RubyGems - davinci_pas_test_kit - Versions diffs - 0.14.1 → 0.15.1 - Mend

davinci_pas_test_kit 0.14.1 → 0.15.1

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data/config/presets/pas_ri.json CHANGED Viewed

@@ -47,7 +47,7 @@
       "optional": true,
       "title": "PAS Inquiry Request Payload",
       "type": "textarea",
-      "value": "{\n  \"resourceType\": \"Bundle\",\n  \"id\": \"PASBundleInquiryExample\",\n  \"meta\": {\n    \"profile\": [\n      \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle\"\n    ]\n  },\n  \"identifier\": {\n    \"system\": \"http://davinci-pas.org/SUBMITTER_TRANSACTION_IDENTIFIER\",\n    \"value\": \"A12345\"\n  },\n  \"type\": \"collection\",\n  \"timestamp\": \"2005-05-02T11:01:00+05:00\",\n  \"entry\": [\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Claim/PASClaimInquiryExample\",\n      \"resource\": {\n        \"resourceType\": \"Claim\",\n        \"id\": \"PASClaimInquiryExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"extensions\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Claim</b><a name=\\\"ReferralAuthorizationExample\\\"> </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 Claim &quot;ReferralAuthorizationExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-claim.html\\\">PAS Claim</a></p></div><p><b>LevelOfServiceCode</b>: Urgent <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (1338#U)</span></p><p><b>identifier</b>: id: 111099</p><p><b>status</b>: active</p><p><b>type</b>: Professional <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-claim-type.html\\\">Claim Type Codes</a>#professional)</span></p><p><b>use</b>: preauthorization</p><p><b>patient</b>: Patient/SubscriberExample</p><p><b>created</b>: 2005-05-02 11:01:00+0500</p><p><b>insurer</b>: Organization/InsurerExample</p><p><b>provider</b>: Organization/UMOExample</p><p><b>priority</b>: Normal <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-processpriority.html\\\">Process Priority Codes</a>#normal)</span></p><h3>CareTeams</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>Provider</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td/><td>1</td><td>PractitionerRole/ReferralPractitionerRoleExample</td></tr></table><h3>Diagnoses</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td/><td>1</td><td>Chronic pain syndrome <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-icd10CM.html\\\">International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)</a>#G89.4)</span></td></tr></table><h3>Insurances</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td>1</td><td>true</td><td>Coverage/InsuranceExample</td></tr></table><h3>Items</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>CareTeamSequence</b></td><td><b>DiagnosisSequence</b></td><td><b>Category</b></td><td><b>ProductOrService</b></td><td><b>Location[x]</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td>, , , , , , , , , </td><td>1</td><td>1</td><td>1</td><td>Consultation <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (1365#3)</span></td><td>Consultation <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (1365#3)</span></td><td>11 <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-CMSPlaceofServiceCodes.html\\\">CMS Place of Service Codes (POS)</a>#11)</span></td></tr></table></div>\"\n        },\n        \"extension\": [\n          {\n            \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-levelOfServiceCode\",\n            \"valueCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://codesystem.x12.org/005010/1338\",\n                  \"code\": \"U\",\n                  \"display\": \"Urgent\"\n                }\n              ]\n            }\n          },\n          {\n            \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType\",\n            \"valueCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://codesystem.x12.org/005010/1322\",\n                  \"code\": \"I\",\n                  \"display\": \"Initial\"\n                }\n              ]\n            }\n          }\n        ],\n        \"identifier\": [\n          {\n            \"extension\": [\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierJurisdiction\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://www.usps.com/\",\n                      \"code\": \"MA\"\n                    }\n                  ]\n                }\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierSubDepartment\",\n                \"valueString\": \"223412\"\n              }\n            ],\n            \"system\": \"http://davinci-pas.org/PATIENT_EVENT_TRACE_NUMBER\",\n            \"value\": \"111099\",\n            \"assigner\": {\n              \"identifier\": {\n                \"system\": \"http://davinci-pas.org/USER_ASSIGNED\",\n                \"value\": \"9012345678\"\n              }\n            }\n          }\n        ],\n        \"status\": \"active\",\n        \"billablePeriod\": {\n          \"start\": \"2016-12-06\",\n          \"end\": \"2020-07-22\"\n        },\n        \"type\": {\n          \"coding\": [\n            {\n              \"system\": \"http://terminology.hl7.org/CodeSystem/claim-type\",\n              \"code\": \"professional\"\n            }\n          ]\n        },\n        \"use\": \"preauthorization\",\n        \"patient\": {\n          \"reference\": \"Patient/SubscriberExample\"\n        },\n        \"created\": \"2005-05-02T11:01:00+05:00\",\n        \"insurer\": {\n          \"reference\": \"Organization/InsurerExample\"\n        },\n        \"provider\": {\n          \"reference\": \"Organization/UMOExample\"\n        },\n        \"priority\": {\n          \"coding\": [\n            {\n              \"system\": \"http://terminology.hl7.org/CodeSystem/processpriority\",\n              \"code\": \"normal\"\n            }\n          ]\n        },\n        \"careTeam\": [\n          {\n            \"extension\": [\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope\",\n                \"valueBoolean\": true\n              }\n            ],\n            \"sequence\": 1,\n            \"provider\": {\n              \"reference\": \"PractitionerRole/ReferralPractitionerRoleExample\"\n            },\n            \"qualification\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://terminology.hl7.org/CodeSystem/ex-providerqualification\",\n                  \"code\": \"604210\"\n                }\n              ]\n            },\n            \"role\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://terminology.hl7.org/CodeSystem/claimcareteamrole\",\n                  \"code\": \"primary\"\n                }\n              ]\n            }\n          }\n        ],\n        \"diagnosis\": [\n          {\n            \"extension\": [\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate\",\n                \"valueDate\": \"2021-05-10\"\n              }\n            ],\n            \"sequence\": 1,\n            \"diagnosisCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://hl7.org/fhir/sid/icd-10-cm\",\n                  \"code\": \"G89.4\"\n                }\n              ]\n            },\n            \"type\": [\n              {\n                \"coding\": [\n                  {\n                    \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n                    \"code\": \"patientreasonforvisit\"\n                  }\n                ]\n              }\n            ]\n          }\n        ],\n        \"insurance\": [\n          {\n            \"sequence\": 1,\n            \"focal\": true,\n            \"coverage\": {\n              \"reference\": \"Coverage/InsuranceExample\"\n            }\n          }\n        ],\n        \"item\": [\n          {\n            \"extension\": [\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber\",\n                \"valueIdentifier\": {\n                  \"system\": \"http://davinci-pas.org/ITEM_TRACE_NUMBER\",\n                  \"value\": \"1122334\"\n                }\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber\",\n                \"valueString\": \"1122445\"\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber\",\n                \"valueString\": \"9988311\"\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://codesystem.x12.org/005010/1525\",\n                      \"code\": \"HS\",\n                      \"display\": \"Health Services Review\"\n                    }\n                  ]\n                }\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://codesystem.x12.org/005010/1322\",\n                      \"code\": \"I\",\n                      \"display\": \"Initial\"\n                    }\n                  ]\n                }\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCertificationIssueDate\",\n                \"valueDate\": \"2021-09-10\"\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCertificationExpirationDate\",\n                \"valueDate\": \"2022-09-10\"\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCertificationEffectiveDate\",\n                \"valueDate\": \"2021-09-10\"\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewActionCode\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://codesystem.x12.org/005010/306\",\n                      \"code\": \"A1\",\n                      \"display\": \"Certified in total\"\n                    }\n                  ]\n                }\n              }\n            ],\n            \"sequence\": 1,\n            \"careTeamSequence\": [\n              1\n            ],\n            \"diagnosisSequence\": [\n              1\n            ],\n            \"informationSequence\": [\n              1\n            ],\n            \"revenue\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://www.nubc.org/revenue-code\",\n                  \"code\": \"0105\"\n                }\n              ]\n            },\n            \"modifier\": [\n              {\n                \"coding\": [\n                  {\n                    \"system\": \"http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets\",\n                    \"code\": \"E0110\"\n                  }\n                ]\n              }\n            ],\n            \"servicedDate\": \"2016-08-09\",\n            \"quantity\": {\n              \"value\": 1\n            },\n            \"locationCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set\",\n                  \"code\": \"11\"\n                }\n              ]\n            },\n            \"productOrService\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets\",\n                  \"code\": \"G0154\"\n                }\n              ]\n            },\n            \"category\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://codesystem.x12.org/005010/1365\",\n                  \"code\": \"3\",\n                  \"display\": \"Consultation\"\n                }\n              ]\n            }\n          },\n          {\n            \"extension\": [\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://codesystem.x12.org/005010/1525\",\n                      \"code\": \"HS\",\n                      \"display\": \"Health Services Review\"\n                    }\n                  ]\n                }\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://codesystem.x12.org/005010/1322\",\n                      \"code\": \"I\",\n                      \"display\": \"Initial\"\n                    }\n                  ]\n                }\n              }\n            ],\n            \"sequence\": 2,\n            \"productOrService\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets\",\n                  \"code\": \"B4184\"\n                }\n              ]\n            },\n            \"category\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://codesystem.x12.org/005010/1365\",\n                  \"code\": \"3\",\n                  \"display\": \"Consultation\"\n                }\n              ]\n            }\n          }\n        ],\n        \"accident\": {\n          \"date\": \"2016-03-09\"\n        }\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Organization/UMOExample\",\n      \"resource\": {\n        \"resourceType\": \"Organization\",\n        \"id\": \"UMOExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Organization</b><a name=\\\"UMOExample\\\"> </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 &quot;UMOExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-requestor.html\\\">PAS Requestor Organization</a></p></div><p><b>identifier</b>: id: <a href=\\\"http://terminology.hl7.org/5.0.0/NamingSystem-npi.html\\\">#</a>8189991234</p><p><b>active</b>: true</p><p><b>type</b>: X3 <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (98#X3)</span></p><p><b>name</b>: DR. JOE SMITH CORPORATION</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>\"\n        },\n        \"identifier\": [\n          {\n            \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n            \"value\": \"8189991234\"\n          },\n          {\n            \"system\": \"http://terminology.hl7.org/NamingSystem/USEIN\",\n            \"value\": \"8189948234\"\n          }\n        ],\n        \"active\": true,\n        \"type\": [\n          {\n            \"coding\": [\n              {\n                \"system\": \"https://codesystem.x12.org/005010/98\",\n                \"code\": \"X3\"\n              }\n            ]\n          }\n        ],\n        \"name\": \"DR. JOE SMITH CORPORATION\",\n        \"address\": [\n          {\n            \"line\": [\n              \"111 1ST STREET\"\n            ],\n            \"city\": \"SAN DIEGO\",\n            \"state\": \"CA\",\n            \"postalCode\": \"92101\",\n            \"country\": \"US\"\n          }\n        ],\n        \"telecom\": [\n          {\n            \"system\": \"phone\",\n            \"value\": \"4029993456\"\n          }\n        ],\n        \"contact\": [\n          {\n            \"telecom\": [\n              {\n                \"system\": \"other\",\n                \"value\": \"http://hl7.org/fhir\"\n              }\n            ],\n            \"name\": {\n              \"family\": \"WATSON\",\n              \"given\": [\n                \"SUSAN\"\n              ]\n            }\n          }\n        ]\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Organization/InsurerExample\",\n      \"resource\": {\n        \"resourceType\": \"Organization\",\n        \"id\": \"InsurerExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Organization</b><a name=\\\"InsurerExample\\\"> </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 &quot;InsurerExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-insurer.html\\\">PAS Insurer Organization</a></p></div><p><b>identifier</b>: id: <a href=\\\"http://terminology.hl7.org/5.0.0/NamingSystem-npi.html\\\">#</a>789312</p><p><b>active</b>: true</p><p><b>type</b>: PR <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (98#PR)</span></p><p><b>name</b>: MARYLAND CAPITAL INSURANCE COMPANY</p></div>\"\n        },\n        \"identifier\": [\n          {\n            \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n            \"value\": \"789312\"\n          },\n          {\n            \"system\": \"http://terminology.hl7.org/NamingSystem/USEIN\",\n            \"value\": \"7239994834\"\n          }\n        ],\n        \"active\": true,\n        \"type\": [\n          {\n            \"coding\": [\n              {\n                \"system\": \"https://codesystem.x12.org/005010/98\",\n                \"code\": \"PR\"\n              }\n            ]\n          }\n        ],\n        \"telecom\": [\n          {\n            \"system\": \"phone\",\n            \"value\": \"3029993456\"\n          }\n        ],\n        \"name\": \"MARYLAND CAPITAL INSURANCE COMPANY\"\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Coverage/InsuranceExample\",\n      \"resource\": {\n        \"resourceType\": \"Coverage\",\n        \"id\": \"InsuranceExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-coverage\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Coverage</b><a name=\\\"InsuranceExample\\\"> </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 &quot;InsuranceExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-coverage.html\\\">PAS Coverage</a></p></div><p><b>status</b>: active</p><p><b>beneficiary</b>: Patient/SubscriberExample</p><p><b>payor</b>: Organization/InsurerExample</p></div>\"\n        },\n        \"status\": \"active\",\n        \"identifier\": [\n          {\n            \"system\": \"http://davinci-pas.org/MIN\",\n            \"value\": \"1234567cov\"\n          }\n        ],\n        \"beneficiary\": {\n          \"reference\": \"Patient/SubscriberExample\"\n        },\n        \"payor\": [\n          {\n            \"reference\": \"Organization/InsurerExample\"\n          }\n        ],\n        \"subscriber\": {\n          \"reference\": \"Patient/SubscriberExample\"\n        },\n        \"subscriberId\": \"12345678901\",\n        \"relationship\": {\n          \"coding\": [\n            {\n              \"system\": \"http://terminology.hl7.org/CodeSystem/subscriber-relationship\",\n              \"code\": \"self\"\n            }\n          ]\n        }\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Patient/SubscriberExample\",\n      \"resource\": {\n        \"resourceType\": \"Patient\",\n        \"id\": \"SubscriberExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"extensions\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Patient</b><a name=\\\"SubscriberExample\\\"> </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 &quot;SubscriberExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-subscriber.html\\\">PAS Subscriber Patient</a></p></div><p><b>MilitaryStatus</b>: RU <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (584#RU)</span></p><p><b>identifier</b>: id: 12345678901</p><p><b>name</b>: JOE SMITH </p><p><b>gender</b>: male</p></div>\"\n        },\n        \"extension\": [\n          {\n            \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-militaryStatus\",\n            \"valueCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://codesystem.x12.org/005010/584\",\n                  \"code\": \"RU\"\n                }\n              ]\n            }\n          },\n          {\n            \"extension\": [\n              {\n                \"url\": \"ombCategory\",\n                \"valueCoding\": {\n                  \"system\": \"urn:oid:2.16.840.1.113883.6.238\",\n                  \"code\": \"2106-3\",\n                  \"display\": \"White\"\n                }\n              },\n              {\n                \"url\": \"text\",\n                \"valueString\": \"Caucasian\"\n              }\n            ],\n            \"url\": \"http://hl7.org/fhir/us/core/StructureDefinition/us-core-race\"\n          },\n          {\n            \"extension\": [\n              {\n                \"url\": \"ombCategory\",\n                \"valueCoding\": {\n                  \"system\": \"urn:oid:2.16.840.1.113883.6.238\",\n                  \"code\": \"2135-2\",\n                  \"display\": \"Hispanic or Latino\"\n                }\n              },\n              {\n                \"url\": \"text\",\n                \"valueString\": \"Filipino\"\n              }\n            ],\n            \"url\": \"http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity\"\n          },\n          {\n            \"url\": \"http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex\",\n            \"valueCode\": \"M\"\n          }\n        ],\n        \"identifier\": [\n          {\n            \"system\": \"http://davinci-pas.org/MIN\",\n            \"value\": \"12345678901\"\n          }\n        ],\n        \"name\": [\n          {\n            \"family\": \"SMITH\",\n            \"given\": [\n              \"JOE\"\n            ],\n            \"prefix\": [\n              \"Mr\"\n            ],\n            \"suffix\": [\n              \"PharmD\"\n            ]\n          }\n        ],\n        \"gender\": \"male\",\n        \"birthDate\": \"1987-02-20\",\n        \"multipleBirthInteger\": 1,\n        \"communication\": [\n          {\n            \"language\": {\n              \"coding\": [\n                {\n                  \"system\": \"urn:ietf:bcp:47\",\n                  \"code\": \"nl-NL\",\n                  \"display\": \"Dutch (Netherlands)\"\n                }\n              ]\n            },\n            \"preferred\": true\n          }\n        ],\n        \"telecom\": [\n          {\n            \"system\": \"phone\",\n            \"value\": \"555-555-5555\",\n            \"use\": \"home\"\n          }\n        ],\n        \"address\": [\n          {\n            \"line\": [\n              \"49 Meadow St\"\n            ],\n            \"city\": \"Mounds\",\n            \"state\": \"OK\",\n            \"district\": \"Meadow\",\n            \"postalCode\": \"74047\",\n            \"country\": \"US\",\n            \"period\": {\n              \"start\": \"2016-12-06\",\n              \"end\": \"2020-07-22\"\n            }\n          }\n        ]\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/PractitionerRole/ReferralPractitionerRoleExample\",\n      \"resource\": {\n        \"resourceType\": \"PractitionerRole\",\n        \"id\": \"ReferralPractitionerRoleExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: PractitionerRole</b><a name=\\\"ReferralPractitionerRoleExample\\\"> </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 PractitionerRole &quot;ReferralPractitionerRoleExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-practitionerrole.html\\\">PAS PractitionerRole</a></p></div><p><b>practitioner</b>: Practitioner/ReferralPractitionerExample</p><p><b>location</b>: Location/ReferralLocationExample</p></div>\"\n        },\n        \"practitioner\": {\n          \"reference\": \"Practitioner/ReferralPractitionerExample\"\n        },\n        \"organization\": {\n          \"reference\": \"Organization/UMOExample\"\n        },\n        \"location\": [\n          {\n            \"reference\": \"Location/ReferralLocationExample\"\n          }\n        ]\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Practitioner/ReferralPractitionerExample\",\n      \"resource\": {\n        \"resourceType\": \"Practitioner\",\n        \"id\": \"ReferralPractitionerExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Practitioner</b><a name=\\\"ReferralPractitionerExample\\\"> </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 &quot;ReferralPractitionerExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-practitioner.html\\\">PAS Practitioner</a></p></div><p><b>identifier</b>: id: <a href=\\\"http://terminology.hl7.org/5.0.0/NamingSystem-npi.html\\\">#</a>987654321</p><p><b>name</b>: SUSAN WATSON </p><p><b>telecom</b>: ph: 4029993456</p></div>\"\n        },\n        \"identifier\": [\n          {\n            \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n            \"value\": \"987654321\"\n          }\n        ],\n        \"name\": [\n          {\n            \"family\": \"WATSON\",\n            \"given\": [\n              \"SUSAN\"\n            ]\n          }\n        ],\n        \"telecom\": [\n          {\n            \"system\": \"phone\",\n            \"value\": \"4029993456\"\n          }\n        ],\n        \"address\": [\n          {\n            \"line\": [\n              \"111 1ST STREET\"\n            ],\n            \"city\": \"SAN DIEGO\",\n            \"state\": \"CA\",\n            \"postalCode\": \"92101\",\n            \"country\": \"US\"\n          }\n        ]\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Location/ReferralLocationExample\",\n      \"resource\": {\n        \"resourceType\": \"Location\",\n        \"id\": \"ReferralLocationExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-location\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Location</b><a name=\\\"ReferralLocationExample\\\"> </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 Location &quot;ReferralLocationExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-location.html\\\">PAS Location Profile</a></p></div><p><b>name</b>: REFERRAL CLINIC</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>\"\n        },\n        \"name\": \"REFERRAL CLINIC\",\n        \"address\": {\n          \"line\": [\n            \"111 1ST STREET\"\n          ],\n          \"city\": \"SAN DIEGO\",\n          \"state\": \"CA\",\n          \"postalCode\": \"92101\",\n          \"country\": \"US\"\n        }\n      }\n    }\n  ]\n}"
