ],
"text": "Within the last year, have you been afraid of your partner or ex-partner?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93026-3",
"display": "Do you feel physically and emotionally safe where you currently live?"
} ],
"text": "Do you feel physically and emotionally safe where you currently live?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93027-1",
"display": "Are you a refugee?"
} ],
"text": "Are you a refugee?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93028-9",
"display": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
} ],
"text": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93038-8",
"display": "Stress level"
} ],
"text": "Stress level"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA13863-8",
"display": "A little bit"
} ],
"text": "A little bit"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93029-7",
"display": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
} ],
"text": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA27722-0",
"display": "Less than once a week"
} ],
"text": "Less than once a week"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93030-5",
"display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
} ],
"text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93031-3",
"display": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
} ],
"text": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30122-8",
"display": "I choose not to answer this question"
} ],
"text": "I choose not to answer this question"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63586-2",
"display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
} ],
"text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
},
"valueQuantity": {
"value": 55950,
"unit": "/a",
"system": "http://unitsofmeasure.org",
"code": "/a"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76437-3",
"display": "Primary insurance"
} ],
"text": "Primary insurance"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30194-7",
"display": "None/uninsured"
} ],
"text": "None/uninsured"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "67875-5",
"display": "Employment status - current"
} ],
"text": "Employment status - current"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30138-4",
"display": "Part-time or temporary work"
} ],
"text": "Part-time or temporary work"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82589-3",
"display": "Highest level of education"
} ],
"text": "Highest level of education"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30193-9",
"display": "More than high school"
} ],
"text": "More than high school"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56799-0",
"display": "Address"
} ],
"text": "Address"
},
"valueString": "287 Treutel Neck"
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93033-9",
"display": "Are you worried about losing your housing?"
} ],
"text": "Are you worried about losing your housing?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "71802-3",
"display": "Housing status"
} ],
"text": "Housing status"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30189-7",
"display": "I have housing"
} ],
"text": "I have housing"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63512-8",
"display": "How many people are living or staying at this address?"
} ],
"text": "How many people are living or staying at this address?"
},
"valueQuantity": {
"value": 7,
"unit": "{#}",
"system": "http://unitsofmeasure.org",
"code": "{#}"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "54899-0",
"display": "Preferred language"
} ],
"text": "Preferred language"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA43-5",
"display": "English"
} ],
"text": "English"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93034-7",
"display": "Have you been discharged from the armed forces of the United States?"
} ],
"text": "Have you been discharged from the armed forces of the United States?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93035-4",
"display": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
} ],
"text": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "32624-9",
"display": "Race"
} ],
"text": "Race"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA4457-3",
"display": "White"
} ],
"text": "White"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56051-6",
"display": "Do you consider yourself Hispanic/Latino?"
} ],
"text": "Do you consider yourself Hispanic/Latino?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:6449098b-3e2d-a0ac-38df-a3990952d333",
"resource": {
"resourceType": "Observation",
"id": "6449098b-3e2d-a0ac-38df-a3990952d333",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "55758-7",
"display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T18:26:09+01:00",
"issued": "2021-03-25T18:26:09.236+01:00",
"valueQuantity": {
"value": 1,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e12e3313-5a1d-7a49-0b6d-b68f4d41a763",
"resource": {
"resourceType": "Observation",
"id": "e12e3313-5a1d-7a49-0b6d-b68f4d41a763",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "75626-2",
"display": "Total score [AUDIT-C]"
} ],
"text": "Total score [AUDIT-C]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T19:05:19+01:00",
"issued": "2021-03-25T19:05:19.236+01:00",
"valueQuantity": {
"value": 3,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:03851a64-30e2-d74c-501c-59638b5ae759",
"resource": {
"resourceType": "Procedure",
"id": "03851a64-30e2-d74c-501c-59638b5ae759",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"performedPeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:39638779-daa8-74c2-e9d5-6309cc8ab034",
"resource": {
"resourceType": "Procedure",
"id": "39638779-daa8-74c2-e9d5-6309cc8ab034",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"performedPeriod": {
"start": "2021-03-25T17:52:02+01:00",
"end": "2021-03-25T18:03:39+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:0e7a8538-a7d6-4c85-6371-50b2c175d984",
"resource": {
"resourceType": "Procedure",
"id": "0e7a8538-a7d6-4c85-6371-50b2c175d984",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"performedPeriod": {
"start": "2021-03-25T18:03:39+01:00",
"end": "2021-03-25T18:26:09+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:c7a21af3-4334-18bb-8e65-3f811730748f",
"resource": {
"resourceType": "Procedure",
"id": "c7a21af3-4334-18bb-8e65-3f811730748f",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"performedPeriod": {
"start": "2021-03-25T18:26:09+01:00",
"end": "2021-03-25T18:39:40+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:33ddf17b-4e95-be8b-8323-92eda3d4e700",
"resource": {
"resourceType": "Procedure",
"id": "33ddf17b-4e95-be8b-8323-92eda3d4e700",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "763302001",
"display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
} ],
"text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"performedPeriod": {
"start": "2021-03-25T18:39:40+01:00",
"end": "2021-03-25T19:05:19+01:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:34ad5b83-092e-bee2-4e70-97032f85c667",
"resource": {
"resourceType": "SupplyDelivery",
"id": "34ad5b83-092e-bee2-4e70-97032f85c667",
"status": "completed",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/supply-item-type",
"code": "device",
"display": "Device"
} ]
},
"suppliedItem": {
"quantity": {
"value": 50
},
"itemCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
}
},
"occurrenceDateTime": "2021-03-25T17:15:30+01:00"
},
"request": {
"method": "POST",
"url": "SupplyDelivery"
}
}, {
"fullUrl": "urn:uuid:5bb34b91-29f5-dbe6-496b-eb49d15724cd",
"resource": {
"resourceType": "SupplyDelivery",
"id": "5bb34b91-29f5-dbe6-496b-eb49d15724cd",
"status": "completed",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/supply-item-type",
"code": "device",
"display": "Device"
} ]
},
"suppliedItem": {
"quantity": {
"value": 100
},
"itemCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "1137596000",
"display": "Blood lancet (physical object)"
} ],
"text": "Blood lancet (physical object)"
}
},
"occurrenceDateTime": "2021-03-25T17:15:30+01:00"
},
"request": {
"method": "POST",
"url": "SupplyDelivery"
}
}, {
"fullUrl": "urn:uuid:cb082f19-47be-448f-b77e-ccae7f34ff3c",
"resource": {
"resourceType": "MedicationRequest",
"id": "cb082f19-47be-448f-b77e-ccae7f34ff3c",
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"authoredOn": "2021-03-25T17:15:30+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"dosageInstruction": [ {
"sequence": 1,
"text": "Every six hours (qualifier value)",
"additionalInstruction": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "307468000",
"display": "Every six hours (qualifier value)"
} ],
"text": "Every six hours (qualifier value)"
} ],
"timing": {
"repeat": {
"frequency": 4,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:aedcfddb-02ad-77f1-aade-116c8dbfa36c",
"resource": {
"resourceType": "Claim",
"id": "aedcfddb-02ad-77f1-aade-116c8dbfa36c",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"created": "2021-03-25T17:52:02+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:cb082f19-47be-448f-b77e-ccae7f34ff3c"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"encounter": [ {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
} ]
} ],
"total": {
"value": 129.94,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:cc14c829-3c0a-175c-079c-9f4496887335",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "cc14c829-3c0a-175c-079c-9f4496887335",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "aedcfddb-02ad-77f1-aade-116c8dbfa36c"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2021-03-25T17:52:02+01:00",
"end": "2022-03-25T17:52:02+01:00"
},
"created": "2021-03-25T17:52:02+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:aedcfddb-02ad-77f1-aade-116c8dbfa36c"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"servicedPeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
} ]
} ],
"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:80c6ccb7-b9b6-f50c-2c34-47aa12d7b513",
"resource": {
"resourceType": "MedicationRequest",
"id": "80c6ccb7-b9b6-f50c-2c34-47aa12d7b513",
"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": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"authoredOn": "2021-03-25T17:15:30+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"reasonReference": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4",
"display": "Essential hypertension (disorder)"
} ],
"dosageInstruction": [ {
"sequence": 1,
"timing": {
"repeat": {
"frequency": 1,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:6c49292e-2439-b889-a5b2-e823c198eb1f",
"resource": {
"resourceType": "Claim",
"id": "6c49292e-2439-b889-a5b2-e823c198eb1f",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"created": "2021-03-25T17:52:02+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:80c6ccb7-b9b6-f50c-2c34-47aa12d7b513"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
} ]
} ],
"total": {
"value": 0.46,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:d32c40f4-e350-71e5-cc9b-a1e302acdf4f",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "d32c40f4-e350-71e5-cc9b-a1e302acdf4f",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "6c49292e-2439-b889-a5b2-e823c198eb1f"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2021-03-25T17:52:02+01:00",
"end": "2022-03-25T17:52:02+01:00"
},
"created": "2021-03-25T17:52:02+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:6c49292e-2439-b889-a5b2-e823c198eb1f"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 0.46,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:b8228a06-7c17-3212-aea9-31cfc6a40ea8",
"resource": {
"resourceType": "MedicationRequest",
"id": "b8228a06-7c17-3212-aea9-31cfc6a40ea8",
"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": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"authoredOn": "2021-03-25T17:15:30+01:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"reasonReference": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4",
"display": "Essential hypertension (disorder)"
} ],
"dosageInstruction": [ {
"sequence": 1,
"timing": {
"repeat": {
"frequency": 1,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:04f9f56b-a384-263c-2a68-b5d314b7ff75",
"resource": {
"resourceType": "Claim",
"id": "04f9f56b-a384-263c-2a68-b5d314b7ff75",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"created": "2021-03-25T17:52:02+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:b8228a06-7c17-3212-aea9-31cfc6a40ea8"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
} ]
} ],
"total": {
"value": 0.91,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:bf28b685-7c93-009d-dcec-a21329d23689",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "bf28b685-7c93-009d-dcec-a21329d23689",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "04f9f56b-a384-263c-2a68-b5d314b7ff75"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2021-03-25T17:52:02+01:00",
"end": "2022-03-25T17:52:02+01:00"
},
"created": "2021-03-25T17:52:02+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:04f9f56b-a384-263c-2a68-b5d314b7ff75"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 0.91,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:1802a766-d9e7-7bb8-532a-f93c6135bf89",
"resource": {
"resourceType": "Immunization",
"id": "1802a766-d9e7-7bb8-532a-f93c6135bf89",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"occurrenceDateTime": "2021-03-25T17:15:30+01:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:60d1df1c-3db3-595e-8324-a9d20963ff97",
"resource": {
"resourceType": "DiagnosticReport",
"id": "60d1df1c-3db3-595e-8324-a9d20963ff97",
"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": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"performer": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
} ],
"result": [ {
"reference": "urn:uuid:b424b212-9752-2d38-8b8c-68f7c2e36828",
"display": "Glucose [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:597ec9a8-6c45-105b-ee23-e89fe0e02e1f",
"display": "Urea nitrogen [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:42d308ad-fbc7-4f02-5af6-0e344734db68",
"display": "Creatinine [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:29b06a24-8f5f-9bcf-07bf-59e1bd6687f8",
"display": "Calcium [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:968ec15f-fd8b-dd0f-ab48-27404d9b2d82",
"display": "Sodium [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:732d06c2-718f-f42f-ce91-d1b3a7b3fe09",
"display": "Potassium [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:0f012ccb-a025-086d-ae87-3b15299e0fb6",
"display": "Chloride [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:6361c155-d6c6-48d2-1adc-989270e171ea",
"display": "Carbon dioxide, total [Moles/volume] in Blood"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:2aef46be-6689-4994-d02a-0e2be8e4b323",
"resource": {
"resourceType": "DiagnosticReport",
"id": "2aef46be-6689-4994-d02a-0e2be8e4b323",
"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": "57698-3",
"display": "Lipid panel with direct LDL - Serum or Plasma"
} ],
"text": "Lipid panel with direct LDL - Serum or Plasma"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"performer": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
} ],
"result": [ {
"reference": "urn:uuid:1e5c337c-118f-df85-eadf-be5c86d682cb",
"display": "Cholesterol [Mass/volume] in Serum or Plasma"
}, {
"reference": "urn:uuid:df721c7c-bc0a-e1da-1aab-2d399e97fd8d",
"display": "Triglycerides"
}, {
"reference": "urn:uuid:48902312-b26f-ef09-4dfe-22d848442bec",
"display": "Low Density Lipoprotein Cholesterol"
}, {
"reference": "urn:uuid:873955a0-38af-400b-2c4a-e93170df9354",
"display": "Cholesterol in HDL [Mass/volume] in Serum or Plasma"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:527821a8-8edc-3a44-e4a2-bc3bc169d6fc",
"resource": {
"resourceType": "DiagnosticReport",
"id": "527821a8-8edc-3a44-e4a2-bc3bc169d6fc",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T18:26:09+01:00",
"issued": "2021-03-25T18:26:09.236+01:00",
"result": [ {
"reference": "urn:uuid:6449098b-3e2d-a0ac-38df-a3990952d333",
"display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:39810193-7618-fcfc-d737-985238ad4bcb",
"resource": {
"resourceType": "DiagnosticReport",
"id": "39810193-7618-fcfc-d737-985238ad4bcb",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72109-2",
"display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
} ],
"text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T19:05:19+01:00",
"issued": "2021-03-25T19:05:19.236+01:00",
"result": [ {
"reference": "urn:uuid:e12e3313-5a1d-7a49-0b6d-b68f4d41a763",
"display": "Total score [AUDIT-C]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:810fc372-9718-cfa6-d6fb-e12abf5521f7",
"resource": {
"resourceType": "DiagnosticReport",
"id": "810fc372-9718-cfa6-d6fb-e12abf5521f7",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
},
"effectiveDateTime": "2021-03-25T17:15:30+01:00",
"issued": "2021-03-25T17:15:30.236+01:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:7f54ceea-4d8a-a7af-61e7-5959ae7868f1",
"resource": {
"resourceType": "DocumentReference",
"id": "7f54ceea-4d8a-a7af-61e7-5959ae7868f1",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:810fc372-9718-cfa6-d6fb-e12abf5521f7"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2021-03-25T17:15:30.236+01:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE 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:b705a224-c1fe-cd7d-b361-92f073340294"
} ],
"period": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:17bb7aba-0487-3a4c-01a9-0d4139e6cd5a",
"resource": {
"resourceType": "Claim",
"id": "17bb7aba-0487-3a4c-01a9-0d4139e6cd5a",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"created": "2021-03-25T17:52:02+01:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:1802a766-d9e7-7bb8-532a-f93c6135bf89"
}
}, {
"sequence": 2,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 4,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 5,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 6,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 7,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:bc6dd251-ff50-c6de-3187-6cd5580b4839"
}
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:534fb2c6-0c93-35f0-3f5e-99bb77a82334"
}
}, {
"sequence": 3,
"diagnosisReference": {
"reference": "urn:uuid:8679ea5e-b099-8f49-6246-25b3211a8d3e"
}
}, {
"sequence": 4,
"diagnosisReference": {
"reference": "urn:uuid:1c50ecff-48e1-e3d4-af64-ccb255df1399"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:03851a64-30e2-d74c-501c-59638b5ae759"
}
}, {
"sequence": 2,
"procedureReference": {
"reference": "urn:uuid:39638779-daa8-74c2-e9d5-6309cc8ab034"
}
}, {
"sequence": 3,
"procedureReference": {
"reference": "urn:uuid:0e7a8538-a7d6-4c85-6371-50b2c175d984"
}
}, {
"sequence": 4,
"procedureReference": {
"reference": "urn:uuid:c7a21af3-4334-18bb-8e65-3f811730748f"
}
}, {
"sequence": 5,
"procedureReference": {
"reference": "urn:uuid:33ddf17b-4e95-be8b-8323-92eda3d4e700"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
} ]
}, {
"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://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
},
"net": {
"value": 6.80,
"currency": "USD"
}
}, {
"sequence": 5,
"informationSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "1137596000",
"display": "Blood lancet (physical object)"
} ],
"text": "Blood lancet (physical object)"
},
"net": {
"value": 0.00,
"currency": "USD"
}
}, {
"sequence": 6,
"informationSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 7,
"informationSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "57698-3",
"display": "Lipid panel with direct LDL - Serum or Plasma"
} ],
"text": "Lipid panel with direct LDL - Serum or Plasma"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 8,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 9,
"diagnosisSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "160904001",
"display": "Part-time employment (finding)"
} ],
"text": "Part-time employment (finding)"
}
}, {
"sequence": 10,
"diagnosisSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "422650009",
"display": "Social isolation (finding)"
} ],
"text": "Social isolation (finding)"
}
}, {
"sequence": 11,
"diagnosisSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "73595000",
"display": "Stress (finding)"
} ],
"text": "Stress (finding)"
}
}, {
"sequence": 12,
"procedureSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 13,
"procedureSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 14,
"informationSequence": [ 6 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 15,
"procedureSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 16,
"procedureSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "763302001",
"display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
} ],
"text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 17,
"informationSequence": [ 7 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "72109-2",
"display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
} ],
"text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
} ],
"total": {
"value": 860.16,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:9a89152c-8f4d-9c0a-0b83-f897df191712",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "9a89152c-8f4d-9c0a-0b83-f897df191712",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "17bb7aba-0487-3a4c-01a9-0d4139e6cd5a"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2021-03-25T17:52:02+01:00",
"end": "2022-03-25T17:52:02+01:00"
},
"created": "2021-03-25T17:52:02+01:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:17bb7aba-0487-3a4c-01a9-0d4139e6cd5a"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:bc6dd251-ff50-c6de-3187-6cd5580b4839"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:534fb2c6-0c93-35f0-3f5e-99bb77a82334"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
}, {
"sequence": 3,
"diagnosisReference": {
"reference": "urn:uuid:8679ea5e-b099-8f49-6246-25b3211a8d3e"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
}, {
"sequence": 4,
"diagnosisReference": {
"reference": "urn:uuid:1c50ecff-48e1-e3d4-af64-ccb255df1399"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"servicedPeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
} ]
}, {
"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": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+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": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+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://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
},
"servicedPeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 6.80,
"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": 1.36,
"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": 5.44,
"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": 6.80,
"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": 6.80,
"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": [ 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": "1137596000",
"display": "Blood lancet (physical object)"
} ],
"text": "Blood lancet (physical object)"
},
"servicedPeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 0.00,
"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": 0.0,
"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": 0.0,
"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": 0.00,
"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": 0.00,
"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": [ 4 ],
"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": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"servicedPeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+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"
} ]
}
} ]
}, {
"sequence": 7,
"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://loinc.org",
"code": "57698-3",
"display": "Lipid panel with direct LDL - Serum or Plasma"
} ],
"text": "Lipid panel with direct LDL - Serum or Plasma"
},
"servicedPeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+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"
} ]
}
} ]
}, {
"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": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"servicedPeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 9,
"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": "160904001",
"display": "Part-time employment (finding)"
} ],
"text": "Part-time employment (finding)"
},
"servicedPeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 10,
"diagnosisSequence": [ 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": "422650009",
"display": "Social isolation (finding)"
} ],
"text": "Social isolation (finding)"
},
"servicedPeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 11,
"diagnosisSequence": [ 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": "73595000",
"display": "Stress (finding)"
} ],
"text": "Stress (finding)"
},
"servicedPeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 12,
"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": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"servicedPeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 13,
"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": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"servicedPeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 14,
"informationSequence": [ 6 ],
"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": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"servicedPeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+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"
} ]
}
} ]
}, {
"sequence": 15,
"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": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"servicedPeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 16,
"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": "763302001",
"display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
} ],
"text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
