davinci_pas_test_kit 0.15.1 → 0.16.0

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Files changed (334) hide show
  1. checksums.yaml +4 -4
  2. data/config/presets/g33_br_provider.json +13 -0
  3. data/config/presets/pas_client_example.json +2 -2
  4. data/config/presets/pas_client_v201_run_against_pas_server.json +2 -2
  5. data/config/presets/pas_client_v221_run_against_pas_server.json +3 -3
  6. data/config/presets/pas_ri.json +6 -6
  7. data/config/presets/pas_server_v201_run_against_pas_client.json.erb +6 -6
  8. data/config/presets/pas_server_v221_run_against_pas_client.json.erb +10 -10
  9. data/lib/davinci_pas_test_kit/client/abstract_approval_submit_test.rb +28 -17
  10. data/lib/davinci_pas_test_kit/client/abstract_denial_submit_test.rb +26 -16
  11. data/lib/davinci_pas_test_kit/client/abstract_gather_must_support_test.rb +45 -74
  12. data/lib/davinci_pas_test_kit/client/abstract_modification_submit_test.rb +29 -19
  13. data/lib/davinci_pas_test_kit/client/abstract_response_attest.rb +75 -6
  14. data/lib/davinci_pas_test_kit/client/abstract_subscription_create_test.rb +26 -9
  15. data/lib/davinci_pas_test_kit/client/abstract_subscription_update_delete_test.rb +91 -0
  16. data/lib/davinci_pas_test_kit/client/client_bundle_validation_helper.rb +245 -0
  17. data/lib/davinci_pas_test_kit/client/client_input_descriptions.rb +96 -1
  18. data/lib/davinci_pas_test_kit/client/endpoints/claim_endpoint.rb +128 -72
  19. data/lib/davinci_pas_test_kit/client/endpoints/endpoint_session_identification.rb +24 -0
  20. data/lib/davinci_pas_test_kit/client/endpoints/expired_token.rb +40 -0
  21. data/lib/davinci_pas_test_kit/client/endpoints/subscription_create_endpoint.rb +7 -12
  22. data/lib/davinci_pas_test_kit/client/endpoints/subscription_delete_endpoint.rb +13 -0
  23. data/lib/davinci_pas_test_kit/client/endpoints/subscription_read_endpoint.rb +13 -0
  24. data/lib/davinci_pas_test_kit/client/endpoints/subscription_status_endpoint.rb +15 -20
  25. data/lib/davinci_pas_test_kit/client/endpoints/subscription_update_endpoint.rb +13 -0
  26. data/lib/davinci_pas_test_kit/client/endpoints/token_endpoint.rb +16 -0
  27. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/beneficiary/client_inquire_request_must_support_beneficiary_test.rb +3 -3
  28. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/beneficiary/client_inquire_response_must_support_beneficiary_test.rb +3 -3
  29. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/beneficiary/client_submit_request_must_support_beneficiary_test.rb +3 -3
  30. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/beneficiary/client_submit_response_must_support_beneficiary_test.rb +3 -3
  31. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/claim_inquiry/client_inquire_request_must_support_claim_inquiry_test.rb +3 -3
  32. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/claim_update/client_submit_request_must_support_claim_update_test.rb +3 -3
  33. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/claiminquiryresponse/client_inquire_response_must_support_claiminquiryresponse_test.rb +3 -3
  34. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/claimresponse/client_submit_response_must_support_claimresponse_test.rb +3 -3
  35. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/communication_request/client_submit_response_must_support_communication_request_test.rb +3 -3
  36. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/coverage/client_inquire_request_must_support_coverage_test.rb +3 -3
  37. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/coverage/client_submit_request_must_support_coverage_test.rb +3 -3
  38. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/encounter/client_submit_request_must_support_encounter_test.rb +3 -3
  39. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/insurer/client_inquire_request_must_support_insurer_test.rb +3 -3
  40. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/insurer/client_inquire_response_must_support_insurer_test.rb +3 -3
  41. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/insurer/client_submit_request_must_support_insurer_test.rb +3 -3
  42. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/insurer/client_submit_response_must_support_insurer_test.rb +3 -3
  43. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/pas_client_inquire_must_support_group.rb +1 -1
  44. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/pas_client_inquire_response_must_support_group.rb +9 -31
  45. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/pas_client_submit_must_support_group.rb +1 -1
  46. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/pas_client_submit_response_must_support_group.rb +10 -32
  47. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/pas_inquiry_request_bundle/client_inquire_request_must_support_pas_inquiry_request_bundle_test.rb +3 -3
  48. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/pas_inquiry_response_bundle/client_inquire_response_must_support_pas_inquiry_response_bundle_test.rb +3 -3
  49. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/pas_request_bundle/client_submit_request_must_support_pas_request_bundle_test.rb +3 -3
  50. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/pas_response_bundle/client_submit_response_must_support_pas_response_bundle_test.rb +3 -3
  51. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/practitioner/client_inquire_request_must_support_practitioner_test.rb +3 -3
  52. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/practitioner/client_inquire_response_must_support_practitioner_test.rb +3 -3
  53. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/practitioner/client_submit_request_must_support_practitioner_test.rb +3 -3
  54. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/practitioner/client_submit_response_must_support_practitioner_test.rb +3 -3
  55. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/practitioner_role/client_inquire_request_must_support_practitioner_role_test.rb +3 -3
  56. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/practitioner_role/client_inquire_response_must_support_practitioner_role_test.rb +3 -3
  57. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/practitioner_role/client_submit_request_must_support_practitioner_role_test.rb +3 -3
  58. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/practitioner_role/client_submit_response_must_support_practitioner_role_test.rb +3 -3
  59. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/requestor/client_inquire_request_must_support_requestor_test.rb +3 -3
  60. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/requestor/client_inquire_response_must_support_requestor_test.rb +3 -3
  61. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/requestor/client_submit_request_must_support_requestor_test.rb +3 -3
  62. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/requestor/client_submit_response_must_support_requestor_test.rb +3 -3
  63. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/subscriber/client_inquire_request_must_support_subscriber_test.rb +3 -3
  64. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/subscriber/client_submit_request_must_support_subscriber_test.rb +3 -3
  65. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/beneficiary/client_inquire_response_must_support_beneficiary_test.rb +4 -3
  66. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/beneficiary/client_submit_response_must_support_beneficiary_test.rb +4 -3
  67. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/claim_inquiry/client_inquire_request_must_support_claim_inquiry_test.rb +3 -3
  68. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/claim_update/client_submit_request_must_support_claim_update_test.rb +3 -3
  69. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/claiminquiryresponse/client_inquire_response_must_support_claiminquiryresponse_test.rb +4 -3
  70. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/claimresponse/client_submit_response_must_support_claimresponse_test.rb +4 -3
  71. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/communication_request/client_submit_response_must_support_communication_request_test.rb +4 -3
  72. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/insurer/client_inquire_response_must_support_insurer_test.rb +4 -3
  73. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/insurer/client_submit_response_must_support_insurer_test.rb +4 -3
  74. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/pas_client_inquire_must_support_group.rb +8 -6
  75. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/pas_client_inquire_response_must_support_group.rb +9 -31
  76. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/pas_client_submit_must_support_group.rb +13 -9
  77. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/pas_client_submit_response_must_support_group.rb +10 -32
  78. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/pas_inquiry_response_bundle/client_inquire_response_must_support_pas_inquiry_response_bundle_test.rb +4 -3
  79. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/pas_response_bundle/client_submit_response_must_support_pas_response_bundle_test.rb +4 -3
  80. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/practitioner/client_inquire_response_must_support_practitioner_test.rb +4 -3
  81. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/practitioner/client_submit_response_must_support_practitioner_test.rb +4 -3
  82. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/practitioner_role/client_inquire_response_must_support_practitioner_role_test.rb +4 -3
  83. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/practitioner_role/client_submit_response_must_support_practitioner_role_test.rb +4 -3
  84. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/requestor/client_inquire_response_must_support_requestor_test.rb +4 -3
  85. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/requestor/client_submit_response_must_support_requestor_test.rb +4 -3
  86. data/lib/davinci_pas_test_kit/client/jobs/send_pas_subscription_notification.rb +64 -3
  87. data/lib/davinci_pas_test_kit/client/pas_client_subscription_pas_conformance_test.rb +4 -3
  88. data/lib/davinci_pas_test_kit/client/registration/abstract_configuration_other_display_test.rb +6 -4
  89. data/lib/davinci_pas_test_kit/client/registration/abstract_configuration_smart_display_test.rb +8 -4
  90. data/lib/davinci_pas_test_kit/client/registration/abstract_configuration_udap_display_test.rb +9 -4
  91. data/lib/davinci_pas_test_kit/client/registration/abstract_other_auth_attest_test.rb +5 -4
  92. data/lib/davinci_pas_test_kit/client/request_count_gating.rb +14 -0
  93. data/lib/davinci_pas_test_kit/client/response_generator.rb +50 -9
  94. data/lib/davinci_pas_test_kit/client/session_identification.rb +26 -7
  95. data/lib/davinci_pas_test_kit/client/subscription_notification_trigger.rb +80 -0
  96. data/lib/davinci_pas_test_kit/client/subscription_setup_requirement.rb +59 -0
  97. data/lib/davinci_pas_test_kit/client/user_input_response.rb +50 -10
  98. data/lib/davinci_pas_test_kit/client/v2.0.1/client_suite.rb +30 -15
  99. data/lib/davinci_pas_test_kit/client/v2.0.1/must_support/pas_client_must_support_request_profiles_test.rb +2 -2
  100. data/lib/davinci_pas_test_kit/client/v2.0.1/pas_client_approval_group.rb +8 -7
  101. data/lib/davinci_pas_test_kit/client/v2.0.1/pas_client_auth_smart_group.rb +4 -4
  102. data/lib/davinci_pas_test_kit/client/v2.0.1/pas_client_auth_udap_group.rb +4 -4
  103. data/lib/davinci_pas_test_kit/client/v2.0.1/pas_client_denial_group.rb +8 -7
  104. data/lib/davinci_pas_test_kit/client/v2.0.1/pas_client_must_support_group.rb +38 -52
  105. data/lib/davinci_pas_test_kit/client/v2.0.1/pas_client_pended_group.rb +28 -22
  106. data/lib/davinci_pas_test_kit/client/v2.0.1/pas_client_registration_group.rb +2 -2
  107. data/lib/davinci_pas_test_kit/client/v2.0.1/pas_client_subscription_setup_group.rb +2 -2
  108. data/lib/davinci_pas_test_kit/client/v2.0.1/pas_client_workflows_group.rb +2 -2
  109. data/lib/davinci_pas_test_kit/client/v2.0.1/workflows/pas_client_inquire_request_bundle_validation_test.rb +15 -21
  110. data/lib/davinci_pas_test_kit/client/v2.0.1/workflows/pas_client_inquire_response_bundle_validation_test.rb +29 -29
