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

: Internal - UAPI Status Update GPF - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="uapi-status-update-1"/>
  <meta>
    <profile
             value="https://fhir.developer.gene.com/StructureDefinition/uapi-bundle-status-update"/>
  </meta>
  <type value="message"/>
  <timestamp value="2020-03-11T08:10:13-05:00"/>
  <entry>
    <fullUrl value="urn:uuid:5c0cdcfa-4e39-4c4d-bff2-9d70a2f49eaa"/>
    <resource>
      <MessageHeader>
        <id value="5c0cdcfa-4e39-4c4d-bff2-9d70a2f49eaa"/>
        <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="5c0cdcfa-4e39-4c4d-bff2-9d70a2f49eaa"> </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 "5c0cdcfa-4e39-4c4d-bff2-9d70a2f49eaa" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-messageheader.html">UAPI MessageHeader</a></p></div><p><b>event</b>: status-update (Details: http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-event-type code status-update = 'status-update', stated as 'null')</p><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>Genentech-PACT</td><td><a href="https://genentech-pps.my.salesforce.com">https://genentech-pps.my.salesforce.com</a></td></tr></table><p><b>focus</b>: <a href="#List_8e055260-dd74-4c89-9ccf-3d2f47135ee0">See above (urn:uuid:8e055260-dd74-4c89-9ccf-3d2f47135ee0)</a></p></div>
        </text>
        <eventCoding>
          <system
                  value="http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-event-type"/>
          <code value="status-update"/>
        </eventCoding>
        <sender>
          <reference value="urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088"/>
          <type value="Organization"/>
        </sender>
        <source>
          <name value="Genentech-PACT"/>
          <endpoint value="https://genentech-pps.my.salesforce.com"/>
        </source>
        <focus>
          <reference value="urn:uuid:8e055260-dd74-4c89-9ccf-3d2f47135ee0"/>
          <type value="List"/>
        </focus>
      </MessageHeader>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:8e055260-dd74-4c89-9ccf-3d2f47135ee0"/>
    <resource>
      <List>
        <id value="8e055260-dd74-4c89-9ccf-3d2f47135ee0"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: List</b><a name="8e055260-dd74-4c89-9ccf-3d2f47135ee0"> </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 "8e055260-dd74-4c89-9ccf-3d2f47135ee0" </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="Bundle-uapi-query-response-1-gpf.html#urn-uuid-b3d46ea3-62e6-4171-b818-d64712edfe55">urn:uuid:b3d46ea3-62e6-4171-b818-d64712edfe55</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="#CoverageEligibilityRequest_223ec8d6-fdc6-4598-9694-74f782eb5104">See above (urn:uuid:223ec8d6-fdc6-4598-9694-74f782eb5104)</a></p></blockquote><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#CoverageEligibilityResponse_0bd127dd-6ba9-4fcf-9a3a-607fc15dd450">See above (urn:uuid:0bd127dd-6ba9-4fcf-9a3a-607fc15dd450)</a></p></blockquote></div>
        </text>
        <status value="current"/>
        <mode value="changes"/>
        <title value="messageContext"/>
        <entry>
          <item>
            <reference value="urn:uuid:b3d46ea3-62e6-4171-b818-d64712edfe55"/>
            <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:223ec8d6-fdc6-4598-9694-74f782eb5104"/>
            <type value="CoverageEligibilityRequest"/>
          </item>
        </entry>
        <entry>
          <item>
            <reference value="urn:uuid:0bd127dd-6ba9-4fcf-9a3a-607fc15dd450"/>
            <type value="CoverageEligibilityResponse"/>
          </item>
        </entry>
      </List>
    </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), id: Vendor_AB_HOSP-12345(use: OFFICIAL)</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>: ph: -unknown-</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>
        <identifier>
          <use value="official"/>
          <system value="http://dev.gene.com/fhir/mulesoft"/>
          <value value="Vendor_AB_HOSP-12345"/>
          <assigner>
            <display value="UAPI Process API Mulesoft"/>
          </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="phone"/>
        </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:7c0c0017-e08d-4a14-9889-9eea26303ff2"/>
    <resource>
      <Patient>
        <id value="7c0c0017-e08d-4a14-9889-9eea26303ff2"/>
