Universal API Implementation Guide
1.1.19 - ci-build

Universal API Implementation Guide - Local Development build (v1.1.19). See the Directory of published versions

: External - UAPI AS Enrollment biPA CoPay Bundle Before (Avastin) - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="c3cd2055-6d19-4859-96a1-6f52f20a11d9"/>
  <meta>
    <profile
             value="https://fhir.developer.gene.com/StructureDefinition/uapi-as-enrollment-bundle"/>
  </meta>
  <identifier>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="RI"/>
        <display value="Resource identifier"/>
      </coding>
    </type>
    <system value="http://vendor.com/ab"/>
    <value value="316e9740-2c4d-4c5d-98b0-c68c84706656"/>
    <assigner>
      <display value="Alpha Beta"/>
    </assigner>
  </identifier>
  <type value="message"/>
  <timestamp value="2020-03-11T08:10:13-05:00"/>
  <entry>
    <fullUrl value="urn:uuid:eb5eb40b-78e8-4a52-903a-0348c1eac387"/>
    <resource>
      <MessageHeader>
        <id value="fe0cc042-1a9a-4bfc-9989-aba61523366f"/>
        <meta>
          <profile
                   value="https://fhir.developer.gene.com/StructureDefinition/uapi-messageheader"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: MessageHeader</b><a name="fe0cc042-1a9a-4bfc-9989-aba61523366f"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource MessageHeader "fe0cc042-1a9a-4bfc-9989-aba61523366f" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-messageheader.html">UAPI MessageHeader</a></p></div><p><b>event</b>: enrollment-with-consent (Details: http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-event-type code enrollment-with-consent = 'enrollment-with-consent', stated as 'null')</p><h3>Destinations</h3><table class="grid"><tr><td>-</td><td><b>Name</b></td><td><b>Endpoint</b></td></tr><tr><td>*</td><td>UAPI-ENR-V2.1</td><td><a href="https://test-us-e1.apis.roche.com/pharma-cmg-ehr-fhir-exp-test/v2/enrollment">https://test-us-e1.apis.roche.com/pharma-cmg-ehr-fhir-exp-test/v2/enrollment</a></td></tr></table><p><b>sender</b>: <a href="#Organization_01c31a2f-321d-4c6e-8349-206af8a88088">See above (urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088)</a></p><h3>Sources</h3><table class="grid"><tr><td>-</td><td><b>Name</b></td><td><b>Endpoint</b></td></tr><tr><td>*</td><td>Vendor_AB</td><td><a href="http://vendor.com/fhir/enrollmentID/ENR-00001">http://vendor.com/fhir/enrollmentID/ENR-00001</a></td></tr></table><p><b>focus</b>: <a href="#List_e20da0b5-cb0a-4dfb-befd-431e3566a08e">See above (urn:uuid:e20da0b5-cb0a-4dfb-befd-431e3566a08e)</a></p></div>
        </text>
        <eventCoding>
          <system
                  value="http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-event-type"/>
          <code value="enrollment-with-consent"/>
        </eventCoding>
        <destination>
          <name value="UAPI-ENR-V2.1"/>
          <endpoint
                    value="https://test-us-e1.apis.roche.com/pharma-cmg-ehr-fhir-exp-test/v2/enrollment"/>
        </destination>
        <sender>
          <reference value="urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088"/>
          <type value="Organization"/>
        </sender>
        <source>
          <name value="Vendor_AB"/>
          <endpoint value="http://vendor.com/fhir/enrollmentID/ENR-00001"/>
        </source>
        <focus>
          <reference value="urn:uuid:e20da0b5-cb0a-4dfb-befd-431e3566a08e"/>
          <type value="List"/>
        </focus>
      </MessageHeader>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:e20da0b5-cb0a-4dfb-befd-431e3566a08e"/>
    <resource>
      <List>
        <id value="e20da0b5-cb0a-4dfb-befd-431e3566a08e"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: List</b><a name="e20da0b5-cb0a-4dfb-befd-431e3566a08e"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource List "e20da0b5-cb0a-4dfb-befd-431e3566a08e" </p></div><p><b>status</b>: current</p><p><b>mode</b>: changes</p><p><b>title</b>: messageContext</p><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#Patient_fc2e5a72-c363-4616-ae00-4ad25cbcb45c">See above (urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)</a></p></blockquote><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#Organization_01c31a2f-321d-4c6e-8349-206af8a88088">See above (urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088)</a></p></blockquote><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#Practitioner_695d0991-5e03-46df-934a-85a28acd95c1">See above (urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1)</a></p></blockquote><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#Coverage_42b41bdb-1781-49aa-a091-78cdd92129df">See above (urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df)</a></p></blockquote><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#RelatedPerson_4db51d32-65c3-4f8c-959e-0155c6d14545">See above (urn:uuid:4db51d32-65c3-4f8c-959e-0155c6d14545)</a></p></blockquote><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#QuestionnaireResponse_0b3f6e0d-3fb5-4e9a-ba3d-e030ec8b543f">See above (urn:uuid:0b3f6e0d-3fb5-4e9a-ba3d-e030ec8b543f)</a></p></blockquote><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#Condition_bc20c5ea-f639-4221-ab61-ce75c5e64aba">See above (urn:uuid:bc20c5ea-f639-4221-ab61-ce75c5e64aba)</a></p></blockquote><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#Consent_1b53bfb2-1361-4906-acd8-35294d30273b">See above (urn:uuid:1b53bfb2-1361-4906-acd8-35294d30273b)</a></p></blockquote><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#Organization_45cf0b29-8c1d-4882-91e1-00bc28c06a52">See above (urn:uuid:45cf0b29-8c1d-4882-91e1-00bc28c06a52)</a></p></blockquote><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#ServiceRequest_212c57ad-45cd-4882-87e7-8415ded3db05">See above (urn:uuid:212c57ad-45cd-4882-87e7-8415ded3db05)</a></p></blockquote><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#ServiceRequest_f71a66c4-f747-4b46-8adc-875a45f8ee7e">See above (urn:uuid:f71a66c4-f747-4b46-8adc-875a45f8ee7e)</a></p></blockquote><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#MedicationRequest_e68d1d73-9bca-40c0-b8e8-3f77dedcbf6f">See above (urn:uuid:e68d1d73-9bca-40c0-b8e8-3f77dedcbf6f)</a></p></blockquote><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#Organization_d3637025-883d-4678-9e0a-1d243a338f9f">See above (urn:uuid:d3637025-883d-4678-9e0a-1d243a338f9f)</a></p></blockquote></div>