  111. data/lib/davinci_pas_test_kit/client/v2.0.1/workflows/pas_client_pended_submit_test.rb +49 -40
  112. data/lib/davinci_pas_test_kit/client/v2.0.1/workflows/pas_client_request_bundle_validation_test.rb +15 -21
  113. data/lib/davinci_pas_test_kit/client/v2.0.1/workflows/pas_client_response_bundle_validation_test.rb +29 -29
  114. data/lib/davinci_pas_test_kit/client/v2.2.1/attestations/attestation_instructions.rb +10 -0
  115. data/lib/davinci_pas_test_kit/client/v2.2.1/attestations/client_data_element_expectations_attestation_test.rb +44 -0
  116. data/lib/davinci_pas_test_kit/client/v2.2.1/attestations/client_provider_review_attestation_test.rb +45 -0
  117. data/lib/davinci_pas_test_kit/client/v2.2.1/attestations/client_security_attestation_test.rb +42 -0
  118. data/lib/davinci_pas_test_kit/client/v2.2.1/attestations/client_subscription_error_recovery_attestation_test.rb +42 -0
  119. data/lib/davinci_pas_test_kit/client/v2.2.1/client_suite.rb +64 -12
  120. data/lib/davinci_pas_test_kit/client/v2.2.1/error_handling/pas_client_operation_failure_submit_test.rb +20 -10
  121. data/lib/davinci_pas_test_kit/client/v2.2.1/error_handling/pas_client_operation_outcome_validation_test.rb +11 -5
  122. data/lib/davinci_pas_test_kit/client/v2.2.1/error_handling/pas_client_processing_error_response_validation_test.rb +21 -12
  123. data/lib/davinci_pas_test_kit/client/v2.2.1/error_handling/pas_client_processing_error_submit_test.rb +19 -8
  124. data/lib/davinci_pas_test_kit/client/v2.2.1/must_support/must_support_with_attestation_option.rb +90 -40
  125. data/lib/davinci_pas_test_kit/client/v2.2.1/pas_client_approval_group.rb +12 -11
  126. data/lib/davinci_pas_test_kit/client/v2.2.1/pas_client_attestations_group.rb +32 -0
  127. data/lib/davinci_pas_test_kit/client/v2.2.1/pas_client_auth_smart_group.rb +4 -4
  128. data/lib/davinci_pas_test_kit/client/v2.2.1/pas_client_auth_udap_group.rb +4 -4
  129. data/lib/davinci_pas_test_kit/client/v2.2.1/pas_client_claim_updates_group.rb +24 -6
  130. data/lib/davinci_pas_test_kit/client/v2.2.1/pas_client_denial_group.rb +12 -10
  131. data/lib/davinci_pas_test_kit/client/v2.2.1/pas_client_modification_group.rb +13 -14
  132. data/lib/davinci_pas_test_kit/client/v2.2.1/pas_client_must_support_group.rb +55 -59
  133. data/lib/davinci_pas_test_kit/client/v2.2.1/pas_client_operation_failure_group.rb +8 -5
  134. data/lib/davinci_pas_test_kit/client/v2.2.1/pas_client_pended_group.rb +53 -41
  135. data/lib/davinci_pas_test_kit/client/v2.2.1/pas_client_processing_error_group.rb +9 -7
  136. data/lib/davinci_pas_test_kit/client/v2.2.1/pas_client_registration_group.rb +2 -2
  137. data/lib/davinci_pas_test_kit/client/v2.2.1/pas_client_subscription_setup_group.rb +9 -4
  138. data/lib/davinci_pas_test_kit/client/v2.2.1/pas_client_subscription_update_delete_group.rb +57 -0
  139. data/lib/davinci_pas_test_kit/client/v2.2.1/pas_client_workflows_group.rb +22 -2
  140. data/lib/davinci_pas_test_kit/client/v2.2.1/subscription/pas_client_subscription_create_test.rb +2 -1
  141. data/lib/davinci_pas_test_kit/client/v2.2.1/subscription/pas_client_subscription_put_update_pas_conformance_test.rb +49 -0
  142. data/lib/davinci_pas_test_kit/client/v2.2.1/subscription/pas_client_subscription_update_delete_test.rb +12 -0
  143. data/lib/davinci_pas_test_kit/client/v2.2.1/workflows/pas_client_claim_update_referenced_resources_test.rb +5 -6
  144. data/lib/davinci_pas_test_kit/client/v2.2.1/workflows/pas_client_claim_update_submit_tests.rb +82 -56
  145. data/lib/davinci_pas_test_kit/client/v2.2.1/workflows/pas_client_inquire_request_bundle_validation_test.rb +17 -20
  146. data/lib/davinci_pas_test_kit/client/v2.2.1/workflows/pas_client_inquire_response_bundle_validation_test.rb +59 -27
  147. data/lib/davinci_pas_test_kit/client/v2.2.1/workflows/pas_client_modification_verification_test.rb +0 -3
  148. data/lib/davinci_pas_test_kit/client/v2.2.1/workflows/pas_client_pended_send_notification_test.rb +138 -0
  149. data/lib/davinci_pas_test_kit/client/v2.2.1/workflows/pas_client_pended_submit_test.rb +32 -85
  150. data/lib/davinci_pas_test_kit/client/v2.2.1/workflows/pas_client_request_bundle_validation_test.rb +16 -21
  151. data/lib/davinci_pas_test_kit/client/v2.2.1/workflows/pas_client_response_bundle_validation_test.rb +27 -27
  152. data/lib/davinci_pas_test_kit/cross_suite/fhirpath_utils.rb +13 -3
  153. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/beneficiary/metadata.yml +4 -0
  154. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/claim_inquiry/metadata.yml +15 -0
  155. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/claim_update/metadata.yml +17 -0
  156. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/claiminquiryresponse/metadata.yml +15 -0
  157. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/claimresponse/metadata.yml +15 -0
  158. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/communication_request/metadata.yml +4 -0
  159. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/coverage/metadata.yml +1 -0
  160. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/device_request/metadata.yml +2 -0
  161. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/encounter/metadata.yml +3 -0
  162. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/insurer/metadata.yml +1 -0
  163. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/medication_request/metadata.yml +2 -0
  164. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/metadata.yml +143 -0
  165. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/nutrition_order/metadata.yml +2 -0
  166. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/pas_inquiry_request_bundle/metadata.yml +2 -0
  167. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/pas_inquiry_response_bundle/metadata.yml +2 -0
  168. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/pas_request_bundle/metadata.yml +2 -0
  169. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/pas_response_bundle/metadata.yml +2 -0
  170. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/practitioner/metadata.yml +1 -0
  171. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/practitioner_role/metadata.yml +1 -0
  172. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/requestor/metadata.yml +1 -0
  173. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/service_request/metadata.yml +3 -0
  174. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/subscriber/metadata.yml +4 -0
  175. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/task/metadata.yml +1 -4
  176. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/beneficiary/metadata.yml +1 -0
  177. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/claim_inquiry/metadata.yml +23 -0
  178. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/claim_update/metadata.yml +31 -0
  179. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/claiminquiryresponse/metadata.yml +42 -0
  180. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/claimresponse/metadata.yml +42 -0
  181. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/communication_request/metadata.yml +4 -0
  182. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/coverage/metadata.yml +1 -0
  183. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/device_request/metadata.yml +2 -0
  184. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/encounter/metadata.yml +3 -0
  185. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/insurer/metadata.yml +1 -0
  186. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/medication_request/metadata.yml +2 -0
  187. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/metadata.yml +265 -1
  188. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/nutrition_order/metadata.yml +2 -0
  189. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/pas_inquiry_request_bundle/metadata.yml +2 -0
  190. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/pas_inquiry_response_bundle/metadata.yml +2 -0
  191. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/pas_request_bundle/metadata.yml +2 -0
  192. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/pas_response_bundle/metadata.yml +2 -0
  193. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/practitioner/metadata.yml +1 -0
  194. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/practitioner_role/metadata.yml +1 -0
  195. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/requestor/metadata.yml +1 -0
  196. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/service_request/metadata.yml +3 -0
  197. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/subscriber/metadata.yml +1 -0
  198. data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/task/metadata.yml +4 -4
  199. data/lib/davinci_pas_test_kit/cross_suite/pas_bundle_validation.rb +570 -312
  200. data/lib/davinci_pas_test_kit/cross_suite/pas_constants.rb +13 -0
  201. data/lib/davinci_pas_test_kit/cross_suite/pas_datatype_constraints.rb +166 -0
  202. data/lib/davinci_pas_test_kit/cross_suite/pas_subscription_verification.rb +8 -4
  203. data/lib/davinci_pas_test_kit/cross_suite/referenced_resource_presence_validation.rb +141 -0
  204. data/lib/davinci_pas_test_kit/cross_suite/response_selection_utils.rb +39 -21
  205. data/lib/davinci_pas_test_kit/cross_suite/tags.rb +11 -6
  206. data/lib/davinci_pas_test_kit/cross_suite/validator_configuration.rb +16 -0
  207. data/lib/davinci_pas_test_kit/cross_suite/validator_suppressions.rb +210 -146
  208. data/lib/davinci_pas_test_kit/docs/demo/PAS Client Suite Demonstration.postman_collection.json +7 -7
  209. data/lib/davinci_pas_test_kit/ext/inferno_core/runnable.rb +1 -0
  210. data/lib/davinci_pas_test_kit/generator/client_must_support_group_generator.rb +47 -16
  211. data/lib/davinci_pas_test_kit/generator/must_support_target_profiles.rb +17 -0
  212. data/lib/davinci_pas_test_kit/generator/must_support_test_generator.rb +14 -2
  213. data/lib/davinci_pas_test_kit/generator/pas_must_support_metadata_extractor.rb +1 -2
  214. data/lib/davinci_pas_test_kit/generator/profile_metadata.rb +1 -1
  215. data/lib/davinci_pas_test_kit/generator/server_must_support_group_generator.rb +23 -0
  216. data/lib/davinci_pas_test_kit/generator/server_suite_generator.rb +8 -7
  217. data/lib/davinci_pas_test_kit/generator/templates/client_must_support_group.rb.erb +22 -3
  218. data/lib/davinci_pas_test_kit/generator/templates/client_must_support_response_group.rb.erb +7 -16
  219. data/lib/davinci_pas_test_kit/generator/templates/must_support.rb.erb +11 -10
  220. data/lib/davinci_pas_test_kit/generator/templates/server_must_support_group.rb.erb +22 -0
  221. data/lib/davinci_pas_test_kit/generator/templates/server_suite.rb.erb +9 -11
  222. data/lib/davinci_pas_test_kit/generator/templates/use_case_group.rb.erb +3 -0
  223. data/lib/davinci_pas_test_kit/generator/use_case_group_generator.rb +19 -13
  224. data/lib/davinci_pas_test_kit/parameters_helper.rb +13 -5
  225. data/lib/davinci_pas_test_kit/pas_notification_conformance_test.rb +2 -2
  226. data/lib/davinci_pas_test_kit/requirements/davinci_pas_test_kit_requirements.csv +14 -7
  227. data/lib/davinci_pas_test_kit/requirements/generated/davinci_pas_client_suite_v201_requirements_coverage.csv +21 -21
  228. data/lib/davinci_pas_test_kit/requirements/generated/davinci_pas_client_suite_v221_requirements_coverage.csv +30 -26
  229. data/lib/davinci_pas_test_kit/requirements/generated/davinci_pas_server_suite_v221_requirements_coverage.csv +39 -33
  230. data/lib/davinci_pas_test_kit/requirements/hl7.fhir.us.davinci-pas_2.2.1_requirements.xlsx +0 -0
  231. data/lib/davinci_pas_test_kit/server/claim_operation_logic.rb +1 -1
  232. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/beneficiary/server_inquire_request_must_support_beneficiary_test.rb +1 -1
  233. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/beneficiary/server_inquire_response_must_support_beneficiary_test.rb +1 -1
  234. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/beneficiary/server_submit_request_must_support_beneficiary_test.rb +1 -1
  235. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/beneficiary/server_submit_response_must_support_beneficiary_test.rb +1 -1
  236. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/claim_inquiry/server_inquire_request_must_support_claim_inquiry_test.rb +1 -1