},
"servicedPeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+01:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 17,
"informationSequence": [ 7 ],
"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": "72109-2",
"display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
} ],
"text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
},
"servicedPeriod": {
"start": "2021-03-25T17:15:30+01:00",
"end": "2021-03-25T17:52:02+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": 860.16,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 2078.496,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af",
"resource": {
"resourceType": "Encounter",
"id": "53f2a9cf-7145-60ef-2f5a-2ec5544f06af",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
}
} ],
"period": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:aa2b3878-3b55-b573-e952-b219e8d85e08",
"resource": {
"resourceType": "Condition",
"id": "aa2b3878-3b55-b573-e952-b219e8d85e08",
"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": "73438004",
"display": "Unemployed (finding)"
} ],
"text": "Unemployed (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"onsetDateTime": "2022-03-31T19:04:54+02:00",
"abatementDateTime": "2023-04-06T18:53:01+02:00",
"recordedDate": "2022-03-31T19:04:54+02:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:51691751-1612-6419-f77c-9a4631b97b28",
"resource": {
"resourceType": "Observation",
"id": "51691751-1612-6419-f77c-9a4631b97b28",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "4548-4",
"display": "Hemoglobin A1c/Hemoglobin.total in Blood"
} ],
"text": "Hemoglobin A1c/Hemoglobin.total in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T18:15:30+02:00",
"issued": "2022-03-31T18:15:30.236+02:00",
"valueQuantity": {
"value": 6.39,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:c833c2ca-7e10-6ead-6282-b5f4c7a016b8",
"resource": {
"resourceType": "Observation",
"id": "c833c2ca-7e10-6ead-6282-b5f4c7a016b8",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T18:15:30+02:00",
"issued": "2022-03-31T18:15:30.236+02:00",
"valueQuantity": {
"value": 174.1,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:f301ee92-93dd-b6a9-82e8-f3cd1f4bc4cb",
"resource": {
"resourceType": "Observation",
"id": "f301ee92-93dd-b6a9-82e8-f3cd1f4bc4cb",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T18:15:30+02:00",
"issued": "2022-03-31T18:15:30.236+02:00",
"valueQuantity": {
"value": 3,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:9e10362e-5425-d8a8-ff96-cd0c90866d2a",
"resource": {
"resourceType": "Observation",
"id": "9e10362e-5425-d8a8-ff96-cd0c90866d2a",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T18:15:30+02:00",
"issued": "2022-03-31T18:15:30.236+02:00",
"valueQuantity": {
"value": 90.6,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:ebafed28-faa0-97a9-8490-5063f6fc6b06",
"resource": {
"resourceType": "Observation",
"id": "ebafed28-faa0-97a9-8490-5063f6fc6b06",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T18:15:30+02:00",
"issued": "2022-03-31T18:15:30.236+02:00",
"valueQuantity": {
"value": 29.88,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:9620af2b-7fa6-359a-7b87-2ab87d048f73",
"resource": {
"resourceType": "Observation",
"id": "9620af2b-7fa6-359a-7b87-2ab87d048f73",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T18:15:30+02:00",
"issued": "2022-03-31T18:15:30.236+02:00",
"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": 108,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:fd8a1385-584c-7ef1-82ae-5a5e81e004ac",
"resource": {
"resourceType": "Observation",
"id": "fd8a1385-584c-7ef1-82ae-5a5e81e004ac",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T18:15:30+02:00",
"issued": "2022-03-31T18:15:30.236+02:00",
"valueQuantity": {
"value": 85,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:370bf532-d56a-5441-642b-9737d78ba8d3",
"resource": {
"resourceType": "Observation",
"id": "370bf532-d56a-5441-642b-9737d78ba8d3",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T18:15:30+02:00",
"issued": "2022-03-31T18:15:30.236+02:00",
"valueQuantity": {
"value": 12,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:62b21f73-0176-1d04-a162-cb27ec7cfa09",
"resource": {
"resourceType": "Observation",
"id": "62b21f73-0176-1d04-a162-cb27ec7cfa09",
"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": "2339-0",
"display": "Glucose [Mass/volume] in Blood"
} ],
"text": "Glucose [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T18:15:30+02:00",
"issued": "2022-03-31T18:15:30.236+02:00",
"valueQuantity": {
"value": 92.09,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:d77a97ce-1b4d-dc68-713b-d2b056b11e51",
"resource": {
"resourceType": "Observation",
"id": "d77a97ce-1b4d-dc68-713b-d2b056b11e51",
"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": "6299-2",
"display": "Urea nitrogen [Mass/volume] in Blood"
} ],
"text": "Urea nitrogen [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T18:15:30+02:00",
"issued": "2022-03-31T18:15:30.236+02:00",
"valueQuantity": {
"value": 9.75,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:afb44d43-d719-0107-9de0-31bb1cd3de46",
"resource": {
"resourceType": "Observation",
"id": "afb44d43-d719-0107-9de0-31bb1cd3de46",
"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": "38483-4",
"display": "Creatinine [Mass/volume] in Blood"
} ],
"text": "Creatinine [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T18:15:30+02:00",
"issued": "2022-03-31T18:15:30.236+02:00",
"valueQuantity": {
"value": 1.49,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:21ecf29b-d8cc-58cc-7e95-816a0bde7b63",
"resource": {
"resourceType": "Observation",
"id": "21ecf29b-d8cc-58cc-7e95-816a0bde7b63",
"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": "49765-1",
"display": "Calcium [Mass/volume] in Blood"
} ],
"text": "Calcium [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T18:15:30+02:00",
"issued": "2022-03-31T18:15:30.236+02:00",
"valueQuantity": {
"value": 9.54,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:94832b99-21f4-0821-37f6-026ba01575c5",
"resource": {
"resourceType": "Observation",
"id": "94832b99-21f4-0821-37f6-026ba01575c5",
"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": "2947-0",
"display": "Sodium [Moles/volume] in Blood"
} ],
"text": "Sodium [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T18:15:30+02:00",
"issued": "2022-03-31T18:15:30.236+02:00",
"valueQuantity": {
"value": 141.16,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:1a11d96a-8503-4f4c-306f-8091c3f66a35",
"resource": {
"resourceType": "Observation",
"id": "1a11d96a-8503-4f4c-306f-8091c3f66a35",
"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": "6298-4",
"display": "Potassium [Moles/volume] in Blood"
} ],
"text": "Potassium [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T18:15:30+02:00",
"issued": "2022-03-31T18:15:30.236+02:00",
"valueQuantity": {
"value": 4.5,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:95df3a68-5110-c216-cc94-5ba0c8174c66",
"resource": {
"resourceType": "Observation",
"id": "95df3a68-5110-c216-cc94-5ba0c8174c66",
"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": "2069-3",
"display": "Chloride [Moles/volume] in Blood"
} ],
"text": "Chloride [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T18:15:30+02:00",
"issued": "2022-03-31T18:15:30.236+02:00",
"valueQuantity": {
"value": 101.35,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:82f1d0fb-5e2b-d5ad-1333-c96a4f48817a",
"resource": {
"resourceType": "Observation",
"id": "82f1d0fb-5e2b-d5ad-1333-c96a4f48817a",
"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": "20565-8",
"display": "Carbon dioxide, total [Moles/volume] in Blood"
} ],
"text": "Carbon dioxide, total [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T18:15:30+02:00",
"issued": "2022-03-31T18:15:30.236+02:00",
"valueQuantity": {
"value": 28.5,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:9e50b980-d35f-2a16-db37-5fc7c128d0e6",
"resource": {
"resourceType": "Observation",
"id": "9e50b980-d35f-2a16-db37-5fc7c128d0e6",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T18:15:30+02:00",
"issued": "2022-03-31T18:15:30.236+02:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "8517006",
"display": "Ex-smoker (finding)"
} ],
"text": "Ex-smoker (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:de33254a-cd8a-2a80-8632-4b596e9d0d41",
"resource": {
"resourceType": "Observation",
"id": "de33254a-cd8a-2a80-8632-4b596e9d0d41",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93025-5",
"display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
} ],
"text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T19:04:54+02:00",
"issued": "2022-03-31T19:04:54.236+02:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76501-6",
"display": "Within the last year, have you been afraid of your partner or ex-partner?"
} ],
"text": "Within the last year, have you been afraid of your partner or ex-partner?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93026-3",
"display": "Do you feel physically and emotionally safe where you currently live?"
} ],
"text": "Do you feel physically and emotionally safe where you currently live?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93027-1",
"display": "Are you a refugee?"
} ],
"text": "Are you a refugee?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93028-9",
"display": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
} ],
"text": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93038-8",
"display": "Stress level"
} ],
"text": "Stress level"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA13909-9",
"display": "Somewhat"
} ],
"text": "Somewhat"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93029-7",
"display": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
} ],
"text": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30132-7",
"display": "5 or more times a week"
} ],
"text": "5 or more times a week"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93030-5",
"display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
} ],
"text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93031-3",
"display": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
} ],
"text": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30122-8",
"display": "I choose not to answer this question"
} ],
"text": "I choose not to answer this question"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63586-2",
"display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
} ],
"text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
},
"valueQuantity": {
"value": 55950,
"unit": "/a",
"system": "http://unitsofmeasure.org",
"code": "/a"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76437-3",
"display": "Primary insurance"
} ],
"text": "Primary insurance"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30194-7",
"display": "None/uninsured"
} ],
"text": "None/uninsured"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "67875-5",
"display": "Employment status - current"
} ],
"text": "Employment status - current"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA17956-6",
"display": "Unemployed"
} ],
"text": "Unemployed"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82589-3",
"display": "Highest level of education"
} ],
"text": "Highest level of education"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30193-9",
"display": "More than high school"
} ],
"text": "More than high school"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56799-0",
"display": "Address"
} ],
"text": "Address"
},
"valueString": "287 Treutel Neck"
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93033-9",
"display": "Are you worried about losing your housing?"
} ],
"text": "Are you worried about losing your housing?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "71802-3",
"display": "Housing status"
} ],
"text": "Housing status"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30189-7",
"display": "I have housing"
} ],
"text": "I have housing"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63512-8",
"display": "How many people are living or staying at this address?"
} ],
"text": "How many people are living or staying at this address?"
},
"valueQuantity": {
"value": 7,
"unit": "{#}",
"system": "http://unitsofmeasure.org",
"code": "{#}"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "54899-0",
"display": "Preferred language"
} ],
"text": "Preferred language"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA43-5",
"display": "English"
} ],
"text": "English"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93034-7",
"display": "Have you been discharged from the armed forces of the United States?"
} ],
"text": "Have you been discharged from the armed forces of the United States?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93035-4",
"display": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
} ],
"text": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "32624-9",
"display": "Race"
} ],
"text": "Race"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA4457-3",
"display": "White"
} ],
"text": "White"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56051-6",
"display": "Do you consider yourself Hispanic/Latino?"
} ],
"text": "Do you consider yourself Hispanic/Latino?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:40ea93b0-5ca0-2806-60cf-be1c5e94abaa",
"resource": {
"resourceType": "Observation",
"id": "40ea93b0-5ca0-2806-60cf-be1c5e94abaa",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "70274-6",
"display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T19:29:28+02:00",
"issued": "2022-03-31T19:29:28.236+02:00",
"valueQuantity": {
"value": 2,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:bc2ad1b5-07b9-0f57-ab0e-db57ae49ad9e",
"resource": {
"resourceType": "Observation",
"id": "bc2ad1b5-07b9-0f57-ab0e-db57ae49ad9e",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "55758-7",
"display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T20:10:46+02:00",
"issued": "2022-03-31T20:10:46.236+02:00",
"valueQuantity": {
"value": 3,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:5725aea5-7119-a7f2-bf94-1c7f42ec87fb",
"resource": {
"resourceType": "Observation",
"id": "5725aea5-7119-a7f2-bf94-1c7f42ec87fb",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "44261-6",
"display": "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]"
} ],
"text": "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T20:33:59+02:00",
"issued": "2022-03-31T20:33:59.236+02:00",
"valueQuantity": {
"value": 9,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:21028b5e-67b8-bac2-ab64-d8134726339b",
"resource": {
"resourceType": "Observation",
"id": "21028b5e-67b8-bac2-ab64-d8134726339b",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82667-7",
"display": "Total score [DAST-10]"
} ],
"text": "Total score [DAST-10]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T21:09:13+02:00",
"issued": "2022-03-31T21:09:13.236+02:00",
"valueQuantity": {
"value": 0,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e4cf38d2-9cee-00ca-df24-e65db5592eda",
"resource": {
"resourceType": "Procedure",
"id": "e4cf38d2-9cee-00ca-df24-e65db5592eda",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"performedPeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:2bfd6188-4781-bcba-20f8-c3b3056c5102",
"resource": {
"resourceType": "Procedure",
"id": "2bfd6188-4781-bcba-20f8-c3b3056c5102",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"performedPeriod": {
"start": "2022-03-31T19:04:54+02:00",
"end": "2022-03-31T19:29:28+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:9868007f-ee2f-3d4b-a188-6c9234339665",
"resource": {
"resourceType": "Procedure",
"id": "9868007f-ee2f-3d4b-a188-6c9234339665",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"performedPeriod": {
"start": "2022-03-31T19:29:28+02:00",
"end": "2022-03-31T19:41:18+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:06a92988-738a-4ede-cb36-9bcf4e9640bc",
"resource": {
"resourceType": "Procedure",
"id": "06a92988-738a-4ede-cb36-9bcf4e9640bc",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"performedPeriod": {
"start": "2022-03-31T19:41:18+02:00",
"end": "2022-03-31T20:10:46+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:d9edcd35-de35-8841-e09e-22f30bcb323a",
"resource": {
"resourceType": "Procedure",
"id": "d9edcd35-de35-8841-e09e-22f30bcb323a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "715252007",
"display": "Depression screening using Patient Health Questionnaire Nine Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Nine Item score (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"performedPeriod": {
"start": "2022-03-31T20:10:46+02:00",
"end": "2022-03-31T20:33:59+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:a9654b90-3a01-5871-70ca-696107909a69",
"resource": {
"resourceType": "Procedure",
"id": "a9654b90-3a01-5871-70ca-696107909a69",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"performedPeriod": {
"start": "2022-03-31T20:33:59+02:00",
"end": "2022-03-31T20:47:24+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:58160f94-95ba-7d50-ada2-28a6938f0829",
"resource": {
"resourceType": "Procedure",
"id": "58160f94-95ba-7d50-ada2-28a6938f0829",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "713106006",
"display": "Screening for drug abuse (procedure)"
} ],
"text": "Screening for drug abuse (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"performedPeriod": {
"start": "2022-03-31T20:47:24+02:00",
"end": "2022-03-31T21:09:13+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:ac32d901-97ea-3eb5-ba10-c6d87a8b8fb1",
"resource": {
"resourceType": "SupplyDelivery",
"id": "ac32d901-97ea-3eb5-ba10-c6d87a8b8fb1",
"status": "completed",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/supply-item-type",
"code": "device",
"display": "Device"
} ]
},
"suppliedItem": {
"quantity": {
"value": 50
},
"itemCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
}
},
"occurrenceDateTime": "2022-03-31T18:15:30+02:00"
},
"request": {
"method": "POST",
"url": "SupplyDelivery"
}
}, {
"fullUrl": "urn:uuid:c33b5c7b-997b-250c-1d49-8fd9e0653661",
"resource": {
"resourceType": "SupplyDelivery",
"id": "c33b5c7b-997b-250c-1d49-8fd9e0653661",
"status": "completed",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/supply-item-type",
"code": "device",
"display": "Device"
} ]
},
"suppliedItem": {
"quantity": {
"value": 100
},
"itemCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "1137596000",
"display": "Blood lancet (physical object)"
} ],
"text": "Blood lancet (physical object)"
}
},
"occurrenceDateTime": "2022-03-31T18:15:30+02:00"
},
"request": {
"method": "POST",
"url": "SupplyDelivery"
}
}, {
"fullUrl": "urn:uuid:c2dbf722-32c1-ed41-8bd0-2bcb8509b4cd",
"resource": {
"resourceType": "MedicationRequest",
"id": "c2dbf722-32c1-ed41-8bd0-2bcb8509b4cd",
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"authoredOn": "2022-03-31T18:15:30+02:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"dosageInstruction": [ {
"sequence": 1,
"text": "Every six hours (qualifier value)",
"additionalInstruction": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "307468000",
"display": "Every six hours (qualifier value)"
} ],
"text": "Every six hours (qualifier value)"
} ],
"timing": {
"repeat": {
"frequency": 4,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:311a3d2e-4302-11ae-29c8-f8565f7f6015",
"resource": {
"resourceType": "Claim",
"id": "311a3d2e-4302-11ae-29c8-f8565f7f6015",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"created": "2022-03-31T19:04:54+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:c2dbf722-32c1-ed41-8bd0-2bcb8509b4cd"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"encounter": [ {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
} ]
} ],
"total": {
"value": 129.94,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:732c9c2d-4a5b-2af9-6c9b-fd1b6b953e38",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "732c9c2d-4a5b-2af9-6c9b-fd1b6b953e38",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "311a3d2e-4302-11ae-29c8-f8565f7f6015"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2022-03-31T19:04:54+02:00",
"end": "2023-03-31T19:04:54+02:00"
},
"created": "2022-03-31T19:04:54+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:311a3d2e-4302-11ae-29c8-f8565f7f6015"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"servicedPeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
} ]
} ],
"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:0be5aac0-f984-4119-bd84-35e0e3301eba",
"resource": {
"resourceType": "MedicationRequest",
"id": "0be5aac0-f984-4119-bd84-35e0e3301eba",
"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": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"authoredOn": "2022-03-31T18:15:30+02:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"reasonReference": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4",
"display": "Essential hypertension (disorder)"
} ],
"dosageInstruction": [ {
"sequence": 1,
"timing": {
"repeat": {
"frequency": 1,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:6d2a398f-efd7-60cc-f0b3-e7afbe7e4b6f",
"resource": {
"resourceType": "Claim",
"id": "6d2a398f-efd7-60cc-f0b3-e7afbe7e4b6f",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"created": "2022-03-31T19:04:54+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:0be5aac0-f984-4119-bd84-35e0e3301eba"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
} ]
} ],
"total": {
"value": 0.71,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:1f26bf90-75f9-2cb0-0d47-f9a3b4f29c11",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "1f26bf90-75f9-2cb0-0d47-f9a3b4f29c11",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "6d2a398f-efd7-60cc-f0b3-e7afbe7e4b6f"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2022-03-31T19:04:54+02:00",
"end": "2023-03-31T19:04:54+02:00"
},
"created": "2022-03-31T19:04:54+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:6d2a398f-efd7-60cc-f0b3-e7afbe7e4b6f"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 0.71,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:6d5696eb-bb5e-07db-94d2-4b287d173798",
"resource": {
"resourceType": "MedicationRequest",
"id": "6d5696eb-bb5e-07db-94d2-4b287d173798",
"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": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"authoredOn": "2022-03-31T18:15:30+02:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"reasonReference": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4",
"display": "Essential hypertension (disorder)"
} ],
"dosageInstruction": [ {
"sequence": 1,
"timing": {
"repeat": {
"frequency": 1,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:8aaf81d6-fb5a-0dc0-fa09-dd457501117f",
"resource": {
"resourceType": "Claim",
"id": "8aaf81d6-fb5a-0dc0-fa09-dd457501117f",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"created": "2022-03-31T19:04:54+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:6d5696eb-bb5e-07db-94d2-4b287d173798"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
} ]
} ],
"total": {
"value": 0.91,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:c2357db3-463f-5d8b-5c2d-492e4db0675c",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "c2357db3-463f-5d8b-5c2d-492e4db0675c",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "8aaf81d6-fb5a-0dc0-fa09-dd457501117f"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2022-03-31T19:04:54+02:00",
"end": "2023-03-31T19:04:54+02:00"
},
"created": "2022-03-31T19:04:54+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:8aaf81d6-fb5a-0dc0-fa09-dd457501117f"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 0.91,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:6a87d668-7833-4b52-58db-f32782b02e15",
"resource": {
"resourceType": "Immunization",
"id": "6a87d668-7833-4b52-58db-f32782b02e15",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"occurrenceDateTime": "2022-03-31T18:15:30+02:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:0c1845db-fde2-e8cb-3aeb-a5178f5f9eca",
"resource": {
"resourceType": "DiagnosticReport",
"id": "0c1845db-fde2-e8cb-3aeb-a5178f5f9eca",
"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": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T18:15:30+02:00",
"issued": "2022-03-31T18:15:30.236+02:00",
"performer": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
} ],
"result": [ {
"reference": "urn:uuid:62b21f73-0176-1d04-a162-cb27ec7cfa09",
"display": "Glucose [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:d77a97ce-1b4d-dc68-713b-d2b056b11e51",
"display": "Urea nitrogen [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:afb44d43-d719-0107-9de0-31bb1cd3de46",
"display": "Creatinine [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:21ecf29b-d8cc-58cc-7e95-816a0bde7b63",
"display": "Calcium [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:94832b99-21f4-0821-37f6-026ba01575c5",
"display": "Sodium [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:1a11d96a-8503-4f4c-306f-8091c3f66a35",
"display": "Potassium [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:95df3a68-5110-c216-cc94-5ba0c8174c66",
"display": "Chloride [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:82f1d0fb-5e2b-d5ad-1333-c96a4f48817a",
"display": "Carbon dioxide, total [Moles/volume] in Blood"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:23374abf-bfa9-3919-2ca3-d5547e515ce2",
"resource": {
"resourceType": "DiagnosticReport",
"id": "23374abf-bfa9-3919-2ca3-d5547e515ce2",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T19:29:28+02:00",
"issued": "2022-03-31T19:29:28.236+02:00",
"result": [ {
"reference": "urn:uuid:40ea93b0-5ca0-2806-60cf-be1c5e94abaa",
"display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:00e2ada1-edbb-b07e-af9a-24ed0930a6b7",
"resource": {
"resourceType": "DiagnosticReport",
"id": "00e2ada1-edbb-b07e-af9a-24ed0930a6b7",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T20:10:46+02:00",
"issued": "2022-03-31T20:10:46.236+02:00",