        <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="7c0c0017-e08d-4a14-9889-9eea26303ff2"> </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 "7c0c0017-e08d-4a14-9889-9eea26303ff2" </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: 540002(use: OFFICIAL), Patient internal identifier: MPAT-000123(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>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="official"/>
          <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="540002"/>
          <assigner>
            <display value="AB Vendor"/>
          </assigner>
        </identifier>
        <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://dev.gene.com/patientmaster"/>
          <value value="MPAT-000123"/>
          <assigner>
            <display value="Genentech Patient Master"/>
          </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>
        <managingOrganization>
          <reference value="urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088"/>
        </managingOrganization>
      </Patient>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:223ec8d6-fdc6-4598-9694-74f782eb5104"/>
    <resource>
      <CoverageEligibilityRequest>
        <id value="223ec8d6-fdc6-4598-9694-74f782eb5104"/>
        <meta>
          <profile
                   value="https://fhir.developer.gene.com/StructureDefinition/uapi-coverage-eligibility-request"/>
        </meta>
        <text>
          <status value="extensions"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: CoverageEligibilityRequest</b><a name="223ec8d6-fdc6-4598-9694-74f782eb5104"> </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 CoverageEligibilityRequest "223ec8d6-fdc6-4598-9694-74f782eb5104" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-coverage-eligibility-request.html">UAPI CoverageEligibilityRequest</a></p></div><p><b>UAPI CoverageEligibilityRequest ServiceRequestType</b>: Patient Foundation <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-uapi-sr-type.html">UAPI Code System - Service Request Type</a>#gpf)</span></p><p><b>UAPI CoverageEligibilityRequest Product</b>: Lucentis <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-uapi-product-name.html">UAPI Code System - Product Names</a>#lucentis)</span></p><p><b>identifier</b>: id: c78bde64-95e8-41f9-8a37-b2ac9aaf33d6(use: OLD), id: Lucentis-5001P00000maWeFQAU-(use: OFFICIAL)</p><p><b>status</b>: active</p><p><b>purpose</b>: benefits</p><p><b>patient</b>: <a href="#Patient_7c0c0017-e08d-4a14-9889-9eea26303ff2">See above (urn:uuid:7c0c0017-e08d-4a14-9889-9eea26303ff2)</a></p><p><b>created</b>: 2021-05-27 08:10:13-0500</p><p><b>provider</b>: <a href="#Organization_01c31a2f-321d-4c6e-8349-206af8a88088">See above (urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088)</a></p><p><b>insurer</b>: <a name="8a0a8882-2667-4703-8c35-fdff0f6cf19f"> </a></p><blockquote><p></p><p><a name="8a0a8882-2667-4703-8c35-fdff0f6cf19f"> </a></p><p><b>identifier</b>: id: ORG-00001(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>: Genentech Patient Foundation</p><p><b>telecom</b>: ph: 1800654332211(WORK)</p></blockquote></div>
        </text>
        <contained>
          <Organization>
            <id value="8a0a8882-2667-4703-8c35-fdff0f6cf19f"/>
            <meta>
              <profile
                       value="https://fhir.developer.gene.com/StructureDefinition/uapi-organization"/>
            </meta>
            <identifier>
              <use value="usual"/>
              <system value="http://gene.com"/>
              <value value="ORG-00001"/>
              <assigner>
                <display value="Genentech"/>
              </assigner>
            </identifier>
            <type>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/organization-type"/>
                <code value="ins"/>
              </coding>
            </type>
            <name value="Genentech Patient Foundation"/>
            <telecom>
              <system value="phone"/>
              <value value="1800654332211"/>
              <use value="work"/>
              <rank value="1"/>
            </telecom>
          </Organization>
        </contained>
        <extension
                   url="https://fhir.developer.gene.com/StructureDefinition/SRType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="https://fhir.developer.gene.com/CodeSystem/uapi-sr-type"/>
              <code value="gpf"/>
              <display value="Patient Foundation"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="https://fhir.developer.gene.com/StructureDefinition/Product">
          <valueCodeableConcept>