  237. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/claim_update/server_submit_request_must_support_claim_update_test.rb +1 -1
  238. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/claiminquiryresponse/server_inquire_response_must_support_claiminquiryresponse_test.rb +1 -1
  239. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/claimresponse/server_submit_response_must_support_claimresponse_test.rb +1 -1
  240. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/communication_request/server_submit_response_must_support_communication_request_test.rb +1 -1
  241. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/coverage/server_inquire_request_must_support_coverage_test.rb +1 -1
  242. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/coverage/server_submit_request_must_support_coverage_test.rb +1 -1
  243. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/encounter/server_submit_request_must_support_encounter_test.rb +1 -1
  244. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/insurer/server_inquire_request_must_support_insurer_test.rb +1 -1
  245. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/insurer/server_inquire_response_must_support_insurer_test.rb +1 -1
  246. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/insurer/server_submit_request_must_support_insurer_test.rb +1 -1
  247. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/insurer/server_submit_response_must_support_insurer_test.rb +1 -1
  248. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/pas_inquiry_request_bundle/server_inquire_request_must_support_pas_inquiry_request_bundle_test.rb +1 -1
  249. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/pas_inquiry_response_bundle/server_inquire_response_must_support_pas_inquiry_response_bundle_test.rb +1 -1
  250. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/pas_request_bundle/server_submit_request_must_support_pas_request_bundle_test.rb +1 -1
  251. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/pas_response_bundle/server_submit_response_must_support_pas_response_bundle_test.rb +1 -1
  252. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/pas_server_approval_use_case_group.rb +4 -3
  253. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/pas_server_denial_use_case_group.rb +4 -3
  254. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/pas_server_pended_use_case_group.rb +7 -6
  255. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/practitioner/server_inquire_request_must_support_practitioner_test.rb +1 -1
  256. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/practitioner/server_inquire_response_must_support_practitioner_test.rb +1 -1
  257. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/practitioner/server_submit_request_must_support_practitioner_test.rb +1 -1
  258. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/practitioner/server_submit_response_must_support_practitioner_test.rb +1 -1
  259. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/practitioner_role/server_inquire_request_must_support_practitioner_role_test.rb +1 -1
  260. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/practitioner_role/server_inquire_response_must_support_practitioner_role_test.rb +1 -1
  261. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/practitioner_role/server_submit_request_must_support_practitioner_role_test.rb +1 -1
  262. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/practitioner_role/server_submit_response_must_support_practitioner_role_test.rb +1 -1
  263. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/requestor/server_inquire_request_must_support_requestor_test.rb +1 -1
  264. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/requestor/server_inquire_response_must_support_requestor_test.rb +1 -1
  265. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/requestor/server_submit_request_must_support_requestor_test.rb +1 -1
  266. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/requestor/server_submit_response_must_support_requestor_test.rb +1 -1
  267. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/server_suite.rb +9 -11
  268. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/subscriber/server_inquire_request_must_support_subscriber_test.rb +1 -1
  269. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/subscriber/server_submit_request_must_support_subscriber_test.rb +1 -1
  270. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/task/server_inquire_response_must_support_task_test.rb +1 -1
  271. data/lib/davinci_pas_test_kit/server/generated/v2.0.1/task/server_submit_response_must_support_task_test.rb +1 -1
  272. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/beneficiary/server_inquire_request_must_support_beneficiary_test.rb +1 -1
  273. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/beneficiary/server_inquire_response_must_support_beneficiary_test.rb +1 -1
  274. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/beneficiary/server_submit_request_must_support_beneficiary_test.rb +1 -1
  275. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/beneficiary/server_submit_response_must_support_beneficiary_test.rb +1 -1
  276. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/claim_inquiry/server_inquire_request_must_support_claim_inquiry_test.rb +1 -1
  277. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/claim_update/server_submit_request_must_support_claim_update_test.rb +1 -1
  278. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/claiminquiryresponse/server_inquire_response_must_support_claiminquiryresponse_test.rb +3 -1
  279. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/claimresponse/server_submit_response_must_support_claimresponse_test.rb +3 -1
  280. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/communication_request/server_submit_response_must_support_communication_request_test.rb +1 -1
  281. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/coverage/server_inquire_request_must_support_coverage_test.rb +1 -1
  282. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/coverage/server_submit_request_must_support_coverage_test.rb +1 -1
  283. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/encounter/server_submit_request_must_support_encounter_test.rb +1 -1
  284. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/insurer/server_inquire_request_must_support_insurer_test.rb +1 -1
  285. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/insurer/server_inquire_response_must_support_insurer_test.rb +1 -1
  286. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/insurer/server_submit_request_must_support_insurer_test.rb +1 -1
  287. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/insurer/server_submit_response_must_support_insurer_test.rb +1 -1
  288. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/pas_inquiry_request_bundle/server_inquire_request_must_support_pas_inquiry_request_bundle_test.rb +1 -1
  289. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/pas_inquiry_response_bundle/server_inquire_response_must_support_pas_inquiry_response_bundle_test.rb +1 -1
  290. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/pas_request_bundle/server_submit_request_must_support_pas_request_bundle_test.rb +1 -1
  291. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/pas_response_bundle/server_submit_response_must_support_pas_response_bundle_test.rb +1 -1
  292. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/pas_server_approval_use_case_group.rb +5 -3
  293. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/pas_server_denial_use_case_group.rb +5 -3
  294. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/pas_server_must_support_group.rb +12 -0
  295. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/pas_server_pended_use_case_group.rb +9 -4
  296. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/practitioner/server_inquire_request_must_support_practitioner_test.rb +1 -1
  297. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/practitioner/server_inquire_response_must_support_practitioner_test.rb +1 -1
  298. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/practitioner/server_submit_request_must_support_practitioner_test.rb +1 -1
  299. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/practitioner/server_submit_response_must_support_practitioner_test.rb +1 -1
  300. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/practitioner_role/server_inquire_request_must_support_practitioner_role_test.rb +1 -1
  301. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/practitioner_role/server_inquire_response_must_support_practitioner_role_test.rb +1 -1
  302. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/practitioner_role/server_submit_request_must_support_practitioner_role_test.rb +1 -1
  303. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/practitioner_role/server_submit_response_must_support_practitioner_role_test.rb +1 -1
  304. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/requestor/server_inquire_request_must_support_requestor_test.rb +1 -1
  305. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/requestor/server_inquire_response_must_support_requestor_test.rb +1 -1
  306. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/requestor/server_submit_request_must_support_requestor_test.rb +1 -1
  307. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/requestor/server_submit_response_must_support_requestor_test.rb +1 -1
  308. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/server_suite.rb +9 -11
  309. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/subscriber/server_inquire_request_must_support_subscriber_test.rb +1 -1
  310. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/subscriber/server_submit_request_must_support_subscriber_test.rb +1 -1
  311. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/task/server_inquire_response_must_support_task_test.rb +1 -1
  312. data/lib/davinci_pas_test_kit/server/generated/v2.2.1/task/server_submit_response_must_support_task_test.rb +1 -1
  313. data/lib/davinci_pas_test_kit/server/pas_claim_response_decision_test.rb +2 -2
  314. data/lib/davinci_pas_test_kit/server/server_request_bundle_validation_test.rb +4 -6
  315. data/lib/davinci_pas_test_kit/server/server_response_bundle_validation_test.rb +17 -10
  316. data/lib/davinci_pas_test_kit/server/v2.0.1/must_support/pas_server_must_support_request_profiles_test.rb +1 -1
  317. data/lib/davinci_pas_test_kit/server/v2.0.1/pas_server_subscription_setup.rb +1 -1
  318. data/lib/davinci_pas_test_kit/server/v2.2.1/claim_inquiry/server_claim_inquiry_response_tests.rb +89 -0
  319. data/lib/davinci_pas_test_kit/server/v2.2.1/must_support/pas_server_must_support_request_profiles_test.rb +1 -1
  320. data/lib/davinci_pas_test_kit/server/v2.2.1/pas_error_group.rb +2 -0
  321. data/lib/davinci_pas_test_kit/server/v2.2.1/pas_server_claim_inquiry_responses_group.rb +17 -0
  322. data/lib/davinci_pas_test_kit/server/v2.2.1/pas_server_claim_updates_group.rb +1 -1
  323. data/lib/davinci_pas_test_kit/server/v2.2.1/pas_server_no_custom_extensions_test.rb +241 -0
  324. data/lib/davinci_pas_test_kit/server/v2.2.1/pas_server_subscription_capability_statement_test.rb +40 -0
  325. data/lib/davinci_pas_test_kit/server/v2.2.1/pas_server_subscription_setup.rb +15 -10
  326. data/lib/davinci_pas_test_kit/server/v2.2.1/server_replaced_pa_inquire_reference_input_test.rb +63 -0
  327. data/lib/davinci_pas_test_kit/server/v2.2.1/server_replaced_pa_inquire_reference_test.rb +109 -0
  328. data/lib/davinci_pas_test_kit/version.rb +2 -2
  329. metadata +38 -13
  330. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/task/client_inquire_response_must_support_task_test.rb +0 -45
  331. data/lib/davinci_pas_test_kit/client/generated/v2.0.1/task/client_submit_response_must_support_task_test.rb +0 -45
  332. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/task/client_inquire_response_must_support_task_test.rb +0 -55
  333. data/lib/davinci_pas_test_kit/client/generated/v2.2.1/task/client_submit_response_must_support_task_test.rb +0 -55
  334. data/lib/davinci_pas_test_kit/client/v2.2.1/pas_client_error_handling_group.rb +0 -20
data/config/presets/pas_client_v221_run_against_pas_server.json CHANGED
@@ -41,15 +41,15 @@
41
41
  "optional": true,