"result": [ {
"reference": "urn:uuid:bc2ad1b5-07b9-0f57-ab0e-db57ae49ad9e",
"display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:2f3a30e6-4311-3df5-04dc-0b04737043a9",
"resource": {
"resourceType": "DiagnosticReport",
"id": "2f3a30e6-4311-3df5-04dc-0b04737043a9",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "44249-1",
"display": "PHQ-9 quick depression assessment panel [Reported.PHQ]"
} ],
"text": "PHQ-9 quick depression assessment panel [Reported.PHQ]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T20:33:59+02:00",
"issued": "2022-03-31T20:33:59.236+02:00",
"result": [ {
"reference": "urn:uuid:5725aea5-7119-a7f2-bf94-1c7f42ec87fb",
"display": "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:a36fcdac-5340-9a2e-f87b-150f474487a7",
"resource": {
"resourceType": "DiagnosticReport",
"id": "a36fcdac-5340-9a2e-f87b-150f474487a7",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82666-9",
"display": "Drug Abuse Screening Test-10 [DAST-10]"
} ],
"text": "Drug Abuse Screening Test-10 [DAST-10]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T21:09:13+02:00",
"issued": "2022-03-31T21:09:13.236+02:00",
"result": [ {
"reference": "urn:uuid:21028b5e-67b8-bac2-ab64-d8134726339b",
"display": "Total score [DAST-10]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:62bd77de-1a47-940b-80e6-a0851056701f",
"resource": {
"resourceType": "DiagnosticReport",
"id": "62bd77de-1a47-940b-80e6-a0851056701f",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
},
"effectiveDateTime": "2022-03-31T18:15:30+02:00",
"issued": "2022-03-31T18:15:30.236+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:a03b1672-578c-5e7b-171b-b763a0d1962c",
"resource": {
"resourceType": "DocumentReference",
"id": "a03b1672-578c-5e7b-171b-b763a0d1962c",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:62bd77de-1a47-940b-80e6-a0851056701f"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2022-03-31T18:15:30.236+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE 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:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
} ],
"period": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:a494f717-dc52-698c-3aa1-ad28e5e732aa",
"resource": {
"resourceType": "Claim",
"id": "a494f717-dc52-698c-3aa1-ad28e5e732aa",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"created": "2022-03-31T19:04:54+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:6a87d668-7833-4b52-58db-f32782b02e15"
}
}, {
"sequence": 2,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 4,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 5,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 6,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 7,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 8,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:aa2b3878-3b55-b573-e952-b219e8d85e08"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:e4cf38d2-9cee-00ca-df24-e65db5592eda"
}
}, {
"sequence": 2,
"procedureReference": {
"reference": "urn:uuid:2bfd6188-4781-bcba-20f8-c3b3056c5102"
}
}, {
"sequence": 3,
"procedureReference": {
"reference": "urn:uuid:9868007f-ee2f-3d4b-a188-6c9234339665"
}
}, {
"sequence": 4,
"procedureReference": {
"reference": "urn:uuid:06a92988-738a-4ede-cb36-9bcf4e9640bc"
}
}, {
"sequence": 5,
"procedureReference": {
"reference": "urn:uuid:d9edcd35-de35-8841-e09e-22f30bcb323a"
}
}, {
"sequence": 6,
"procedureReference": {
"reference": "urn:uuid:a9654b90-3a01-5871-70ca-696107909a69"
}
}, {
"sequence": 7,
"procedureReference": {
"reference": "urn:uuid:58160f94-95ba-7d50-ada2-28a6938f0829"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
} ]
}, {
"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,
"informationSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
},
"net": {
"value": 6.80,
"currency": "USD"
}
}, {
"sequence": 4,
"informationSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "1137596000",
"display": "Blood lancet (physical object)"
} ],
"text": "Blood lancet (physical object)"
},
"net": {
"value": 0.00,
"currency": "USD"
}
}, {
"sequence": 5,
"informationSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 6,
"procedureSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 7,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "73438004",
"display": "Unemployed (finding)"
} ],
"text": "Unemployed (finding)"
}
}, {
"sequence": 8,
"procedureSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 9,
"informationSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 10,
"procedureSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 11,
"procedureSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 12,
"informationSequence": [ 6 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 13,
"procedureSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "715252007",
"display": "Depression screening using Patient Health Questionnaire Nine Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Nine Item score (procedure)"
},
"net": {
"value": 32.43,
"currency": "USD"
}
}, {
"sequence": 14,
"informationSequence": [ 7 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "44249-1",
"display": "PHQ-9 quick depression assessment panel [Reported.PHQ]"
} ],
"text": "PHQ-9 quick depression assessment panel [Reported.PHQ]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 15,
"procedureSequence": [ 6 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 16,
"procedureSequence": [ 7 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "713106006",
"display": "Screening for drug abuse (procedure)"
} ],
"text": "Screening for drug abuse (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 17,
"informationSequence": [ 8 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "82666-9",
"display": "Drug Abuse Screening Test-10 [DAST-10]"
} ],
"text": "Drug Abuse Screening Test-10 [DAST-10]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
} ],
"total": {
"value": 785.58,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:a0d8b2ca-9912-9a5d-7d1b-26f11705f91f",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "a0d8b2ca-9912-9a5d-7d1b-26f11705f91f",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "a494f717-dc52-698c-3aa1-ad28e5e732aa"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2022-03-31T19:04:54+02:00",
"end": "2023-03-31T19:04:54+02:00"
},
"created": "2022-03-31T19:04:54+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:a494f717-dc52-698c-3aa1-ad28e5e732aa"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:aa2b3878-3b55-b573-e952-b219e8d85e08"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"servicedPeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
} ]
}, {
"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": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+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://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
},
"servicedPeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 6.80,
"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": 1.36,
"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": 5.44,
"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": 6.80,
"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": 6.80,
"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://snomed.info/sct",
"code": "1137596000",
"display": "Blood lancet (physical object)"
} ],
"text": "Blood lancet (physical object)"
},
"servicedPeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 0.00,
"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": 0.0,
"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": 0.0,
"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": 0.00,
"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": 0.00,
"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://loinc.org",
"code": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"servicedPeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"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"
} ]
}
} ]
}, {
"sequence": 6,
"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": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"servicedPeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"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": "73438004",
"display": "Unemployed (finding)"
} ],
"text": "Unemployed (finding)"
},
"servicedPeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+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": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"servicedPeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 9,
"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://loinc.org",
"code": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"servicedPeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"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"
} ]
}
} ]
}, {
"sequence": 10,
"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": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"servicedPeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 11,
"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": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"servicedPeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 12,
"informationSequence": [ 6 ],
"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": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"servicedPeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"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"
} ]
}
} ]
}, {
"sequence": 13,
"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": "715252007",
"display": "Depression screening using Patient Health Questionnaire Nine Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Nine Item score (procedure)"
},
"servicedPeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 32.43,
"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": 6.486000000000001,
"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": 25.944000000000003,
"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": 32.43,
"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": 32.43,
"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": 14,
"informationSequence": [ 7 ],
"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": "44249-1",
"display": "PHQ-9 quick depression assessment panel [Reported.PHQ]"
} ],
"text": "PHQ-9 quick depression assessment panel [Reported.PHQ]"
},
"servicedPeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"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"
} ]
}
} ]
}, {
"sequence": 15,
"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": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"servicedPeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 16,
"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": "713106006",
"display": "Screening for drug abuse (procedure)"
} ],
"text": "Screening for drug abuse (procedure)"
},
"servicedPeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 17,
"informationSequence": [ 8 ],
"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": "82666-9",
"display": "Drug Abuse Screening Test-10 [DAST-10]"
} ],
"text": "Drug Abuse Screening Test-10 [DAST-10]"
},
"servicedPeriod": {
"start": "2022-03-31T18:15:30+02:00",
"end": "2022-03-31T19:04:54+02:00"
},
"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": 785.58,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 2509.2239999999997,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67",
"resource": {
"resourceType": "Encounter",
"id": "eb775196-ba78-0c17-042e-358078bf3d67",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter" ]
},
"identifier": [ {
"use": "official",
"system": "https://github.com/synthetichealth/synthea",
"value": "eb775196-ba78-0c17-042e-358078bf3d67"
} ],
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB"
},
"type": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
} ],
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Mr. Murray856 Garfield38 Lesch175"
},
"participant": [ {
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF",
"display": "primary performer"
} ],
"text": "primary performer"
} ],
"period": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"individual": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
}
} ],
"period": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"location": [ {
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
} ],
"serviceProvider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
}, {
"fullUrl": "urn:uuid:100b791e-1cd3-17be-c07c-88c5541a669b",
"resource": {
"resourceType": "Condition",
"id": "100b791e-1cd3-17be-c07c-88c5541a669b",
"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": "160903007",
"display": "Full-time employment (finding)"
} ],
"text": "Full-time employment (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"onsetDateTime": "2023-04-06T18:53:01+02:00",
"recordedDate": "2023-04-06T18:53:01+02:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:e03a534d-adfe-f077-1aee-9f652fc2ee50",
"resource": {
"resourceType": "Condition",
"id": "e03a534d-adfe-f077-1aee-9f652fc2ee50",
"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": "706893006",
"display": "Victim of intimate partner abuse (finding)"
} ],
"text": "Victim of intimate partner abuse (finding)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"onsetDateTime": "2023-04-06T19:55:07+02:00",
"recordedDate": "2023-04-06T19:55:07+02:00"
},
"request": {
"method": "POST",
"url": "Condition"
}
}, {
"fullUrl": "urn:uuid:3837824d-a222-dbd7-97f2-6c0c8ede5f7e",
"resource": {
"resourceType": "Observation",
"id": "3837824d-a222-dbd7-97f2-6c0c8ede5f7e",
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "4548-4",
"display": "Hemoglobin A1c/Hemoglobin.total in Blood"
} ],
"text": "Hemoglobin A1c/Hemoglobin.total in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T18:15:30+02:00",
"issued": "2023-04-06T18:15:30.236+02:00",
"valueQuantity": {
"value": 6.12,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:9b1c749c-9f55-a89f-8927-3b089f14520e",
"resource": {
"resourceType": "Observation",
"id": "9b1c749c-9f55-a89f-8927-3b089f14520e",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T18:15:30+02:00",
"issued": "2023-04-06T18:15:30.236+02:00",
"valueQuantity": {
"value": 174.1,
"unit": "cm",
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:ce93fbcb-140a-7568-6888-3f84db3e7c95",
"resource": {
"resourceType": "Observation",
"id": "ce93fbcb-140a-7568-6888-3f84db3e7c95",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T18:15:30+02:00",
"issued": "2023-04-06T18:15:30.236+02:00",
"valueQuantity": {
"value": 2,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:1d465066-fd72-50c8-319c-1549d01cfb16",
"resource": {
"resourceType": "Observation",
"id": "1d465066-fd72-50c8-319c-1549d01cfb16",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T18:15:30+02:00",
"issued": "2023-04-06T18:15:30.236+02:00",
"valueQuantity": {
"value": 88.3,
"unit": "kg",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:93583905-76d9-c8dd-1cbf-17d79a3e479a",
"resource": {
"resourceType": "Observation",
"id": "93583905-76d9-c8dd-1cbf-17d79a3e479a",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T18:15:30+02:00",
"issued": "2023-04-06T18:15:30.236+02:00",
"valueQuantity": {
"value": 29.14,
"unit": "kg/m2",
"system": "http://unitsofmeasure.org",
"code": "kg/m2"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:2a1fcc98-f430-3f65-04ce-a752d714ab44",
"resource": {
"resourceType": "Observation",
"id": "2a1fcc98-f430-3f65-04ce-a752d714ab44",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T18:15:30+02:00",
"issued": "2023-04-06T18:15:30.236+02:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic Blood Pressure"
} ],
"text": "Diastolic Blood Pressure"
},
"valueQuantity": {
"value": 78,
"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": 97,
"unit": "mm[Hg]",
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:114e89d1-3f54-2c4f-88f7-31782a8f145f",
"resource": {
"resourceType": "Observation",
"id": "114e89d1-3f54-2c4f-88f7-31782a8f145f",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T18:15:30+02:00",
"issued": "2023-04-06T18:15:30.236+02:00",
"valueQuantity": {
"value": 74,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:7ad2962b-e98c-e9e5-739d-39cbc585c527",
"resource": {
"resourceType": "Observation",
"id": "7ad2962b-e98c-e9e5-739d-39cbc585c527",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T18:15:30+02:00",
"issued": "2023-04-06T18:15:30.236+02:00",
"valueQuantity": {
"value": 12,
"unit": "/min",
"system": "http://unitsofmeasure.org",
"code": "/min"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:9b76f31f-51cf-8eb9-76fd-f3147d3da311",
"resource": {
"resourceType": "Observation",
"id": "9b76f31f-51cf-8eb9-76fd-f3147d3da311",
"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": "2339-0",
"display": "Glucose [Mass/volume] in Blood"
} ],
"text": "Glucose [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T18:15:30+02:00",
"issued": "2023-04-06T18:15:30.236+02:00",
"valueQuantity": {
"value": 98.31,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:9fc3252a-02ce-37d5-38c4-e9efd63607cc",
"resource": {
"resourceType": "Observation",
"id": "9fc3252a-02ce-37d5-38c4-e9efd63607cc",
"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": "6299-2",
"display": "Urea nitrogen [Mass/volume] in Blood"
} ],
"text": "Urea nitrogen [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T18:15:30+02:00",
"issued": "2023-04-06T18:15:30.236+02:00",
"valueQuantity": {
"value": 11.5,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:83caef52-9ced-0ff0-9aa0-c71367b71a02",
"resource": {
"resourceType": "Observation",
"id": "83caef52-9ced-0ff0-9aa0-c71367b71a02",
"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": "38483-4",
"display": "Creatinine [Mass/volume] in Blood"
} ],
"text": "Creatinine [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T18:15:30+02:00",
"issued": "2023-04-06T18:15:30.236+02:00",
"valueQuantity": {
"value": 1.29,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:b57a1601-04da-1e14-39be-9b003ee7b3d7",
"resource": {
"resourceType": "Observation",
"id": "b57a1601-04da-1e14-39be-9b003ee7b3d7",
"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": "49765-1",
"display": "Calcium [Mass/volume] in Blood"
} ],
"text": "Calcium [Mass/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T18:15:30+02:00",
"issued": "2023-04-06T18:15:30.236+02:00",
"valueQuantity": {
"value": 9.83,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:033aeae0-5055-adb8-9810-2686e890db16",
"resource": {
"resourceType": "Observation",
"id": "033aeae0-5055-adb8-9810-2686e890db16",
"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": "2947-0",
"display": "Sodium [Moles/volume] in Blood"
} ],
"text": "Sodium [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T18:15:30+02:00",
"issued": "2023-04-06T18:15:30.236+02:00",
"valueQuantity": {
"value": 143.19,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:4a1f3308-0d90-a40d-c18f-a79075a408ad",
"resource": {
"resourceType": "Observation",
"id": "4a1f3308-0d90-a40d-c18f-a79075a408ad",
"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": "6298-4",
"display": "Potassium [Moles/volume] in Blood"
} ],
"text": "Potassium [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T18:15:30+02:00",
"issued": "2023-04-06T18:15:30.236+02:00",
"valueQuantity": {
"value": 4.97,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:7e2ecb5c-b88a-5698-bc6d-2e16d099f35b",
"resource": {
"resourceType": "Observation",
"id": "7e2ecb5c-b88a-5698-bc6d-2e16d099f35b",
"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": "2069-3",
"display": "Chloride [Moles/volume] in Blood"
} ],
"text": "Chloride [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T18:15:30+02:00",
"issued": "2023-04-06T18:15:30.236+02:00",
"valueQuantity": {
"value": 103.32,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:23d1af38-065c-b700-474d-bd7618e6d1a7",
"resource": {
"resourceType": "Observation",
"id": "23d1af38-065c-b700-474d-bd7618e6d1a7",
"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": "20565-8",
"display": "Carbon dioxide, total [Moles/volume] in Blood"
} ],
"text": "Carbon dioxide, total [Moles/volume] in Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T18:15:30+02:00",
"issued": "2023-04-06T18:15:30.236+02:00",
"valueQuantity": {
"value": 26.03,
"unit": "mmol/L",
"system": "http://unitsofmeasure.org",
"code": "mmol/L"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:e54716b0-3df3-9081-58b4-824ee9207091",
"resource": {
"resourceType": "Observation",
"id": "e54716b0-3df3-9081-58b4-824ee9207091",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T18:15:30+02:00",
"issued": "2023-04-06T18:15:30.236+02:00",
"valueCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "8517006",
"display": "Ex-smoker (finding)"
} ],
"text": "Ex-smoker (finding)"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:0683617b-e9a5-b47c-08a5-d1261265ae9a",
"resource": {
"resourceType": "Observation",
"id": "0683617b-e9a5-b47c-08a5-d1261265ae9a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93025-5",
"display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
} ],
"text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T18:53:01+02:00",
"issued": "2023-04-06T18:53:01.236+02:00",
"component": [ {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76501-6",
"display": "Within the last year, have you been afraid of your partner or ex-partner?"
} ],
"text": "Within the last year, have you been afraid of your partner or ex-partner?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93026-3",
"display": "Do you feel physically and emotionally safe where you currently live?"
} ],
"text": "Do you feel physically and emotionally safe where you currently live?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93027-1",
"display": "Are you a refugee?"
} ],
"text": "Are you a refugee?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93028-9",
"display": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
} ],
"text": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93038-8",
"display": "Stress level"
} ],
"text": "Stress level"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA13863-8",
"display": "A little bit"
} ],
"text": "A little bit"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93029-7",
"display": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
} ],
"text": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30131-9",
"display": "3 to 5 times a week"
} ],
"text": "3 to 5 times a week"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93030-5",
"display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
} ],
"text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93031-3",
"display": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
} ],
"text": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30122-8",
"display": "I choose not to answer this question"
} ],
"text": "I choose not to answer this question"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63586-2",
"display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
} ],
"text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
},
"valueQuantity": {
"value": 55950,
"unit": "/a",
"system": "http://unitsofmeasure.org",
"code": "/a"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76437-3",
"display": "Primary insurance"
} ],
"text": "Primary insurance"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30194-7",
"display": "None/uninsured"
} ],
"text": "None/uninsured"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "67875-5",
"display": "Employment status - current"
} ],
"text": "Employment status - current"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30136-8",
"display": "Full-time work"
} ],
"text": "Full-time work"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "82589-3",
"display": "Highest level of education"
} ],
"text": "Highest level of education"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30193-9",
"display": "More than high school"
} ],
"text": "More than high school"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56799-0",
"display": "Address"
} ],
"text": "Address"
},
"valueString": "287 Treutel Neck"
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93033-9",
"display": "Are you worried about losing your housing?"
} ],
"text": "Are you worried about losing your housing?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
} ],
"text": "Yes"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "71802-3",
"display": "Housing status"
} ],
"text": "Housing status"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30189-7",
"display": "I have housing"
} ],
"text": "I have housing"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "63512-8",
"display": "How many people are living or staying at this address?"
} ],
"text": "How many people are living or staying at this address?"
},
"valueQuantity": {
"value": 7,
"unit": "{#}",
"system": "http://unitsofmeasure.org",
"code": "{#}"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "54899-0",
"display": "Preferred language"
} ],
"text": "Preferred language"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA43-5",
"display": "English"
} ],
"text": "English"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93034-7",
"display": "Have you been discharged from the armed forces of the United States?"
} ],
"text": "Have you been discharged from the armed forces of the United States?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "93035-4",
"display": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
} ],
"text": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "32624-9",
"display": "Race"
} ],
"text": "Race"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA30122-8",
"display": "I choose not to answer this question"
} ],
"text": "I choose not to answer this question"
}
}, {
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "56051-6",
"display": "Do you consider yourself Hispanic/Latino?"
} ],
"text": "Do you consider yourself Hispanic/Latino?"