        </text>
        <status value="current"/>
        <mode value="changes"/>
        <title value="messageContext"/>
        <entry>
          <item>
            <reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
            <type value="Patient"/>
          </item>
        </entry>
        <entry>
          <item>
            <reference value="urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088"/>
            <type value="Organization"/>
          </item>
        </entry>
        <entry>
          <item>
            <reference value="urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1"/>
            <type value="Practitioner"/>
          </item>
        </entry>
        <entry>
          <item>
            <reference value="urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df"/>
            <type value="Coverage"/>
          </item>
        </entry>
        <entry>
          <item>
            <reference value="urn:uuid:4db51d32-65c3-4f8c-959e-0155c6d14545"/>
            <type value="RelatedPerson"/>
          </item>
        </entry>
        <entry>
          <item>
            <reference value="urn:uuid:0b3f6e0d-3fb5-4e9a-ba3d-e030ec8b543f"/>
            <type value="QuestionnaireResponse"/>
          </item>
        </entry>
        <entry>
          <item>
            <reference value="urn:uuid:bc20c5ea-f639-4221-ab61-ce75c5e64aba"/>
            <type value="Condition"/>
          </item>
        </entry>
        <entry>
          <item>
            <reference value="urn:uuid:1b53bfb2-1361-4906-acd8-35294d30273b"/>
            <type value="Consent"/>
          </item>
        </entry>
        <entry>
          <item>
            <reference value="urn:uuid:45cf0b29-8c1d-4882-91e1-00bc28c06a52"/>
            <type value="Organization"/>
          </item>
        </entry>
        <entry>
          <item>
            <reference value="urn:uuid:212c57ad-45cd-4882-87e7-8415ded3db05"/>
            <type value="ServiceRequest"/>
          </item>
        </entry>
        <entry>
          <item>
            <reference value="urn:uuid:f71a66c4-f747-4b46-8adc-875a45f8ee7e"/>
            <type value="ServiceRequest"/>
          </item>
        </entry>
        <entry>
          <item>
            <reference value="urn:uuid:e68d1d73-9bca-40c0-b8e8-3f77dedcbf6f"/>
            <type value="MedicationRequest"/>
          </item>
        </entry>
        <entry>
          <item>
            <reference value="urn:uuid:d3637025-883d-4678-9e0a-1d243a338f9f"/>
            <type value="Organization"/>
          </item>
        </entry>
      </List>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
    <resource>
      <Patient>
        <id value="fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
        <meta>
          <profile
                   value="https://fhir.developer.gene.com/StructureDefinition/uapi-patient"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Patient</b><a name="fc2e5a72-c363-4616-ae00-4ad25cbcb45c"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Patient "fc2e5a72-c363-4616-ae00-4ad25cbcb45c" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-patient.html">UAPI Patient</a></p></div><p><b>identifier</b>: Patient internal identifier: 6bcd8467-0473-4836-9128-2e7972f23177(use: USUAL)</p><p><b>name</b>: Ryan Michaelson (OFFICIAL)</p><p><b>telecom</b>: ph: 1231231234(HOME), ph: 1234561234(MOBILE), <a href="mailto:bobster83@example.com">bobster83@example.com</a></p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1972-10-29</p><p><b>address</b>: 1234 Main St San Francisco CA 94105 US </p><h3>Communications</h3><table class="grid"><tr><td>-</td><td><b>Language</b></td><td><b>Preferred</b></td></tr><tr><td>*</td><td>English <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-v3-ietf3066.html">Tags for the Identification of Languages</a>#en)</span></td><td>true</td></tr></table><p><b>generalPractitioner</b>: <a href="#Practitioner_695d0991-5e03-46df-934a-85a28acd95c1">See above (urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1)</a></p><p><b>managingOrganization</b>: <a href="#Organization_01c31a2f-321d-4c6e-8349-206af8a88088">See above (urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088)</a></p></div>
        </text>
        <identifier>
          <use value="usual"/>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="PI"/>
              <display value="Patient internal identifier"/>
            </coding>
          </type>
          <system value="http://vendor.com/ab"/>
          <value value="6bcd8467-0473-4836-9128-2e7972f23177"/>
          <assigner>
            <display value="AB Vendor"/>
          </assigner>
        </identifier>
        <name>
          <use value="official"/>
          <family value="Michaelson"/>
          <given value="Ryan"/>
        </name>
        <telecom>
          <system value="phone"/>
          <value value="1231231234"/>
          <use value="home"/>
          <rank value="1"/>