42
42
  "title": "Claim approved response JSON",
43
43
  "type": "textarea",
44
- "value": "{\r\n \"id\": \"b0000001-0000-0000-0000-000000000001\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-response-bundle\"\r\n ]\r\n },\r\n \"identifier\": {\r\n \"system\": \"urn:ietf:rfc:3986\",\r\n \"value\": \"urn:uuid:b0000001-0000-0000-0000-000000000001\"\r\n },\r\n \"type\": \"collection\",\r\n \"timestamp\": \"2024-01-30T13:29:32Z\",\r\n \"entry\": [\r\n {\r\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0001-0000-0000-000000000001\",\r\n \"resource\": {\r\n \"id\": \"a1b2c3d4-0001-0000-0000-000000000001\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse\"\r\n ]\r\n },\r\n \"extension\": [\r\n {\r\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-TransmissionIdentifiers\",\r\n \"extension\": [\r\n {\r\n \"url\": \"applicationSenderCode\",\r\n \"valueString\": \"SENDER01\"\r\n },\r\n {\r\n \"url\": 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\"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\r\n \"code\": \"payer-url\"\r\n }\r\n ]\r\n },\r\n \"valueUrl\": \"https://prior-auth.davinci.hl7.org/fhir/payer\"\r\n },\r\n {\r\n \"extension\": [\r\n {\r\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber\",\r\n \"valuePositiveInt\": 1\r\n },\r\n {\r\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-contentModifier\",\r\n \"valueCodeableConcept\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http://loinc.org\",\r\n \"code\": \"18804-5\"\r\n }\r\n ]\r\n }\r\n }\r\n ],\r\n \"type\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\r\n \"code\": \"attachments-needed\"\r\n }\r\n ]\r\n },\r\n \"valueCodeableConcept\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http://loinc.org\",\r\n \"code\": \"28570-0\"\r\n }\r\n ]\r\n }\r\n },\r\n {\r\n \"extension\": [\r\n {\r\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber\",\r\n \"valuePositiveInt\": 1\r\n }\r\n ],\r\n \"type\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\r\n \"code\": \"questionnaire-context\"\r\n }\r\n ]\r\n },\r\n \"valueString\": \"http://example.org/questionnaire\"\r\n }\r\n ],\r\n \"resourceType\": \"Task\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\",\r\n \"resource\": {\r\n \"id\": \"0b321e9e-571b-4f83-8cea-fa23424383bb\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary\"\r\n ]\r\n },\r\n \"extension\": [\r\n {\r\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-militaryStatus\",\r\n \"valueCodeableConcept\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"https://codesystem.x12.org/005010/584\",\r\n \"code\": \"RU\"\r\n }\r\n ]\r\n }\r\n }\r\n ],\r\n \"identifier\": [\r\n {\r\n \"system\": \"http://notreal.com/MIN\",\r\n \"value\": \"12345678901\"\r\n }\r\n ],\r\n \"name\": [\r\n {\r\n \"family\": \"SMITH\",\r\n \"given\": [\r\n \"JOE\"\r\n ]\r\n }\r\n ],\r\n \"gender\": \"male\",\r\n \"resourceType\": \"Patient\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\",\r\n \"resource\": {\r\n \"id\": \"ff7adc9d-8854-4947-874a-8b61bca953c1\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer\"\r\n ]\r\n },\r\n \"identifier\": [\r\n {\r\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\r\n \"value\": \"7893120007\"\r\n }\r\n ],\r\n \"active\": true,\r\n \"type\": [\r\n {\r\n \"coding\": [\r\n {\r\n \"system\": \"https://codesystem.x12.org/005010/98\",\r\n \"code\": \"PR\"\r\n }\r\n ]\r\n }\r\n ],\r\n \"name\": \"MARYLAND CAPITAL INSURANCE COMPANY\",\r\n \"resourceType\": \"Organization\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:b0881003-0d22-499d-840b-91dc7f6f4479\",\r\n \"resource\": {\r\n \"id\": \"b0881003-0d22-499d-840b-91dc7f6f4479\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor\"\r\n ]\r\n },\r\n \"identifier\": [\r\n {\r\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\r\n \"value\": \"8189991234\"\r\n }\r\n ],\r\n \"active\": true,\r\n \"type\": [\r\n {\r\n \"coding\": [\r\n {\r\n \"system\": \"https://codesystem.x12.org/005010/98\",\r\n \"code\": \"X3\"\r\n }\r\n ]\r\n }\r\n ],\r\n \"name\": \"DR. JOE SMITH CORPORATION\",\r\n \"address\": [\r\n {\r\n \"line\": [\r\n \"111 1ST STREET\"\r\n ],\r\n \"city\": \"SAN DIEGO\",\r\n \"state\": \"CA\",\r\n \"postalCode\": \"92101\",\r\n \"country\": \"US\"\r\n }\r\n ],\r\n \"resourceType\": \"Organization\"\r\n }\r\n }\r\n ],\r\n \"resourceType\": \"Bundle\"\r\n}"
44
+ "value": "{\r\n \"id\": \"b0000001-0000-0000-0000-000000000001\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-response-bundle\"\r\n ]\r\n },\r\n \"identifier\": {\r\n \"system\": \"urn:ietf:rfc:3986\",\r\n \"value\": \"urn:uuid:b0000001-0000-0000-0000-000000000001\"\r\n },\r\n \"type\": \"collection\",\r\n \"timestamp\": \"2024-01-30T13:29:32Z\",\r\n \"entry\": [\r\n {\r\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0001-0000-0000-000000000001\",\r\n \"resource\": {\r\n \"id\": \"a1b2c3d4-0001-0000-0000-000000000001\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse\"\r\n ]\r\n },\r\n \"extension\": [\r\n {\r\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-TransmissionIdentifiers\",\r\n \"extension\": [\r\n {\r\n \"url\": \"applicationSenderCode\",\r\n \"valueString\": \"SENDER01\"\r\n },\r\n {\r\n \"url\": 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\"code\": \"CA\"\r\n }\r\n ]\r\n }\r\n }\r\n ],\r\n \"system\": \"http://notreal.com/PATIENT_EVENT_TRACE_NUMBER\",\r\n \"value\": \"111366\",\r\n \"assigner\": {\r\n \"identifier\": {\r\n \"system\": \"http://notreal.com/USER_ASSIGNED\",\r\n \"value\": \"5556667771\"\r\n }\r\n }\r\n }\r\n ],\r\n \"status\": \"active\",\r\n \"type\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http://terminology.hl7.org/CodeSystem/claim-type\",\r\n \"code\": \"professional\"\r\n }\r\n ]\r\n },\r\n \"use\": \"preauthorization\",\r\n \"patient\": {\r\n \"reference\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\"\r\n },\r\n \"created\": \"2024-01-30T13:29:32Z\",\r\n \"insurer\": {\r\n \"reference\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\"\r\n },\r\n \"requestor\": {\r\n \"reference\": \"urn:uuid:b0881003-0d22-499d-840b-91dc7f6f4479\"\r\n },\r\n \"request\": {\r\n \"extension\": [\r\n {\r\n \"url\": \"http://hl7.org/fhir/StructureDefinition/data-absent-reason\",\r\n \"valueCode\": 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\"ClaimResponse.status\"\r\n }\r\n ]\r\n },\r\n {\r\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorPath\",\r\n \"valueString\": \"ClaimResponse.status\"\r\n }\r\n ],\r\n \"code\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"https://codesystem.x12.org/005010/901\",\r\n \"code\": \"04\"\r\n }\r\n ]\r\n }\r\n }\r\n ],\r\n \"resourceType\": \"ClaimResponse\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0002-0000-0000-000000000001\",\r\n \"resource\": {\r\n \"id\": \"a1b2c3d4-0002-0000-0000-000000000001\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-communicationrequest\"\r\n ]\r\n },\r\n \"extension\": [\r\n {\r\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber\",\r\n \"valuePositiveInt\": 1\r\n }\r\n ],\r\n \"identifier\": [\r\n {\r\n \"system\": \"http://davinci-pas.org/fhir/comm-req-id\",\r\n \"value\": \"COMM001\"\r\n }\r\n ],\r\n 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\"18804-5\"\r\n }\r\n ]\r\n }\r\n }\r\n ],\r\n \"contentString\": \"18776-5\"\r\n }\r\n ],\r\n \"requester\": {\r\n \"display\": \"Mock Requester\"\r\n },\r\n \"recipient\": [\r\n {\r\n \"display\": \"Mock Recipient\"\r\n }\r\n ],\r\n \"sender\": {\r\n \"display\": \"Mock Sender\"\r\n },\r\n \"resourceType\": \"CommunicationRequest\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0003-0000-0000-000000000001\",\r\n \"resource\": {\r\n \"id\": \"a1b2c3d4-0003-0000-0000-000000000001\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner\"\r\n ]\r\n },\r\n \"identifier\": [\r\n {\r\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\r\n \"value\": \"7644195407\"\r\n }\r\n ],\r\n \"name\": [\r\n {\r\n \"family\": \"WATSON\",\r\n \"given\": [\r\n \"SUSAN\"\r\n ]\r\n }\r\n ],\r\n \"address\": [\r\n {\r\n \"line\": [\r\n \"123 Main St\"\r\n ],\r\n \"city\": \"Springfield\",\r\n \"state\": \"IL\",\r\n \"postalCode\": \"62701\",\r\n \"country\": \"US\"\r\n }\r\n ],\r\n \"telecom\": [\r\n {\r\n \"system\": \"phone\",\r\n \"value\": \"5555550100\"\r\n }\r\n ],\r\n \"resourceType\": \"Practitioner\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0004-0000-0000-000000000001\",\r\n \"resource\": {\r\n \"id\": \"a1b2c3d4-0004-0000-0000-000000000001\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole\"\r\n ]\r\n },\r\n \"practitioner\": {\r\n \"reference\": \"urn:uuid:a1b2c3d4-0003-0000-0000-000000000001\"\r\n },\r\n \"organization\": {\r\n \"display\": \"Mock Organization\"\r\n },\r\n \"code\": [\r\n {\r\n \"coding\": [\r\n {\r\n \"system\": \"http://nucc.org/provider-taxonomy\",\r\n \"code\": \"208D00000X\",\r\n \"display\": \"General Practice Physician\"\r\n }\r\n ]\r\n }\r\n ],\r\n \"specialty\": [\r\n {\r\n \"coding\": [\r\n {\r\n \"system\": \"http://nucc.org/provider-taxonomy\",\r\n \"code\": \"208D00000X\",\r\n \"display\": \"General Practice Physician\"\r\n }\r\n ]\r\n }\r\n ],\r\n \"location\": [\r\n {\r\n \"display\": \"Mock Location\"\r\n }\r\n ],\r\n \"endpoint\": [\r\n {\r\n \"display\": \"Mock Endpoint\"\r\n }\r\n ],\r\n \"telecom\": [\r\n {\r\n \"system\": \"phone\",\r\n \"value\": \"5555550100\"\r\n }\r\n ],\r\n \"resourceType\": \"PractitionerRole\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0005-0000-0000-000000000001\",\r\n \"resource\": {\r\n \"id\": \"a1b2c3d4-0005-0000-0000-000000000001\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-task\"\r\n ]\r\n },\r\n \"identifier\": [\r\n {\r\n \"system\": \"https://prior-auth.davinci.hl7.org/fhir/ITEM_TRACE_NUMBER\",\r\n \"value\": \"TASK001\"\r\n }\r\n ],\r\n \"status\": \"requested\",\r\n \"statusReason\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\r\n \"code\": \"priorAuthorization\"\r\n }\r\n ]\r\n },\r\n \"intent\": \"order\",\r\n \"code\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\r\n \"code\": \"attachment-request-code\"\r\n }\r\n ]\r\n },\r\n \"for\": {\r\n \"display\": \"Mock Patient\"\r\n },\r\n \"requester\": {\r\n \"identifier\": {\r\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\r\n \"value\": \"1234567893\"\r\n }\r\n },\r\n \"owner\": {\r\n \"identifier\": {\r\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\r\n \"value\": \"1234567893\"\r\n }\r\n },\r\n \"reasonCode\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\r\n \"code\": \"priorAuthorization\"\r\n }\r\n ]\r\n },\r\n \"reasonReference\": {\r\n \"display\": \"Mock Claim\"\r\n },\r\n \"restriction\": {\r\n \"period\": {\r\n \"start\": \"2023-01-01\",\r\n \"end\": \"2023-12-31\"\r\n }\r\n },\r\n \"input\": [\r\n {\r\n \"type\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\r\n \"code\": \"payer-url\"\r\n }\r\n ]\r\n },\r\n \"valueUrl\": \"https://prior-auth.davinci.hl7.org/fhir/payer\"\r\n },\r\n {\r\n \"extension\": [\r\n {\r\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber\",\r\n \"valuePositiveInt\": 1\r\n },\r\n {\r\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-contentModifier\",\r\n \"valueCodeableConcept\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http://loinc.org\",\r\n \"code\": \"18804-5\"\r\n }\r\n ]\r\n }\r\n }\r\n ],\r\n \"type\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\r\n \"code\": \"attachments-needed\"\r\n }\r\n ]\r\n },\r\n \"valueCodeableConcept\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http://loinc.org\",\r\n \"code\": \"28570-0\"\r\n }\r\n ]\r\n }\r\n },\r\n {\r\n \"extension\": [\r\n {\r\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber\",\r\n \"valuePositiveInt\": 1\r\n }\r\n ],\r\n \"type\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\r\n \"code\": \"questionnaire-context\"\r\n }\r\n ]\r\n },\r\n \"valueString\": \"http://example.org/questionnaire\"\r\n }\r\n ],\r\n \"resourceType\": \"Task\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\",\r\n \"resource\": {\r\n \"id\": \"0b321e9e-571b-4f83-8cea-fa23424383bb\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary\"\r\n ]\r\n },\r\n \"extension\": [\r\n {\r\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-militaryStatus\",\r\n \"valueCodeableConcept\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"https://codesystem.x12.org/005010/584\",\r\n \"code\": \"RU\"\r\n }\r\n ]\r\n }\r\n }\r\n ],\r\n \"identifier\": [\r\n {\r\n \"system\": \"http://notreal.com/MIN\",\r\n \"value\": \"12345678901\"\r\n }\r\n ],\r\n \"name\": [\r\n {\r\n \"family\": \"SMITH\",\r\n \"given\": [\r\n \"JOE\"\r\n ]\r\n }\r\n ],\r\n \"gender\": \"male\",\r\n \"resourceType\": \"Patient\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\",\r\n \"resource\": {\r\n \"id\": \"ff7adc9d-8854-4947-874a-8b61bca953c1\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer\"\r\n ]\r\n },\r\n \"identifier\": [\r\n {\r\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\r\n \"value\": \"7893120007\"\r\n }\r\n ],\r\n \"active\": true,\r\n \"type\": [\r\n {\r\n \"coding\": [\r\n {\r\n \"system\": \"https://codesystem.x12.org/005010/98\",\r\n \"code\": \"PR\"\r\n }\r\n ]\r\n }\r\n ],\r\n \"name\": \"MARYLAND CAPITAL INSURANCE COMPANY\",\r\n \"resourceType\": \"Organization\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:b0881003-0d22-499d-840b-91dc7f6f4479\",\r\n \"resource\": {\r\n \"id\": \"b0881003-0d22-499d-840b-91dc7f6f4479\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor\"\r\n ]\r\n },\r\n \"identifier\": [\r\n {\r\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\r\n \"value\": \"8189991234\"\r\n }\r\n ],\r\n \"active\": true,\r\n \"type\": [\r\n {\r\n \"coding\": [\r\n {\r\n \"system\": \"https://codesystem.x12.org/005010/98\",\r\n \"code\": \"X3\"\r\n }\r\n ]\r\n }\r\n ],\r\n \"name\": \"DR. JOE SMITH CORPORATION\",\r\n \"address\": [\r\n {\r\n \"line\": [\r\n \"111 1ST STREET\"\r\n ],\r\n \"city\": \"SAN DIEGO\",\r\n \"state\": \"CA\",\r\n \"postalCode\": \"92101\",\r\n \"country\": \"US\"\r\n }\r\n ],\r\n \"resourceType\": \"Organization\"\r\n }\r\n }\r\n ],\r\n \"resourceType\": \"Bundle\"\r\n}"