},
"valueCodeableConcept": {
"coding": [ {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
} ],
"text": "No"
}
} ]
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:bc51b8cd-264a-4ded-564c-df1362205f22",
"resource": {
"resourceType": "Observation",
"id": "bc51b8cd-264a-4ded-564c-df1362205f22",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "70274-6",
"display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T19:11:56+02:00",
"issued": "2023-04-06T19:11:56.236+02:00",
"valueQuantity": {
"value": 3,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:52ee4e06-bdbe-a448-3c96-083f37a142a2",
"resource": {
"resourceType": "Observation",
"id": "52ee4e06-bdbe-a448-3c96-083f37a142a2",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment", "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76504-0",
"display": "Total score [HARK]"
} ],
"text": "Total score [HARK]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T19:55:07+02:00",
"issued": "2023-04-06T19:55:07.236+02:00",
"valueQuantity": {
"value": 2,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:259163d9-c5cd-4590-03bd-e530a554ab84",
"resource": {
"resourceType": "Observation",
"id": "259163d9-c5cd-4590-03bd-e530a554ab84",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "55758-7",
"display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T20:27:46+02:00",
"issued": "2023-04-06T20:27:46.236+02:00",
"valueQuantity": {
"value": 4,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:4db44c6a-87cc-1989-64c4-a1cd0dd24444",
"resource": {
"resourceType": "Observation",
"id": "4db44c6a-87cc-1989-64c4-a1cd0dd24444",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "44261-6",
"display": "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]"
} ],
"text": "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T20:54:49+02:00",
"issued": "2023-04-06T20:54:49.236+02:00",
"valueQuantity": {
"value": 17,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:94bcc65e-9c94-dce9-a509-986a8f3d37df",
"resource": {
"resourceType": "Observation",
"id": "94bcc65e-9c94-dce9-a509-986a8f3d37df",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey" ]
},
"status": "final",
"category": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "survey",
"display": "Survey"
} ]
} ],
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "75626-2",
"display": "Total score [AUDIT-C]"
} ],
"text": "Total score [AUDIT-C]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T21:31:04+02:00",
"issued": "2023-04-06T21:31:04.236+02:00",
"valueQuantity": {
"value": 2,
"unit": "{score}",
"system": "http://unitsofmeasure.org",
"code": "{score}"
}
},
"request": {
"method": "POST",
"url": "Observation"
}
}, {
"fullUrl": "urn:uuid:b999642f-f2c5-63af-b771-ca96045db14d",
"resource": {
"resourceType": "Procedure",
"id": "b999642f-f2c5-63af-b771-ca96045db14d",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"performedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:30:30+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:754d547b-bfd9-7d98-16ca-e62d9464c436",
"resource": {
"resourceType": "Procedure",
"id": "754d547b-bfd9-7d98-16ca-e62d9464c436",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"performedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:e4eaca12-adf0-3021-59f6-bc6eb17e5adc",
"resource": {
"resourceType": "Procedure",
"id": "e4eaca12-adf0-3021-59f6-bc6eb17e5adc",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"performedPeriod": {
"start": "2023-04-06T18:53:01+02:00",
"end": "2023-04-06T19:11:56+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:4fc961b1-ee47-8657-3199-5cc2ffbf40b0",
"resource": {
"resourceType": "Procedure",
"id": "4fc961b1-ee47-8657-3199-5cc2ffbf40b0",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "866148006",
"display": "Screening for domestic abuse (procedure)"
} ],
"text": "Screening for domestic abuse (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"performedPeriod": {
"start": "2023-04-06T19:11:56+02:00",
"end": "2023-04-06T19:55:07+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:c989643a-e1cd-566b-e775-e65240506b78",
"resource": {
"resourceType": "Procedure",
"id": "c989643a-e1cd-566b-e775-e65240506b78",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"performedPeriod": {
"start": "2023-04-06T19:55:07+02:00",
"end": "2023-04-06T20:06:33+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:d4e6335a-c7af-950d-734f-25360172067a",
"resource": {
"resourceType": "Procedure",
"id": "d4e6335a-c7af-950d-734f-25360172067a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"performedPeriod": {
"start": "2023-04-06T20:06:33+02:00",
"end": "2023-04-06T20:27:46+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:81dff8d1-b723-6024-725e-3cd470638bd4",
"resource": {
"resourceType": "Procedure",
"id": "81dff8d1-b723-6024-725e-3cd470638bd4",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "715252007",
"display": "Depression screening using Patient Health Questionnaire Nine Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Nine Item score (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"performedPeriod": {
"start": "2023-04-06T20:27:46+02:00",
"end": "2023-04-06T20:54:49+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:4850a7e3-ee5a-6ee7-cda6-c4e24acb0280",
"resource": {
"resourceType": "Procedure",
"id": "4850a7e3-ee5a-6ee7-cda6-c4e24acb0280",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"performedPeriod": {
"start": "2023-04-06T20:54:49+02:00",
"end": "2023-04-06T21:05:53+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:8e1eb4a7-7d09-8c09-4373-f0ba6aac0883",
"resource": {
"resourceType": "Procedure",
"id": "8e1eb4a7-7d09-8c09-4373-f0ba6aac0883",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure" ]
},
"status": "completed",
"code": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "763302001",
"display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
} ],
"text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"performedPeriod": {
"start": "2023-04-06T21:05:53+02:00",
"end": "2023-04-06T21:31:04+02:00"
},
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Procedure"
}
}, {
"fullUrl": "urn:uuid:075b1fde-11a3-d242-dbd7-0ea79b92f7cc",
"resource": {
"resourceType": "SupplyDelivery",
"id": "075b1fde-11a3-d242-dbd7-0ea79b92f7cc",
"status": "completed",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/supply-item-type",
"code": "device",
"display": "Device"
} ]
},
"suppliedItem": {
"quantity": {
"value": 50
},
"itemCodeableConcept": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
}
},
"occurrenceDateTime": "2023-04-06T18:15:30+02:00"
},
"request": {
"method": "POST",
"url": "SupplyDelivery"
}
}, {
"fullUrl": "urn:uuid:440c5478-7884-7980-7ec7-920deae39b19",
"resource": {
"resourceType": "MedicationRequest",
"id": "440c5478-7884-7980-7ec7-920deae39b19",
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"authoredOn": "2023-04-06T18:15:30+02:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"dosageInstruction": [ {
"sequence": 1,
"text": "Every six hours (qualifier value)",
"additionalInstruction": [ {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "307468000",
"display": "Every six hours (qualifier value)"
} ],
"text": "Every six hours (qualifier value)"
} ],
"timing": {
"repeat": {
"frequency": 4,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:60d23e4b-3b86-ab7d-2d38-70efd42945b7",
"resource": {
"resourceType": "Claim",
"id": "60d23e4b-3b86-ab7d-2d38-70efd42945b7",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"created": "2023-04-06T18:53:01+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:440c5478-7884-7980-7ec7-920deae39b19"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"encounter": [ {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
} ]
} ],
"total": {
"value": 129.94,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:2d7f7f7c-dbd7-002b-0a09-7c348c4e11b7",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "2d7f7f7c-dbd7-002b-0a09-7c348c4e11b7",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "60d23e4b-3b86-ab7d-2d38-70efd42945b7"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2023-04-06T18:53:01+02:00",
"end": "2024-04-06T18:53:01+02:00"
},
"created": "2023-04-06T18:53:01+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:60d23e4b-3b86-ab7d-2d38-70efd42945b7"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "1049625",
"display": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
} ],
"text": "Acetaminophen 325 MG / Oxycodone Hydrochloride 10 MG Oral Tablet [Percocet]"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
} ]
} ],
"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:5abcea8b-fd8f-28e9-95cb-289da63333a1",
"resource": {
"resourceType": "MedicationRequest",
"id": "5abcea8b-fd8f-28e9-95cb-289da63333a1",
"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": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"authoredOn": "2023-04-06T18:15:30+02:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"reasonReference": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4",
"display": "Essential hypertension (disorder)"
} ],
"dosageInstruction": [ {
"sequence": 1,
"timing": {
"repeat": {
"frequency": 1,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:4fc716de-ed69-ec3f-1245-7d0ace4b65b1",
"resource": {
"resourceType": "Claim",
"id": "4fc716de-ed69-ec3f-1245-7d0ace4b65b1",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"created": "2023-04-06T18:53:01+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:5abcea8b-fd8f-28e9-95cb-289da63333a1"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
} ]
} ],
"total": {
"value": 0.53,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:86a0d34e-5af3-c1af-01a8-446718bc617b",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "86a0d34e-5af3-c1af-01a8-446718bc617b",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "4fc716de-ed69-ec3f-1245-7d0ace4b65b1"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2023-04-06T18:53:01+02:00",
"end": "2024-04-06T18:53:01+02:00"
},
"created": "2023-04-06T18:53:01+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:4fc716de-ed69-ec3f-1245-7d0ace4b65b1"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "310798",
"display": "Hydrochlorothiazide 25 MG Oral Tablet"
} ],
"text": "Hydrochlorothiazide 25 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 0.53,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:918b204e-5459-d3b0-787f-659c96d76366",
"resource": {
"resourceType": "MedicationRequest",
"id": "918b204e-5459-d3b0-787f-659c96d76366",
"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": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"authoredOn": "2023-04-06T18:15:30+02:00",
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"reasonReference": [ {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4",
"display": "Essential hypertension (disorder)"
} ],
"dosageInstruction": [ {
"sequence": 1,
"timing": {
"repeat": {
"frequency": 1,
"period": 1.0,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseAndRate": [ {
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
} ]
},
"doseQuantity": {
"value": 1.0
}
} ]
} ]
},
"request": {
"method": "POST",
"url": "MedicationRequest"
}
}, {
"fullUrl": "urn:uuid:8cd708a4-8b45-a40b-041e-ed070efa98fe",
"resource": {
"resourceType": "Claim",
"id": "8cd708a4-8b45-a40b-041e-ed070efa98fe",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"created": "2023-04-06T18:53:01+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"prescription": {
"reference": "urn:uuid:918b204e-5459-d3b0-787f-659c96d76366"
},
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"encounter": [ {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
} ]
} ],
"total": {
"value": 0.91,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:763f0809-80ea-78ff-d936-2a88b6d696c3",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "763f0809-80ea-78ff-d936-2a88b6d696c3",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "8cd708a4-8b45-a40b-041e-ed070efa98fe"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2023-04-06T18:53:01+02:00",
"end": "2024-04-06T18:53:01+02:00"
},
"created": "2023-04-06T18:53:01+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:8cd708a4-8b45-a40b-041e-ed070efa98fe"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "314076",
"display": "lisinopril 10 MG Oral Tablet"
} ],
"text": "lisinopril 10 MG Oral Tablet"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
} ]
} ],
"total": [ {
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
"code": "submitted",
"display": "Submitted Amount"
} ],
"text": "Submitted Amount"
},
"amount": {
"value": 0.91,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 0.0,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:28e9af41-d1a5-a016-91ff-02fcd06d486b",
"resource": {
"resourceType": "Immunization",
"id": "28e9af41-d1a5-a016-91ff-02fcd06d486b",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"occurrenceDateTime": "2023-04-06T18:15:30+02:00",
"primarySource": true,
"location": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
},
"request": {
"method": "POST",
"url": "Immunization"
}
}, {
"fullUrl": "urn:uuid:18814546-3dfe-e829-3c84-bde99c1c4713",
"resource": {
"resourceType": "DiagnosticReport",
"id": "18814546-3dfe-e829-3c84-bde99c1c4713",
"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": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T18:15:30+02:00",
"issued": "2023-04-06T18:15:30.236+02:00",
"performer": [ {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
} ],
"result": [ {
"reference": "urn:uuid:9b76f31f-51cf-8eb9-76fd-f3147d3da311",
"display": "Glucose [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:9fc3252a-02ce-37d5-38c4-e9efd63607cc",
"display": "Urea nitrogen [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:83caef52-9ced-0ff0-9aa0-c71367b71a02",
"display": "Creatinine [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:b57a1601-04da-1e14-39be-9b003ee7b3d7",
"display": "Calcium [Mass/volume] in Blood"
}, {
"reference": "urn:uuid:033aeae0-5055-adb8-9810-2686e890db16",
"display": "Sodium [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:4a1f3308-0d90-a40d-c18f-a79075a408ad",
"display": "Potassium [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:7e2ecb5c-b88a-5698-bc6d-2e16d099f35b",
"display": "Chloride [Moles/volume] in Blood"
}, {
"reference": "urn:uuid:23d1af38-065c-b700-474d-bd7618e6d1a7",
"display": "Carbon dioxide, total [Moles/volume] in Blood"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:cd592562-e0c1-0255-006c-41e3a95416d4",
"resource": {
"resourceType": "DiagnosticReport",
"id": "cd592562-e0c1-0255-006c-41e3a95416d4",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T19:11:56+02:00",
"issued": "2023-04-06T19:11:56.236+02:00",
"result": [ {
"reference": "urn:uuid:bc51b8cd-264a-4ded-564c-df1362205f22",
"display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:e444e436-54fe-e0c0-3161-a2bb056d22f6",
"resource": {
"resourceType": "DiagnosticReport",
"id": "e444e436-54fe-e0c0-3161-a2bb056d22f6",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "76499-3",
"display": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
} ],
"text": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T19:55:07+02:00",
"issued": "2023-04-06T19:55:07.236+02:00",
"result": [ {
"reference": "urn:uuid:52ee4e06-bdbe-a448-3c96-083f37a142a2",
"display": "Total score [HARK]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:71aa9ab5-7d4d-8a7c-ee52-acd386d227fb",
"resource": {
"resourceType": "DiagnosticReport",
"id": "71aa9ab5-7d4d-8a7c-ee52-acd386d227fb",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T20:27:46+02:00",
"issued": "2023-04-06T20:27:46.236+02:00",
"result": [ {
"reference": "urn:uuid:259163d9-c5cd-4590-03bd-e530a554ab84",
"display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:bbd55e03-ec99-47ce-c158-4389c8e2f926",
"resource": {
"resourceType": "DiagnosticReport",
"id": "bbd55e03-ec99-47ce-c158-4389c8e2f926",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "44249-1",
"display": "PHQ-9 quick depression assessment panel [Reported.PHQ]"