            <coding>
              <system
                      value="https://fhir.developer.gene.com/CodeSystem/uapi-product-name"/>
              <code value="lucentis"/>
              <display value="Lucentis"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <identifier>
          <use value="old"/>
          <system
                  value="https://fhir.developer.gene.com/enrollment/bundle-enrollment-id"/>
          <value value="c78bde64-95e8-41f9-8a37-b2ac9aaf33d6"/>
        </identifier>
        <identifier>
          <use value="official"/>
          <system
                  value="https://genentech-pps.my.salesforce.com/Product-Case-Insurance"/>
          <value value="Lucentis-5001P00000maWeFQAU-"/>
        </identifier>
        <status value="active"/>
        <purpose value="benefits"/>
        <patient>
          <reference value="urn:uuid:7c0c0017-e08d-4a14-9889-9eea26303ff2"/>
          <type value="Patient"/>
        </patient>
        <created value="2021-05-27T08:10:13-05:00"/>
        <provider>
          <reference value="urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088"/>
          <type value="Organization"/>
        </provider>
        <insurer>
          <reference value="#8a0a8882-2667-4703-8c35-fdff0f6cf19f"/>
          <type value="Organization"/>
        </insurer>
      </CoverageEligibilityRequest>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:0bd127dd-6ba9-4fcf-9a3a-607fc15dd450"/>
    <resource>
      <CoverageEligibilityResponse>
        <id value="0bd127dd-6ba9-4fcf-9a3a-607fc15dd450"/>
        <meta>
          <profile
                   value="https://fhir.developer.gene.com/StructureDefinition/uapi-coverage-eligibility-response"/>
        </meta>
        <text>
          <status value="extensions"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: CoverageEligibilityResponse</b><a name="0bd127dd-6ba9-4fcf-9a3a-607fc15dd450"> </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 CoverageEligibilityResponse "0bd127dd-6ba9-4fcf-9a3a-607fc15dd450" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-coverage-eligibility-response.html">UAPI CoverageEligibilityResponse</a></p></div><p><b>UAPI CoverageEligibilityResponse Shipment Method</b>: Upfront <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-gpf-shipment-method.html">UAPI Code System - Shipment Methods</a>#upfront)</span></p><p><b>UAPI CoverageEligibilityResponse Status</b>: Approved <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-uapi-coverage-outcome.html">UAPI Code System - CoverageEligibilityRequest outcome</a>#approved)</span></p><p><b>status</b>: active</p><p><b>purpose</b>: benefits</p><p><b>patient</b>: <a href="#Patient_7c0c0017-e08d-4a14-9889-9eea26303ff2">See above (urn:uuid:7c0c0017-e08d-4a14-9889-9eea26303ff2)</a></p><p><b>serviced</b>: 2021-06-01</p><p><b>created</b>: 2021-05-27 08:10:13-0500</p><p><b>request</b>: <a name="0c3b8b8b-cf22-41e2-a14d-1f3c288760c9"> </a></p><blockquote><p></p><p><a name="0c3b8b8b-cf22-41e2-a14d-1f3c288760c9"> </a></p><p><b>UAPI CoverageEligibilityRequest ServiceRequestType</b>: Patient Foundation <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-uapi-sr-type.html">UAPI Code System - Service Request Type</a>#gpf)</span></p><p><b>UAPI CoverageEligibilityRequest Product</b>: Lucentis <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-uapi-product-name.html">UAPI Code System - Product Names</a>#lucentis)</span></p><p><b>status</b>: active</p><p><b>purpose</b>: benefits</p><p><b>patient</b>: <a href="#Patient_7c0c0017-e08d-4a14-9889-9eea26303ff2">See above (urn:uuid:7c0c0017-e08d-4a14-9889-9eea26303ff2)</a></p><p><b>created</b>: 2021-05-27 08:10:13-0500</p><p><b>provider</b>: <a href="#Organization_01c31a2f-321d-4c6e-8349-206af8a88088">See above (urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088)</a></p><p><b>insurer</b>: <a href="Bundle-uapi-query-response-1-gpf.html#urn-uuid-8a0a8882-2667-4703-8c35-fdff0f6cf19f">urn:uuid:8a0a8882-2667-4703-8c35-fdff0f6cf19f</a></p></blockquote><p><b>outcome</b>: complete</p><p><b>disposition</b>: Not Insured</p><p><b>insurer</b>: <a name="8a0a8882-2667-4703-8c35-fdff0f6cf19f"> </a></p><blockquote><p></p><p><a name="8a0a8882-2667-4703-8c35-fdff0f6cf19f"> </a></p><p><b>identifier</b>: id: ORG-00001(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>: Genentech Patient Foundation</p><p><b>telecom</b>: ph: 1800654332211(WORK)</p></blockquote></div>
        </text>
        <contained>
          <Organization>
            <id value="8a0a8882-2667-4703-8c35-fdff0f6cf19f"/>