45
45
  },
46
46
  {
47
47
  "name": "ms_inquire_responses",
48
- "value": "[\n {\n \"id\": \"b0000002-0000-0000-0000-000000000001\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-inquiry-response-bundle\"\n ]\n },\n \"identifier\": {\n \"system\": \"urn:ietf:rfc:3986\",\n \"value\": \"urn:uuid:b0000002-0000-0000-0000-000000000001\"\n },\n \"type\": \"collection\",\n \"timestamp\": \"2024-01-30T13:29:32Z\",\n \"entry\": [\n {\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0006-0000-0000-000000000001\",\n \"resource\": {\n \"id\": \"a1b2c3d4-0006-0000-0000-000000000001\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claiminquiryresponse\"\n ]\n },\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-TransmissionIdentifiers\",\n \"extension\": [\n {\n \"url\": \"applicationSenderCode\",\n \"valueString\": \"SENDER01\"\n },\n {\n \"url\": \"applicationReceiverCode\",\n \"valueString\": \"RECEIVER01\"\n }\n ]\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-claimResponseReviewer\",\n \"extension\": [\n {\n \"url\": \"wasHumanReviewedFlag\",\n \"valueBoolean\": true\n }\n ]\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider\",\n \"extension\": [\n {\n \"url\": \"provider\",\n \"valueReference\": {\n \"display\": \"Mock Authorized Provider\"\n }\n }\n ]\n }\n ],\n \"identifier\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierSubDepartment\",\n \"valueString\": \"SUBDEPT01\"\n },\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\": \"CA\"\n }\n ]\n }\n }\n ],\n \"system\": \"http://notreal.com/PATIENT_EVENT_TRACE_NUMBER\",\n \"value\": \"111366\",\n \"assigner\": {\n \"identifier\": {\n \"system\": \"http://notreal.com/USER_ASSIGNED\",\n \"value\": \"5556667771\"\n }\n }\n }\n ],\n \"status\": \"active\",\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\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\"\n },\n \"created\": \"2024-01-30T13:29:32Z\",\n \"insurer\": {\n \"reference\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\"\n },\n \"requestor\": {\n \"reference\": \"urn:uuid:b0881003-0d22-499d-840b-91dc7f6f4479\"\n },\n \"request\": {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/StructureDefinition/data-absent-reason\",\n \"valueCode\": \"unknown\"\n }\n ]\n },\n \"outcome\": \"complete\",\n \"preAuthPeriod\": {\n \"start\": \"2024-01-30\",\n \"end\": \"2024-02-29\"\n },\n \"item\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate\",\n \"valueDate\": \"2024-01-30\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod\",\n \"valuePeriod\": {\n \"start\": \"2024-01-30\",\n \"end\": \"2024-02-29\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber\",\n \"valueIdentifier\": {\n \"system\": \"https://prior-auth.davinci.hl7.org/fhir/ITEM_TRACE_NUMBER\",\n \"value\": \"1\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber\",\n \"valueString\": \"AUTH123\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber\",\n \"valueString\": \"ADMIN123\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemRequestedServiceDate\",\n \"valuePeriod\": {\n \"start\": \"2024-01-30\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDetail\",\n \"extension\": [\n {\n \"url\": \"productOrServiceCode\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1365\",\n \"code\": \"G0153\"\n }\n ]\n }\n }\n ]\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider\",\n \"extension\": [\n {\n \"url\": \"provider\",\n \"valueReference\": {\n \"display\": \"Mock Item Provider\"\n }\n }\n ]\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-admissionDates\",\n \"valuePeriod\": {\n \"start\": \"2023-01-01\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-dischargeDate\",\n \"valueDate\": \"2023-01-10\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/icd-10-cm\",\n \"code\": \"J06.9\"\n }\n ]\n }\n }\n ],\n \"itemSequence\": 1,\n \"noteNumber\": [\n 1\n ],\n \"adjudication\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction\",\n \"extension\": [\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 }\n ],\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/adjudication\",\n \"code\": \"submitted\"\n }\n ]\n }\n }\n ]\n }\n ],\n \"addItem\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber\",\n \"valueIdentifier\": {\n \"system\": \"https://prior-auth.davinci.hl7.org/fhir/ITEM_TRACE_NUMBER\",\n \"value\": \"TRACE001\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate\",\n \"valueDate\": \"2024-01-30\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod\",\n \"valuePeriod\": {\n \"start\": \"2024-01-30\",\n \"end\": \"2024-02-29\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber\",\n \"valueString\": \"AUTH456\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber\",\n \"valueString\": \"ADMIN456\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator\",\n \"valueBoolean\": false\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://valueset.x12.org/x217/005010/response/2000F/NX1/1/01/00/1345\",\n \"code\": \"2\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeLevelOfCare\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://valueset.x12.org/x217/005010/response/2000F/NX1/1/02/00/1306\",\n \"code\": \"2\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-productOrServiceCodeEnd\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1365\",\n \"code\": \"G0153\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueCode\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://www.nubc.org/CodeSystem/RevenueCodes\",\n \"code\": \"0300\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueUnitRateLimit\",\n \"valueDecimal\": 100.0\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService\",\n \"valueReference\": {\n \"display\": \"Mock Requested Service\"\n }\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\": \"SC\",\n \"display\": \"Specialty Care 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-admissionDates\",\n \"valuePeriod\": {\n \"start\": \"2023-01-01\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-dischargeDate\",\n \"valueDate\": \"2023-01-10\"\n }\n ],\n \"itemSequence\": [\n 1\n ],\n \"provider\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizedProviderType\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/98\",\n \"code\": \"IL\"\n }\n ]\n }\n }\n ],\n \"display\": \"Mock AddItem Provider\"\n }\n ],\n \"productOrService\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1365\",\n \"code\": \"G0153\"\n }\n ]\n },\n \"modifier\": [\n {\n \"coding\": [\n {\n \"system\": \"http://www.ama-assn.org/go/cpt\",\n \"code\": \"25\"\n }\n ]\n }\n ],\n \"servicedDate\": \"2024-01-30\",\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 \"quantity\": {\n \"value\": 1\n },\n \"unitPrice\": {\n \"value\": 100.0,\n \"currency\": \"USD\"\n },\n \"adjudication\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction\",\n \"extension\": [\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 }\n ],\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/adjudication\",\n \"code\": \"submitted\"\n }\n ]\n }\n }\n ]\n }\n ],\n \"adjudication\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction\",\n \"extension\": [\n {\n \"url\": \"number\",\n \"valueString\": \"1\"\n }\n ]\n }\n ],\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/adjudication\",\n \"code\": \"submitted\"\n }\n ]\n }\n }\n ],\n \"processNote\": [\n {\n \"number\": 1,\n \"text\": \"Prior authorization processing note\"\n }\n ],\n \"error\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorFollowupAction\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/889\",\n \"code\": \"N\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorElement\",\n \"extension\": [\n {\n \"url\": \"error\",\n \"valueString\": \"ClaimResponse.status\"\n }\n ]\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorPath\",\n \"valueString\": \"ClaimResponse.status\"\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/901\",\n \"code\": \"04\"\n }\n ]\n }\n }\n ],\n \"resourceType\": \"ClaimResponse\"\n }\n },\n {\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0003-0000-0000-000000000001\",\n \"resource\": {\n \"id\": \"a1b2c3d4-0003-0000-0000-000000000001\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner\"\n ]\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"1234567893\"\n }\n ],\n \"name\": [\n {\n \"family\": \"WATSON\",\n \"given\": [\n \"SUSAN\"\n ]\n }\n ],\n \"address\": [\n {\n \"line\": [\n \"123 Main St\"\n ],\n \"city\": \"Springfield\",\n \"state\": \"IL\",\n \"postalCode\": \"62701\",\n \"country\": \"US\"\n }\n ],\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5555550100\"\n }\n ],\n \"resourceType\": \"Practitioner\"\n }\n },\n {\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0004-0000-0000-000000000001\",\n \"resource\": {\n \"id\": \"a1b2c3d4-0004-0000-0000-000000000001\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole\"\n ]\n },\n \"practitioner\": {\n \"reference\": \"urn:uuid:a1b2c3d4-0003-0000-0000-000000000001\"\n },\n \"organization\": {\n \"display\": \"Mock Organization\"\n },\n \"code\": [\n {\n \"coding\": [\n {\n \"system\": \"http://nucc.org/provider-taxonomy\",\n \"code\": \"208D00000X\",\n \"display\": \"General Practice Physician\"\n }\n ]\n }\n ],\n \"specialty\": [\n {\n \"coding\": [\n {\n \"system\": \"http://nucc.org/provider-taxonomy\",\n \"code\": \"208D00000X\",\n \"display\": \"General Practice Physician\"\n }\n ]\n }\n ],\n \"location\": [\n {\n \"display\": \"Mock Location\"\n }\n ],\n \"endpoint\": [\n {\n \"display\": \"Mock Endpoint\"\n }\n ],\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5555550100\"\n }\n ],\n \"resourceType\": \"PractitionerRole\"\n }\n },\n {\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0005-0000-0000-000000000001\",\n \"resource\": {\n \"id\": \"a1b2c3d4-0005-0000-0000-000000000001\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-task\"\n ]\n },\n \"identifier\": [\n {\n \"system\": \"https://prior-auth.davinci.hl7.org/fhir/ITEM_TRACE_NUMBER\",\n \"value\": \"TASK001\"\n }\n ],\n \"status\": \"requested\",\n \"statusReason\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"priorAuthorization\"\n }\n ]\n },\n \"intent\": \"order\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"attachment-request-code\"\n }\n ]\n },\n \"for\": {\n \"display\": \"Mock Patient\"\n },\n \"requester\": {\n \"identifier\": {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"1234567893\"\n }\n },\n \"owner\": {\n \"identifier\": {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"1234567893\"\n }\n },\n \"reasonCode\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"priorAuthorization\"\n }\n ]\n },\n \"reasonReference\": {\n \"display\": \"Mock Claim\"\n },\n \"restriction\": {\n \"period\": {\n \"start\": \"2023-01-01\",\n \"end\": \"2023-12-31\"\n }\n },\n \"input\": [\n {\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"payer-url\"\n }\n ]\n },\n \"valueUrl\": \"https://prior-auth.davinci.hl7.org/fhir/payer\"\n },\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber\",\n \"valuePositiveInt\": 1\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-contentModifier\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"18804-5\"\n }\n ]\n }\n }\n ],\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"attachments-needed\"\n }\n ]\n },\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"28570-0\"\n }\n ]\n }\n },\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber\",\n \"valuePositiveInt\": 1\n }\n ],\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"questionnaire-context\"\n }\n ]\n },\n \"valueString\": \"http://example.org/questionnaire\"\n }\n ],\n \"resourceType\": \"Task\"\n }\n },\n {\n \"fullUrl\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\",\n \"resource\": {\n \"id\": \"0b321e9e-571b-4f83-8cea-fa23424383bb\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary\"\n ]\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 \"identifier\": [\n {\n \"system\": \"http://notreal.com/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 \"Jr.