} ],
"text": "PHQ-9 quick depression assessment panel [Reported.PHQ]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T20:54:49+02:00",
"issued": "2023-04-06T20:54:49.236+02:00",
"result": [ {
"reference": "urn:uuid:4db44c6a-87cc-1989-64c4-a1cd0dd24444",
"display": "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:f81e0137-d2d6-5d6e-eb03-16aa8eee6b80",
"resource": {
"resourceType": "DiagnosticReport",
"id": "f81e0137-d2d6-5d6e-eb03-16aa8eee6b80",
"status": "final",
"code": {
"coding": [ {
"system": "http://loinc.org",
"code": "72109-2",
"display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
} ],
"text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
},
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T21:31:04+02:00",
"issued": "2023-04-06T21:31:04.236+02:00",
"result": [ {
"reference": "urn:uuid:94bcc65e-9c94-dce9-a509-986a8f3d37df",
"display": "Total score [AUDIT-C]"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:647640d9-2193-5b5c-14ed-217a12dca094",
"resource": {
"resourceType": "DiagnosticReport",
"id": "647640d9-2193-5b5c-14ed-217a12dca094",
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"encounter": {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
},
"effectiveDateTime": "2023-04-06T18:15:30+02:00",
"issued": "2023-04-06T18:15:30.236+02:00",
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"presentedForm": [ {
"contentType": "text/plain; charset=utf-8",
"data": "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"
} ]
},
"request": {
"method": "POST",
"url": "DiagnosticReport"
}
}, {
"fullUrl": "urn:uuid:f945513e-a7d0-a3ef-436f-0ec25ed5ab7a",
"resource": {
"resourceType": "DocumentReference",
"id": "f945513e-a7d0-a3ef-436f-0ec25ed5ab7a",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference" ]
},
"identifier": [ {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:647640d9-2193-5b5c-14ed-217a12dca094"
} ],
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"date": "2023-04-06T18:15:30.236+02:00",
"author": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491",
"display": "Dr. Alvin56 Hayes766"
} ],
"custodian": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE 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:eb775196-ba78-0c17-042e-358078bf3d67"
} ],
"period": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
}
}
},
"request": {
"method": "POST",
"url": "DocumentReference"
}
}, {
"fullUrl": "urn:uuid:b4a06423-f1d8-1d32-fcdd-0e07061bda93",
"resource": {
"resourceType": "Claim",
"id": "b4a06423-f1d8-1d32-fcdd-0e07061bda93",
"status": "active",
"type": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
} ]
},
"use": "claim",
"patient": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84",
"display": "Murray856 Lesch175"
},
"billablePeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"created": "2023-04-06T18:53:01+02:00",
"provider": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"priority": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
} ]
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"supportingInfo": [ {
"sequence": 1,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
},
"valueReference": {
"reference": "urn:uuid:28e9af41-d1a5-a016-91ff-02fcd06d486b"
}
}, {
"sequence": 2,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 3,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 4,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 5,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 6,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 7,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
}, {
"sequence": 8,
"category": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code": "info"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:100b791e-1cd3-17be-c07c-88c5541a669b"
}
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:e03a534d-adfe-f077-1aee-9f652fc2ee50"
}
} ],
"procedure": [ {
"sequence": 1,
"procedureReference": {
"reference": "urn:uuid:b999642f-f2c5-63af-b771-ca96045db14d"
}
}, {
"sequence": 2,
"procedureReference": {
"reference": "urn:uuid:754d547b-bfd9-7d98-16ca-e62d9464c436"
}
}, {
"sequence": 3,
"procedureReference": {
"reference": "urn:uuid:e4eaca12-adf0-3021-59f6-bc6eb17e5adc"
}
}, {
"sequence": 4,
"procedureReference": {
"reference": "urn:uuid:4fc961b1-ee47-8657-3199-5cc2ffbf40b0"
}
}, {
"sequence": 5,
"procedureReference": {
"reference": "urn:uuid:c989643a-e1cd-566b-e775-e65240506b78"
}
}, {
"sequence": 6,
"procedureReference": {
"reference": "urn:uuid:d4e6335a-c7af-950d-734f-25360172067a"
}
}, {
"sequence": 7,
"procedureReference": {
"reference": "urn:uuid:81dff8d1-b723-6024-725e-3cd470638bd4"
}
}, {
"sequence": 8,
"procedureReference": {
"reference": "urn:uuid:4850a7e3-ee5a-6ee7-cda6-c4e24acb0280"
}
}, {
"sequence": 9,
"procedureReference": {
"reference": "urn:uuid:8e1eb4a7-7d09-8c09-4373-f0ba6aac0883"
}
} ],
"insurance": [ {
"sequence": 1,
"focal": true,
"coverage": {
"display": "NO_INSURANCE"
}
} ],
"item": [ {
"sequence": 1,
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"encounter": [ {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
} ]
}, {
"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": 306.45,
"currency": "USD"
}
}, {
"sequence": 4,
"informationSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
},
"net": {
"value": 6.80,
"currency": "USD"
}
}, {
"sequence": 5,
"informationSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 6,
"procedureSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 7,
"diagnosisSequence": [ 1 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "160903007",
"display": "Full-time employment (finding)"
} ],
"text": "Full-time employment (finding)"
}
}, {
"sequence": 8,
"procedureSequence": [ 3 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 9,
"informationSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 10,
"procedureSequence": [ 4 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "866148006",
"display": "Screening for domestic abuse (procedure)"
} ],
"text": "Screening for domestic abuse (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 11,
"diagnosisSequence": [ 2 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "706893006",
"display": "Victim of intimate partner abuse (finding)"
} ],
"text": "Victim of intimate partner abuse (finding)"
}
}, {
"sequence": 12,
"informationSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "76499-3",
"display": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
} ],
"text": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 13,
"procedureSequence": [ 5 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 14,
"procedureSequence": [ 6 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 15,
"informationSequence": [ 6 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 16,
"procedureSequence": [ 7 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "715252007",
"display": "Depression screening using Patient Health Questionnaire Nine Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Nine Item score (procedure)"
},
"net": {
"value": 28.90,
"currency": "USD"
}
}, {
"sequence": 17,
"informationSequence": [ 7 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "44249-1",
"display": "PHQ-9 quick depression assessment panel [Reported.PHQ]"
} ],
"text": "PHQ-9 quick depression assessment panel [Reported.PHQ]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
}, {
"sequence": 18,
"procedureSequence": [ 8 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 19,
"procedureSequence": [ 9 ],
"productOrService": {
"coding": [ {
"system": "http://snomed.info/sct",
"code": "763302001",
"display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
} ],
"text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
},
"net": {
"value": 431.40,
"currency": "USD"
}
}, {
"sequence": 20,
"informationSequence": [ 8 ],
"productOrService": {
"coding": [ {
"system": "http://loinc.org",
"code": "72109-2",
"display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
} ],
"text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
},
"net": {
"value": 74.58,
"currency": "USD"
}
} ],
"total": {
"value": 1092.03,
"currency": "USD"
}
},
"request": {
"method": "POST",
"url": "Claim"
}
}, {
"fullUrl": "urn:uuid:2e8c179c-8fc1-ebd4-738a-7374cb4ab1c2",
"resource": {
"resourceType": "ExplanationOfBenefit",
"id": "2e8c179c-8fc1-ebd4-738a-7374cb4ab1c2",
"contained": [ {
"resourceType": "ServiceRequest",
"id": "referral",
"status": "completed",
"intent": "order",
"subject": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"requester": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"performer": [ {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
} ]
}, {
"resourceType": "Coverage",
"id": "coverage",
"status": "active",
"type": {
"text": "NO_INSURANCE"
},
"beneficiary": {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"payor": [ {
"display": "NO_INSURANCE"
} ]
} ],
"identifier": [ {
"system": "https://bluebutton.cms.gov/resources/variables/clm_id",
"value": "b4a06423-f1d8-1d32-fcdd-0e07061bda93"
}, {
"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:0759e805-61d1-ba2b-8b14-9e4308784a84"
},
"billablePeriod": {
"start": "2023-04-06T18:53:01+02:00",
"end": "2024-04-06T18:53:01+02:00"
},
"created": "2023-04-06T18:53:01+02:00",
"insurer": {
"display": "NO_INSURANCE"
},
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"referral": {
"reference": "#referral"
},
"facility": {
"reference": "Location?identifier=https://github.com/synthetichealth/synthea|3ea65cb7-a072-322c-94ca-6a659412c6c1",
"display": "CHELMSFORD PRIMARY CARE LLC"
},
"claim": {
"reference": "urn:uuid:b4a06423-f1d8-1d32-fcdd-0e07061bda93"
},
"outcome": "complete",
"careTeam": [ {
"sequence": 1,
"provider": {
"reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999965491"
},
"role": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code": "primary",
"display": "Primary provider"
} ]
}
} ],
"diagnosis": [ {
"sequence": 1,
"diagnosisReference": {
"reference": "urn:uuid:100b791e-1cd3-17be-c07c-88c5541a669b"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
}, {
"sequence": 2,
"diagnosisReference": {
"reference": "urn:uuid:e03a534d-adfe-f077-1aee-9f652fc2ee50"
},
"type": [ {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code": "principal"
} ]
} ]
} ],
"insurance": [ {
"focal": true,
"coverage": {
"reference": "#coverage",
"display": "NO_INSURANCE"
}
} ],
"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": "162673000",
"display": "General examination of patient (procedure)"
} ],
"text": "General examination of patient (procedure)"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"encounter": [ {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
} ]
}, {
"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": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+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,
"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": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 306.45,
"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": 61.29,
"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": 245.16,
"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": 306.45,
"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": 306.45,
"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": 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://snomed.info/sct",
"code": "337388004",
"display": "Blood glucose testing strips (physical object)"
} ],
"text": "Blood glucose testing strips (physical object)"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 6.80,
"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": 1.36,
"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": 5.44,
"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": 6.80,
"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": 6.80,
"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": [ 3 ],
"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": "51990-0",
"display": "Basic metabolic panel - Blood"
} ],
"text": "Basic metabolic panel - Blood"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"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"
} ]
}
} ]
}, {
"sequence": 6,
"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": "710824005",
"display": "Assessment of health and social care needs (procedure)"
} ],
"text": "Assessment of health and social care needs (procedure)"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"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": "160903007",
"display": "Full-time employment (finding)"
} ],
"text": "Full-time employment (finding)"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+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": "710841007",
"display": "Assessment of anxiety (procedure)"
} ],
"text": "Assessment of anxiety (procedure)"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 9,
"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://loinc.org",
"code": "69737-5",
"display": "Generalized anxiety disorder 7 item (GAD-7)"
} ],
"text": "Generalized anxiety disorder 7 item (GAD-7)"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"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"
} ]
}
} ]
}, {
"sequence": 10,
"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": "866148006",
"display": "Screening for domestic abuse (procedure)"
} ],
"text": "Screening for domestic abuse (procedure)"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 11,
"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": "706893006",
"display": "Victim of intimate partner abuse (finding)"
} ],
"text": "Victim of intimate partner abuse (finding)"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
}
}, {
"sequence": 12,
"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://loinc.org",
"code": "76499-3",
"display": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
} ],
"text": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"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"
} ]
}
} ]
}, {
"sequence": 13,
"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": "171207006",
"display": "Depression screening (procedure)"
} ],
"text": "Depression screening (procedure)"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 14,
"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": "454711000124102",
"display": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Two-Item score (procedure)"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 15,
"informationSequence": [ 6 ],
"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": "55757-9",
"display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
} ],
"text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"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"
} ]
}
} ]
}, {
"sequence": 16,
"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": "715252007",
"display": "Depression screening using Patient Health Questionnaire Nine Item score (procedure)"
} ],
"text": "Depression screening using Patient Health Questionnaire Nine Item score (procedure)"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient Hospital"
} ]
},
"net": {
"value": 28.90,
"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": 5.78,
"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": 23.12,
"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": 28.90,
"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": 28.90,
"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": 17,
"informationSequence": [ 7 ],
"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": "44249-1",
"display": "PHQ-9 quick depression assessment panel [Reported.PHQ]"
} ],
"text": "PHQ-9 quick depression assessment panel [Reported.PHQ]"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"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"
} ]
}
} ]
}, {
"sequence": 18,
"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": "428211000124100",
"display": "Assessment of substance use (procedure)"
} ],
"text": "Assessment of substance use (procedure)"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 19,
"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": "763302001",