+      "value": "{\n  \"resourceType\": \"Bundle\",\n  \"id\": \"PASBundleInquiryExample\",\n  \"meta\": {\n    \"profile\": [\n      \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle\"\n    ]\n  },\n  \"identifier\": {\n    \"system\": \"http://davinci-pas.org/SUBMITTER_TRANSACTION_IDENTIFIER\",\n    \"value\": \"A12345\"\n  },\n  \"type\": \"collection\",\n  \"timestamp\": \"2005-05-02T11:01:00+05:00\",\n  \"entry\": [\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Claim/PASClaimInquiryExample\",\n      \"resource\": {\n        \"resourceType\": \"Claim\",\n        \"id\": \"PASClaimInquiryExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"extensions\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Claim</b><a name=\\\"ReferralAuthorizationExample\\\"> </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 Claim &quot;ReferralAuthorizationExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-claim.html\\\">PAS Claim</a></p></div><p><b>LevelOfServiceCode</b>: Urgent <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (1338#U)</span></p><p><b>identifier</b>: id: 111099</p><p><b>status</b>: active</p><p><b>type</b>: Professional <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-claim-type.html\\\">Claim Type Codes</a>#professional)</span></p><p><b>use</b>: preauthorization</p><p><b>patient</b>: Patient/SubscriberExample</p><p><b>created</b>: 2005-05-02 11:01:00+0500</p><p><b>insurer</b>: Organization/InsurerExample</p><p><b>provider</b>: Organization/UMOExample</p><p><b>priority</b>: Normal <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-processpriority.html\\\">Process Priority Codes</a>#normal)</span></p><h3>CareTeams</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>Provider</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td/><td>1</td><td>PractitionerRole/ReferralPractitionerRoleExample</td></tr></table><h3>Diagnoses</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td/><td>1</td><td>Chronic pain syndrome <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-icd10CM.html\\\">International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)</a>#G89.4)</span></td></tr></table><h3>Insurances</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td>1</td><td>true</td><td>Coverage/InsuranceExample</td></tr></table><h3>Items</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>CareTeamSequence</b></td><td><b>DiagnosisSequence</b></td><td><b>Category</b></td><td><b>ProductOrService</b></td><td><b>Location[x]</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td>, , , , , , , , , </td><td>1</td><td>1</td><td>1</td><td>Consultation <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (1365#3)</span></td><td>Consultation <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (1365#3)</span></td><td>11 <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-CMSPlaceofServiceCodes.html\\\">CMS Place of Service Codes (POS)</a>#11)</span></td></tr></table></div>\"\n        },\n        \"extension\": [\n          {\n            \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-levelOfServiceCode\",\n            \"valueCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://codesystem.x12.org/005010/1338\",\n                  \"code\": \"U\",\n                  \"display\": \"Urgent\"\n                }\n              ]\n            }\n          },\n          {\n            \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType\",\n            \"valueCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://codesystem.x12.org/005010/1322\",\n                  \"code\": \"I\",\n                  \"display\": \"Initial\"\n                }\n              ]\n            }\n          }\n        ],\n        \"identifier\": [\n          {\n            \"extension\": [\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierJurisdiction\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://www.usps.com/\",\n                      \"code\": \"MA\"\n                    }\n                  ]\n                }\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierSubDepartment\",\n                \"valueString\": \"223412\"\n              }\n            ],\n            \"system\": \"http://davinci-pas.org/PATIENT_EVENT_TRACE_NUMBER\",\n            \"value\": \"111099\",\n            \"assigner\": {\n              \"identifier\": {\n                \"system\": \"http://davinci-pas.org/USER_ASSIGNED\",\n                \"value\": \"9012345678\"\n              }\n            }\n          }\n        ],\n        \"status\": \"active\",\n        \"billablePeriod\": {\n          \"start\": \"2016-12-06\",\n          \"end\": \"2020-07-22\"\n        },\n        \"type\": {\n          \"coding\": [\n            {\n              \"system\": \"http://terminology.hl7.org/CodeSystem/claim-type\",\n              \"code\": \"professional\"\n            }\n          ]\n        },\n        \"use\": \"preauthorization\",\n        \"patient\": {\n          \"reference\": \"Patient/SubscriberExample\"\n        },\n        \"created\": \"2005-05-02T11:01:00+05:00\",\n        \"insurer\": {\n          \"reference\": \"Organization/InsurerExample\"\n        },\n        \"provider\": {\n          \"reference\": \"Organization/UMOExample\"\n        },\n        \"priority\": {\n          \"coding\": [\n            {\n              \"system\": \"http://terminology.hl7.org/CodeSystem/processpriority\",\n              \"code\": \"normal\"\n            }\n          ]\n        },\n        \"careTeam\": [\n          {\n            \"extension\": [\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope\",\n                \"valueBoolean\": true\n              }\n            ],\n            \"sequence\": 1,\n            \"provider\": {\n              \"reference\": \"PractitionerRole/ReferralPractitionerRoleExample\"\n            },\n            \"qualification\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://terminology.hl7.org/CodeSystem/ex-providerqualification\",\n                  \"code\": \"604210\"\n                }\n              ]\n            },\n            \"role\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://terminology.hl7.org/CodeSystem/claimcareteamrole\",\n                  \"code\": \"primary\"\n                }\n              ]\n            }\n          }\n        ],\n        \"diagnosis\": [\n          {\n            \"extension\": [\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate\",\n                \"valueDate\": \"2021-05-10\"\n              }\n            ],\n            \"sequence\": 1,\n            \"diagnosisCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://hl7.org/fhir/sid/icd-10-cm\",\n                  \"code\": \"G89.4\"\n                }\n              ]\n            },\n            \"type\": [\n              {\n                \"coding\": [\n                  {\n                    \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n                    \"code\": \"patientreasonforvisit\"\n                  }\n                ]\n              }\n            ]\n          }\n        ],\n        \"insurance\": [\n          {\n            \"sequence\": 1,\n            \"focal\": true,\n            \"coverage\": {\n              \"reference\": \"Coverage/InsuranceExample\"\n            }\n          }\n        ],\n        \"item\": [\n          {\n            \"extension\": [\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber\",\n                \"valueIdentifier\": {\n                  \"system\": \"http://davinci-pas.org/ITEM_TRACE_NUMBER\",\n                  \"value\": \"1122334\"\n                }\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber\",\n                \"valueString\": \"1122445\"\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber\",\n                \"valueString\": \"9988311\"\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://codesystem.x12.org/005010/1525\",\n                      \"code\": \"HS\",\n                      \"display\": \"Health Services Review\"\n                    }\n                  ]\n                }\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://codesystem.x12.org/005010/1322\",\n                      \"code\": \"I\",\n                      \"display\": \"Initial\"\n                    }\n                  ]\n                }\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCertificationIssueDate\",\n                \"valueDate\": \"2021-09-10\"\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCertificationExpirationDate\",\n                \"valueDate\": \"2022-09-10\"\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCertificationEffectiveDate\",\n                \"valueDate\": \"2021-09-10\"\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewActionCode\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://codesystem.x12.org/005010/306\",\n                      \"code\": \"A1\",\n                      \"display\": \"Certified in total\"\n                    }\n                  ]\n                }\n              }\n            ],\n            \"sequence\": 1,\n            \"careTeamSequence\": [\n              1\n            ],\n            \"diagnosisSequence\": [\n              1\n            ],\n            \"informationSequence\": [\n              1\n            ],\n            \"revenue\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://www.nubc.org/revenue-code\",\n                  \"code\": \"0105\"\n                }\n              ]\n            },\n            \"modifier\": [\n              {\n                \"coding\": [\n                  {\n                    \"system\": \"http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets\",\n                    \"code\": \"E0110\"\n                  }\n                ]\n              }\n            ],\n            \"servicedDate\": \"2016-08-09\",\n            \"quantity\": {\n              \"value\": 1\n            },\n            \"locationCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set\",\n                  \"code\": \"11\"\n                }\n              ]\n            },\n            \"productOrService\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets\",\n                  \"code\": \"G0154\"\n                }\n              ]\n            },\n            \"category\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://codesystem.x12.org/005010/1365\",\n                  \"code\": \"3\",\n                  \"display\": \"Consultation\"\n                }\n              ]\n            }\n          },\n          {\n            \"extension\": [\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://codesystem.x12.org/005010/1525\",\n                      \"code\": \"HS\",\n                      \"display\": \"Health Services Review\"\n                    }\n                  ]\n                }\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://codesystem.x12.org/005010/1322\",\n                      \"code\": \"I\",\n                      \"display\": \"Initial\"\n                    }\n                  ]\n                }\n              }\n            ],\n            \"sequence\": 2,\n            \"productOrService\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets\",\n                  \"code\": \"B4185\"\n                }\n              ]\n            },\n            \"category\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://codesystem.x12.org/005010/1365\",\n                  \"code\": \"3\",\n                  \"display\": \"Consultation\"\n                }\n              ]\n            }\n          }\n        ],\n        \"accident\": {\n          \"date\": \"2016-03-09\"\n        }\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Organization/UMOExample\",\n      \"resource\": {\n        \"resourceType\": \"Organization\",\n        \"id\": \"UMOExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Organization</b><a name=\\\"UMOExample\\\"> </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 &quot;UMOExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-requestor.html\\\">PAS Requestor Organization</a></p></div><p><b>identifier</b>: id: <a href=\\\"http://terminology.hl7.org/5.0.0/NamingSystem-npi.html\\\">#</a>8189991234</p><p><b>active</b>: true</p><p><b>type</b>: X3 <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (98#X3)</span></p><p><b>name</b>: DR. JOE SMITH CORPORATION</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>\"\n        },\n        \"identifier\": [\n          {\n            \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n            \"value\": \"8189991234\"\n          },\n          {\n            \"system\": \"http://terminology.hl7.org/NamingSystem/USEIN\",\n            \"value\": \"8189948234\"\n          }\n        ],\n        \"active\": true,\n        \"type\": [\n          {\n            \"coding\": [\n              {\n                \"system\": \"https://codesystem.x12.org/005010/98\",\n                \"code\": \"X3\"\n              }\n            ]\n          }\n        ],\n        \"name\": \"DR. JOE SMITH CORPORATION\",\n        \"address\": [\n          {\n            \"line\": [\n              \"111 1ST STREET\"\n            ],\n            \"city\": \"SAN DIEGO\",\n            \"state\": \"CA\",\n            \"postalCode\": \"92101\",\n            \"country\": \"US\"\n          }\n        ],\n        \"telecom\": [\n          {\n            \"system\": \"phone\",\n            \"value\": \"4029993456\"\n          }\n        ],\n        \"contact\": [\n          {\n            \"telecom\": [\n              {\n                \"system\": \"other\",\n                \"value\": \"http://hl7.org/fhir\"\n              }\n            ],\n            \"name\": {\n              \"family\": \"WATSON\",\n              \"given\": [\n                \"SUSAN\"\n              ]\n            }\n          }\n        ]\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Organization/InsurerExample\",\n      \"resource\": {\n        \"resourceType\": \"Organization\",\n        \"id\": \"InsurerExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Organization</b><a name=\\\"InsurerExample\\\"> </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 &quot;InsurerExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-insurer.html\\\">PAS Insurer Organization</a></p></div><p><b>identifier</b>: id: <a href=\\\"http://terminology.hl7.org/5.0.0/NamingSystem-npi.html\\\">#</a>789312</p><p><b>active</b>: true</p><p><b>type</b>: PR <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (98#PR)</span></p><p><b>name</b>: MARYLAND CAPITAL INSURANCE COMPANY</p></div>\"\n        },\n        \"identifier\": [\n          {\n            \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n            \"value\": \"789312\"\n          },\n          {\n            \"system\": \"http://terminology.hl7.org/NamingSystem/USEIN\",\n            \"value\": \"7239994834\"\n          }\n        ],\n        \"active\": true,\n        \"type\": [\n          {\n            \"coding\": [\n              {\n                \"system\": \"https://codesystem.x12.org/005010/98\",\n                \"code\": \"PR\"\n              }\n            ]\n          }\n        ],\n        \"telecom\": [\n          {\n            \"system\": \"phone\",\n            \"value\": \"3029993456\"\n          }\n        ],\n        \"name\": \"MARYLAND CAPITAL INSURANCE COMPANY\"\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Coverage/InsuranceExample\",\n      \"resource\": {\n        \"resourceType\": \"Coverage\",\n        \"id\": \"InsuranceExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-coverage\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Coverage</b><a name=\\\"InsuranceExample\\\"> </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 &quot;InsuranceExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-coverage.html\\\">PAS Coverage</a></p></div><p><b>status</b>: active</p><p><b>beneficiary</b>: Patient/SubscriberExample</p><p><b>payor</b>: Organization/InsurerExample</p></div>\"\n        },\n        \"status\": \"active\",\n        \"identifier\": [\n          {\n            \"system\": \"http://davinci-pas.org/MIN\",\n            \"value\": \"1234567cov\"\n          }\n        ],\n        \"beneficiary\": {\n          \"reference\": \"Patient/SubscriberExample\"\n        },\n        \"payor\": [\n          {\n            \"reference\": \"Organization/InsurerExample\"\n          }\n        ],\n        \"subscriber\": {\n          \"reference\": \"Patient/SubscriberExample\"\n        },\n        \"subscriberId\": \"12345678901\",\n        \"relationship\": {\n          \"coding\": [\n            {\n              \"system\": \"http://terminology.hl7.org/CodeSystem/subscriber-relationship\",\n              \"code\": \"self\"\n            }\n          ]\n        }\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Patient/SubscriberExample\",\n      \"resource\": {\n        \"resourceType\": \"Patient\",\n        \"id\": \"SubscriberExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"extensions\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Patient</b><a name=\\\"SubscriberExample\\\"> </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 &quot;SubscriberExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-subscriber.html\\\">PAS Subscriber Patient</a></p></div><p><b>MilitaryStatus</b>: RU <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (584#RU)</span></p><p><b>identifier</b>: id: 12345678901</p><p><b>name</b>: JOE SMITH </p><p><b>gender</b>: male</p></div>\"\n        },\n        \"extension\": [\n          {\n            \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-militaryStatus\",\n            \"valueCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://codesystem.x12.org/005010/584\",\n                  \"code\": \"RU\"\n                }\n              ]\n            }\n          },\n          {\n            \"extension\": [\n              {\n                \"url\": \"ombCategory\",\n                \"valueCoding\": {\n                  \"system\": \"urn:oid:2.16.840.1.113883.6.238\",\n                  \"code\": \"2106-3\",\n                  \"display\": \"White\"\n                }\n              },\n              {\n                \"url\": \"text\",\n                \"valueString\": \"Caucasian\"\n              }\n            ],\n            \"url\": \"http://hl7.org/fhir/us/core/StructureDefinition/us-core-race\"\n          },\n          {\n            \"extension\": [\n              {\n                \"url\": \"ombCategory\",\n                \"valueCoding\": {\n                  \"system\": \"urn:oid:2.16.840.1.113883.6.238\",\n                  \"code\": \"2135-2\",\n                  \"display\": \"Hispanic or Latino\"\n                }\n              },\n              {\n                \"url\": \"text\",\n                \"valueString\": \"Filipino\"\n              }\n            ],\n            \"url\": \"http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity\"\n          },\n          {\n            \"url\": \"http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex\",\n            \"valueCode\": \"M\"\n          }\n        ],\n        \"identifier\": [\n          {\n            \"system\": \"http://davinci-pas.org/MIN\",\n            \"value\": \"12345678901\"\n          }\n        ],\n        \"name\": [\n          {\n            \"family\": \"SMITH\",\n            \"given\": [\n              \"JOE\"\n            ],\n            \"prefix\": [\n              \"Mr\"\n            ],\n            \"suffix\": [\n              \"PharmD\"\n            ]\n          }\n        ],\n        \"gender\": \"male\",\n        \"birthDate\": \"1987-02-20\",\n        \"multipleBirthInteger\": 1,\n        \"communication\": [\n          {\n            \"language\": {\n              \"coding\": [\n                {\n                  \"system\": \"urn:ietf:bcp:47\",\n                  \"code\": \"nl-NL\",\n                  \"display\": \"Dutch (Netherlands)\"\n                }\n              ]\n            },\n            \"preferred\": true\n          }\n        ],\n        \"telecom\": [\n          {\n            \"system\": \"phone\",\n            \"value\": \"555-555-5555\",\n            \"use\": \"home\"\n          }\n        ],\n        \"address\": [\n          {\n            \"line\": [\n              \"49 Meadow St\"\n            ],\n            \"city\": \"Mounds\",\n            \"state\": \"OK\",\n            \"district\": \"Meadow\",\n            \"postalCode\": \"74047\",\n            \"country\": \"US\",\n            \"period\": {\n              \"start\": \"2016-12-06\",\n              \"end\": \"2020-07-22\"\n            }\n          }\n        ]\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/PractitionerRole/ReferralPractitionerRoleExample\",\n      \"resource\": {\n        \"resourceType\": \"PractitionerRole\",\n        \"id\": \"ReferralPractitionerRoleExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: PractitionerRole</b><a name=\\\"ReferralPractitionerRoleExample\\\"> </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 PractitionerRole &quot;ReferralPractitionerRoleExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-practitionerrole.html\\\">PAS PractitionerRole</a></p></div><p><b>practitioner</b>: Practitioner/ReferralPractitionerExample</p><p><b>location</b>: Location/ReferralLocationExample</p></div>\"\n        },\n        \"practitioner\": {\n          \"reference\": \"Practitioner/ReferralPractitionerExample\"\n        },\n        \"organization\": {\n          \"reference\": \"Organization/UMOExample\"\n        },\n        \"location\": [\n          {\n            \"reference\": \"Location/ReferralLocationExample\"\n          }\n        ]\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Practitioner/ReferralPractitionerExample\",\n      \"resource\": {\n        \"resourceType\": \"Practitioner\",\n        \"id\": \"ReferralPractitionerExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Practitioner</b><a name=\\\"ReferralPractitionerExample\\\"> </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 &quot;ReferralPractitionerExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-practitioner.html\\\">PAS Practitioner</a></p></div><p><b>identifier</b>: id: <a href=\\\"http://terminology.hl7.org/5.0.0/NamingSystem-npi.html\\\">#</a>987654321</p><p><b>name</b>: SUSAN WATSON </p><p><b>telecom</b>: ph: 4029993456</p></div>\"\n        },\n        \"identifier\": [\n          {\n            \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n            \"value\": \"987654321\"\n          }\n        ],\n        \"name\": [\n          {\n            \"family\": \"WATSON\",\n            \"given\": [\n              \"SUSAN\"\n            ]\n          }\n        ],\n        \"telecom\": [\n          {\n            \"system\": \"phone\",\n            \"value\": \"4029993456\"\n          }\n        ],\n        \"address\": [\n          {\n            \"line\": [\n              \"111 1ST STREET\"\n            ],\n            \"city\": \"SAN DIEGO\",\n            \"state\": \"CA\",\n            \"postalCode\": \"92101\",\n            \"country\": \"US\"\n          }\n        ]\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Location/ReferralLocationExample\",\n      \"resource\": {\n        \"resourceType\": \"Location\",\n        \"id\": \"ReferralLocationExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-location\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Location</b><a name=\\\"ReferralLocationExample\\\"> </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 Location &quot;ReferralLocationExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-location.html\\\">PAS Location Profile</a></p></div><p><b>name</b>: REFERRAL CLINIC</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>\"\n        },\n        \"name\": \"REFERRAL CLINIC\",\n        \"address\": {\n          \"line\": [\n            \"111 1ST STREET\"\n          ],\n          \"city\": \"SAN DIEGO\",\n          \"state\": \"CA\",\n          \"postalCode\": \"92101\",\n          \"country\": \"US\"\n        }\n      }\n    }\n  ]\n}"
     },
     {
       "name": "must_support_pa_submit_request_payload",
@@ -63,7 +63,7 @@
       "optional": true,
       "title": "Additional PAS Inquiry Request Payloads",
       "type": "textarea",