        </telecom>
        <telecom>
          <system value="phone"/>
          <value value="1234561234"/>
          <use value="mobile"/>
          <rank value="2"/>
        </telecom>
        <telecom>
          <system value="email"/>
          <value value="bobster83@example.com"/>
          <use value="home"/>
          <rank value="3"/>
        </telecom>
        <gender value="male"/>
        <birthDate value="1972-10-29"/>
        <address>
          <line value="1234 Main St"/>
          <city value="San Francisco"/>
          <state value="CA"/>
          <postalCode value="94105"/>
          <country value="US"/>
        </address>
        <communication>
          <language>
            <coding>
              <system value="urn:ietf:bcp:47"/>
              <code value="en"/>
              <display value="English"/>
            </coding>
          </language>
          <preferred value="true"/>
        </communication>
        <generalPractitioner>
          <reference value="urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1"/>
        </generalPractitioner>
        <managingOrganization>
          <reference value="urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088"/>
        </managingOrganization>
      </Patient>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088"/>
    <resource>
      <Organization>
        <id value="01c31a2f-321d-4c6e-8349-206af8a88088"/>
        <meta>
          <profile
                   value="https://fhir.developer.gene.com/StructureDefinition/uapi-organization"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Organization</b><a name="01c31a2f-321d-4c6e-8349-206af8a88088"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Organization "01c31a2f-321d-4c6e-8349-206af8a88088" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-organization.html">UAPI Organization</a></p></div><p><b>identifier</b>: id: HOSP-12345(use: USUAL)</p><p><b>type</b>: Healthcare Provider <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R4B/codesystem-organization-type.html">OrganizationType</a>#prov)</span></p><p><b>name</b>: Mid Atlantic Retina</p><p><b>telecom</b>: <a href="mailto:mar@example.com">mar@example.com</a></p><p><b>address</b>: 8 Ranoldo Terrace Cherry Hill NJ 08034 US </p><h3>Contacts</h3><table class="grid"><tr><td>-</td><td><b>Name</b></td><td><b>Telecom</b></td></tr><tr><td>*</td><td>Venus Yardav (OFFICIAL)</td><td>ph: 8882704882(WORK), fax: 8179974042(WORK)</td></tr></table></div>
        </text>
        <identifier>
          <use value="usual"/>
          <system value="http://vendor.com/ab"/>
          <value value="HOSP-12345"/>
          <assigner>
            <display value="AB Vendor"/>
          </assigner>
        </identifier>
        <type>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/organization-type"/>
            <code value="prov"/>
            <display value="Healthcare Provider"/>
          </coding>
        </type>
        <name value="Mid Atlantic Retina"/>
        <telecom>
          <system value="email"/>
          <value value="mar@example.com"/>
        </telecom>
        <address>
          <line value="8 Ranoldo Terrace"/>
          <city value="Cherry Hill"/>
          <state value="NJ"/>
          <postalCode value="08034"/>
          <country value="US"/>
        </address>
        <contact>
          <name>
            <use value="official"/>
            <family value="Yardav"/>
            <given value="Venus"/>
          </name>
          <telecom>
            <system value="phone"/>
            <value value="8882704882"/>
            <use value="work"/>
            <rank value="1"/>
          </telecom>
          <telecom>
            <system value="fax"/>
            <value value="8179974042"/>
            <use value="work"/>
            <rank value="2"/>
          </telecom>
        </contact>
      </Organization>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1"/>
    <resource>
      <Practitioner>
        <id value="695d0991-5e03-46df-934a-85a28acd95c1"/>
        <meta>
          <profile
                   value="https://fhir.developer.gene.com/StructureDefinition/uapi-practitioner"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Practitioner</b><a name="695d0991-5e03-46df-934a-85a28acd95c1"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Practitioner "695d0991-5e03-46df-934a-85a28acd95c1" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-practitioner.html">UAPI Practitioner</a></p></div><p><b>identifier</b>: Provider identifier: 1922071448(use: OFFICIAL), Tax ID number: 00000000(use: OFFICIAL), National provider identifier: 1639285034(use: OFFICIAL)</p><p><b>name</b>: MARISSA CRUZ (OFFICIAL)</p></div>
        </text>
        <identifier>
          <use value="official"/>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="PRN"/>
              <display value="Provider identifier"/>
            </coding>
          </type>
          <system value="http://hl7.org/fhir/sid/us-npi"/>
          <value value="1922071448"/>
          <assigner>
            <display value="Centers for Medicare &amp; Medicaid Services"/>
          </assigner>
        </identifier>
        <identifier>
          <use value="official"/>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="TAX"/>
              <display value="Tax ID number"/>
            </coding>
          </type>
          <system value="http://hl7.org/fhir/sid/us-npi"/>
          <value value="00000000"/>
        </identifier>
        <identifier>
          <use value="official"/>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="NPI"/>
              <display value="National provider identifier"/>
            </coding>
          </type>