"display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
} ],
"text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"locationCodeableConcept": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/ex-serviceplace",
"code": "19",
"display": "Off Campus-Outpatient 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"
} ]
}
} ]
}, {
"sequence": 20,
"informationSequence": [ 8 ],
"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": "72109-2",
"display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
} ],
"text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
},
"servicedPeriod": {
"start": "2023-04-06T18:15:30+02:00",
"end": "2023-04-06T18:53:01+02:00"
},
"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": 1092.03,
"currency": "USD"
}
} ],
"payment": {
"amount": {
"value": 3156.3440000000005,
"currency": "USD"
}
}
},
"request": {
"method": "POST",
"url": "ExplanationOfBenefit"
}
}, {
"fullUrl": "urn:uuid:89f01872-ea73-282f-04f7-878182f3d7fb",
"resource": {
"resourceType": "Provenance",
"id": "89f01872-ea73-282f-04f7-878182f3d7fb",
"meta": {
"profile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-provenance" ]
},
"target": [ {
"reference": "urn:uuid:0759e805-61d1-ba2b-8b14-9e4308784a84"
}, {
"reference": "urn:uuid:ecf5f7fe-6da5-135c-62f2-478efe3f0630"
}, {
"reference": "urn:uuid:e9214315-227b-d244-b5c1-a2d8c29c565e"
}, {
"reference": "urn:uuid:15f087e1-b14e-f080-9e6c-4ed645c9855e"
}, {
"reference": "urn:uuid:14e991b9-6414-08bf-7946-f1ba1771d06e"
}, {
"reference": "urn:uuid:283d8230-d679-5da6-0078-f2814f1e0042"
}, {
"reference": "urn:uuid:7a221c7c-7a79-7425-9f37-7b3e55fbf7ea"
}, {
"reference": "urn:uuid:5a5dc2fb-d7b1-bacc-95c1-bb8ec92bacbe"
}, {
"reference": "urn:uuid:a9b2431e-7f68-5034-3e83-d79b3718c736"
}, {
"reference": "urn:uuid:ec132001-972a-5eb1-3464-af51b100ed19"
}, {
"reference": "urn:uuid:36d9b422-e4c3-f63e-09a5-105707781240"
}, {
"reference": "urn:uuid:32cffbc5-fbe5-71ca-5cbe-b470cfe887d0"
}, {
"reference": "urn:uuid:10c79f7c-ebaa-22e6-0210-e4b49c210387"
}, {
"reference": "urn:uuid:18430b69-9b66-4c24-cf48-12f3e59009a7"
}, {
"reference": "urn:uuid:99c6d263-f40a-3404-6f7c-d9f329482f8e"
}, {
"reference": "urn:uuid:d33a81e2-1f4d-8ce5-b67e-3179155c6d8e"
}, {
"reference": "urn:uuid:69b0a09c-c3f1-573b-15a1-98cb9d58b1d0"
}, {
"reference": "urn:uuid:35d057bd-1db3-2ea8-90be-13303678eb61"
}, {
"reference": "urn:uuid:f8ca14b3-4fa7-810b-989c-5ece7a110a1b"
}, {
"reference": "urn:uuid:b6421bf5-1563-65fe-db57-7ab6f0e5e9c3"
}, {
"reference": "urn:uuid:c29b832b-be6c-947d-d6b9-ac546562a359"
}, {
"reference": "urn:uuid:bc5260c6-8e03-40ad-8647-188e736c1e98"
}, {
"reference": "urn:uuid:5ce5ff1a-6d7d-86a1-64f0-8ed66a353718"
}, {
"reference": "urn:uuid:42d57e75-711d-fdec-a646-d06d96205450"
}, {
"reference": "urn:uuid:09590c89-5201-9f82-00b6-b878a68c1bde"
}, {
"reference": "urn:uuid:f88974d2-0636-c2b5-c8c1-f354856e08dd"
}, {
"reference": "urn:uuid:d38ff67e-d693-ac03-2e0f-bc3ecdd63232"
}, {
"reference": "urn:uuid:74aee4ba-3f6a-f1ff-c0af-5e177f886eda"
}, {
"reference": "urn:uuid:d5aeb0e3-65fc-2ed2-202a-34613fa8b15c"
}, {
"reference": "urn:uuid:0355d21c-df0e-a24c-8bf1-f1e77471e54a"
}, {
"reference": "urn:uuid:38970323-346c-acd6-f6f2-db5eb8fc0936"
}, {
"reference": "urn:uuid:1fe20dbc-eebf-6477-61c4-a0475e205238"
}, {
"reference": "urn:uuid:eff102b4-d72a-bfa8-f75f-0cc3ebbf1323"
}, {
"reference": "urn:uuid:af7f23f5-59ca-ad14-5120-cde92cdbe032"
}, {
"reference": "urn:uuid:bd317e58-5b2b-254c-833d-6415dee36e42"
}, {
"reference": "urn:uuid:35039fc8-332d-9815-3b94-aec207f33b47"
}, {
"reference": "urn:uuid:5ee3e334-4ddc-cb64-119c-10e29ed254be"
}, {
"reference": "urn:uuid:c0c590ed-0d31-3da5-8260-750a8f73c11b"
}, {
"reference": "urn:uuid:f3591df5-a52e-b93f-d0b7-ac274bcf9aaf"
}, {
"reference": "urn:uuid:34658444-f6b8-6261-74f3-5d6c8999fc81"
}, {
"reference": "urn:uuid:139ea944-18f8-b0ea-7be8-cca5e3e48ecb"
}, {
"reference": "urn:uuid:62934773-8841-5b27-7676-386cc8923a61"
}, {
"reference": "urn:uuid:6839c1ee-d271-f10b-f2d2-44af76bcd5c8"
}, {
"reference": "urn:uuid:6163e744-5cde-0a93-6f53-fe177b270cfb"
}, {
"reference": "urn:uuid:5c1017e1-0ccd-b5fd-0222-1e7eb5f53c1b"
}, {
"reference": "urn:uuid:e5f40230-457d-d068-938f-b142fc03779e"
}, {
"reference": "urn:uuid:96b63773-69bf-4b6f-caaa-c0d6ed30c19a"
}, {
"reference": "urn:uuid:012e5304-4c54-58e6-540e-79ff3ad45518"
}, {
"reference": "urn:uuid:339f683b-2cef-6673-c18d-a542604b897c"
}, {
"reference": "urn:uuid:3c0480fc-672c-1b17-ca73-ed858082256a"
}, {
"reference": "urn:uuid:f801cea9-362b-a461-50c1-c52157eff68c"
}, {
"reference": "urn:uuid:752292d6-f615-6e83-c039-974df3a8fc7b"
}, {
"reference": "urn:uuid:45bb8b49-907f-6e2b-3d94-c73e75131374"
}, {
"reference": "urn:uuid:93855b44-b3df-75e7-b170-3a4701c9ee7a"
}, {
"reference": "urn:uuid:46e99e40-79e2-6f80-9d59-b87b122ca0f2"
}, {
"reference": "urn:uuid:084c110b-2454-e19e-f1ad-78d034c89b91"
}, {
"reference": "urn:uuid:9d8025de-211a-81c2-6bc9-9575172962e7"
}, {
"reference": "urn:uuid:9f14eeeb-08e5-e35b-984d-20bae6bcf879"
}, {
"reference": "urn:uuid:b721d3de-719c-97e6-86bd-002b54c84032"
}, {
"reference": "urn:uuid:25470208-818e-4cbd-8246-a10327d47e35"
}, {
"reference": "urn:uuid:18da592a-65b5-76c8-04f8-1152a207c81e"
}, {
"reference": "urn:uuid:83512e59-9b7b-c9e6-15db-9dba893d0bc9"
}, {
"reference": "urn:uuid:78305e76-4823-1027-0c08-4eed02910f63"
}, {
"reference": "urn:uuid:057017a3-c26d-214b-2a3e-61135963302c"
}, {
"reference": "urn:uuid:486cf3e7-7159-7e2c-f9f9-486b99cf2c97"
}, {
"reference": "urn:uuid:23cae86c-9324-9e87-6b7f-743d556d7008"
}, {
"reference": "urn:uuid:b3592d07-d824-c642-2777-91b2ac40f9f6"
}, {
"reference": "urn:uuid:d30da092-0f4d-9be5-c0d9-1b997fe1974d"
}, {
"reference": "urn:uuid:801015e2-e16b-1834-29c4-eebb53443092"
}, {
"reference": "urn:uuid:27c6ffb0-6184-5a8a-3c5b-532b68f26499"
}, {
"reference": "urn:uuid:adf1ff74-1ea6-aadc-1e42-7818c1428318"
}, {
"reference": "urn:uuid:f981acae-64b6-7c45-2144-e75c400b21ff"
}, {
"reference": "urn:uuid:0aad4c58-ff27-ae12-cc89-7157d9232170"
}, {
"reference": "urn:uuid:b877e42a-204c-3f8e-eab7-b3c44ec636a4"
}, {
"reference": "urn:uuid:a0cb3230-cfef-9ddd-cffc-991f4a474332"
}, {
"reference": "urn:uuid:df374d74-18f2-da26-7716-7cc8e246aefe"
}, {
"reference": "urn:uuid:96ef4eef-83f9-2cb5-84b0-90d216839c16"
}, {
"reference": "urn:uuid:9fc1343a-e62d-42dc-f33c-3ba8f03c5770"
}, {
"reference": "urn:uuid:4de77f63-1eb2-7d61-55a9-d66e762d1f12"
}, {
"reference": "urn:uuid:3f912e23-cc8b-5143-3f0a-9d84ba9df1a0"
}, {
"reference": "urn:uuid:d62aa78d-aacc-47cb-b89b-bac37f48767e"
}, {
"reference": "urn:uuid:12e9619e-499f-8e93-9b71-8272c174aa42"
}, {
"reference": "urn:uuid:af3a63d7-7074-8e08-618e-cdce5283101e"
}, {
"reference": "urn:uuid:0ecea5a1-da92-4d76-037f-dc031221cd76"
}, {
"reference": "urn:uuid:e928c953-bc14-8f17-944a-3fc79313427c"
}, {
"reference": "urn:uuid:cc509a8c-6f43-feac-0790-b9134bee7277"
}, {
"reference": "urn:uuid:6913e291-38ea-bdc7-4839-33d5c42eb306"
}, {
"reference": "urn:uuid:0be3308f-8c52-cc2f-a32d-1d04c6ec6e7b"
}, {
"reference": "urn:uuid:93ac2fe6-9bc0-cf4e-1572-81cd525f0ea4"
}, {
"reference": "urn:uuid:7feea98c-f483-b086-e07e-0a54c4e8b6ec"
}, {
"reference": "urn:uuid:cd2a9350-00b9-b4a6-0aba-93c597c20a39"
}, {
"reference": "urn:uuid:43c2674f-6b56-16ab-437a-0f1159a189bc"
}, {
"reference": "urn:uuid:42f1caa1-104d-ebe5-120a-17f28cdcc64c"
}, {
"reference": "urn:uuid:bed5b5ca-8859-9f22-fac5-6bbae9e7f9d5"
}, {
"reference": "urn:uuid:8cdc585d-edb9-2542-68e0-40eb3491204b"
}, {
"reference": "urn:uuid:346ee6c2-d4e8-8854-2efb-c0a42c903c12"
}, {
"reference": "urn:uuid:4fd5c897-68ea-3cbc-d050-9bdd07cbd219"
}, {
"reference": "urn:uuid:1e15ab2b-669f-d822-2ab8-a5ce55b50820"
}, {
"reference": "urn:uuid:15439f01-c5ed-c40a-fad9-d216921a3bd9"
}, {
"reference": "urn:uuid:0df2f064-5e44-7672-190d-c08c7a38f3eb"
}, {
"reference": "urn:uuid:82d571b6-e2eb-c3fb-137a-6275614625f0"
}, {
"reference": "urn:uuid:33380ca1-b461-e538-aea3-754506f7433d"
}, {
"reference": "urn:uuid:04f008fa-23e0-1a3f-b4e0-412fe274fe59"
}, {
"reference": "urn:uuid:6c0af8b6-c5cf-01fa-45cb-a65c5570b348"
}, {
"reference": "urn:uuid:3d99a471-04d8-4e35-fb37-c7c3de74fdde"
}, {
"reference": "urn:uuid:d30b4127-cc14-59a0-258d-be576a17c334"
}, {
"reference": "urn:uuid:b726a886-e255-f6b1-2e59-8d815ffc6101"
}, {
"reference": "urn:uuid:2a002c1d-3028-ba28-7df4-47e820105ed9"
}, {
"reference": "urn:uuid:2dbd1e4c-ef4f-f1de-5847-8a465eb0dff2"
}, {
"reference": "urn:uuid:30c5f900-80ab-dbdf-0351-d103df87154f"
}, {
"reference": "urn:uuid:4267c847-afbf-c812-fdb1-aa5a440228c4"
}, {
"reference": "urn:uuid:84d08d2e-d5ee-ae04-1b65-421c16546add"
}, {
"reference": "urn:uuid:e9560c94-27cf-95ec-5760-1ba8bc2310f4"
}, {
"reference": "urn:uuid:180ba361-2e12-d725-b3e3-ded17e8b7bc7"
}, {
"reference": "urn:uuid:99b08787-ab80-dabf-6abd-ff0ffc2c758f"
}, {
"reference": "urn:uuid:15e368d7-e4cd-bec8-0201-2b5d361b3dfe"
}, {
"reference": "urn:uuid:25b19df7-3e7c-d61e-aff5-21585f26863f"
}, {
"reference": "urn:uuid:799e6738-5cdb-0458-f789-6123a6bf2358"
}, {
"reference": "urn:uuid:3571d926-35fd-d827-a3a2-b1de3ab8c2b0"
}, {
"reference": "urn:uuid:267c2e4a-b56b-5447-2bfe-bf4db1a71275"
}, {
"reference": "urn:uuid:875fd198-fa6e-091c-7bc0-861f5a3f3beb"
}, {
"reference": "urn:uuid:5a253f2f-1a7b-a19f-4983-6bbede0f0b25"
}, {
"reference": "urn:uuid:f2df27db-0f22-c0b7-4512-dfb0281f02d3"
}, {
"reference": "urn:uuid:2ce71ed1-f5b4-fb31-0791-96125beac8fc"
}, {
"reference": "urn:uuid:f92d2053-9c02-2821-22f1-ed4737dd1332"
}, {
"reference": "urn:uuid:d6fdd58a-2255-b686-9a4f-d5d36c2be048"
}, {
"reference": "urn:uuid:879b2554-87e9-0ea1-a5ae-e69418b416ab"
}, {
"reference": "urn:uuid:9acec9af-815d-03d9-ab3b-2dac54f096b1"
}, {
"reference": "urn:uuid:8c417014-604a-8150-513f-371a0f582058"
}, {
"reference": "urn:uuid:7fa3d4ea-5270-1115-c8d5-403503dba203"
}, {
"reference": "urn:uuid:877928db-02d4-6eab-b060-086e8dc7c09d"
}, {
"reference": "urn:uuid:9e8d6888-30c8-81da-3abe-2ade7d8f7194"
}, {
"reference": "urn:uuid:7d308f25-63ab-dfec-c7a4-3a3324566862"
}, {
"reference": "urn:uuid:d7985ee0-7a6b-3c79-7068-b17af07af84b"
}, {
"reference": "urn:uuid:d8b0bf00-6d9d-ac0d-f2e0-91fe11593d8e"
}, {
"reference": "urn:uuid:9df57034-e89d-ebeb-3609-02986c1fe112"
}, {
"reference": "urn:uuid:bb8d484c-03de-0f2e-214d-7fdc7f912da7"
}, {
"reference": "urn:uuid:301427db-51b7-f865-9f75-15f159e8395e"
}, {
"reference": "urn:uuid:1f72ab64-ff79-281f-ff1a-76aa24021ebf"
}, {
"reference": "urn:uuid:8793ad56-5644-5329-db8d-21f23c4c7d18"
}, {
"reference": "urn:uuid:3114bafd-a887-725d-ec6d-db89c66b4f05"
}, {
"reference": "urn:uuid:09f80eea-3425-b321-ec8a-995995137462"
}, {
"reference": "urn:uuid:e4c2be16-7d4f-9b1b-52cc-cd2b11a31623"
}, {
"reference": "urn:uuid:27775b4e-9607-9aa6-bb90-2a8326fd1db9"
}, {
"reference": "urn:uuid:a53a9d7d-5514-8e92-6716-c98db59681f1"
}, {
"reference": "urn:uuid:404579ff-bc16-574f-e03c-dc8d3ac82f49"
}, {
"reference": "urn:uuid:7f40a25f-f7c5-d090-0777-da6c4e98c5c3"
}, {
"reference": "urn:uuid:4f524ecd-a8cf-1c77-1564-e331a276d98a"
}, {
"reference": "urn:uuid:b660e41e-2f50-c8ab-ff71-3333b2127959"
}, {
"reference": "urn:uuid:feb6eaea-1dbe-0b27-9397-1c90b547fe64"
}, {
"reference": "urn:uuid:fc4c6dd4-889c-fc6a-1028-1344e10cd293"
}, {
"reference": "urn:uuid:f448b5ef-8d4d-938f-8dcb-6b6378cbc9bd"
}, {
"reference": "urn:uuid:79c0c399-f135-6245-140c-0d928754098c"
}, {
"reference": "urn:uuid:302f82c5-76f1-65a5-6da2-0ef28f4fbbe0"
}, {
"reference": "urn:uuid:58c6c09d-2a2b-859a-a8cd-be3104ea9278"
}, {
"reference": "urn:uuid:b5ecb804-77b2-7828-6361-ac2de93ea6bc"
}, {
"reference": "urn:uuid:86b98ac1-2061-8551-fa0b-73ebdb70d4c1"
}, {
"reference": "urn:uuid:4c9d36b9-5a68-4c71-473c-dbd3e0f8fc7c"
}, {
"reference": "urn:uuid:1db661c7-b745-7a7b-c979-bef7be608b77"
}, {
"reference": "urn:uuid:2191a01f-52c0-5d1c-52f4-580e7ef8b73e"
}, {
"reference": "urn:uuid:619fb6ba-39a4-d735-12d6-c0db15dfc8a5"
}, {
"reference": "urn:uuid:44ea56af-ff74-9b9a-b135-0fa0897dde2f"
}, {
"reference": "urn:uuid:1708b9cc-a9aa-d016-feff-57d50820f0b3"
}, {
"reference": "urn:uuid:79e8f45d-4968-5cb2-3e46-82153441fe3c"
}, {
"reference": "urn:uuid:45fc104a-5cff-6b36-04e2-2f583b377f31"
}, {
"reference": "urn:uuid:bea04569-5538-daf0-11b5-1b666eb789b5"
}, {
"reference": "urn:uuid:0680beeb-6182-ab22-ee8f-ce877513a0ce"
}, {
"reference": "urn:uuid:6afcff1d-8121-c461-4c8e-813260aebebf"
}, {
"reference": "urn:uuid:d83e1162-ae8c-885a-fc35-23f6ddf6ac09"
}, {
"reference": "urn:uuid:0c2dbe79-e84f-fe3a-1530-6d4040b4d037"
}, {
"reference": "urn:uuid:7be3d6ce-1d6d-a18d-18ad-4ee427e6fa2a"
}, {
"reference": "urn:uuid:be013d0e-b588-d32e-f84b-cec829354467"
}, {
"reference": "urn:uuid:f8db9b5c-dbb4-6985-be81-5f8c1e4587dc"
}, {
"reference": "urn:uuid:74274553-6b86-9351-302c-021fd48f70fe"
}, {
"reference": "urn:uuid:6e307fbd-01d2-d4b6-13f4-803150583c08"
}, {
"reference": "urn:uuid:b3e7dc0f-8cea-38cd-163f-647881c3b1b9"
}, {
"reference": "urn:uuid:1eb7c3f2-3553-442d-f8a4-3e11d79a7571"
}, {
"reference": "urn:uuid:8e2bde4a-3d78-66b9-ab87-241f4b3f5cba"
}, {
"reference": "urn:uuid:73f670fd-a68d-0554-5f28-ff45c5148df5"
}, {
"reference": "urn:uuid:f595e663-d3d2-6865-fcf4-1bef077ead03"
}, {
"reference": "urn:uuid:295a50f2-2fb5-d557-8f50-d5d895650102"
}, {
"reference": "urn:uuid:f17a6cde-900a-175c-2d00-665415887335"
}, {
"reference": "urn:uuid:afc35f43-71fd-2656-5ce2-32222180668f"
}, {
"reference": "urn:uuid:3285e310-3696-acb3-aeb0-b28b52ce4750"
}, {
"reference": "urn:uuid:805f8f4c-8270-131f-1a25-abd87af039cf"
}, {
"reference": "urn:uuid:2eb8d091-dbba-f1b1-fc6a-243e8a634325"
}, {
"reference": "urn:uuid:baf64dc5-708c-7639-c091-1ca242394749"
}, {
"reference": "urn:uuid:eff024bc-2a01-f624-5f51-12d40fd80c1e"
}, {
"reference": "urn:uuid:9083f77e-e75f-4e01-1f01-4c262800fdff"
}, {
"reference": "urn:uuid:917dfe83-d0e5-4434-d6b5-aefab186357d"
}, {
"reference": "urn:uuid:050502f6-472f-3a2b-0c8f-4d2004b2f130"
}, {
"reference": "urn:uuid:82d4e373-ff2b-735d-2b61-53199b6b1fa7"
}, {
"reference": "urn:uuid:b2ec6b24-022a-55f0-ac5b-cc121a102c06"
}, {
"reference": "urn:uuid:7b01102b-7804-a9d4-e9e2-c1247e2051e2"
}, {
"reference": "urn:uuid:f442da11-4ee2-ad8b-5ffd-338dcae832a4"
}, {
"reference": "urn:uuid:4667d279-6e93-6038-30de-c970dec13412"
}, {
"reference": "urn:uuid:740e0592-2683-e14b-c9bb-8c1a01d9c1f0"
}, {
"reference": "urn:uuid:c05d2e32-0de8-b335-35a7-f55dc34386f5"
}, {
"reference": "urn:uuid:e7f1019c-fb12-3a70-f452-51395c3f0372"
}, {
"reference": "urn:uuid:818e134b-396f-13d7-aab3-f55a94bd29f8"
}, {
"reference": "urn:uuid:2fd2a7e7-e576-92f0-ff3c-4df445946d10"
}, {
"reference": "urn:uuid:e12f2ada-a8fa-646d-29c0-fc10755ba324"
}, {
"reference": "urn:uuid:f9351122-8d48-bd31-cd73-56722cc4ac98"
}, {
"reference": "urn:uuid:6f204efb-0ebf-da52-c91c-b78e018748d6"
}, {
"reference": "urn:uuid:74342955-03c8-e2de-07ab-85ee448fd4e5"
}, {
"reference": "urn:uuid:aac062fb-c0f0-6331-945b-f85f9f6b046b"
}, {
"reference": "urn:uuid:7160ec77-5d08-1c04-048a-8c09e94b9500"
}, {
"reference": "urn:uuid:e78617d2-ae57-24de-df16-e7cf5ca0f7b8"
}, {
"reference": "urn:uuid:c765c4a5-cf85-41ca-bd87-11f600768001"
}, {
"reference": "urn:uuid:cb04c84e-aef9-604a-0475-dc0c92962bb0"
}, {
"reference": "urn:uuid:67381681-8a6e-6f8b-a421-a90aab875855"
}, {
"reference": "urn:uuid:68238db0-832b-9555-b384-2b40ef7c263b"
}, {
"reference": "urn:uuid:afc635c4-8d4d-f9e4-1a1a-f43eb7b50ac6"
}, {
"reference": "urn:uuid:2842795b-b1b8-da6a-257c-abb6edc59e46"
}, {
"reference": "urn:uuid:10142431-da04-0b37-55be-d68db35aa4ac"
}, {
"reference": "urn:uuid:4bb4ca26-9bdf-e193-201b-bb6615b949cb"
}, {
"reference": "urn:uuid:57da79b5-845c-4885-13fa-5401976e5c46"
}, {
"reference": "urn:uuid:b2d01746-a5c9-7206-dc7d-378d7db0457b"
}, {
"reference": "urn:uuid:97dc94ac-83a1-2df8-27ba-7d8c81e79498"
}, {
"reference": "urn:uuid:d6b0f307-af18-d494-fb92-f75a81548802"
}, {
"reference": "urn:uuid:e72ab75d-8b76-7285-704f-a48f337153be"
}, {
"reference": "urn:uuid:b91a16b8-341d-f018-eb2a-45c77ce269b3"
}, {
"reference": "urn:uuid:20bb8f49-39ab-c282-d548-f263d7cc5485"
}, {
"reference": "urn:uuid:0559355b-8090-4770-c84a-cd71442a8bcf"
}, {
"reference": "urn:uuid:682b6dc3-2c57-11fe-4c60-596f13ae1422"
}, {
"reference": "urn:uuid:4109e540-a9a7-a07b-e5a9-344fa455995f"
}, {
"reference": "urn:uuid:4506ce53-9413-164e-0f7f-5c6b7555518a"