-      "value": "[\n{\n  \"resourceType\": \"Bundle\",\n  \"id\": \"PASBundleInquiryExample\",\n  \"meta\": {\n    \"profile\": [\n      \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle\"\n    ]\n  },\n  \"identifier\": {\n    \"system\": \"http://davinci-pas.org/SUBMITTER_TRANSACTION_IDENTIFIER\",\n    \"value\": \"A12345\"\n  },\n  \"type\": \"collection\",\n  \"timestamp\": \"2005-05-02T11:01:00+05:00\",\n  \"entry\": [\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Claim/PASClaimInquiryExample\",\n      \"resource\": {\n        \"resourceType\": \"Claim\",\n        \"id\": \"PASClaimInquiryExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"extensions\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Claim</b><a name=\\\"ReferralAuthorizationExample\\\"> </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 Claim &quot;ReferralAuthorizationExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-claim.html\\\">PAS Claim</a></p></div><p><b>LevelOfServiceCode</b>: Urgent <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (1338#U)</span></p><p><b>identifier</b>: id: 111099</p><p><b>status</b>: active</p><p><b>type</b>: Professional <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-claim-type.html\\\">Claim Type Codes</a>#professional)</span></p><p><b>use</b>: preauthorization</p><p><b>patient</b>: Patient/SubscriberExample</p><p><b>created</b>: 2005-05-02 11:01:00+0500</p><p><b>insurer</b>: Organization/InsurerExample</p><p><b>provider</b>: Organization/UMOExample</p><p><b>priority</b>: Normal <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-processpriority.html\\\">Process Priority Codes</a>#normal)</span></p><h3>CareTeams</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>Provider</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td/><td>1</td><td>PractitionerRole/ReferralPractitionerRoleExample</td></tr></table><h3>Diagnoses</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td/><td>1</td><td>Chronic pain syndrome <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-icd10CM.html\\\">International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)</a>#G89.4)</span></td></tr></table><h3>Insurances</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td>1</td><td>true</td><td>Coverage/InsuranceExample</td></tr></table><h3>Items</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>CareTeamSequence</b></td><td><b>DiagnosisSequence</b></td><td><b>Category</b></td><td><b>ProductOrService</b></td><td><b>Location[x]</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td>, , , , , , , , , </td><td>1</td><td>1</td><td>1</td><td>Consultation <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (1365#3)</span></td><td>Consultation <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (1365#3)</span></td><td>11 <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-CMSPlaceofServiceCodes.html\\\">CMS Place of Service Codes (POS)</a>#11)</span></td></tr></table></div>\"\n        },\n        \"extension\": [\n          {\n            \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-levelOfServiceCode\",\n            \"valueCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://codesystem.x12.org/005010/1338\",\n                  \"code\": \"U\",\n                  \"display\": \"Urgent\"\n                }\n              ]\n            }\n          },\n          {\n            \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType\",\n            \"valueCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://codesystem.x12.org/005010/1322\",\n                  \"code\": \"I\",\n                  \"display\": \"Initial\"\n                }\n              ]\n            }\n          }\n        ],\n        \"identifier\": [\n          {\n            \"extension\": [\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierJurisdiction\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://www.usps.com/\",\n                      \"code\": \"MA\"\n                    }\n                  ]\n                }\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierSubDepartment\",\n                \"valueString\": \"223412\"\n              }\n            ],\n            \"system\": \"http://davinci-pas.org/PATIENT_EVENT_TRACE_NUMBER\",\n            \"value\": \"111099\",\n            \"assigner\": {\n              \"identifier\": {\n                \"system\": \"http://davinci-pas.org/USER_ASSIGNED\",\n                \"value\": \"9012345678\"\n              }\n            }\n          }\n        ],\n        \"status\": \"active\",\n        \"billablePeriod\": {\n          \"start\": \"2016-12-06\",\n          \"end\": \"2020-07-22\"\n        },\n        \"type\": {\n          \"coding\": [\n            {\n              \"system\": \"http://terminology.hl7.org/CodeSystem/claim-type\",\n              \"code\": \"professional\"\n            }\n          ]\n        },\n        \"use\": \"preauthorization\",\n        \"patient\": {\n          \"reference\": \"Patient/SubscriberExample\"\n        },\n        \"created\": \"2005-05-02T11:01:00+05:00\",\n        \"insurer\": {\n          \"reference\": \"Organization/InsurerExample\"\n        },\n        \"provider\": {\n          \"reference\": \"Organization/UMOExample\"\n        },\n        \"priority\": {\n          \"coding\": [\n            {\n              \"system\": \"http://terminology.hl7.org/CodeSystem/processpriority\",\n              \"code\": \"normal\"\n            }\n          ]\n        },\n        \"careTeam\": [\n          {\n            \"extension\": [\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope\",\n                \"valueBoolean\": true\n              }\n            ],\n            \"sequence\": 1,\n            \"provider\": {\n              \"reference\": \"PractitionerRole/ReferralPractitionerRoleExample\"\n            },\n            \"qualification\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://terminology.hl7.org/CodeSystem/ex-providerqualification\",\n                  \"code\": \"604210\"\n                }\n              ]\n            },\n            \"role\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://terminology.hl7.org/CodeSystem/claimcareteamrole\",\n                  \"code\": \"primary\"\n                }\n              ]\n            }\n          }\n        ],\n        \"diagnosis\": [\n          {\n            \"extension\": [\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate\",\n                \"valueDate\": \"2021-05-10\"\n              }\n            ],\n            \"sequence\": 1,\n            \"diagnosisCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://hl7.org/fhir/sid/icd-10-cm\",\n                  \"code\": \"G89.4\"\n                }\n              ]\n            },\n            \"type\": [\n              {\n                \"coding\": [\n                  {\n                    \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n                    \"code\": \"patientreasonforvisit\"\n                  }\n                ]\n              }\n            ]\n          }\n        ],\n        \"insurance\": [\n          {\n            \"sequence\": 1,\n            \"focal\": true,\n            \"coverage\": {\n              \"reference\": \"Coverage/InsuranceExample\"\n            }\n          }\n        ],\n        \"item\": [\n          {\n            \"extension\": [\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber\",\n                \"valueIdentifier\": {\n                  \"system\": \"http://davinci-pas.org/ITEM_TRACE_NUMBER\",\n                  \"value\": \"1122334\"\n                }\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber\",\n                \"valueString\": \"1122445\"\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber\",\n                \"valueString\": \"9988311\"\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://codesystem.x12.org/005010/1525\",\n                      \"code\": \"HS\",\n                      \"display\": \"Health Services Review\"\n                    }\n                  ]\n                }\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://codesystem.x12.org/005010/1322\",\n                      \"code\": \"I\",\n                      \"display\": \"Initial\"\n                    }\n                  ]\n                }\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCertificationIssueDate\",\n                \"valueDate\": \"2021-09-10\"\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCertificationExpirationDate\",\n                \"valueDate\": \"2022-09-10\"\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCertificationEffectiveDate\",\n                \"valueDate\": \"2021-09-10\"\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewActionCode\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://codesystem.x12.org/005010/306\",\n                      \"code\": \"A1\",\n                      \"display\": \"Certified in total\"\n                    }\n                  ]\n                }\n              }\n            ],\n            \"sequence\": 1,\n            \"careTeamSequence\": [\n              1\n            ],\n            \"diagnosisSequence\": [\n              1\n            ],\n            \"informationSequence\": [\n              1\n            ],\n            \"revenue\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://www.nubc.org/revenue-code\",\n                  \"code\": \"0105\"\n                }\n              ]\n            },\n            \"modifier\": [\n              {\n                \"coding\": [\n                  {\n                    \"system\": \"http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets\",\n                    \"code\": \"E0110\"\n                  }\n                ]\n              }\n            ],\n            \"servicedDate\": \"2016-08-09\",\n            \"quantity\": {\n              \"value\": 1\n            },\n            \"locationCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set\",\n                  \"code\": \"11\"\n                }\n              ]\n            },\n            \"productOrService\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets\",\n                  \"code\": \"G0154\"\n                }\n              ]\n            },\n            \"category\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://codesystem.x12.org/005010/1365\",\n                  \"code\": \"3\",\n                  \"display\": \"Consultation\"\n                }\n              ]\n            }\n          },\n          {\n            \"extension\": [\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://codesystem.x12.org/005010/1525\",\n                      \"code\": \"HS\",\n                      \"display\": \"Health Services Review\"\n                    }\n                  ]\n                }\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://codesystem.x12.org/005010/1322\",\n                      \"code\": \"I\",\n                      \"display\": \"Initial\"\n                    }\n                  ]\n                }\n              }\n            ],\n            \"sequence\": 2,\n            \"productOrService\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets\",\n                  \"code\": \"B4184\"\n                }\n              ]\n            },\n            \"category\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://codesystem.x12.org/005010/1365\",\n                  \"code\": \"3\",\n                  \"display\": \"Consultation\"\n                }\n              ]\n            }\n          }\n        ],\n        \"supportingInfo\": [\n          {\n            \"category\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n                  \"code\": \"freeFormMessage\",\n                  \"display\": \"Free Form Message\"\n                }\n              ]\n            },\n            \"sequence\": 2,\n            \"valueString\": \"1\"\n          }\n        ],\n        \"accident\": {\n          \"date\": \"2016-03-09\"\n        }\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Organization/UMOExample\",\n      \"resource\": {\n        \"resourceType\": \"Organization\",\n        \"id\": \"UMOExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Organization</b><a name=\\\"UMOExample\\\"> </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 &quot;UMOExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-requestor.html\\\">PAS Requestor Organization</a></p></div><p><b>identifier</b>: id: <a href=\\\"http://terminology.hl7.org/5.0.0/NamingSystem-npi.html\\\">#</a>8189991234</p><p><b>active</b>: true</p><p><b>type</b>: X3 <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (98#X3)</span></p><p><b>name</b>: DR. JOE SMITH CORPORATION</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>\"\n        },\n        \"identifier\": [\n          {\n            \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n            \"value\": \"8189991234\"\n          },\n          {\n            \"system\": \"http://terminology.hl7.org/NamingSystem/USEIN\",\n            \"value\": \"8189948234\"\n          }\n        ],\n        \"active\": true,\n        \"type\": [\n          {\n            \"coding\": [\n              {\n                \"system\": \"https://codesystem.x12.org/005010/98\",\n                \"code\": \"X3\"\n              }\n            ]\n          }\n        ],\n        \"name\": \"DR. JOE SMITH CORPORATION\",\n        \"address\": [\n          {\n            \"line\": [\n              \"111 1ST STREET\"\n            ],\n            \"city\": \"SAN DIEGO\",\n            \"state\": \"CA\",\n            \"postalCode\": \"92101\",\n            \"country\": \"US\"\n          }\n        ],\n        \"telecom\": [\n          {\n            \"system\": \"phone\",\n            \"value\": \"4029993456\"\n          }\n        ],\n        \"contact\": [\n          {\n            \"telecom\": [\n              {\n                \"system\": \"other\",\n                \"value\": \"http://hl7.org/fhir\"\n              }\n            ],\n            \"name\": {\n              \"family\": \"WATSON\",\n              \"given\": [\n                \"SUSAN\"\n              ]\n            }\n          }\n        ]\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Organization/InsurerExample\",\n      \"resource\": {\n        \"resourceType\": \"Organization\",\n        \"id\": \"InsurerExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Organization</b><a name=\\\"InsurerExample\\\"> </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 &quot;InsurerExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-insurer.html\\\">PAS Insurer Organization</a></p></div><p><b>identifier</b>: id: <a href=\\\"http://terminology.hl7.org/5.0.0/NamingSystem-npi.html\\\">#</a>789312</p><p><b>active</b>: true</p><p><b>type</b>: PR <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (98#PR)</span></p><p><b>name</b>: MARYLAND CAPITAL INSURANCE COMPANY</p></div>\"\n        },\n        \"identifier\": [\n          {\n            \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n            \"value\": \"789312\"\n          },\n          {\n            \"system\": \"http://terminology.hl7.org/NamingSystem/USEIN\",\n            \"value\": \"7239994834\"\n          }\n        ],\n        \"active\": true,\n        \"type\": [\n          {\n            \"coding\": [\n              {\n                \"system\": \"https://codesystem.x12.org/005010/98\",\n                \"code\": \"PR\"\n              }\n            ]\n          }\n        ],\n        \"telecom\": [\n          {\n            \"system\": \"phone\",\n            \"value\": \"3029993456\"\n          }\n        ],\n        \"name\": \"MARYLAND CAPITAL INSURANCE COMPANY\"\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Coverage/InsuranceExample\",\n      \"resource\": {\n        \"resourceType\": \"Coverage\",\n        \"id\": \"InsuranceExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-coverage\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Coverage</b><a name=\\\"InsuranceExample\\\"> </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 &quot;InsuranceExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-coverage.html\\\">PAS Coverage</a></p></div><p><b>status</b>: active</p><p><b>beneficiary</b>: Patient/SubscriberExample</p><p><b>payor</b>: Organization/InsurerExample</p></div>\"\n        },\n        \"status\": \"active\",\n        \"identifier\": [\n          {\n            \"system\": \"http://davinci-pas.org/MIN\",\n            \"value\": \"1234567cov\"\n          }\n        ],\n        \"beneficiary\": {\n          \"reference\": \"Patient/SubscriberExample\"\n        },\n        \"payor\": [\n          {\n            \"reference\": \"Organization/InsurerExample\"\n          }\n        ],\n        \"subscriber\": {\n          \"reference\": \"Patient/SubscriberExample\"\n        },\n        \"subscriberId\": \"12345678901\",\n        \"relationship\": {\n          \"coding\": [\n            {\n              \"system\": \"http://terminology.hl7.org/CodeSystem/subscriber-relationship\",\n              \"code\": \"self\"\n            }\n          ]\n        }\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Patient/SubscriberExample\",\n      \"resource\": {\n        \"resourceType\": \"Patient\",\n        \"id\": \"SubscriberExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"extensions\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Patient</b><a name=\\\"SubscriberExample\\\"> </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 &quot;SubscriberExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-subscriber.html\\\">PAS Subscriber Patient</a></p></div><p><b>MilitaryStatus</b>: RU <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (584#RU)</span></p><p><b>identifier</b>: id: 12345678901</p><p><b>name</b>: JOE SMITH </p><p><b>gender</b>: male</p></div>\"\n        },\n        \"extension\": [\n          {\n            \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-militaryStatus\",\n            \"valueCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://codesystem.x12.org/005010/584\",\n                  \"code\": \"RU\"\n                }\n              ]\n            }\n          },\n          {\n            \"extension\": [\n              {\n                \"url\": \"ombCategory\",\n                \"valueCoding\": {\n                  \"system\": \"urn:oid:2.16.840.1.113883.6.238\",\n                  \"code\": \"2106-3\",\n                  \"display\": \"White\"\n                }\n              },\n              {\n                \"url\": \"text\",\n                \"valueString\": \"Caucasian\"\n              }\n            ],\n            \"url\": \"http://hl7.org/fhir/us/core/StructureDefinition/us-core-race\"\n          },\n          {\n            \"extension\": [\n              {\n                \"url\": \"ombCategory\",\n                \"valueCoding\": {\n                  \"system\": \"urn:oid:2.16.840.1.113883.6.238\",\n                  \"code\": \"2135-2\",\n                  \"display\": \"Hispanic or Latino\"\n                }\n              },\n              {\n                \"url\": \"text\",\n                \"valueString\": \"Filipino\"\n              }\n            ],\n            \"url\": \"http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity\"\n          },\n          {\n            \"url\": \"http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex\",\n            \"valueCode\": \"M\"\n          }\n        ],\n        \"identifier\": [\n          {\n            \"system\": \"http://davinci-pas.org/MIN\",\n            \"value\": \"12345678901\"\n          }\n        ],\n        \"name\": [\n          {\n            \"family\": \"SMITH\",\n            \"given\": [\n              \"JOE\"\n            ],\n            \"prefix\": [\n              \"Mr\"\n            ],\n            \"suffix\": [\n              \"PharmD\"\n            ]\n          }\n        ],\n        \"gender\": \"male\",\n        \"birthDate\": \"1987-02-20\",\n        \"multipleBirthInteger\": 1,\n        \"communication\": [\n          {\n            \"language\": {\n              \"coding\": [\n                {\n                  \"system\": \"urn:ietf:bcp:47\",\n                  \"code\": \"nl-NL\",\n                  \"display\": \"Dutch (Netherlands)\"\n                }\n              ]\n            },\n            \"preferred\": true\n          }\n        ],\n        \"telecom\": [\n          {\n            \"system\": \"phone\",\n            \"value\": \"555-555-5555\",\n            \"use\": \"home\"\n          }\n        ],\n        \"address\": [\n          {\n            \"line\": [\n              \"49 Meadow St\"\n            ],\n            \"city\": \"Mounds\",\n            \"state\": \"OK\",\n            \"district\": \"Meadow\",\n            \"postalCode\": \"74047\",\n            \"country\": \"US\",\n            \"period\": {\n              \"start\": \"2016-12-06\",\n              \"end\": \"2020-07-22\"\n            }\n          }\n        ]\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/PractitionerRole/ReferralPractitionerRoleExample\",\n      \"resource\": {\n        \"resourceType\": \"PractitionerRole\",\n        \"id\": \"ReferralPractitionerRoleExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: PractitionerRole</b><a name=\\\"ReferralPractitionerRoleExample\\\"> </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 PractitionerRole &quot;ReferralPractitionerRoleExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-practitionerrole.html\\\">PAS PractitionerRole</a></p></div><p><b>practitioner</b>: Practitioner/ReferralPractitionerExample</p><p><b>location</b>: Location/ReferralLocationExample</p></div>\"\n        },\n        \"practitioner\": {\n          \"reference\": \"Practitioner/ReferralPractitionerExample\"\n        },\n        \"organization\": {\n          \"reference\": \"Organization/UMOExample\"\n        },\n        \"location\": [\n          {\n            \"reference\": \"Location/ReferralLocationExample\"\n          }\n        ]\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Practitioner/ReferralPractitionerExample\",\n      \"resource\": {\n        \"resourceType\": \"Practitioner\",\n        \"id\": \"ReferralPractitionerExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Practitioner</b><a name=\\\"ReferralPractitionerExample\\\"> </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 &quot;ReferralPractitionerExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-practitioner.html\\\">PAS Practitioner</a></p></div><p><b>identifier</b>: id: <a href=\\\"http://terminology.hl7.org/5.0.0/NamingSystem-npi.html\\\">#</a>987654321</p><p><b>name</b>: SUSAN WATSON </p><p><b>telecom</b>: ph: 4029993456</p></div>\"\n        },\n        \"identifier\": [\n          {\n            \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n            \"value\": \"987654321\"\n          }\n        ],\n        \"name\": [\n          {\n            \"family\": \"WATSON\",\n            \"given\": [\n              \"SUSAN\"\n            ]\n          }\n        ],\n        \"telecom\": [\n          {\n            \"system\": \"phone\",\n            \"value\": \"4029993456\"\n          }\n        ],\n        \"address\": [\n          {\n            \"line\": [\n              \"111 1ST STREET\"\n            ],\n            \"city\": \"SAN DIEGO\",\n            \"state\": \"CA\",\n            \"postalCode\": \"92101\",\n            \"country\": \"US\"\n          }\n        ]\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Location/ReferralLocationExample\",\n      \"resource\": {\n        \"resourceType\": \"Location\",\n        \"id\": \"ReferralLocationExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-location\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Location</b><a name=\\\"ReferralLocationExample\\\"> </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 Location &quot;ReferralLocationExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-location.html\\\">PAS Location Profile</a></p></div><p><b>name</b>: REFERRAL CLINIC</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>\"\n        },\n        \"name\": \"REFERRAL CLINIC\",\n        \"address\": {\n          \"line\": [\n            \"111 1ST STREET\"\n          ],\n          \"city\": \"SAN DIEGO\",\n          \"state\": \"CA\",\n          \"postalCode\": \"92101\",\n          \"country\": \"US\"\n        }\n      }\n    }\n  ]\n}\n]"