          <system value="http://hl7.org/fhir/sid/us-npi"/>
          <value value="1639285034"/>
        </identifier>
        <name>
          <use value="official"/>
          <family value="CRUZ"/>
          <given value="MARISSA"/>
        </name>
      </Practitioner>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df"/>
    <resource>
      <Coverage>
        <id value="42b41bdb-1781-49aa-a091-78cdd92129df"/>
        <meta>
          <profile
                   value="https://fhir.developer.gene.com/StructureDefinition/uapi-coverage"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Coverage</b><a name="42b41bdb-1781-49aa-a091-78cdd92129df"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Coverage "42b41bdb-1781-49aa-a091-78cdd92129df" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-coverage.html">UAPI Coverage</a></p></div><p><b>status</b>: active</p><p><b>type</b>: health insurance plan policy <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-v3-ActCode.html">ActCode</a>#HIP)</span></p><p><b>subscriber</b>: <a href="#RelatedPerson_4db51d32-65c3-4f8c-959e-0155c6d14545">See above (urn:uuid:4db51d32-65c3-4f8c-959e-0155c6d14545)</a></p><p><b>subscriberId</b>: 4353</p><p><b>beneficiary</b>: <a href="#Patient_fc2e5a72-c363-4616-ae00-4ad25cbcb45c">See above (urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)</a></p><p><b>payor</b>: <a href="#Organization_d3637025-883d-4678-9e0a-1d243a338f9f">See above (urn:uuid:d3637025-883d-4678-9e0a-1d243a338f9f)</a></p><h3>Classes</h3><table class="grid"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td><td><b>Name</b></td></tr><tr><td>*</td><td>Group <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R4B/codesystem-coverage-class.html">Coverage Class Codes</a>#group)</span></td><td>12344frgr</td><td>Group Number</td></tr></table><p><b>order</b>: 1</p><p><b>network</b>: Dakotacare</p></div>
        </text>
        <status value="active"/>
        <type>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
            <code value="HIP"/>
            <display value="health insurance plan policy"/>
          </coding>
        </type>
        <subscriber>
          <reference value="urn:uuid:4db51d32-65c3-4f8c-959e-0155c6d14545"/>
          <type value="RelatedPerson"/>
        </subscriber>
        <subscriberId value="4353"/>
        <beneficiary>
          <reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
          <type value="Patient"/>
        </beneficiary>
        <payor>
          <reference value="urn:uuid:d3637025-883d-4678-9e0a-1d243a338f9f"/>
          <type value="Organization"/>
        </payor>
        <class>
          <type>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
              <code value="group"/>
              <display value="Group"/>
            </coding>
          </type>
          <value value="12344frgr"/>
          <name value="Group Number"/>
        </class>
        <order value="1"/>
        <network value="Dakotacare"/>
      </Coverage>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:4db51d32-65c3-4f8c-959e-0155c6d14545"/>
    <resource>
      <RelatedPerson>
        <id value="4db51d32-65c3-4f8c-959e-0155c6d14545"/>
        <meta>
          <profile
                   value="https://fhir.developer.gene.com/StructureDefinition/uapi-relatedPerson"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: RelatedPerson</b><a name="4db51d32-65c3-4f8c-959e-0155c6d14545"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource RelatedPerson "4db51d32-65c3-4f8c-959e-0155c6d14545" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-relatedPerson.html">UAPI RelatedPerson</a></p></div><p><b>patient</b>: <a href="#Patient_fc2e5a72-c363-4616-ae00-4ad25cbcb45c">See above (urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)</a></p><p><b>relationship</b>: significant other <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-v3-RoleCode.html">RoleCode</a>#SIGOTHR)</span></p><p><b>name</b>: Bob Paul Smith (OFFICIAL)</p><p><b>telecom</b>: <a href="tel:+33(237)998327">+33 (237) 998327</a></p><p><b>birthDate</b>: 1972-10-29</p></div>
        </text>
        <patient>
          <reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
          <type value="Patient"/>
        </patient>
        <relationship>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
            <code value="SIGOTHR"/>
            <display value="significant other"/>
          </coding>
        </relationship>
        <name>
          <use value="official"/>
          <family value="Smith"/>
          <given value="Bob Paul"/>
        </name>
        <telecom>
          <system value="phone"/>
          <value value="+33 (237) 998327"/>
          <use value="mobile"/>
        </telecom>
        <birthDate value="1972-10-29"/>
      </RelatedPerson>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:0b3f6e0d-3fb5-4e9a-ba3d-e030ec8b543f"/>
    <resource>
      <QuestionnaireResponse>