}, {
"reference": "urn:uuid:0695d40b-8431-fc6b-3870-69980d1e672b"
}, {
"reference": "urn:uuid:ba0e1726-a26d-72b3-c2e9-221135efb555"
}, {
"reference": "urn:uuid:b4c874f4-330e-8258-c3aa-112bf1be194e"
}, {
"reference": "urn:uuid:f1cc8416-e7b7-7332-abe9-00937228097d"
}, {
"reference": "urn:uuid:d8391c25-0e09-fc50-29bb-addf3b93d75b"
}, {
"reference": "urn:uuid:2d8add4f-17b7-4650-9e69-d80d738f81d6"
}, {
"reference": "urn:uuid:9b48399c-7b2d-5375-3579-1e9659bf8140"
}, {
"reference": "urn:uuid:f7716e02-b501-07d9-a79e-f1b3de32f9d6"
}, {
"reference": "urn:uuid:1bf538ae-b7fa-cfc1-e4b5-f72ebfc8d7de"
}, {
"reference": "urn:uuid:c90ff7f7-1a67-459a-d764-9d65c85b5c79"
}, {
"reference": "urn:uuid:5b400ea0-5da7-3800-90ae-5669d37c22a3"
}, {
"reference": "urn:uuid:4aeda98a-3c63-ba6a-3baf-2991d719bb91"
}, {
"reference": "urn:uuid:719d456e-69ff-0096-8f60-7ddde75e3682"
}, {
"reference": "urn:uuid:c39de5a5-f4f6-64a0-e3de-1c5ce90b877a"
}, {
"reference": "urn:uuid:f02ad92b-b193-aa94-5f8b-c6ecf3763d1f"
}, {
"reference": "urn:uuid:64117db3-8d0c-2142-78a5-d12e947a2b51"
}, {
"reference": "urn:uuid:516aa582-406e-eb68-5de1-d83bdfe078d5"
}, {
"reference": "urn:uuid:f24dc453-27d6-daf2-632c-bf1183af1679"
}, {
"reference": "urn:uuid:a80df190-68b6-6d0d-85c8-c21d0680a459"
}, {
"reference": "urn:uuid:3e5863c4-88bf-fea4-2669-1a360e16c2dc"
}, {
"reference": "urn:uuid:22ace0d7-be69-f631-36cb-0a006560050d"
}, {
"reference": "urn:uuid:7efdd590-c372-8b5c-2f74-b631b4bbd094"
}, {
"reference": "urn:uuid:a412dcf3-1ace-cbee-a68b-8ec14cf92b5c"
}, {
"reference": "urn:uuid:917dff6f-48e5-6056-ae35-afe655d55584"
}, {
"reference": "urn:uuid:7cac62e1-e89b-44a3-d6ca-b8c99465cecd"
}, {
"reference": "urn:uuid:536604cc-425a-7c5e-5b9f-46521616f905"
}, {
"reference": "urn:uuid:6e6afa43-1cbc-a80c-99c6-f08f2a4d2db1"
}, {
"reference": "urn:uuid:901d577e-b38e-f736-2176-cc240d76971f"
}, {
"reference": "urn:uuid:efa8adcd-83fe-1728-5096-c7b79f9b1098"
}, {
"reference": "urn:uuid:146047ed-8de5-4d09-2374-dc4108ecbb13"
}, {
"reference": "urn:uuid:00231651-3826-273b-3b93-66c9dcc8c313"
}, {
"reference": "urn:uuid:597f2b1a-4e87-17c1-b6b4-8a25a455f5c5"
}, {
"reference": "urn:uuid:5ea9a0de-5f60-e687-53b7-6f5b17115d94"
}, {
"reference": "urn:uuid:ba2493e7-16ce-3cb0-78eb-99fc23a74828"
}, {
"reference": "urn:uuid:c8d077de-f032-b9e4-7902-9dd472145378"
}, {
"reference": "urn:uuid:04250566-5e9a-29b0-9a86-0a144482aa3d"
}, {
"reference": "urn:uuid:e8a2bb4e-e912-3076-4b78-135bbd64c02f"
}, {
"reference": "urn:uuid:4608eb46-caba-e795-038c-a24bd24531bf"
}, {
"reference": "urn:uuid:f23000b4-2aed-852c-4481-56a048a5ad69"
}, {
"reference": "urn:uuid:991abcea-6ac8-4fd6-ff39-baf4646600e1"
}, {
"reference": "urn:uuid:22f12e89-ee94-58c1-08ea-9deadcae6ac6"
}, {
"reference": "urn:uuid:5165191d-c028-dabb-7b8f-f3e35663db26"
}, {
"reference": "urn:uuid:979a7c6c-6e85-6bd7-b48b-6d8fcc459bae"
}, {
"reference": "urn:uuid:393ad0d5-d8b9-cb90-2cd0-7d64f13abf22"
}, {
"reference": "urn:uuid:a1bce00d-1732-7413-8132-ccd1deb9c75d"
}, {
"reference": "urn:uuid:6dcc4ab2-50fb-5ece-0f8e-89746d5d4de1"
}, {
"reference": "urn:uuid:af45b1c5-a737-5f6b-0eb8-02647a60b225"
}, {
"reference": "urn:uuid:ff77c6fa-2170-5606-dae3-a3002b34e55d"
}, {
"reference": "urn:uuid:987a35c1-c8fa-f90d-1e80-5a5326e1c4c1"
}, {
"reference": "urn:uuid:03fc4d08-f8f1-3da7-a1f3-a64b206e73d2"
}, {
"reference": "urn:uuid:5b30ea26-d3aa-64ff-d146-1a9c2140a2a3"
}, {
"reference": "urn:uuid:319a550b-5049-b8f5-8a96-f705b8e3cb56"
}, {
"reference": "urn:uuid:263e35ee-a771-5ee9-8f9b-55de0f17e2f1"
}, {
"reference": "urn:uuid:3bb82130-3cbd-c3b3-cc6b-b3be4bfed133"
}, {
"reference": "urn:uuid:0af7d745-c419-b133-e16c-2a3b1253a27f"
}, {
"reference": "urn:uuid:a5711259-19f0-9ad3-93fb-1eb0256e5dd6"
}, {
"reference": "urn:uuid:af0e8903-28d2-e2ff-cab9-0ca99fdb0968"
}, {
"reference": "urn:uuid:db0bd959-fb14-83d4-3798-12853383e46e"
}, {
"reference": "urn:uuid:5554a02d-71e1-0f17-d045-24559464ea36"
}, {
"reference": "urn:uuid:a727408c-437b-3968-9237-090aff8bf27f"
}, {
"reference": "urn:uuid:61aa584d-70d3-ddf5-55ad-5bb4fcafa660"
}, {
"reference": "urn:uuid:2ae41665-b6d6-b3a5-26d3-0002f8eee435"
}, {
"reference": "urn:uuid:33a1702f-abe6-4dd5-263f-64656c391258"
}, {
"reference": "urn:uuid:99d5a8a4-260b-3a0d-d222-2571c332c595"
}, {
"reference": "urn:uuid:77005040-462b-24bb-b56e-6aec5fbb45a1"
}, {
"reference": "urn:uuid:9c372c35-48c0-c20e-232b-fb8d26b75c0a"
}, {
"reference": "urn:uuid:97b2e564-6128-4153-4eb5-3975a6c5af95"
}, {
"reference": "urn:uuid:6bee6a68-9989-0011-ad60-67e93e7a1ffb"
}, {
"reference": "urn:uuid:1184c8d9-b5d3-9921-67ca-77d58415dca8"
}, {
"reference": "urn:uuid:3c553657-6708-be71-6506-cfcbab7c7560"
}, {
"reference": "urn:uuid:21309549-b87d-b070-f048-5fa018c5bcc0"
}, {
"reference": "urn:uuid:405d709a-115b-5685-0e30-b318a123dc8d"
}, {
"reference": "urn:uuid:7fc408bd-f545-8b33-e663-3eaa1308cee6"
}, {
"reference": "urn:uuid:c243a2d5-e0da-e081-be69-3a0ab7f2f0e5"
}, {
"reference": "urn:uuid:8cfbc363-4278-5f95-5fff-7b2677817981"
}, {
"reference": "urn:uuid:43259541-5aa8-4ad6-00a9-4da9d1151ebc"
}, {
"reference": "urn:uuid:52902248-3275-2522-b386-4ce22bca4110"
}, {
"reference": "urn:uuid:b0113b45-6461-ef0d-998e-0f2d46089859"
}, {
"reference": "urn:uuid:3190ee21-4f55-24a9-668a-5d823d6f4244"
}, {
"reference": "urn:uuid:b987e74e-67f2-2de8-91a4-fcf095247ab7"
}, {
"reference": "urn:uuid:f49e1f8c-8b0d-64b6-55cd-85d0d88a0306"
}, {
"reference": "urn:uuid:b9946e95-51c4-e626-41eb-47704f13388e"
}, {
"reference": "urn:uuid:bd497c3a-5ced-a4d2-f861-a63d7f87200e"
}, {
"reference": "urn:uuid:29a2671c-eef9-045c-6b84-f9a75e59f21d"
}, {
"reference": "urn:uuid:3e701902-d9f5-bda6-45de-2311ee8a1121"
}, {
"reference": "urn:uuid:86c05e88-24eb-57eb-459d-b7714162eade"
}, {
"reference": "urn:uuid:5bc3f776-47fe-bbc1-d230-cb5c05827429"
}, {
"reference": "urn:uuid:e3aa3c41-0d55-26c3-446c-a510a3aa9081"
}, {
"reference": "urn:uuid:29b46b86-5c17-fe14-31d6-e4db0b6ff73d"
}, {
"reference": "urn:uuid:2446d071-1abd-a2ab-ac98-d410a4519816"
}, {
"reference": "urn:uuid:43d6726a-df9e-37b3-2a4a-a6d4d57c7187"
}, {
"reference": "urn:uuid:81eae32b-e649-9fe5-02ed-f0520f7e1f6e"
}, {
"reference": "urn:uuid:817a695e-1300-fa33-f8d1-6175f6fd7da8"
}, {
"reference": "urn:uuid:6581a337-32ee-0fbb-ae80-8200895690b8"
}, {
"reference": "urn:uuid:9e38c33d-fd75-d4ef-e03d-680b8770e43a"
}, {
"reference": "urn:uuid:06fc1dd9-d811-4c9a-860e-425ed1e6d8a9"
}, {
"reference": "urn:uuid:d77bc978-b8de-65be-c38b-a72633cf4e1c"
}, {
"reference": "urn:uuid:7bf5c471-15a8-657f-6c18-cbe770686c00"
}, {
"reference": "urn:uuid:07823ae7-876f-a4a2-96ab-64cef99f0604"
}, {
"reference": "urn:uuid:04b2b8a6-29ae-dcac-9a31-d92169d27c50"
}, {
"reference": "urn:uuid:28e4c333-eda6-3f70-d078-71d3425b888e"
}, {
"reference": "urn:uuid:90e90893-1bd8-5674-c5ff-a5c55a10d5f7"
}, {
"reference": "urn:uuid:5eb607c5-4fdd-59be-b7de-ef2401e81445"
}, {
"reference": "urn:uuid:a7567733-c4b5-dc7e-439e-746a4e58ec3d"
}, {
"reference": "urn:uuid:9ffadb59-8b16-2a4a-febc-b6dc0edb4f5f"
}, {
"reference": "urn:uuid:3ecbfe5c-ef88-6bc4-67f4-a552fe647fe2"
}, {
"reference": "urn:uuid:1482c330-777a-e7a2-df53-e8e83d105d1a"
}, {
"reference": "urn:uuid:143ccba6-9e4b-c0b0-bbd2-4a0276874739"
}, {
"reference": "urn:uuid:874a185b-2414-ec0d-d0b1-c689449b91ed"
}, {
"reference": "urn:uuid:046c846c-ea6b-00cb-40ef-fc9025d2a2dc"
}, {
"reference": "urn:uuid:5acad755-4fd0-0004-1463-a3ad8ed62f8d"
}, {
"reference": "urn:uuid:197b59b5-1c9b-f662-0f8a-35c93ac51f09"
}, {
"reference": "urn:uuid:4b807edc-2e51-e441-94c5-b68ca5328532"
}, {
"reference": "urn:uuid:5454974a-ad03-e3b6-7b77-f25106044963"
}, {
"reference": "urn:uuid:427b7bd1-dcdd-2bf0-d971-8ab3802b6093"
}, {
"reference": "urn:uuid:5c7cfa27-c15a-cd94-4ec3-034e4daed6bc"
}, {
"reference": "urn:uuid:6b0c2ffa-8ca2-34cd-4720-4e23b5492adc"
}, {
"reference": "urn:uuid:4009cfee-5cdc-4032-97ba-46cefdcd8977"
}, {
"reference": "urn:uuid:f69ebf8f-d700-3528-0b6c-9a97812e0e17"
}, {
"reference": "urn:uuid:5e655e9e-5f6f-1ecb-8add-45bb171f95d8"
}, {
"reference": "urn:uuid:54a39803-576e-2e43-bfc4-302534711c0c"
}, {
"reference": "urn:uuid:f8de6eab-88e3-a31d-211a-c0fcdecfc0d6"
}, {
"reference": "urn:uuid:bec95ebd-ac4c-f6e8-1fb7-1fff8edf8158"
}, {
"reference": "urn:uuid:fd914d7c-31d6-e6c6-1a35-8b3216cd9164"
}, {
"reference": "urn:uuid:30979f5c-eba7-30d9-3051-3c149c1e3e1c"
}, {
"reference": "urn:uuid:0c02e7f6-0df9-ac8c-823e-0bdd3904bd74"
}, {
"reference": "urn:uuid:dff9057c-5163-c21a-35ce-6c8ad8a0b52d"
}, {
"reference": "urn:uuid:885b3e59-2191-672e-12a5-6816a5486c36"
}, {
"reference": "urn:uuid:c0184b5d-cd48-71e5-7840-87b01e9e5e03"
}, {
"reference": "urn:uuid:b06dab2a-cd44-f00f-01ff-df06dd22b36a"
}, {
"reference": "urn:uuid:857cf9cb-c26c-e571-2f8d-872f5962f453"
}, {
"reference": "urn:uuid:49248bb8-359b-8420-0253-682d67d98736"
}, {
"reference": "urn:uuid:3de73043-5073-2fbc-6ca8-53e40e56b64f"
}, {
"reference": "urn:uuid:dc49bb66-4d0b-4995-501a-5da69f9146db"
}, {
"reference": "urn:uuid:84ff0963-be14-22e2-5d88-c789f96085a0"
}, {
"reference": "urn:uuid:bb4af66c-ef90-2d8a-fd2d-88f75ef11b4b"
}, {
"reference": "urn:uuid:7bc5dd90-1e70-3da9-8333-e79f33049124"
}, {
"reference": "urn:uuid:a7e76f40-e09b-25db-62ff-4f65d12ae43a"
}, {
"reference": "urn:uuid:8904c46d-582c-bf72-bef0-e230c7746bed"
}, {
"reference": "urn:uuid:3e023371-4077-7c02-0c19-23d5f89f3210"
}, {
"reference": "urn:uuid:db6175db-b452-58c3-eaf6-0d119de07d50"
}, {
"reference": "urn:uuid:aa03cf1d-ea75-63d8-882b-b6ed14d2525b"
}, {
"reference": "urn:uuid:ed686b5f-beaa-cf1f-7a0c-1e1a4f3dd901"
}, {
"reference": "urn:uuid:f67f2f00-4c1e-ca31-5163-efe0f906b400"
}, {
"reference": "urn:uuid:39bbdd07-213b-bcbb-8d26-1754fa79b006"
}, {
"reference": "urn:uuid:c0389331-1ef2-41b7-107f-c06a4f6e37c8"
}, {
"reference": "urn:uuid:c148b970-4b67-e392-af0c-6ddde033241e"
}, {
"reference": "urn:uuid:8690ed6b-8174-2f47-ee3f-7287fce84ca0"
}, {
"reference": "urn:uuid:dc0c7ddf-68b1-59c4-2da8-94434594f819"
}, {
"reference": "urn:uuid:c759f180-4265-0fd4-faaa-c58efd6f6980"
}, {
"reference": "urn:uuid:103de47d-b72c-e399-6c1d-9fdb32aab6cc"
}, {
"reference": "urn:uuid:780517f1-d3d0-4f1e-adbb-36b6de3313eb"
}, {
"reference": "urn:uuid:661cb4a7-593f-8b42-2a34-c5204c561b69"
}, {
"reference": "urn:uuid:a1c35701-fb61-ebce-795f-d79d13206ec0"
}, {
"reference": "urn:uuid:f5c46931-aad5-ff92-3d14-539330ec4d20"
}, {
"reference": "urn:uuid:43526ca6-08d1-0ecd-7f13-1fd8037c5271"
}, {
"reference": "urn:uuid:4fb7e6bf-3e0d-9bd1-4b56-42854e54a298"
}, {
"reference": "urn:uuid:6fdde4c7-1a8e-c9e7-56e4-880ec96504f9"
}, {
"reference": "urn:uuid:5fe763bf-b19c-d04b-01a8-18826818e654"
}, {
"reference": "urn:uuid:73349095-3123-3318-b2b7-296d67573d8f"
}, {
"reference": "urn:uuid:6d73d9ee-ad17-d67a-214f-f709d2d905a4"
}, {
"reference": "urn:uuid:6504e999-96ca-975c-9d8e-aa06de5d87e6"
}, {
"reference": "urn:uuid:e8c46bb9-7c06-be12-c19d-3d4c8368bcc8"
}, {
"reference": "urn:uuid:12728529-a027-51b0-c2bc-4311179c3784"
}, {
"reference": "urn:uuid:e4e95fdb-ce58-d97e-ef1c-8d449fc350bd"
}, {
"reference": "urn:uuid:b00ebd8d-ff38-be89-24e3-c265ccbf0fc2"
}, {
"reference": "urn:uuid:3d6b78fa-e735-b7d1-bb53-9f0772da1f01"
}, {
"reference": "urn:uuid:2a7427f4-bbb8-0dd0-133d-61d1134dac03"
}, {
"reference": "urn:uuid:12781d92-0d5b-fa92-f309-8e83f45bee5e"
}, {
"reference": "urn:uuid:5a09ec64-85d7-ccff-cc40-36ea690bcf07"
}, {
"reference": "urn:uuid:cd574841-155d-902d-3b42-de3e53950bad"
}, {
"reference": "urn:uuid:775217cd-ed3e-0353-466d-cf3a6daf65ea"
}, {
"reference": "urn:uuid:5a7c7745-05eb-ed01-6706-e4fcfe5fd69b"
}, {
"reference": "urn:uuid:b24cc530-3de6-96e6-f18f-e06fb8edef53"
}, {
"reference": "urn:uuid:17f029cf-8b84-0171-73c8-655673cc716f"
}, {
"reference": "urn:uuid:59906b55-0700-1c3c-232c-8f9db2084794"
}, {
"reference": "urn:uuid:4bd70ad6-6a1c-a342-ddfc-d2923d068e7b"
}, {
"reference": "urn:uuid:d44d8d2b-27db-50f2-bc95-fd2983b38c79"
}, {
"reference": "urn:uuid:75a27585-f2f9-a9e8-1694-4feba74f96c7"
}, {
"reference": "urn:uuid:5e8bbe74-2d0c-f684-f0ef-73da0b01af99"
}, {
"reference": "urn:uuid:6104e9bd-7f40-56de-2479-0df57e7642fc"
}, {
"reference": "urn:uuid:4c61d21c-ab31-f00e-4bad-a24c76d1001d"
}, {
"reference": "urn:uuid:f1224b20-5ff8-ce6f-a250-0797d13ab43c"
}, {
"reference": "urn:uuid:f01c6ca2-6450-3d6a-6d18-fd92182e5d14"
}, {
"reference": "urn:uuid:87b10633-7f48-412a-416d-8dcc7c5a245a"
}, {
"reference": "urn:uuid:b926550f-5265-296f-bf0c-081d6e213507"
}, {
"reference": "urn:uuid:9f454adf-fd66-4c5e-564a-526a479009e2"
}, {
"reference": "urn:uuid:89110fdd-792e-1ade-defd-2d95a16a6d2f"
}, {
"reference": "urn:uuid:7d26ae9d-fb12-3be9-5388-5afbbd4b5888"
}, {
"reference": "urn:uuid:40429be7-b1f5-83e7-c035-faa98e2cc62a"
}, {
"reference": "urn:uuid:453daa6d-b332-83be-fe0e-7643b2a5d1de"
}, {
"reference": "urn:uuid:cbd82f1a-137c-2447-b31e-3c0ab0656971"
}, {
"reference": "urn:uuid:fb2cab63-7b3c-e2f2-08cd-93e1d83f5b85"
}, {
"reference": "urn:uuid:8842a1cf-e239-385c-388e-cfa3cd93beb7"
}, {
"reference": "urn:uuid:4b882e74-0c62-df6a-c79c-5077f98780af"
}, {
"reference": "urn:uuid:2af461b9-aba0-cf9b-22bd-b1c6e5ce4a43"
}, {
"reference": "urn:uuid:7907567b-7186-c598-3bc3-54df0403a4a4"
}, {
"reference": "urn:uuid:620b9f29-9cdc-cba5-2c22-98a9e2e7ab51"
}, {
"reference": "urn:uuid:1c542cef-b03c-f478-f86d-93c6c5441c53"
}, {
"reference": "urn:uuid:037ef59b-e0ea-572b-ff7f-004fe6a22711"
}, {
"reference": "urn:uuid:684c3d67-d88a-3a35-cd89-c568a5e5c373"
}, {
"reference": "urn:uuid:ab27c417-c738-7b8d-07bd-57a91a035877"
}, {
"reference": "urn:uuid:46f8cdde-9200-fdb3-8a48-26565edf41b6"
}, {
"reference": "urn:uuid:b9a9394e-c4f8-d7a1-1889-b4afc66931d8"
}, {
"reference": "urn:uuid:b1e3dd1e-7e3a-5940-8950-b7554da68e26"
}, {
"reference": "urn:uuid:f7347e2c-3e38-631d-4d13-23e6c3ce6f5c"
}, {
"reference": "urn:uuid:d522a1c4-69c3-055c-11a5-16eb77e45bc3"
}, {
"reference": "urn:uuid:ebb0c021-6142-99ec-ffdd-b3f3727c0e7f"
}, {
"reference": "urn:uuid:2ceb1620-fc88-a490-0d1f-6616564f0d07"
}, {
"reference": "urn:uuid:578b62ad-d31a-4d31-0726-cedbde7c0533"
}, {
"reference": "urn:uuid:c75a4738-da92-376f-d8f8-753a788fcd00"
}, {
"reference": "urn:uuid:e471e01d-8ade-aacb-dbe5-d9a26f92c4e6"
}, {
"reference": "urn:uuid:3a1a886a-bd50-c361-9e28-b3666ad43197"
}, {
"reference": "urn:uuid:504fb7e6-ae3f-a81d-6322-464db27d3a58"
}, {
"reference": "urn:uuid:d4e853e5-dfb0-3676-0f80-a695c76ff37d"
}, {
"reference": "urn:uuid:c4ebc494-4c84-3f21-4bcd-9fdd4b4a1c16"
}, {
"reference": "urn:uuid:b56b52c2-9da5-5445-0074-0fb3a225bd2c"
}, {
"reference": "urn:uuid:b8cdf264-7aba-e50d-ab52-bebcb8622620"
}, {
"reference": "urn:uuid:19c83c29-8f5b-43ad-9626-2ba8cbdfa508"
}, {
"reference": "urn:uuid:d15be174-5e9b-2323-80ac-ceceffe064ac"
}, {
"reference": "urn:uuid:1c3cfd70-3463-286a-13f3-ff8fc81d7d3f"
}, {
"reference": "urn:uuid:76da252f-7fb8-13d7-1061-a790554c409b"
}, {
"reference": "urn:uuid:cd655edd-0bce-eb04-a1b6-e0100522da3d"
}, {
"reference": "urn:uuid:ccf8b1cf-1a12-80b9-1044-6690f1cecb63"
}, {
"reference": "urn:uuid:25804cc2-e134-6fca-7a3b-e6a682554cb7"
}, {
"reference": "urn:uuid:937b3d63-611f-f447-f0b1-4a075e857ffe"
}, {
"reference": "urn:uuid:ed42ce16-d69a-7f75-2353-cda398f9678f"
}, {
"reference": "urn:uuid:d17f3cef-b57d-cfa9-99eb-897dea34a9e7"
}, {
"reference": "urn:uuid:0e22d2f4-1c53-d407-fd6f-ea96e69c911d"
}, {
"reference": "urn:uuid:a09117f3-25ef-27d0-d9c8-938361aff0c0"
}, {
"reference": "urn:uuid:db860404-8ddb-77a4-4200-fbba39a2abaf"
}, {
"reference": "urn:uuid:06352398-1d60-1f4d-d115-8941772b7ac6"
}, {
"reference": "urn:uuid:f90b5fee-cc34-908a-7bb1-de3347026431"
}, {
"reference": "urn:uuid:9a757fb3-3c67-7e37-d71d-4b2e43d86a2d"
}, {
"reference": "urn:uuid:9eb0fefa-2ccb-7cdf-2fba-59e2162a6f7f"
}, {
"reference": "urn:uuid:f84d3698-6cfc-a1c8-ade0-30e802aaaea9"
}, {
"reference": "urn:uuid:fe9008b5-a4d8-5805-f12f-3ea1c29c07de"
}, {
"reference": "urn:uuid:41a744dc-c38d-4969-d654-b4d307698046"
}, {
"reference": "urn:uuid:48364dfa-b01a-9010-437e-514dcf2fde31"
}, {
"reference": "urn:uuid:387800b8-b6a2-851a-2b17-36a4d46634f3"
}, {
"reference": "urn:uuid:faa07a23-187b-8b5a-4907-805b76723c35"
}, {
"reference": "urn:uuid:463d9b33-a74d-cdfb-44e7-63ff4121e025"
}, {
"reference": "urn:uuid:d4b44239-46c7-9f36-7f43-0514491a0a34"
}, {
"reference": "urn:uuid:cd79c20b-b493-9efa-390e-751d2a77938a"
}, {