+      "value": "[\n{\n  \"resourceType\": \"Bundle\",\n  \"id\": \"PASBundleInquiryExample\",\n  \"meta\": {\n    \"profile\": [\n      \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle\"\n    ]\n  },\n  \"identifier\": {\n    \"system\": \"http://davinci-pas.org/SUBMITTER_TRANSACTION_IDENTIFIER\",\n    \"value\": \"A12345\"\n  },\n  \"type\": \"collection\",\n  \"timestamp\": \"2005-05-02T11:01:00+05:00\",\n  \"entry\": [\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Claim/PASClaimInquiryExample\",\n      \"resource\": {\n        \"resourceType\": \"Claim\",\n        \"id\": \"PASClaimInquiryExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"extensions\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Claim</b><a name=\\\"ReferralAuthorizationExample\\\"> </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 Claim &quot;ReferralAuthorizationExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-claim.html\\\">PAS Claim</a></p></div><p><b>LevelOfServiceCode</b>: Urgent <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (1338#U)</span></p><p><b>identifier</b>: id: 111099</p><p><b>status</b>: active</p><p><b>type</b>: Professional <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-claim-type.html\\\">Claim Type Codes</a>#professional)</span></p><p><b>use</b>: preauthorization</p><p><b>patient</b>: Patient/SubscriberExample</p><p><b>created</b>: 2005-05-02 11:01:00+0500</p><p><b>insurer</b>: Organization/InsurerExample</p><p><b>provider</b>: Organization/UMOExample</p><p><b>priority</b>: Normal <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-processpriority.html\\\">Process Priority Codes</a>#normal)</span></p><h3>CareTeams</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>Provider</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td/><td>1</td><td>PractitionerRole/ReferralPractitionerRoleExample</td></tr></table><h3>Diagnoses</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td/><td>1</td><td>Chronic pain syndrome <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-icd10CM.html\\\">International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)</a>#G89.4)</span></td></tr></table><h3>Insurances</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td>1</td><td>true</td><td>Coverage/InsuranceExample</td></tr></table><h3>Items</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>CareTeamSequence</b></td><td><b>DiagnosisSequence</b></td><td><b>Category</b></td><td><b>ProductOrService</b></td><td><b>Location[x]</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td>, , , , , , , , , </td><td>1</td><td>1</td><td>1</td><td>Consultation <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (1365#3)</span></td><td>Consultation <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (1365#3)</span></td><td>11 <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-CMSPlaceofServiceCodes.html\\\">CMS Place of Service Codes (POS)</a>#11)</span></td></tr></table></div>\"\n        },\n        \"extension\": [\n          {\n            \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-levelOfServiceCode\",\n            \"valueCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://codesystem.x12.org/005010/1338\",\n                  \"code\": \"U\",\n                  \"display\": \"Urgent\"\n                }\n              ]\n            }\n          },\n          {\n            \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType\",\n            \"valueCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://codesystem.x12.org/005010/1322\",\n                  \"code\": \"I\",\n                  \"display\": \"Initial\"\n                }\n              ]\n            }\n          }\n        ],\n        \"identifier\": [\n          {\n            \"extension\": [\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierJurisdiction\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://www.usps.com/\",\n                      \"code\": \"MA\"\n                    }\n                  ]\n                }\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierSubDepartment\",\n                \"valueString\": \"223412\"\n              }\n            ],\n            \"system\": \"http://davinci-pas.org/PATIENT_EVENT_TRACE_NUMBER\",\n            \"value\": \"111099\",\n            \"assigner\": {\n              \"identifier\": {\n                \"system\": \"http://davinci-pas.org/USER_ASSIGNED\",\n                \"value\": \"9012345678\"\n              }\n            }\n          }\n        ],\n        \"status\": \"active\",\n        \"billablePeriod\": {\n          \"start\": \"2016-12-06\",\n          \"end\": \"2020-07-22\"\n        },\n        \"type\": {\n          \"coding\": [\n            {\n              \"system\": \"http://terminology.hl7.org/CodeSystem/claim-type\",\n              \"code\": \"professional\"\n            }\n          ]\n        },\n        \"use\": \"preauthorization\",\n        \"patient\": {\n          \"reference\": \"Patient/SubscriberExample\"\n        },\n        \"created\": \"2005-05-02T11:01:00+05:00\",\n        \"insurer\": {\n          \"reference\": \"Organization/InsurerExample\"\n        },\n        \"provider\": {\n          \"reference\": \"Organization/UMOExample\"\n        },\n        \"priority\": {\n          \"coding\": [\n            {\n              \"system\": \"http://terminology.hl7.org/CodeSystem/processpriority\",\n              \"code\": \"normal\"\n            }\n          ]\n        },\n        \"careTeam\": [\n          {\n            \"extension\": [\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope\",\n                \"valueBoolean\": true\n              }\n            ],\n            \"sequence\": 1,\n            \"provider\": {\n              \"reference\": \"PractitionerRole/ReferralPractitionerRoleExample\"\n            },\n            \"qualification\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://terminology.hl7.org/CodeSystem/ex-providerqualification\",\n                  \"code\": \"604210\"\n                }\n              ]\n            },\n            \"role\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://terminology.hl7.org/CodeSystem/claimcareteamrole\",\n                  \"code\": \"primary\"\n                }\n              ]\n            }\n          }\n        ],\n        \"diagnosis\": [\n          {\n            \"extension\": [\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate\",\n                \"valueDate\": \"2021-05-10\"\n              }\n            ],\n            \"sequence\": 1,\n            \"diagnosisCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://hl7.org/fhir/sid/icd-10-cm\",\n                  \"code\": \"G89.4\"\n                }\n              ]\n            },\n            \"type\": [\n              {\n                \"coding\": [\n                  {\n                    \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n                    \"code\": \"patientreasonforvisit\"\n                  }\n                ]\n              }\n            ]\n          }\n        ],\n        \"insurance\": [\n          {\n            \"sequence\": 1,\n            \"focal\": true,\n            \"coverage\": {\n              \"reference\": \"Coverage/InsuranceExample\"\n            }\n          }\n        ],\n        \"item\": [\n          {\n            \"extension\": [\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber\",\n                \"valueIdentifier\": {\n                  \"system\": \"http://davinci-pas.org/ITEM_TRACE_NUMBER\",\n                  \"value\": \"1122334\"\n                }\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber\",\n                \"valueString\": \"1122445\"\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber\",\n                \"valueString\": \"9988311\"\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://codesystem.x12.org/005010/1525\",\n                      \"code\": \"HS\",\n                      \"display\": \"Health Services Review\"\n                    }\n                  ]\n                }\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://codesystem.x12.org/005010/1322\",\n                      \"code\": \"I\",\n                      \"display\": \"Initial\"\n                    }\n                  ]\n                }\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCertificationIssueDate\",\n                \"valueDate\": \"2021-09-10\"\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCertificationExpirationDate\",\n                \"valueDate\": \"2022-09-10\"\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCertificationEffectiveDate\",\n                \"valueDate\": \"2021-09-10\"\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewActionCode\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://codesystem.x12.org/005010/306\",\n                      \"code\": \"A1\",\n                      \"display\": \"Certified in total\"\n                    }\n                  ]\n                }\n              }\n            ],\n            \"sequence\": 1,\n            \"careTeamSequence\": [\n              1\n            ],\n            \"diagnosisSequence\": [\n              1\n            ],\n            \"informationSequence\": [\n              1\n            ],\n            \"revenue\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://www.nubc.org/revenue-code\",\n                  \"code\": \"0105\"\n                }\n              ]\n            },\n            \"modifier\": [\n              {\n                \"coding\": [\n                  {\n                    \"system\": \"http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets\",\n                    \"code\": \"E0110\"\n                  }\n                ]\n              }\n            ],\n            \"servicedDate\": \"2016-08-09\",\n            \"quantity\": {\n              \"value\": 1\n            },\n            \"locationCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set\",\n                  \"code\": \"11\"\n                }\n              ]\n            },\n            \"productOrService\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets\",\n                  \"code\": \"G0154\"\n                }\n              ]\n            },\n            \"category\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://codesystem.x12.org/005010/1365\",\n                  \"code\": \"3\",\n                  \"display\": \"Consultation\"\n                }\n              ]\n            }\n          },\n          {\n            \"extension\": [\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://codesystem.x12.org/005010/1525\",\n                      \"code\": \"HS\",\n                      \"display\": \"Health Services Review\"\n                    }\n                  ]\n                }\n              },\n              {\n                \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType\",\n                \"valueCodeableConcept\": {\n                  \"coding\": [\n                    {\n                      \"system\": \"https://codesystem.x12.org/005010/1322\",\n                      \"code\": \"I\",\n                      \"display\": \"Initial\"\n                    }\n                  ]\n                }\n              }\n            ],\n            \"sequence\": 2,\n            \"productOrService\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets\",\n                  \"code\": \"B4185\"\n                }\n              ]\n            },\n            \"category\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://codesystem.x12.org/005010/1365\",\n                  \"code\": \"3\",\n                  \"display\": \"Consultation\"\n                }\n              ]\n            }\n          }\n        ],\n        \"supportingInfo\": [\n          {\n            \"category\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n                  \"code\": \"freeFormMessage\",\n                  \"display\": \"Free Form Message\"\n                }\n              ]\n            },\n            \"sequence\": 2,\n            \"valueString\": \"1\"\n          }\n        ],\n        \"accident\": {\n          \"date\": \"2016-03-09\"\n        }\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Organization/UMOExample\",\n      \"resource\": {\n        \"resourceType\": \"Organization\",\n        \"id\": \"UMOExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Organization</b><a name=\\\"UMOExample\\\"> </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 &quot;UMOExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-requestor.html\\\">PAS Requestor Organization</a></p></div><p><b>identifier</b>: id: <a href=\\\"http://terminology.hl7.org/5.0.0/NamingSystem-npi.html\\\">#</a>8189991234</p><p><b>active</b>: true</p><p><b>type</b>: X3 <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (98#X3)</span></p><p><b>name</b>: DR. JOE SMITH CORPORATION</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>\"\n        },\n        \"identifier\": [\n          {\n            \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n            \"value\": \"8189991234\"\n          },\n          {\n            \"system\": \"http://terminology.hl7.org/NamingSystem/USEIN\",\n            \"value\": \"8189948234\"\n          }\n        ],\n        \"active\": true,\n        \"type\": [\n          {\n            \"coding\": [\n              {\n                \"system\": \"https://codesystem.x12.org/005010/98\",\n                \"code\": \"X3\"\n              }\n            ]\n          }\n        ],\n        \"name\": \"DR. JOE SMITH CORPORATION\",\n        \"address\": [\n          {\n            \"line\": [\n              \"111 1ST STREET\"\n            ],\n            \"city\": \"SAN DIEGO\",\n            \"state\": \"CA\",\n            \"postalCode\": \"92101\",\n            \"country\": \"US\"\n          }\n        ],\n        \"telecom\": [\n          {\n            \"system\": \"phone\",\n            \"value\": \"4029993456\"\n          }\n        ],\n        \"contact\": [\n          {\n            \"telecom\": [\n              {\n                \"system\": \"other\",\n                \"value\": \"http://hl7.org/fhir\"\n              }\n            ],\n            \"name\": {\n              \"family\": \"WATSON\",\n              \"given\": [\n                \"SUSAN\"\n              ]\n            }\n          }\n        ]\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Organization/InsurerExample\",\n      \"resource\": {\n        \"resourceType\": \"Organization\",\n        \"id\": \"InsurerExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Organization</b><a name=\\\"InsurerExample\\\"> </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 &quot;InsurerExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-insurer.html\\\">PAS Insurer Organization</a></p></div><p><b>identifier</b>: id: <a href=\\\"http://terminology.hl7.org/5.0.0/NamingSystem-npi.html\\\">#</a>789312</p><p><b>active</b>: true</p><p><b>type</b>: PR <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (98#PR)</span></p><p><b>name</b>: MARYLAND CAPITAL INSURANCE COMPANY</p></div>\"\n        },\n        \"identifier\": [\n          {\n            \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n            \"value\": \"789312\"\n          },\n          {\n            \"system\": \"http://terminology.hl7.org/NamingSystem/USEIN\",\n            \"value\": \"7239994834\"\n          }\n        ],\n        \"active\": true,\n        \"type\": [\n          {\n            \"coding\": [\n              {\n                \"system\": \"https://codesystem.x12.org/005010/98\",\n                \"code\": \"PR\"\n              }\n            ]\n          }\n        ],\n        \"telecom\": [\n          {\n            \"system\": \"phone\",\n            \"value\": \"3029993456\"\n          }\n        ],\n        \"name\": \"MARYLAND CAPITAL INSURANCE COMPANY\"\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Coverage/InsuranceExample\",\n      \"resource\": {\n        \"resourceType\": \"Coverage\",\n        \"id\": \"InsuranceExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-coverage\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Coverage</b><a name=\\\"InsuranceExample\\\"> </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 &quot;InsuranceExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-coverage.html\\\">PAS Coverage</a></p></div><p><b>status</b>: active</p><p><b>beneficiary</b>: Patient/SubscriberExample</p><p><b>payor</b>: Organization/InsurerExample</p></div>\"\n        },\n        \"status\": \"active\",\n        \"identifier\": [\n          {\n            \"system\": \"http://davinci-pas.org/MIN\",\n            \"value\": \"1234567cov\"\n          }\n        ],\n        \"beneficiary\": {\n          \"reference\": \"Patient/SubscriberExample\"\n        },\n        \"payor\": [\n          {\n            \"reference\": \"Organization/InsurerExample\"\n          }\n        ],\n        \"subscriber\": {\n          \"reference\": \"Patient/SubscriberExample\"\n        },\n        \"subscriberId\": \"12345678901\",\n        \"relationship\": {\n          \"coding\": [\n            {\n              \"system\": \"http://terminology.hl7.org/CodeSystem/subscriber-relationship\",\n              \"code\": \"self\"\n            }\n          ]\n        }\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Patient/SubscriberExample\",\n      \"resource\": {\n        \"resourceType\": \"Patient\",\n        \"id\": \"SubscriberExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"extensions\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Patient</b><a name=\\\"SubscriberExample\\\"> </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 &quot;SubscriberExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-subscriber.html\\\">PAS Subscriber Patient</a></p></div><p><b>MilitaryStatus</b>: RU <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (584#RU)</span></p><p><b>identifier</b>: id: 12345678901</p><p><b>name</b>: JOE SMITH </p><p><b>gender</b>: male</p></div>\"\n        },\n        \"extension\": [\n          {\n            \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-militaryStatus\",\n            \"valueCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"https://codesystem.x12.org/005010/584\",\n                  \"code\": \"RU\"\n                }\n              ]\n            }\n          },\n          {\n            \"extension\": [\n              {\n                \"url\": \"ombCategory\",\n                \"valueCoding\": {\n                  \"system\": \"urn:oid:2.16.840.1.113883.6.238\",\n                  \"code\": \"2106-3\",\n                  \"display\": \"White\"\n                }\n              },\n              {\n                \"url\": \"text\",\n                \"valueString\": \"Caucasian\"\n              }\n            ],\n            \"url\": \"http://hl7.org/fhir/us/core/StructureDefinition/us-core-race\"\n          },\n          {\n            \"extension\": [\n              {\n                \"url\": \"ombCategory\",\n                \"valueCoding\": {\n                  \"system\": \"urn:oid:2.16.840.1.113883.6.238\",\n                  \"code\": \"2135-2\",\n                  \"display\": \"Hispanic or Latino\"\n                }\n              },\n              {\n                \"url\": \"text\",\n                \"valueString\": \"Filipino\"\n              }\n            ],\n            \"url\": \"http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity\"\n          },\n          {\n            \"url\": \"http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex\",\n            \"valueCode\": \"M\"\n          }\n        ],\n        \"identifier\": [\n          {\n            \"system\": \"http://davinci-pas.org/MIN\",\n            \"value\": \"12345678901\"\n          }\n        ],\n        \"name\": [\n          {\n            \"family\": \"SMITH\",\n            \"given\": [\n              \"JOE\"\n            ],\n            \"prefix\": [\n              \"Mr\"\n            ],\n            \"suffix\": [\n              \"PharmD\"\n            ]\n          }\n        ],\n        \"gender\": \"male\",\n        \"birthDate\": \"1987-02-20\",\n        \"multipleBirthInteger\": 1,\n        \"communication\": [\n          {\n            \"language\": {\n              \"coding\": [\n                {\n                  \"system\": \"urn:ietf:bcp:47\",\n                  \"code\": \"nl-NL\",\n                  \"display\": \"Dutch (Netherlands)\"\n                }\n              ]\n            },\n            \"preferred\": true\n          }\n        ],\n        \"telecom\": [\n          {\n            \"system\": \"phone\",\n            \"value\": \"555-555-5555\",\n            \"use\": \"home\"\n          }\n        ],\n        \"address\": [\n          {\n            \"line\": [\n              \"49 Meadow St\"\n            ],\n            \"city\": \"Mounds\",\n            \"state\": \"OK\",\n            \"district\": \"Meadow\",\n            \"postalCode\": \"74047\",\n            \"country\": \"US\",\n            \"period\": {\n              \"start\": \"2016-12-06\",\n              \"end\": \"2020-07-22\"\n            }\n          }\n        ]\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/PractitionerRole/ReferralPractitionerRoleExample\",\n      \"resource\": {\n        \"resourceType\": \"PractitionerRole\",\n        \"id\": \"ReferralPractitionerRoleExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: PractitionerRole</b><a name=\\\"ReferralPractitionerRoleExample\\\"> </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 PractitionerRole &quot;ReferralPractitionerRoleExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-practitionerrole.html\\\">PAS PractitionerRole</a></p></div><p><b>practitioner</b>: Practitioner/ReferralPractitionerExample</p><p><b>location</b>: Location/ReferralLocationExample</p></div>\"\n        },\n        \"practitioner\": {\n          \"reference\": \"Practitioner/ReferralPractitionerExample\"\n        },\n        \"organization\": {\n          \"reference\": \"Organization/UMOExample\"\n        },\n        \"location\": [\n          {\n            \"reference\": \"Location/ReferralLocationExample\"\n          }\n        ]\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Practitioner/ReferralPractitionerExample\",\n      \"resource\": {\n        \"resourceType\": \"Practitioner\",\n        \"id\": \"ReferralPractitionerExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Practitioner</b><a name=\\\"ReferralPractitionerExample\\\"> </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 &quot;ReferralPractitionerExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-practitioner.html\\\">PAS Practitioner</a></p></div><p><b>identifier</b>: id: <a href=\\\"http://terminology.hl7.org/5.0.0/NamingSystem-npi.html\\\">#</a>987654321</p><p><b>name</b>: SUSAN WATSON </p><p><b>telecom</b>: ph: 4029993456</p></div>\"\n        },\n        \"identifier\": [\n          {\n            \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n            \"value\": \"987654321\"\n          }\n        ],\n        \"name\": [\n          {\n            \"family\": \"WATSON\",\n            \"given\": [\n              \"SUSAN\"\n            ]\n          }\n        ],\n        \"telecom\": [\n          {\n            \"system\": \"phone\",\n            \"value\": \"4029993456\"\n          }\n        ],\n        \"address\": [\n          {\n            \"line\": [\n              \"111 1ST STREET\"\n            ],\n            \"city\": \"SAN DIEGO\",\n            \"state\": \"CA\",\n            \"postalCode\": \"92101\",\n            \"country\": \"US\"\n          }\n        ]\n      }\n    },\n    {\n      \"fullUrl\": \"http://davinci-pas.org/fhir/Location/ReferralLocationExample\",\n      \"resource\": {\n        \"resourceType\": \"Location\",\n        \"id\": \"ReferralLocationExample\",\n        \"meta\": {\n          \"profile\": [\n            \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-location\"\n          ]\n        },\n        \"text\": {\n          \"status\": \"generated\",\n          \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Location</b><a name=\\\"ReferralLocationExample\\\"> </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 Location &quot;ReferralLocationExample&quot; </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-location.html\\\">PAS Location Profile</a></p></div><p><b>name</b>: REFERRAL CLINIC</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>\"\n        },\n        \"name\": \"REFERRAL CLINIC\",\n        \"address\": {\n          \"line\": [\n            \"111 1ST STREET\"\n          ],\n          \"city\": \"SAN DIEGO\",\n          \"state\": \"CA\",\n          \"postalCode\": \"92101\",\n          \"country\": \"US\"\n        }\n      }\n    }\n  ]\n}\n]"
     }
   ]
 }