            <meta>
              <profile
                       value="https://fhir.developer.gene.com/StructureDefinition/uapi-organization"/>
            </meta>
            <identifier>
              <use value="usual"/>
              <system value="http://gene.com"/>
              <value value="ORG-00001"/>
              <assigner>
                <display value="Genentech"/>
              </assigner>
            </identifier>
            <type>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/organization-type"/>
                <code value="ins"/>
              </coding>
            </type>
            <name value="Genentech Patient Foundation"/>
            <telecom>
              <system value="phone"/>
              <value value="1800654332211"/>
              <use value="work"/>
              <rank value="1"/>
            </telecom>
          </Organization>
        </contained>
        <contained>
          <CoverageEligibilityRequest>
            <id value="0c3b8b8b-cf22-41e2-a14d-1f3c288760c9"/>
            <meta>
              <profile
                       value="https://fhir.developer.gene.com/StructureDefinition/uapi-coverage-eligibility-request"/>
            </meta>
            <extension
                       url="https://fhir.developer.gene.com/StructureDefinition/SRType">
              <valueCodeableConcept>
                <coding>
                  <system
                          value="https://fhir.developer.gene.com/CodeSystem/uapi-sr-type"/>
                  <code value="gpf"/>
                  <display value="Patient Foundation"/>
                </coding>
              </valueCodeableConcept>
            </extension>
            <extension
                       url="https://fhir.developer.gene.com/StructureDefinition/Product">
              <valueCodeableConcept>
                <coding>
                  <system
                          value="https://fhir.developer.gene.com/CodeSystem/uapi-product-name"/>
                  <code value="lucentis"/>
                  <display value="Lucentis"/>
                </coding>
              </valueCodeableConcept>
            </extension>
            <status value="active"/>
            <purpose value="benefits"/>
            <patient>
              <reference
                         value="urn:uuid:7c0c0017-e08d-4a14-9889-9eea26303ff2"/>
              <type value="Patient"/>
            </patient>
            <created value="2021-05-27T08:10:13-05:00"/>
            <provider>
              <reference
                         value="urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088"/>
              <type value="Organization"/>
            </provider>
            <insurer>
              <reference
                         value="urn:uuid:8a0a8882-2667-4703-8c35-fdff0f6cf19f"/>
              <type value="Organization"/>
            </insurer>
          </CoverageEligibilityRequest>
        </contained>
        <extension
                   url="https://fhir.developer.gene.com/StructureDefinition/gpf-shipment-method">
          <valueCodeableConcept>
            <coding>
              <system
                      value="https://fhir.developer.gene.com/CodeSystem/gpf-shipment-method"/>
              <code value="upfront"/>
              <display value="Upfront"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="https://fhir.developer.gene.com/StructureDefinition/statusOutcome">
          <valueCodeableConcept>
            <coding>
              <system
                      value="https://fhir.developer.gene.com/CodeSystem/uapi-coverage-outcome"/>
              <code value="approved"/>
              <display value="Approved"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <status value="active"/>
        <purpose value="benefits"/>
        <patient>
          <reference value="urn:uuid:7c0c0017-e08d-4a14-9889-9eea26303ff2"/>
          <type value="Patient"/>
        </patient>
        <servicedDate value="2021-06-01"/>
        <created value="2021-05-27T08:10:13-05:00"/>
        <request>
          <reference value="#0c3b8b8b-cf22-41e2-a14d-1f3c288760c9"/>
          <type value="CoverageEligibilityRequest"/>
        </request>
        <outcome value="complete"/>
        <disposition value="Not Insured"/>
        <insurer>
          <reference value="#8a0a8882-2667-4703-8c35-fdff0f6cf19f"/>
          <type value="Organization"/>
        </insurer>
      </CoverageEligibilityResponse>
    </resource>
  </entry>
</Bundle>