"reference": "urn:uuid:c6fd5dc1-208d-f7c7-aac2-8fd4e4132f2b"
}, {
"reference": "urn:uuid:d2d2e9bd-b50f-c0f2-e3ca-131048a3e174"
}, {
"reference": "urn:uuid:1ebf171f-d0cd-56e9-7fac-d861b35fe158"
}, {
"reference": "urn:uuid:278fa46e-ad02-b44d-bbe3-1f761b0cc361"
}, {
"reference": "urn:uuid:a7dbe7f6-c365-025d-8764-8f64620c3ffb"
}, {
"reference": "urn:uuid:2a8da2ec-c3d5-df1c-d259-1df434c1d558"
}, {
"reference": "urn:uuid:a398e9a2-4a4e-d575-1965-12210e25be08"
}, {
"reference": "urn:uuid:942bdfc4-567b-abfb-a895-3dc3d796479c"
}, {
"reference": "urn:uuid:306c2577-c20d-5360-89ce-4fcd56014e87"
}, {
"reference": "urn:uuid:e20b995d-027d-c8e9-1d39-da1d90527aaa"
}, {
"reference": "urn:uuid:73750d94-08e6-bda8-7ae6-011a2ed18923"
}, {
"reference": "urn:uuid:a075120d-7ea8-b62a-ff36-ed90026ddb3f"
}, {
"reference": "urn:uuid:d32afe66-951b-db60-fc53-a55ca3f7ef7e"
}, {
"reference": "urn:uuid:aa8da1ed-387f-1f77-e60f-cee999d1a4df"
}, {
"reference": "urn:uuid:9dc25cd2-a144-f406-693d-644394cb19f1"
}, {
"reference": "urn:uuid:cf69e400-18aa-1360-e0c4-7df05ae783f1"
}, {
"reference": "urn:uuid:dcbb8c55-d92a-e410-d239-0c94c0bf4801"
}, {
"reference": "urn:uuid:a9b2184f-3bd4-9401-13b8-010daf2b8773"
}, {
"reference": "urn:uuid:9e98eeba-47e7-971f-a768-91f46ed0a3e8"
}, {
"reference": "urn:uuid:45d3d95c-e38b-2b64-2a5b-f34754b7cf1e"
}, {
"reference": "urn:uuid:d278fe67-7b22-deaa-86fa-1c8c60be40bd"
}, {
"reference": "urn:uuid:93ef7589-5be8-8878-a9b1-ff0631563caf"
}, {
"reference": "urn:uuid:6b368dbb-3e19-a18a-493c-7390591475e0"
}, {
"reference": "urn:uuid:82aa36fb-34e9-866f-c64a-1843c15bd857"
}, {
"reference": "urn:uuid:3d5e0b67-2774-8b7c-05c6-5ec7cfc28aa9"
}, {
"reference": "urn:uuid:d6466ee7-bc8d-be31-5797-92fcef0890c5"
}, {
"reference": "urn:uuid:8eb9a1cc-1522-65d3-6dd6-d6875e2aaf1f"
}, {
"reference": "urn:uuid:57e8e7af-f503-6fdc-45b9-b40c11122895"
}, {
"reference": "urn:uuid:d627c13a-ffd3-aaa1-53cb-ff527f2c666c"
}, {
"reference": "urn:uuid:6397372f-65b3-6d22-240f-655fb8b2a576"
}, {
"reference": "urn:uuid:0ac319cc-0758-6ca2-5e74-54884a4857cb"
}, {
"reference": "urn:uuid:e6c95276-3554-d778-adaa-e0a697b16db9"
}, {
"reference": "urn:uuid:61722b94-ef34-c927-6f67-27ab7cefb9f8"
}, {
"reference": "urn:uuid:acaab2bc-41f6-6bac-6ce8-fa554e55e522"
}, {
"reference": "urn:uuid:08d135da-148f-185d-1538-362067962769"
}, {
"reference": "urn:uuid:be85aae4-4a37-6681-a9fa-84116003e80d"
}, {
"reference": "urn:uuid:ef7a908e-6d5a-f544-063d-473d6ef16607"
}, {
"reference": "urn:uuid:f6aa19c8-66b0-cc7e-394d-06b35edaba75"
}, {
"reference": "urn:uuid:a73635a8-483b-cd09-e32a-e3fc07b7773f"
}, {
"reference": "urn:uuid:6e0f2547-9b59-53b4-bc1f-054a46334efd"
}, {
"reference": "urn:uuid:dbb50431-ab90-00af-eb73-1eb930fa0e62"
}, {
"reference": "urn:uuid:7fd38f8e-c5f3-b46b-d4bc-794eca6af1a9"
}, {
"reference": "urn:uuid:721dd141-94a7-517e-bafd-af123aa384ee"
}, {
"reference": "urn:uuid:b41fda6e-f01d-649d-f08b-7d202f9e8cdd"
}, {
"reference": "urn:uuid:7078d2b8-3fd6-e7e7-b20e-abccb6d6c1da"
}, {
"reference": "urn:uuid:83b3270f-339e-8c69-54b0-100639e45a57"
}, {
"reference": "urn:uuid:30dbe30d-9b4a-b7f7-cda3-f590e91c41ef"
}, {
"reference": "urn:uuid:c8e9685c-42bd-2581-17ac-90a6bc79ef7c"
}, {
"reference": "urn:uuid:34573b65-3bf8-fba2-1278-5e057b183d6d"
}, {
"reference": "urn:uuid:a0fce53b-86f5-870c-b454-4bd7103ffadf"
}, {
"reference": "urn:uuid:b052de89-3fff-efa4-7149-8252d6dea1d0"
}, {
"reference": "urn:uuid:7aeaa6ef-906c-903a-b510-8ebb0b740131"
}, {
"reference": "urn:uuid:50ed1640-9cac-9a32-c49a-1014ab57ae34"
}, {
"reference": "urn:uuid:1dca3471-7e3f-cf7d-ed8a-f438c468375e"
}, {
"reference": "urn:uuid:5d8b1b71-5dbb-78c3-54c5-415929368034"
}, {
"reference": "urn:uuid:b3eec0fa-caa5-2602-9afa-99ed8861d180"
}, {
"reference": "urn:uuid:938a0756-fe22-610a-d1ee-791df2d0f642"
}, {
"reference": "urn:uuid:b72249ac-17eb-e4cc-86b9-3fbaf9da5918"
}, {
"reference": "urn:uuid:a4dd568b-f531-8b10-8186-671c495a715c"
}, {
"reference": "urn:uuid:d840990b-e8d2-5a17-914e-cd3ea611a461"
}, {
"reference": "urn:uuid:79ac6d74-8dcc-4812-cb0d-ccdd9da6ffa2"
}, {
"reference": "urn:uuid:a51d7ba5-2fac-01e3-d14c-911f0ebd19c0"
}, {
"reference": "urn:uuid:ffe69594-314c-855b-7097-cb0870c0374e"
}, {
"reference": "urn:uuid:6dedd768-45b4-3ed9-e632-b75a18f78f0b"
}, {
"reference": "urn:uuid:d27d377d-4918-2d60-c3c6-7cb4f98f0e01"
}, {
"reference": "urn:uuid:c992e177-4825-4cc5-8097-e901924f0a49"
}, {
"reference": "urn:uuid:c1cd671f-5fa8-9adf-ddfa-86fc93bfed48"
}, {
"reference": "urn:uuid:7ca7200d-e1f1-d1ed-bb02-f84969aba31c"
}, {
"reference": "urn:uuid:cc13baf0-4285-e189-e307-383109d21c0e"
}, {
"reference": "urn:uuid:521fabd0-2bfe-d88e-6d18-3d62ff82a7e2"
}, {
"reference": "urn:uuid:7bd34013-1fff-8b5c-2c4a-20b41148d094"
}, {
"reference": "urn:uuid:5ac651a1-ffd9-73e3-a4f0-0f25b6de7b6d"
}, {
"reference": "urn:uuid:b4096254-0993-f1eb-8200-b3838d765c76"
}, {
"reference": "urn:uuid:ce4e59dd-3fcf-95a6-3f45-dc1c2f9b10ae"
}, {
"reference": "urn:uuid:b705a224-c1fe-cd7d-b361-92f073340294"
}, {
"reference": "urn:uuid:bc6dd251-ff50-c6de-3187-6cd5580b4839"
}, {
"reference": "urn:uuid:534fb2c6-0c93-35f0-3f5e-99bb77a82334"
}, {
"reference": "urn:uuid:8679ea5e-b099-8f49-6246-25b3211a8d3e"
}, {
"reference": "urn:uuid:1c50ecff-48e1-e3d4-af64-ccb255df1399"
}, {
"reference": "urn:uuid:8023aeb7-d1a4-1263-f99c-ff3fd45d522b"
}, {
"reference": "urn:uuid:a2f0c498-becb-81fa-f322-72bd816696a3"
}, {
"reference": "urn:uuid:8ed1e8d2-1a87-c45f-6f28-c49bc8b1a6f5"
}, {
"reference": "urn:uuid:c12ed541-ce10-1879-5107-a2296b49af97"
}, {
"reference": "urn:uuid:70639ea2-6172-2b9d-0e70-a285efb4ba31"
}, {
"reference": "urn:uuid:c9c97483-8baf-8658-84ef-a3bef6b9d50b"
}, {
"reference": "urn:uuid:41651f1b-aae3-9f34-a9c2-88ba9e7a3fdc"
}, {
"reference": "urn:uuid:5665d6b7-dedb-2e6e-005f-84561e077df7"
}, {
"reference": "urn:uuid:b424b212-9752-2d38-8b8c-68f7c2e36828"
}, {
"reference": "urn:uuid:597ec9a8-6c45-105b-ee23-e89fe0e02e1f"
}, {
"reference": "urn:uuid:42d308ad-fbc7-4f02-5af6-0e344734db68"
}, {
"reference": "urn:uuid:29b06a24-8f5f-9bcf-07bf-59e1bd6687f8"
}, {
"reference": "urn:uuid:968ec15f-fd8b-dd0f-ab48-27404d9b2d82"
}, {
"reference": "urn:uuid:732d06c2-718f-f42f-ce91-d1b3a7b3fe09"
}, {
"reference": "urn:uuid:0f012ccb-a025-086d-ae87-3b15299e0fb6"
}, {
"reference": "urn:uuid:6361c155-d6c6-48d2-1adc-989270e171ea"
}, {
"reference": "urn:uuid:1e5c337c-118f-df85-eadf-be5c86d682cb"
}, {
"reference": "urn:uuid:df721c7c-bc0a-e1da-1aab-2d399e97fd8d"
}, {
"reference": "urn:uuid:48902312-b26f-ef09-4dfe-22d848442bec"
}, {
"reference": "urn:uuid:873955a0-38af-400b-2c4a-e93170df9354"
}, {
"reference": "urn:uuid:7ae4b43a-965d-70ce-59a7-0c423d9b2a7b"
}, {
"reference": "urn:uuid:75b7dfaa-fde1-38ca-4904-0c6a8d9339cf"
}, {
"reference": "urn:uuid:6449098b-3e2d-a0ac-38df-a3990952d333"
}, {
"reference": "urn:uuid:e12e3313-5a1d-7a49-0b6d-b68f4d41a763"
}, {
"reference": "urn:uuid:03851a64-30e2-d74c-501c-59638b5ae759"
}, {
"reference": "urn:uuid:39638779-daa8-74c2-e9d5-6309cc8ab034"
}, {
"reference": "urn:uuid:0e7a8538-a7d6-4c85-6371-50b2c175d984"
}, {
"reference": "urn:uuid:c7a21af3-4334-18bb-8e65-3f811730748f"
}, {
"reference": "urn:uuid:33ddf17b-4e95-be8b-8323-92eda3d4e700"
}, {
"reference": "urn:uuid:34ad5b83-092e-bee2-4e70-97032f85c667"
}, {
"reference": "urn:uuid:5bb34b91-29f5-dbe6-496b-eb49d15724cd"
}, {
"reference": "urn:uuid:cb082f19-47be-448f-b77e-ccae7f34ff3c"
}, {
"reference": "urn:uuid:aedcfddb-02ad-77f1-aade-116c8dbfa36c"
}, {
"reference": "urn:uuid:cc14c829-3c0a-175c-079c-9f4496887335"
}, {
"reference": "urn:uuid:80c6ccb7-b9b6-f50c-2c34-47aa12d7b513"
}, {
"reference": "urn:uuid:6c49292e-2439-b889-a5b2-e823c198eb1f"
}, {
"reference": "urn:uuid:d32c40f4-e350-71e5-cc9b-a1e302acdf4f"
}, {
"reference": "urn:uuid:b8228a06-7c17-3212-aea9-31cfc6a40ea8"
}, {
"reference": "urn:uuid:04f9f56b-a384-263c-2a68-b5d314b7ff75"
}, {
"reference": "urn:uuid:bf28b685-7c93-009d-dcec-a21329d23689"
}, {
"reference": "urn:uuid:1802a766-d9e7-7bb8-532a-f93c6135bf89"
}, {
"reference": "urn:uuid:60d1df1c-3db3-595e-8324-a9d20963ff97"
}, {
"reference": "urn:uuid:2aef46be-6689-4994-d02a-0e2be8e4b323"
}, {
"reference": "urn:uuid:527821a8-8edc-3a44-e4a2-bc3bc169d6fc"
}, {
"reference": "urn:uuid:39810193-7618-fcfc-d737-985238ad4bcb"
}, {
"reference": "urn:uuid:810fc372-9718-cfa6-d6fb-e12abf5521f7"
}, {
"reference": "urn:uuid:7f54ceea-4d8a-a7af-61e7-5959ae7868f1"
}, {
"reference": "urn:uuid:17bb7aba-0487-3a4c-01a9-0d4139e6cd5a"
}, {
"reference": "urn:uuid:9a89152c-8f4d-9c0a-0b83-f897df191712"
}, {
"reference": "urn:uuid:53f2a9cf-7145-60ef-2f5a-2ec5544f06af"
}, {
"reference": "urn:uuid:aa2b3878-3b55-b573-e952-b219e8d85e08"
}, {
"reference": "urn:uuid:51691751-1612-6419-f77c-9a4631b97b28"
}, {
"reference": "urn:uuid:c833c2ca-7e10-6ead-6282-b5f4c7a016b8"
}, {
"reference": "urn:uuid:f301ee92-93dd-b6a9-82e8-f3cd1f4bc4cb"
}, {
"reference": "urn:uuid:9e10362e-5425-d8a8-ff96-cd0c90866d2a"
}, {
"reference": "urn:uuid:ebafed28-faa0-97a9-8490-5063f6fc6b06"
}, {
"reference": "urn:uuid:9620af2b-7fa6-359a-7b87-2ab87d048f73"
}, {
"reference": "urn:uuid:fd8a1385-584c-7ef1-82ae-5a5e81e004ac"
}, {
"reference": "urn:uuid:370bf532-d56a-5441-642b-9737d78ba8d3"
}, {
"reference": "urn:uuid:62b21f73-0176-1d04-a162-cb27ec7cfa09"
}, {
"reference": "urn:uuid:d77a97ce-1b4d-dc68-713b-d2b056b11e51"
}, {
"reference": "urn:uuid:afb44d43-d719-0107-9de0-31bb1cd3de46"
}, {
"reference": "urn:uuid:21ecf29b-d8cc-58cc-7e95-816a0bde7b63"
}, {
"reference": "urn:uuid:94832b99-21f4-0821-37f6-026ba01575c5"
}, {
"reference": "urn:uuid:1a11d96a-8503-4f4c-306f-8091c3f66a35"
}, {
"reference": "urn:uuid:95df3a68-5110-c216-cc94-5ba0c8174c66"
}, {
"reference": "urn:uuid:82f1d0fb-5e2b-d5ad-1333-c96a4f48817a"
}, {
"reference": "urn:uuid:9e50b980-d35f-2a16-db37-5fc7c128d0e6"
}, {
"reference": "urn:uuid:de33254a-cd8a-2a80-8632-4b596e9d0d41"
}, {
"reference": "urn:uuid:40ea93b0-5ca0-2806-60cf-be1c5e94abaa"
}, {
"reference": "urn:uuid:bc2ad1b5-07b9-0f57-ab0e-db57ae49ad9e"
}, {
"reference": "urn:uuid:5725aea5-7119-a7f2-bf94-1c7f42ec87fb"
}, {
"reference": "urn:uuid:21028b5e-67b8-bac2-ab64-d8134726339b"
}, {
"reference": "urn:uuid:e4cf38d2-9cee-00ca-df24-e65db5592eda"
}, {
"reference": "urn:uuid:2bfd6188-4781-bcba-20f8-c3b3056c5102"
}, {
"reference": "urn:uuid:9868007f-ee2f-3d4b-a188-6c9234339665"
}, {
"reference": "urn:uuid:06a92988-738a-4ede-cb36-9bcf4e9640bc"
}, {
"reference": "urn:uuid:d9edcd35-de35-8841-e09e-22f30bcb323a"
}, {
"reference": "urn:uuid:a9654b90-3a01-5871-70ca-696107909a69"
}, {
"reference": "urn:uuid:58160f94-95ba-7d50-ada2-28a6938f0829"
}, {
"reference": "urn:uuid:ac32d901-97ea-3eb5-ba10-c6d87a8b8fb1"
}, {
"reference": "urn:uuid:c33b5c7b-997b-250c-1d49-8fd9e0653661"
}, {
"reference": "urn:uuid:c2dbf722-32c1-ed41-8bd0-2bcb8509b4cd"
}, {
"reference": "urn:uuid:311a3d2e-4302-11ae-29c8-f8565f7f6015"
}, {
"reference": "urn:uuid:732c9c2d-4a5b-2af9-6c9b-fd1b6b953e38"
}, {
"reference": "urn:uuid:0be5aac0-f984-4119-bd84-35e0e3301eba"
}, {
"reference": "urn:uuid:6d2a398f-efd7-60cc-f0b3-e7afbe7e4b6f"
}, {
"reference": "urn:uuid:1f26bf90-75f9-2cb0-0d47-f9a3b4f29c11"
}, {
"reference": "urn:uuid:6d5696eb-bb5e-07db-94d2-4b287d173798"
}, {
"reference": "urn:uuid:8aaf81d6-fb5a-0dc0-fa09-dd457501117f"
}, {
"reference": "urn:uuid:c2357db3-463f-5d8b-5c2d-492e4db0675c"
}, {
"reference": "urn:uuid:6a87d668-7833-4b52-58db-f32782b02e15"
}, {
"reference": "urn:uuid:0c1845db-fde2-e8cb-3aeb-a5178f5f9eca"
}, {
"reference": "urn:uuid:23374abf-bfa9-3919-2ca3-d5547e515ce2"
}, {
"reference": "urn:uuid:00e2ada1-edbb-b07e-af9a-24ed0930a6b7"
}, {
"reference": "urn:uuid:2f3a30e6-4311-3df5-04dc-0b04737043a9"
}, {
"reference": "urn:uuid:a36fcdac-5340-9a2e-f87b-150f474487a7"
}, {
"reference": "urn:uuid:62bd77de-1a47-940b-80e6-a0851056701f"
}, {
"reference": "urn:uuid:a03b1672-578c-5e7b-171b-b763a0d1962c"
}, {
"reference": "urn:uuid:a494f717-dc52-698c-3aa1-ad28e5e732aa"
}, {
"reference": "urn:uuid:a0d8b2ca-9912-9a5d-7d1b-26f11705f91f"
}, {
"reference": "urn:uuid:eb775196-ba78-0c17-042e-358078bf3d67"
}, {
"reference": "urn:uuid:100b791e-1cd3-17be-c07c-88c5541a669b"
}, {
"reference": "urn:uuid:e03a534d-adfe-f077-1aee-9f652fc2ee50"
}, {
"reference": "urn:uuid:3837824d-a222-dbd7-97f2-6c0c8ede5f7e"
}, {
"reference": "urn:uuid:9b1c749c-9f55-a89f-8927-3b089f14520e"
}, {
"reference": "urn:uuid:ce93fbcb-140a-7568-6888-3f84db3e7c95"
}, {
"reference": "urn:uuid:1d465066-fd72-50c8-319c-1549d01cfb16"
}, {
"reference": "urn:uuid:93583905-76d9-c8dd-1cbf-17d79a3e479a"
}, {
"reference": "urn:uuid:2a1fcc98-f430-3f65-04ce-a752d714ab44"
}, {
"reference": "urn:uuid:114e89d1-3f54-2c4f-88f7-31782a8f145f"
}, {
"reference": "urn:uuid:7ad2962b-e98c-e9e5-739d-39cbc585c527"
}, {
"reference": "urn:uuid:9b76f31f-51cf-8eb9-76fd-f3147d3da311"
}, {
"reference": "urn:uuid:9fc3252a-02ce-37d5-38c4-e9efd63607cc"
}, {
"reference": "urn:uuid:83caef52-9ced-0ff0-9aa0-c71367b71a02"
}, {
"reference": "urn:uuid:b57a1601-04da-1e14-39be-9b003ee7b3d7"
}, {
"reference": "urn:uuid:033aeae0-5055-adb8-9810-2686e890db16"
}, {
"reference": "urn:uuid:4a1f3308-0d90-a40d-c18f-a79075a408ad"
}, {
"reference": "urn:uuid:7e2ecb5c-b88a-5698-bc6d-2e16d099f35b"
}, {
"reference": "urn:uuid:23d1af38-065c-b700-474d-bd7618e6d1a7"
}, {
"reference": "urn:uuid:e54716b0-3df3-9081-58b4-824ee9207091"
}, {
"reference": "urn:uuid:0683617b-e9a5-b47c-08a5-d1261265ae9a"
}, {
"reference": "urn:uuid:bc51b8cd-264a-4ded-564c-df1362205f22"
}, {
"reference": "urn:uuid:52ee4e06-bdbe-a448-3c96-083f37a142a2"
}, {
"reference": "urn:uuid:259163d9-c5cd-4590-03bd-e530a554ab84"
}, {
"reference": "urn:uuid:4db44c6a-87cc-1989-64c4-a1cd0dd24444"
}, {
"reference": "urn:uuid:94bcc65e-9c94-dce9-a509-986a8f3d37df"
}, {
"reference": "urn:uuid:b999642f-f2c5-63af-b771-ca96045db14d"
}, {
"reference": "urn:uuid:754d547b-bfd9-7d98-16ca-e62d9464c436"
}, {
"reference": "urn:uuid:e4eaca12-adf0-3021-59f6-bc6eb17e5adc"
}, {
"reference": "urn:uuid:4fc961b1-ee47-8657-3199-5cc2ffbf40b0"
}, {
"reference": "urn:uuid:c989643a-e1cd-566b-e775-e65240506b78"
}, {
"reference": "urn:uuid:d4e6335a-c7af-950d-734f-25360172067a"
}, {
"reference": "urn:uuid:81dff8d1-b723-6024-725e-3cd470638bd4"
}, {
"reference": "urn:uuid:4850a7e3-ee5a-6ee7-cda6-c4e24acb0280"
}, {
"reference": "urn:uuid:8e1eb4a7-7d09-8c09-4373-f0ba6aac0883"
}, {
"reference": "urn:uuid:075b1fde-11a3-d242-dbd7-0ea79b92f7cc"
}, {
"reference": "urn:uuid:440c5478-7884-7980-7ec7-920deae39b19"
}, {
"reference": "urn:uuid:60d23e4b-3b86-ab7d-2d38-70efd42945b7"
}, {
"reference": "urn:uuid:2d7f7f7c-dbd7-002b-0a09-7c348c4e11b7"
}, {
"reference": "urn:uuid:5abcea8b-fd8f-28e9-95cb-289da63333a1"
}, {
"reference": "urn:uuid:4fc716de-ed69-ec3f-1245-7d0ace4b65b1"
}, {
"reference": "urn:uuid:86a0d34e-5af3-c1af-01a8-446718bc617b"
}, {
"reference": "urn:uuid:918b204e-5459-d3b0-787f-659c96d76366"
}, {
"reference": "urn:uuid:8cd708a4-8b45-a40b-041e-ed070efa98fe"
}, {
"reference": "urn:uuid:763f0809-80ea-78ff-d936-2a88b6d696c3"
}, {
"reference": "urn:uuid:28e9af41-d1a5-a016-91ff-02fcd06d486b"
}, {
"reference": "urn:uuid:18814546-3dfe-e829-3c84-bde99c1c4713"
}, {
"reference": "urn:uuid:cd592562-e0c1-0255-006c-41e3a95416d4"
}, {
"reference": "urn:uuid:e444e436-54fe-e0c0-3161-a2bb056d22f6"
}, {
"reference": "urn:uuid:71aa9ab5-7d4d-8a7c-ee52-acd386d227fb"
}, {
"reference": "urn:uuid:bbd55e03-ec99-47ce-c158-4389c8e2f926"
}, {
"reference": "urn:uuid:f81e0137-d2d6-5d6e-eb03-16aa8eee6b80"
}, {
"reference": "urn:uuid:647640d9-2193-5b5c-14ed-217a12dca094"
}, {
"reference": "urn:uuid:f945513e-a7d0-a3ef-436f-0ec25ed5ab7a"
}, {
"reference": "urn:uuid:b4a06423-f1d8-1d32-fcdd-0e07061bda93"
}, {
"reference": "urn:uuid:2e8c179c-8fc1-ebd4-738a-7374cb4ab1c2"
} ],
"recorded": "2023-09-07T18:15:30.236+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|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"onBehalfOf": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE 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|9999965491",
"display": "Dr. Alvin56 Hayes766"
},
"onBehalfOf": {
"reference": "Organization?identifier=https://github.com/synthetichealth/synthea|7ac466c6-7968-33fd-882c-6d5418f88c8a",
"display": "CHELMSFORD PRIMARY CARE LLC"
}
} ]
},
"request": {
"method": "POST",
"url": "Provenance"
}
} ]
}