        <id value="0b3f6e0d-3fb5-4e9a-ba3d-e030ec8b543f"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: QuestionnaireResponse</b><a name="0b3f6e0d-3fb5-4e9a-ba3d-e030ec8b543f"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource QuestionnaireResponse "0b3f6e0d-3fb5-4e9a-ba3d-e030ec8b543f" </p></div><p><b>questionnaire</b>: <a href="https://dev.gene.com/fhir/uapi/fhirapi/Questionnaire/1234">https://dev.gene.com/fhir/uapi/fhirapi/Questionnaire/1234</a></p><p><b>status</b>: completed</p><p><b>subject</b>: <a href="#Patient_fc2e5a72-c363-4616-ae00-4ad25cbcb45c">See above (urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)</a></p><blockquote><p><b>item</b></p><p><b>linkId</b>: authorization</p><p><b>text</b>: Authorization #</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>321654</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: avastin-list-other-pt</p><p><b>text</b>: List other previous treatment (if chemotherapy, please specify)</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>specified therapy</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: dot</p><p><b>text</b>: Date of Treatment</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>2022-02-13</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: household-size</p><p><b>text</b>: Household size</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>14</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: line-of-therapy-other</p><p><b>text</b>: Line of therapy-other?</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>other therapy</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: opn-optional</p><p><b>text</b>: Onsite Pharmacy Name (Optional)</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Onsite pharmacy</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: preferred-sp-optional</p><p><b>text</b>: Preferred Specialty Pharmacy (Optional)</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Specialty pharmacy</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: site-of-treatment</p><p><b>text</b>: Site of Treatment</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td><a href="#Organization_45cf0b29-8c1d-4882-91e1-00bc28c06a52">See above (urn:uuid:45cf0b29-8c1d-4882-91e1-00bc28c06a52)</a></td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: avastin-previous-treatment</p><p><b>text</b>: Previous treatment?</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Radiation</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: avastin-tnm-stage</p><p><b>text</b>: Clinical TNM stage?</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>IIB</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: contact-patient</p><p><b>text</b>: Do not contact patient</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Yes</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: detailed-message</p><p><b>text</b>: Ok to leave a detailed message?</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>No</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: has-treatment-started</p><p><b>text</b>: Has treatment started?</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Yes</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: household-income</p><p><b>text</b>: Annual household income</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>$100,001 - $125,000</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: line-of-therapy</p><p><b>text</b>: Line of therapy?</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>First</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: onsite-pharmacy</p><p><b>text</b>: Onsite Pharmacy?</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Yes</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: pa-in-place</p><p><b>text</b>: Is prior authorization in place?</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Yes</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: pos</p><p><b>text</b>: Place of Service</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>In Office</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: prescription-plan</p><p><b>text</b>: Is this a Prescription plan?</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>No</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: re-verify-benefits-at-pa-expiration</p><p><b>text</b>: Re-verify benefits at PA expiration</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Yes</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: specialty-pharmacy</p><p><b>text</b>: Specialty Pharmacy?</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Yes</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: tcpa-consent</p><p><b>text</b>: TCPA Consent Provided?</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Yes</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: text-message</p><p><b>text</b>: Ok to send a text message?</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Yes</td></tr></table></blockquote></div>
        </text>
        <questionnaire
                       value="https://dev.gene.com/fhir/uapi/fhirapi/Questionnaire/1234"/>
        <status value="completed"/>
        <subject>
          <reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
          <type value="Patient"/>
        </subject>
        <item>
          <linkId value="authorization"/>
          <text value="Authorization #"/>
          <answer>
            <valueString value="321654"/>
          </answer>
        </item>
        <item>
          <linkId value="avastin-list-other-pt"/>
          <text
                value="List other previous treatment (if chemotherapy, please specify)"/>
          <answer>
            <valueString value="specified therapy"/>
          </answer>
        </item>
        <item>
          <linkId value="dot"/>
          <text value="Date of Treatment"/>
          <answer>
            <valueDate value="2022-02-13"/>
          </answer>
        </item>
        <item>
          <linkId value="household-size"/>
          <text value="Household size"/>
          <answer>
            <valueString value="14"/>
          </answer>
        </item>
        <item>
          <linkId value="line-of-therapy-other"/>
          <text value="Line of therapy-other?"/>
          <answer>
            <valueString value="other therapy"/>
          </answer>
        </item>
        <item>
          <linkId value="opn-optional"/>
          <text value="Onsite Pharmacy Name (Optional)"/>
          <answer>
            <valueString value="Onsite pharmacy"/>
          </answer>
        </item>
        <item>
          <linkId value="preferred-sp-optional"/>
          <text value="Preferred Specialty Pharmacy (Optional)"/>
          <answer>
            <valueString value="Specialty pharmacy"/>
          </answer>
        </item>
        <item>
          <linkId value="site-of-treatment"/>
          <text value="Site of Treatment"/>
          <answer>
            <valueReference>
              <reference
                         value="urn:uuid:45cf0b29-8c1d-4882-91e1-00bc28c06a52"/>
              <type value="Organization"/>
            </valueReference>
          </answer>
        </item>
        <item>
          <linkId value="avastin-previous-treatment"/>
          <text value="Previous treatment?"/>
          <answer>
            <valueString value="Radiation"/>
          </answer>
        </item>
        <item>
          <linkId value="avastin-tnm-stage"/>
          <text value="Clinical TNM stage?"/>
          <answer>
            <valueString value="IIB"/>
          </answer>
        </item>
        <item>
          <linkId value="contact-patient"/>
          <text value="Do not contact patient"/>
          <answer>
            <valueString value="Yes"/>
          </answer>
        </item>
        <item>
          <linkId value="detailed-message"/>
          <text value="Ok to leave a detailed message?"/>
          <answer>
            <valueString value="No"/>
          </answer>
        </item>
        <item>
          <linkId value="has-treatment-started"/>
          <text value="Has treatment started?"/>
          <answer>
            <valueString value="Yes"/>
          </answer>
        </item>
        <item>
          <linkId value="household-income"/>
          <text value="Annual household income"/>
          <answer>
            <valueString value="$100,001 - $125,000"/>
          </answer>
        </item>
        <item>
          <linkId value="line-of-therapy"/>
          <text value="Line of therapy?"/>
          <answer>
            <valueString value="First"/>
          </answer>
        </item>
        <item>
          <linkId value="onsite-pharmacy"/>
          <text value="Onsite Pharmacy?"/>
          <answer>
            <valueString value="Yes"/>
          </answer>
        </item>
        <item>
          <linkId value="pa-in-place"/>
          <text value="Is prior authorization in place?"/>
          <answer>
            <valueString value="Yes"/>
          </answer>
        </item>
        <item>
          <linkId value="pos"/>
          <text value="Place of Service"/>
          <answer>
            <valueString value="In Office"/>
          </answer>
        </item>
        <item>
          <linkId value="prescription-plan"/>
          <text value="Is this a Prescription plan?"/>
          <answer>
            <valueString value="No"/>
          </answer>
        </item>
        <item>
          <linkId value="re-verify-benefits-at-pa-expiration"/>
          <text value="Re-verify benefits at PA expiration"/>
          <answer>
            <valueString value="Yes"/>
          </answer>
        </item>
        <item>
          <linkId value="specialty-pharmacy"/>
          <text value="Specialty Pharmacy?"/>
          <answer>
            <valueString value="Yes"/>
          </answer>
        </item>
        <item>
          <linkId value="tcpa-consent"/>
          <text value="TCPA Consent Provided?"/>
          <answer>
            <valueString value="Yes"/>
          </answer>
        </item>
        <item>
          <linkId value="text-message"/>
          <text value="Ok to send a text message?"/>
          <answer>
            <valueString value="Yes"/>
          </answer>
        </item>
      </QuestionnaireResponse>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:bc20c5ea-f639-4221-ab61-ce75c5e64aba"/>
    <resource>
      <Condition>
        <id value="bc20c5ea-f639-4221-ab61-ce75c5e64aba"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Condition</b><a name="bc20c5ea-f639-4221-ab61-ce75c5e64aba"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Condition "bc20c5ea-f639-4221-ab61-ce75c5e64aba" </p></div><p><b>code</b>: Type 1 diab with mild nonp rtnop with macular edema, r eye <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-icd10CM.html">International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)</a>#E10.3211)</span></p><p><b>subject</b>: <a href="#Patient_fc2e5a72-c363-4616-ae00-4ad25cbcb45c">See above (urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)</a></p></div>
        </text>
        <code>
          <coding>
            <system value="http://hl7.org/fhir/sid/icd-10-cm"/>
            <code value="E10.3211"/>
          </coding>
        </code>
        <subject>
          <reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
          <type value="Patient"/>
        </subject>
      </Condition>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:1b53bfb2-1361-4906-acd8-35294d30273b"/>
    <resource>
      <Consent>
        <id value="1b53bfb2-1361-4906-acd8-35294d30273b"/>
        <meta>
          <profile
                   value="https://fhir.developer.gene.com/StructureDefinition/uapi-consent"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Consent</b><a name="1b53bfb2-1361-4906-acd8-35294d30273b"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Consent "1b53bfb2-1361-4906-acd8-35294d30273b" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-consent.html">UAPI Consent</a></p></div><p><b>status</b>: active</p><p><b>scope</b>: Privacy Consent <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R4B/codesystem-consent-scope.html">Consent Scope Codes</a>#patient-privacy)</span></p><p><b>category</b>: Patient Authorization Signature <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#59284-0)</span></p><p><b>patient</b>: <a href="#Patient_fc2e5a72-c363-4616-ae00-4ad25cbcb45c">See above (urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)</a></p><p><b>dateTime</b>: 2016-06-16 04:24:45+0000</p><p><b>performer</b>: <a href="#Patient_fc2e5a72-c363-4616-ae00-4ad25cbcb45c">See above (urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)</a></p><p><b>policyRule</b>: HIPAA Authorization <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R4B/codesystem-consent-policy.html">Policy Codes</a>#hipaa-auth)</span></p><h3>Provisions</h3><table class="grid"><tr><td>-</td><td><b>Type</b></td></tr><tr><td>*</td><td>permit</td></tr></table></div>
        </text>
        <status value="active"/>
        <scope>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/consentscope"/>
            <code value="patient-privacy"/>
            <display value="Privacy Consent"/>
          </coding>
        </scope>
        <category>
          <coding>
            <system value="http://loinc.org"/>
            <code value="59284-0"/>
            <display value="Patient Authorization Signature"/>
          </coding>
        </category>
        <patient>
          <reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
          <type value="Patient"/>
        </patient>
        <dateTime value="2016-06-16T16:24:45Z"/>
        <performer>
          <reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
          <type value="Patient"/>
        </performer>
        <policyRule>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/consentpolicycodes"/>
            <code value="hipaa-auth"/>
            <display value="HIPAA Authorization"/>
          </coding>
        </policyRule>
        <provision>
          <type value="permit"/>
        </provision>
      </Consent>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:45cf0b29-8c1d-4882-91e1-00bc28c06a52"/>
    <resource>
      <Organization>
        <id value="45cf0b29-8c1d-4882-91e1-00bc28c06a52"/>
        <meta>
          <profile
                   value="https://fhir.developer.gene.com/StructureDefinition/uapi-organization"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Organization</b><a name="45cf0b29-8c1d-4882-91e1-00bc28c06a52"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Organization "45cf0b29-8c1d-4882-91e1-00bc28c06a52" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-organization.html">UAPI Organization</a></p></div><p><b>identifier</b>: id: Infusion Site Id(use: USUAL)</p><p><b>type</b>: Site of Treatment <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R4B/codesystem-organization-type.html">OrganizationType</a>#other)</span></p><p><b>name</b>: Infusion Centre</p><p><b>telecom</b>: ph: 8882704882(WORK), fax: 8179974042(WORK)</p><p><b>address</b>: 8 Ranoldo Terrace Cherry Hill NJ 08034 US </p><h3>Contacts</h3><table class="grid"><tr><td>-</td><td><b>Name</b></td><td><b>Telecom</b></td></tr><tr><td>*</td><td>Venus Yardav (OFFICIAL)</td><td>ph: -unknown-</td></tr></table></div>
        </text>
        <identifier>
          <use value="usual"/>
          <system value="http://SOT.com/ab"/>
          <value value="Infusion Site Id"/>
          <assigner>
            <display value="Site of Treatment/Infusion Centre Name"/>
          </assigner>
        </identifier>
        <type>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/organization-type"/>
            <code value="other"/>
            <display value="Site of Treatment"/>
          </coding>
          <text value="Site of Treatment"/>
        </type>
        <name value="Infusion Centre"/>
        <telecom>
          <system value="phone"/>
          <value value="8882704882"/>
          <use value="work"/>
          <rank value="1"/>
        </telecom>
        <telecom>
          <system value="fax"/>
          <value value="8179974042"/>
          <use value="work"/>
          <rank value="2"/>
        </telecom>
        <address>
          <line value="8 Ranoldo Terrace"/>
          <city value="Cherry Hill"/>
          <state value="NJ"/>
          <postalCode value="08034"/>
          <country value="US"/>
        </address>
        <contact>
          <name>
            <use value="official"/>
            <family value="Yardav"/>
            <given value="Venus"/>
          </name>
          <telecom>
            <system value="phone"/>
          </telecom>
        </contact>
      </Organization>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:212c57ad-45cd-4882-87e7-8415ded3db05"/>
    <resource>
      <ServiceRequest>
        <id value="212c57ad-45cd-4882-87e7-8415ded3db05"/>
        <meta>
          <profile
                   value="https://fhir.developer.gene.com/StructureDefinition/uapi-servicerequest"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: ServiceRequest</b><a name="212c57ad-45cd-4882-87e7-8415ded3db05"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource ServiceRequest "212c57ad-45cd-4882-87e7-8415ded3db05" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-servicerequest.html">UAPI ServiceRequest</a></p></div><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>code</b>: Benefit Investigation / Prior Authorization <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-uapi-sr-type.html">UAPI Code System - Service Request Type</a>#bipa)</span></p><p><b>subject</b>: <a href="#Patient_fc2e5a72-c363-4616-ae00-4ad25cbcb45c">See above (urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)</a></p></div>
        </text>
        <status value="active"/>
        <intent value="order"/>
        <code>
          <coding>
            <system
                    value="https://fhir.developer.gene.com/CodeSystem/uapi-sr-type"/>
            <code value="bipa"/>
          </coding>
        </code>
        <subject>
          <reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
          <type value="Patient"/>
        </subject>
      </ServiceRequest>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:f71a66c4-f747-4b46-8adc-875a45f8ee7e"/>
    <resource>
      <ServiceRequest>
        <id value="f71a66c4-f747-4b46-8adc-875a45f8ee7e"/>
        <meta>
          <profile
                   value="https://fhir.developer.gene.com/StructureDefinition/uapi-servicerequest"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: ServiceRequest</b><a name="f71a66c4-f747-4b46-8adc-875a45f8ee7e"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource ServiceRequest "f71a66c4-f747-4b46-8adc-875a45f8ee7e" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-servicerequest.html">UAPI ServiceRequest</a></p></div><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>code</b>: Copay <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-uapi-sr-type.html">UAPI Code System - Service Request Type</a>#copay)</span></p><p><b>subject</b>: <a href="#Patient_fc2e5a72-c363-4616-ae00-4ad25cbcb45c">See above (urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)</a></p></div>
        </text>
        <status value="active"/>
        <intent value="order"/>
        <code>
          <coding>
            <system
                    value="https://fhir.developer.gene.com/CodeSystem/uapi-sr-type"/>
            <code value="copay"/>
          </coding>
        </code>
        <subject>
          <reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
          <type value="Patient"/>
        </subject>
      </ServiceRequest>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:e68d1d73-9bca-40c0-b8e8-3f77dedcbf6f"/>
    <resource>
      <MedicationRequest>
        <id value="e68d1d73-9bca-40c0-b8e8-3f77dedcbf6f"/>
        <meta>
          <profile
                   value="https://fhir.developer.gene.com/StructureDefinition/uapi-medicationrequest"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: MedicationRequest</b><a name="e68d1d73-9bca-40c0-b8e8-3f77dedcbf6f"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource MedicationRequest "e68d1d73-9bca-40c0-b8e8-3f77dedcbf6f" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-medicationrequest.html">UAPI MedicationRequest</a></p></div><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>medication</b>: Avastin <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-uapi-product-name.html">UAPI Code System - Product Names</a>#avastin)</span></p><p><b>subject</b>: <a href="#Patient_fc2e5a72-c363-4616-ae00-4ad25cbcb45c">See above (urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)</a></p><p><b>requester</b>: <a href="#Practitioner_695d0991-5e03-46df-934a-85a28acd95c1">See above (urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1)</a></p><p><b>insurance</b>: <a href="#Coverage_42b41bdb-1781-49aa-a091-78cdd92129df">See above (urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df)</a></p></div>
        </text>
        <status value="active"/>
        <intent value="order"/>
        <medicationCodeableConcept>
          <coding>
            <system
                    value="https://fhir.developer.gene.com/CodeSystem/uapi-product-name"/>
            <code value="avastin"/>
            <display value="Avastin"/>
          </coding>
        </medicationCodeableConcept>
        <subject>
          <reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
          <type value="Patient"/>
        </subject>
        <requester>
          <reference value="urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1"/>
          <type value="Practitioner"/>
        </requester>
        <insurance>
          <reference value="urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df"/>
          <type value="Coverage"/>
        </insurance>
      </MedicationRequest>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:d3637025-883d-4678-9e0a-1d243a338f9f"/>
    <resource>
      <Organization>
        <id value="d3637025-883d-4678-9e0a-1d243a338f9f"/>
        <meta>
          <profile
                   value="https://fhir.developer.gene.com/StructureDefinition/uapi-organization"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Organization</b><a name="d3637025-883d-4678-9e0a-1d243a338f9f"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Organization "d3637025-883d-4678-9e0a-1d243a338f9f" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-organization.html">UAPI Organization</a></p></div><p><b>identifier</b>: id: PAY-111(use: USUAL)</p><p><b>type</b>: Insurance Company <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R4B/codesystem-organization-type.html">OrganizationType</a>#ins)</span></p><p><b>name</b>: Dakotacare</p><p><b>telecom</b>: ph: 8778472862(WORK)</p></div>
        </text>
        <identifier>
          <use value="usual"/>
          <system value="http://vendor.com/ab"/>
          <value value="PAY-111"/>
          <assigner>
            <display value="AB Vendor"/>
          </assigner>
        </identifier>
        <type>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/organization-type"/>
            <code value="ins"/>
          </coding>
        </type>
        <name value="Dakotacare"/>
        <telecom>
          <system value="phone"/>
          <value value="8778472862"/>
          <use value="work"/>
          <rank value="1"/>
        </telecom>
      </Organization>
    </resource>
  </entry>
</Bundle>