\"\n ]\n }\n ],\n \"gender\": \"male\",\n \"resourceType\": \"Patient\",\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5555550100\",\n \"use\": \"home\"\n }\n ],\n \"birthDate\": \"1980-01-01\",\n \"address\": [\n {\n \"line\": [\n \"111 1ST STREET\"\n ],\n \"city\": \"SAN DIEGO\",\n \"district\": \"SAN DIEGO COUNTY\",\n \"state\": \"CA\",\n \"postalCode\": \"92101\",\n \"country\": \"US\"\n }\n ],\n \"communication\": [\n {\n \"language\": {\n \"coding\": [\n {\n \"system\": \"urn:ietf:bcp:47\",\n \"code\": \"en\"\n }\n ]\n }\n }\n ],\n \"multipleBirthInteger\": 1\n }\n },\n {\n \"fullUrl\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\",\n \"resource\": {\n \"id\": \"ff7adc9d-8854-4947-874a-8b61bca953c1\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer\"\n ]\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"7893120007\"\n },\n {\n \"system\": \"http://terminology.hl7.org/NamingSystem/USEIN\",\n \"value\": \"123456789\"\n },\n {\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType\",\n \"code\": \"payerid\"\n }\n ]\n },\n \"value\": \"PI-7893120007\",\n \"system\": \"http://davinci-pas.org/fhir/payer-id\"\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 \"name\": \"MARYLAND CAPITAL INSURANCE COMPANY\",\n \"resourceType\": \"Organization\",\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5555550100\"\n }\n ]\n }\n },\n {\n \"fullUrl\": \"urn:uuid:b0881003-0d22-499d-840b-91dc7f6f4479\",\n \"resource\": {\n \"id\": \"b0881003-0d22-499d-840b-91dc7f6f4479\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor\"\n ]\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\": \"987654321\"\n },\n {\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType\",\n \"code\": \"payerid\"\n }\n ]\n },\n \"value\": \"PI-8189991234\",\n \"system\": \"http://davinci-pas.org/fhir/payer-id\"\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 \"resourceType\": \"Organization\",\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5555550100\"\n }\n ],\n \"contact\": [\n {\n \"name\": {\n \"text\": \"DR. JOE SMITH\"\n },\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5555550100\"\n }\n ]\n }\n ]\n }\n }\n ],\n \"resourceType\": \"Bundle\"\n }\n]"
48
+ "value": "[\n {\n \"id\": \"b0000002-0000-0000-0000-000000000001\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-inquiry-response-bundle\"\n ]\n },\n \"identifier\": {\n \"system\": \"urn:ietf:rfc:3986\",\n \"value\": \"urn:uuid:b0000002-0000-0000-0000-000000000001\"\n },\n \"type\": \"collection\",\n \"timestamp\": \"2024-01-30T13:29:32Z\",\n \"entry\": [\n {\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0006-0000-0000-000000000001\",\n \"resource\": {\n \"id\": \"a1b2c3d4-0006-0000-0000-000000000001\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claiminquiryresponse\"\n ]\n },\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-TransmissionIdentifiers\",\n \"extension\": [\n {\n \"url\": \"applicationSenderCode\",\n \"valueString\": \"SENDER01\"\n },\n {\n \"url\": \"applicationReceiverCode\",\n \"valueString\": \"RECEIVER01\"\n }\n ]\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-claimResponseReviewer\",\n \"extension\": [\n {\n \"url\": \"wasHumanReviewedFlag\",\n \"valueBoolean\": true\n }\n ]\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider\",\n \"extension\": [\n {\n \"url\": \"provider\",\n \"valueReference\": {\n \"display\": \"Mock Authorized Provider\"\n }\n }\n ]\n }\n ],\n \"identifier\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierSubDepartment\",\n \"valueString\": \"SUBDEPT01\"\n },\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\": \"CA\"\n }\n ]\n }\n }\n ],\n \"system\": \"http://notreal.com/PATIENT_EVENT_TRACE_NUMBER\",\n \"value\": \"111366\",\n \"assigner\": {\n \"identifier\": {\n \"system\": \"http://notreal.com/USER_ASSIGNED\",\n \"value\": \"5556667771\"\n }\n }\n }\n ],\n \"status\": \"active\",\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\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\"\n },\n \"created\": \"2024-01-30T13:29:32Z\",\n \"insurer\": {\n \"reference\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\"\n },\n \"requestor\": {\n \"reference\": \"urn:uuid:b0881003-0d22-499d-840b-91dc7f6f4479\"\n },\n \"request\": {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/StructureDefinition/data-absent-reason\",\n \"valueCode\": \"unknown\"\n }\n ]\n },\n \"outcome\": \"complete\",\n \"preAuthPeriod\": {\n \"start\": \"2024-01-30\",\n \"end\": \"2024-02-29\"\n },\n \"item\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate\",\n \"valueDate\": \"2024-01-30\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod\",\n \"valuePeriod\": {\n \"start\": \"2024-01-30\",\n \"end\": \"2024-02-29\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber\",\n \"valueIdentifier\": {\n \"system\": \"https://prior-auth.davinci.hl7.org/fhir/ITEM_TRACE_NUMBER\",\n \"value\": \"1\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber\",\n \"valueString\": \"AUTH123\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber\",\n \"valueString\": \"ADMIN123\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemRequestedServiceDate\",\n \"valuePeriod\": {\n \"start\": \"2024-01-30\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDetail\",\n \"extension\": [\n {\n \"url\": \"productOrServiceCode\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1365\",\n \"code\": \"G0153\"\n }\n ]\n }\n }\n ]\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider\",\n \"extension\": [\n {\n \"url\": \"provider\",\n \"valueReference\": {\n \"display\": \"Mock Item Provider\"\n }\n }\n ]\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-admissionDates\",\n \"valuePeriod\": {\n \"start\": \"2023-01-01\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-dischargeDate\",\n \"valueDate\": \"2023-01-10\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/icd-10-cm\",\n \"code\": \"J06.9\"\n }\n ]\n }\n }\n ],\n \"itemSequence\": 1,\n \"noteNumber\": [\n 1\n ],\n \"adjudication\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction\",\n \"extension\": [\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 }\n ],\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/adjudication\",\n \"code\": \"submitted\"\n }\n ]\n }\n }\n ]\n }\n ],\n \"addItem\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber\",\n \"valueIdentifier\": {\n \"system\": \"https://prior-auth.davinci.hl7.org/fhir/ITEM_TRACE_NUMBER\",\n \"value\": \"TRACE001\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate\",\n \"valueDate\": \"2024-01-30\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod\",\n \"valuePeriod\": {\n \"start\": \"2024-01-30\",\n \"end\": \"2024-02-29\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber\",\n \"valueString\": \"AUTH456\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber\",\n \"valueString\": \"ADMIN456\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator\",\n \"valueBoolean\": false\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://valueset.x12.org/x217/005010/response/2000F/NX1/1/01/00/1345\",\n \"code\": \"2\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeLevelOfCare\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://valueset.x12.org/x217/005010/response/2000F/NX1/1/02/00/1306\",\n \"code\": \"2\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-productOrServiceCodeEnd\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1365\",\n \"code\": \"G0153\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueCode\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://www.nubc.org/CodeSystem/RevenueCodes\",\n \"code\": \"0300\"\n }\n ]\n }\n },\n {\n \"url\": 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\"2023-01-01\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-dischargeDate\",\n \"valueDate\": \"2023-01-10\"\n }\n ],\n \"itemSequence\": [\n 1\n ],\n \"provider\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizedProviderType\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/98\",\n \"code\": \"IL\"\n }\n ]\n }\n }\n ],\n \"display\": \"Mock AddItem Provider\"\n }\n ],\n \"productOrService\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1365\",\n \"code\": \"G0153\"\n }\n ]\n },\n \"modifier\": [\n {\n \"coding\": [\n {\n \"system\": \"http://www.ama-assn.org/go/cpt\",\n \"code\": \"25\"\n }\n ]\n }\n ],\n \"servicedDate\": \"2024-01-30\",\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 \"quantity\": {\n \"value\": 1,\n \"unit\": \"visit\"\n },\n \"unitPrice\": {\n \"value\": 100.0,\n \"currency\": \"USD\"\n },\n \"adjudication\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction\",\n \"extension\": [\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 }\n ],\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/adjudication\",\n \"code\": \"submitted\"\n }\n ]\n }\n }\n ]\n }\n ],\n \"adjudication\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction\",\n \"extension\": [\n {\n \"url\": \"number\",\n \"valueString\": \"1\"\n }\n ]\n }\n ],\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/adjudication\",\n \"code\": \"submitted\"\n }\n ]\n }\n }\n ],\n \"processNote\": [\n {\n \"number\": 1,\n \"text\": \"Prior authorization processing note\"\n }\n ],\n \"error\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorFollowupAction\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/889\",\n \"code\": \"N\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorElement\",\n \"extension\": [\n {\n \"url\": \"error\",\n \"valueString\": \"ClaimResponse.status\"\n }\n ]\n },\n {\n \"url\": 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\"5555550100\"\n }\n ],\n \"resourceType\": \"Practitioner\"\n }\n },\n {\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0004-0000-0000-000000000001\",\n \"resource\": {\n \"id\": \"a1b2c3d4-0004-0000-0000-000000000001\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole\"\n ]\n },\n \"practitioner\": {\n \"reference\": \"urn:uuid:a1b2c3d4-0003-0000-0000-000000000001\"\n },\n \"organization\": {\n \"display\": \"Mock Organization\"\n },\n \"code\": [\n {\n \"coding\": [\n {\n \"system\": \"http://nucc.org/provider-taxonomy\",\n \"code\": \"208D00000X\",\n \"display\": \"General Practice Physician\"\n }\n ]\n }\n ],\n \"specialty\": [\n {\n \"coding\": [\n {\n \"system\": \"http://nucc.org/provider-taxonomy\",\n \"code\": \"208D00000X\",\n \"display\": \"General Practice Physician\"\n }\n ]\n }\n ],\n \"location\": [\n {\n \"display\": \"Mock Location\"\n }\n ],\n \"endpoint\": [\n {\n \"display\": \"Mock Endpoint\"\n }\n ],\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5555550100\"\n }\n ],\n \"resourceType\": \"PractitionerRole\"\n }\n },\n {\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0005-0000-0000-000000000001\",\n \"resource\": {\n \"id\": \"a1b2c3d4-0005-0000-0000-000000000001\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-task\"\n ]\n },\n \"identifier\": [\n {\n \"system\": \"https://prior-auth.davinci.hl7.org/fhir/ITEM_TRACE_NUMBER\",\n \"value\": \"TASK001\"\n }\n ],\n \"status\": \"requested\",\n \"statusReason\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"priorAuthorization\"\n }\n ]\n },\n \"intent\": \"order\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"attachment-request-code\"\n }\n ]\n },\n \"for\": {\n \"display\": \"Mock Patient\"\n },\n \"requester\": {\n \"identifier\": {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"1234567893\"\n }\n },\n \"owner\": {\n \"identifier\": {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"1234567893\"\n }\n },\n \"reasonCode\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"priorAuthorization\"\n }\n ]\n },\n \"reasonReference\": {\n \"display\": \"Mock Claim\"\n },\n \"restriction\": {\n \"period\": {\n \"start\": \"2023-01-01\",\n \"end\": \"2023-12-31\"\n }\n },\n \"input\": [\n {\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"payer-url\"\n }\n ]\n },\n \"valueUrl\": \"https://prior-auth.davinci.hl7.org/fhir/payer\"\n },\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber\",\n \"valuePositiveInt\": 1\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-contentModifier\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"18804-5\"\n }\n ]\n }\n }\n ],\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"attachments-needed\"\n }\n ]\n },\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"28570-0\"\n }\n ]\n }\n },\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber\",\n \"valuePositiveInt\": 1\n }\n ],\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"questionnaire-context\"\n }\n ]\n },\n \"valueString\": \"http://example.org/questionnaire\"\n }\n ],\n \"resourceType\": \"Task\"\n }\n },\n {\n \"fullUrl\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\",\n \"resource\": {\n \"id\": \"0b321e9e-571b-4f83-8cea-fa23424383bb\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary\"\n ]\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 \"identifier\": [\n {\n \"system\": \"http://notreal.com/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 \"Jr.\"\n ]\n }\n ],\n \"gender\": \"male\",\n \"resourceType\": \"Patient\",\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5555550100\",\n \"use\": \"home\"\n }\n ],\n \"birthDate\": \"1980-01-01\",\n \"address\": [\n {\n \"line\": [\n \"111 1ST STREET\"\n ],\n \"city\": \"SAN DIEGO\",\n \"district\": \"SAN DIEGO COUNTY\",\n \"state\": \"CA\",\n \"postalCode\": \"92101\",\n \"country\": \"US\"\n }\n ],\n \"communication\": [\n {\n \"language\": {\n \"coding\": [\n {\n \"system\": \"urn:ietf:bcp:47\",\n \"code\": \"en\"\n }\n ]\n }\n }\n ],\n \"multipleBirthInteger\": 1\n }\n },\n {\n \"fullUrl\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\",\n \"resource\": {\n \"id\": \"ff7adc9d-8854-4947-874a-8b61bca953c1\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer\"\n ]\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"7893120007\"\n },\n {\n \"system\": \"http://terminology.hl7.org/NamingSystem/USEIN\",\n \"value\": \"123456789\"\n },\n {\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType\",\n \"code\": \"payerid\"\n }\n ]\n },\n \"value\": \"PI-7893120007\",\n \"system\": \"http://davinci-pas.org/fhir/payer-id\"\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 \"name\": \"MARYLAND CAPITAL INSURANCE COMPANY\",\n \"resourceType\": \"Organization\",\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5555550100\"\n }\n ]\n }\n },\n {\n \"fullUrl\": \"urn:uuid:b0881003-0d22-499d-840b-91dc7f6f4479\",\n \"resource\": {\n \"id\": \"b0881003-0d22-499d-840b-91dc7f6f4479\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor\"\n ]\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\": \"987654321\"\n },\n {\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType\",\n \"code\": \"payerid\"\n }\n ]\n },\n \"value\": \"PI-8189991234\",\n \"system\": \"http://davinci-pas.org/fhir/payer-id\"\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 \"resourceType\": \"Organization\",\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5555550100\"\n }\n ],\n \"contact\": [\n {\n \"name\": {\n \"text\": \"DR. JOE SMITH\"\n },\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5555550100\"\n }\n ]\n }\n ]\n }\n }\n ],\n \"resourceType\": \"Bundle\"\n }\n]"
49
49
  },
50
50
  {
51
51
  "name": "ms_submit_responses",
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\"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-claimResponseReviewer\",\n \"extension\": [\n {\n \"url\": \"wasHumanReviewedFlag\",\n \"valueBoolean\": true\n }\n ]\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider\",\n \"extension\": [\n {\n \"url\": \"provider\",\n \"valueReference\": {\n \"display\": \"Mock Authorized Provider\"\n }\n }\n ]\n }\n ],\n \"identifier\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierSubDepartment\",\n \"valueString\": \"SUBDEPT01\"\n },\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\": \"CA\"\n }\n ]\n }\n }\n ],\n \"system\": \"http://notreal.com/PATIENT_EVENT_TRACE_NUMBER\",\n \"value\": \"111366\",\n \"assigner\": {\n \"identifier\": {\n \"system\": \"http://notreal.com/USER_ASSIGNED\",\n \"value\": \"5556667771\"\n }\n }\n }\n ],\n \"status\": \"active\",\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\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\"\n },\n \"created\": \"2024-01-30T13:29:32Z\",\n \"insurer\": {\n \"reference\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\"\n },\n \"requestor\": {\n \"reference\": \"urn:uuid:b0881003-0d22-499d-840b-91dc7f6f4479\"\n },\n \"request\": {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/StructureDefinition/data-absent-reason\",\n \"valueCode\": \"unknown\"\n }\n ]\n },\n \"outcome\": \"complete\",\n \"preAuthPeriod\": {\n \"start\": \"2024-01-30\",\n \"end\": \"2024-02-29\"\n },\n \"communicationRequest\": [\n {\n \"reference\": \"urn:uuid:a1b2c3d4-0002-0000-0000-000000000001\"\n }\n ],\n \"item\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate\",\n \"valueDate\": \"2024-01-30\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod\",\n \"valuePeriod\": {\n \"start\": \"2024-01-30\",\n \"end\": \"2024-02-29\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber\",\n \"valueIdentifier\": {\n \"system\": \"https://prior-auth.davinci.hl7.org/fhir/ITEM_TRACE_NUMBER\",\n \"value\": \"1\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber\",\n \"valueString\": \"AUTH123\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber\",\n \"valueString\": \"ADMIN123\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemRequestedServiceDate\",\n \"valuePeriod\": {\n \"start\": \"2024-01-30\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDetail\",\n \"extension\": [\n {\n \"url\": \"productOrServiceCode\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1365\",\n \"code\": \"G0153\"\n }\n ]\n }\n }\n ]\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider\",\n \"extension\": [\n {\n \"url\": \"provider\",\n \"valueReference\": {\n \"display\": \"Mock Item Provider\"\n }\n }\n ]\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-admissionDates\",\n \"valuePeriod\": {\n \"start\": \"2023-01-01\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-dischargeDate\",\n \"valueDate\": \"2023-01-10\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/icd-10-cm\",\n \"code\": \"J06.9\"\n }\n ]\n }\n }\n ],\n \"itemSequence\": 1,\n \"noteNumber\": [\n 1\n ],\n \"adjudication\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction\",\n \"extension\": [\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 }\n ],\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/adjudication\",\n \"code\": \"submitted\"\n }\n ]\n }\n }\n ]\n }\n ],\n \"addItem\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber\",\n \"valueIdentifier\": {\n \"system\": \"https://prior-auth.davinci.hl7.org/fhir/ITEM_TRACE_NUMBER\",\n \"value\": \"TRACE001\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate\",\n \"valueDate\": \"2024-01-30\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod\",\n \"valuePeriod\": {\n \"start\": \"2024-01-30\",\n \"end\": \"2024-02-29\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber\",\n \"valueString\": \"AUTH456\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber\",\n \"valueString\": \"ADMIN456\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator\",\n \"valueBoolean\": false\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://valueset.x12.org/x217/005010/response/2000F/NX1/1/01/00/1345\",\n \"code\": \"2\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeLevelOfCare\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://valueset.x12.org/x217/005010/response/2000F/NX1/1/02/00/1306\",\n \"code\": \"2\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-productOrServiceCodeEnd\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1365\",\n \"code\": \"G0153\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueCode\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://www.nubc.org/CodeSystem/RevenueCodes\",\n \"code\": \"0300\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueUnitRateLimit\",\n \"valueDecimal\": 100.0\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService\",\n \"valueReference\": {\n \"display\": \"Mock Requested Service\"\n }\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\": \"SC\",\n \"display\": \"Specialty Care 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-admissionDates\",\n \"valuePeriod\": {\n \"start\": \"2023-01-01\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-dischargeDate\",\n \"valueDate\": \"2023-01-10\"\n }\n ],\n \"itemSequence\": [\n 1\n ],\n \"provider\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizedProviderType\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/98\",\n \"code\": \"IL\"\n }\n ]\n }\n }\n ],\n \"display\": \"Mock AddItem Provider\"\n }\n ],\n \"productOrService\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1365\",\n \"code\": \"G0153\"\n }\n ]\n },\n \"modifier\": [\n {\n \"coding\": [\n {\n \"system\": \"http://www.ama-assn.org/go/cpt\",\n \"code\": \"25\"\n }\n ]\n }\n ],\n \"servicedDate\": \"2024-01-30\",\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 \"quantity\": {\n \"value\": 1\n },\n \"unitPrice\": {\n \"value\": 100.0,\n \"currency\": \"USD\"\n },\n \"adjudication\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction\",\n \"extension\": [\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 }\n ],\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/adjudication\",\n \"code\": \"submitted\"\n }\n ]\n }\n }\n ]\n }\n ],\n \"adjudication\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction\",\n \"extension\": [\n {\n \"url\": \"number\",\n \"valueString\": \"1\"\n }\n ]\n }\n ],\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/adjudication\",\n \"code\": \"submitted\"\n }\n ]\n }\n }\n ],\n \"processNote\": [\n {\n \"number\": 1,\n \"text\": \"Prior authorization processing note\"\n }\n ],\n \"error\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorFollowupAction\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/889\",\n \"code\": \"N\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorElement\",\n \"extension\": [\n {\n \"url\": \"error\",\n \"valueString\": \"ClaimResponse.status\"\n }\n ]\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorPath\",\n \"valueString\": \"ClaimResponse.status\"\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/901\",\n \"code\": \"04\"\n }\n ]\n }\n }\n ],\n \"resourceType\": \"ClaimResponse\"\n }\n },\n {\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0002-0000-0000-000000000001\",\n \"resource\": {\n \"id\": \"a1b2c3d4-0002-0000-0000-000000000001\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-communicationrequest\"\n ]\n },\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber\",\n \"valuePositiveInt\": 1\n }\n ],\n \"identifier\": [\n {\n \"system\": \"http://davinci-pas.org/fhir/comm-req-id\",\n \"value\": \"COMM001\"\n }\n ],\n \"status\": \"active\",\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/755\",\n \"code\": \"15\",\n \"display\": \"Justification for Admissions\"\n }\n ]\n }\n ],\n \"medium\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/v3-ParticipationMode\",\n \"code\": \"WRITTEN\"\n }\n ]\n }\n ],\n \"subject\": {\n \"display\": \"Mock Patient\"\n },\n \"payload\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/icd-10-cm\",\n \"code\": \"J06.9\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-contentModifier\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"18804-5\"\n }\n ]\n }\n }\n ],\n \"contentString\": \"18776-5\"\n }\n ],\n \"requester\": {\n \"display\": \"Mock Requester\"\n },\n \"recipient\": [\n {\n \"display\": \"Mock Recipient\"\n }\n ],\n \"sender\": {\n \"display\": \"Mock Sender\"\n },\n \"resourceType\": \"CommunicationRequest\"\n }\n },\n {\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0003-0000-0000-000000000001\",\n \"resource\": {\n \"id\": \"a1b2c3d4-0003-0000-0000-000000000001\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner\"\n ]\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"1234567893\"\n }\n ],\n \"name\": [\n {\n \"family\": \"WATSON\",\n \"given\": [\n \"SUSAN\"\n ]\n }\n ],\n \"address\": [\n {\n \"line\": [\n \"123 Main St\"\n ],\n \"city\": \"Springfield\",\n \"state\": \"IL\",\n \"postalCode\": \"62701\",\n \"country\": \"US\"\n }\n ],\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5555550100\"\n }\n ],\n \"resourceType\": \"Practitioner\"\n }\n },\n {\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0004-0000-0000-000000000001\",\n \"resource\": {\n \"id\": \"a1b2c3d4-0004-0000-0000-000000000001\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole\"\n ]\n },\n \"practitioner\": {\n \"reference\": \"urn:uuid:a1b2c3d4-0003-0000-0000-000000000001\"\n },\n \"organization\": {\n \"display\": \"Mock Organization\"\n },\n \"code\": [\n {\n \"coding\": [\n {\n \"system\": \"http://nucc.org/provider-taxonomy\",\n \"code\": \"208D00000X\",\n \"display\": \"General Practice Physician\"\n }\n ]\n }\n ],\n \"specialty\": [\n {\n \"coding\": [\n {\n \"system\": \"http://nucc.org/provider-taxonomy\",\n \"code\": \"208D00000X\",\n \"display\": \"General Practice Physician\"\n }\n ]\n }\n ],\n \"location\": [\n {\n \"display\": \"Mock Location\"\n }\n ],\n \"endpoint\": [\n {\n \"display\": \"Mock Endpoint\"\n }\n ],\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5555550100\"\n }\n ],\n \"resourceType\": \"PractitionerRole\"\n }\n },\n {\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0005-0000-0000-000000000001\",\n \"resource\": {\n \"id\": \"a1b2c3d4-0005-0000-0000-000000000001\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-task\"\n ]\n },\n \"identifier\": [\n {\n \"system\": \"https://prior-auth.davinci.hl7.org/fhir/ITEM_TRACE_NUMBER\",\n \"value\": \"TASK001\"\n }\n ],\n \"status\": \"requested\",\n \"statusReason\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"priorAuthorization\"\n }\n ]\n },\n \"intent\": \"order\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"attachment-request-code\"\n }\n ]\n },\n \"for\": {\n \"display\": \"Mock Patient\"\n },\n \"requester\": {\n \"identifier\": {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"1234567893\"\n }\n },\n \"owner\": {\n \"identifier\": {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"1234567893\"\n }\n },\n \"reasonCode\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"priorAuthorization\"\n }\n ]\n },\n \"reasonReference\": {\n \"display\": \"Mock Claim\"\n },\n \"restriction\": {\n \"period\": {\n \"start\": \"2023-01-01\",\n \"end\": \"2023-12-31\"\n }\n },\n \"input\": [\n {\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"payer-url\"\n }\n ]\n },\n \"valueUrl\": \"https://prior-auth.davinci.hl7.org/fhir/payer\"\n },\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber\",\n \"valuePositiveInt\": 1\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-contentModifier\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"18804-5\"\n }\n ]\n }\n }\n ],\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"attachments-needed\"\n }\n ]\n },\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"28570-0\"\n }\n ]\n }\n },\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber\",\n \"valuePositiveInt\": 1\n }\n ],\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"questionnaire-context\"\n }\n ]\n },\n \"valueString\": \"http://example.org/questionnaire\"\n }\n ],\n \"resourceType\": \"Task\"\n }\n },\n {\n \"fullUrl\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\",\n \"resource\": {\n \"id\": \"0b321e9e-571b-4f83-8cea-fa23424383bb\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary\"\n ]\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 \"identifier\": [\n {\n \"system\": \"http://notreal.com/MIN\",\n \"value\": \"12345678901\"\n }\n ],\n \"name\": [\n {\n \"family\": \"SMITH\",\n \"given\": [\n \"JOE\"\n ],\n \"prefix\": [\n \"Ms.\"\n ],\n \"suffix\": [\n \"Jr.\"\n ]\n }\n ],\n \"gender\": \"male\",\n \"resourceType\": \"Patient\",\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5551234567\",\n \"use\": \"home\"\n }\n ],\n \"birthDate\": \"1980-06-15\",\n \"address\": [\n {\n \"line\": [\n \"456 OAK AVE\"\n ],\n \"city\": \"CHICAGO\",\n \"district\": \"COOK\",\n \"state\": \"IL\",\n \"postalCode\": \"60601\",\n \"country\": \"US\"\n }\n ],\n \"communication\": [\n {\n \"language\": {\n \"coding\": [\n {\n \"system\": \"urn:ietf:bcp:47\",\n \"code\": \"en\"\n }\n ]\n }\n }\n ],\n \"multipleBirthInteger\": 1\n }\n },\n {\n \"fullUrl\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\",\n \"resource\": {\n \"id\": \"ff7adc9d-8854-4947-874a-8b61bca953c1\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer\"\n ]\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"7893120007\"\n },\n {\n \"system\": \"http://terminology.hl7.org/NamingSystem/USEIN\",\n \"value\": \"123456789\"\n },\n {\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType\",\n \"code\": \"payerid\"\n }\n ]\n },\n \"system\": \"http://notreal.com/payerid\",\n \"value\": \"PAYER001\"\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 \"name\": \"MARYLAND CAPITAL INSURANCE COMPANY\",\n \"resourceType\": \"Organization\",\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5552223333\"\n }\n ],\n \"address\": [\n {\n \"line\": [\n \"789 INSURANCE BLVD\"\n ],\n \"city\": \"BALTIMORE\",\n \"state\": \"MD\",\n \"postalCode\": \"21201\",\n \"country\": \"US\"\n }\n ]\n }\n },\n {\n \"fullUrl\": \"urn:uuid:b0881003-0d22-499d-840b-91dc7f6f4479\",\n \"resource\": {\n \"id\": \"b0881003-0d22-499d-840b-91dc7f6f4479\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor\"\n ]\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\": \"987654321\"\n },\n {\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType\",\n \"code\": \"payerid\"\n }\n ]\n },\n \"system\": \"http://notreal.com/providerid\",\n \"value\": \"PROV001\"\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 \"resourceType\": \"Organization\",\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5554445555\"\n }\n ],\n \"contact\": [\n {\n \"name\": {\n \"text\": \"Jane Contact\"\n },\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5556667777\"\n }\n ]\n }\n ]\n }\n }\n ],\n \"resourceType\": \"Bundle\"\n }\n]"
52
+ "value": "[\n {\n \"id\": \"b0000001-0000-0000-0000-000000000001\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-response-bundle\"\n ]\n },\n \"identifier\": {\n \"system\": \"urn:ietf:rfc:3986\",\n \"value\": \"urn:uuid:b0000001-0000-0000-0000-000000000001\"\n },\n \"type\": \"collection\",\n \"timestamp\": \"2024-01-30T13:29:32Z\",\n \"entry\": [\n {\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0001-0000-0000-000000000001\",\n \"resource\": {\n \"id\": \"a1b2c3d4-0001-0000-0000-000000000001\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse\"\n ]\n },\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-TransmissionIdentifiers\",\n \"extension\": [\n {\n \"url\": \"applicationSenderCode\",\n \"valueString\": \"SENDER01\"\n },\n {\n \"url\": \"applicationReceiverCode\",\n \"valueString\": \"RECEIVER01\"\n }\n ]\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-claimResponseReviewer\",\n \"extension\": [\n {\n \"url\": \"wasHumanReviewedFlag\",\n \"valueBoolean\": true\n }\n ]\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider\",\n \"extension\": [\n {\n \"url\": \"provider\",\n \"valueReference\": {\n \"display\": \"Mock Authorized Provider\"\n }\n }\n ]\n }\n ],\n \"identifier\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierSubDepartment\",\n \"valueString\": \"SUBDEPT01\"\n },\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\": \"CA\"\n }\n ]\n }\n }\n ],\n \"system\": \"http://notreal.com/PATIENT_EVENT_TRACE_NUMBER\",\n \"value\": \"111366\",\n \"assigner\": {\n \"identifier\": {\n \"system\": \"http://notreal.com/USER_ASSIGNED\",\n \"value\": \"5556667771\"\n }\n }\n }\n ],\n \"status\": \"active\",\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\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\"\n },\n \"created\": \"2024-01-30T13:29:32Z\",\n \"insurer\": {\n \"reference\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\"\n },\n \"requestor\": {\n \"reference\": \"urn:uuid:b0881003-0d22-499d-840b-91dc7f6f4479\"\n },\n \"request\": {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/StructureDefinition/data-absent-reason\",\n \"valueCode\": \"unknown\"\n }\n ]\n },\n \"outcome\": \"complete\",\n \"preAuthPeriod\": {\n \"start\": \"2024-01-30\",\n \"end\": \"2024-02-29\"\n },\n \"communicationRequest\": [\n {\n \"reference\": \"urn:uuid:a1b2c3d4-0002-0000-0000-000000000001\"\n }\n ],\n \"item\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate\",\n \"valueDate\": \"2024-01-30\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod\",\n \"valuePeriod\": {\n \"start\": \"2024-01-30\",\n \"end\": \"2024-02-29\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber\",\n \"valueIdentifier\": {\n \"system\": \"https://prior-auth.davinci.hl7.org/fhir/ITEM_TRACE_NUMBER\",\n \"value\": \"1\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber\",\n \"valueString\": \"AUTH123\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber\",\n \"valueString\": \"ADMIN123\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemRequestedServiceDate\",\n \"valuePeriod\": {\n \"start\": \"2024-01-30\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDetail\",\n \"extension\": [\n {\n \"url\": \"productOrServiceCode\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1365\",\n \"code\": \"G0153\"\n }\n ]\n }\n }\n ]\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider\",\n \"extension\": [\n {\n \"url\": \"provider\",\n \"valueReference\": {\n \"display\": \"Mock Item Provider\"\n }\n }\n ]\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-admissionDates\",\n \"valuePeriod\": {\n \"start\": \"2023-01-01\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-dischargeDate\",\n \"valueDate\": \"2023-01-10\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/icd-10-cm\",\n \"code\": \"J06.9\"\n }\n ]\n }\n }\n ],\n \"itemSequence\": 1,\n \"noteNumber\": [\n 1\n ],\n \"adjudication\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction\",\n \"extension\": [\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 }\n ],\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/adjudication\",\n \"code\": \"submitted\"\n }\n ]\n }\n }\n ]\n }\n ],\n \"addItem\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber\",\n \"valueIdentifier\": {\n \"system\": \"https://prior-auth.davinci.hl7.org/fhir/ITEM_TRACE_NUMBER\",\n \"value\": \"TRACE001\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate\",\n \"valueDate\": \"2024-01-30\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod\",\n \"valuePeriod\": {\n \"start\": \"2024-01-30\",\n \"end\": \"2024-02-29\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber\",\n \"valueString\": \"AUTH456\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber\",\n \"valueString\": \"ADMIN456\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator\",\n \"valueBoolean\": false\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://valueset.x12.org/x217/005010/response/2000F/NX1/1/01/00/1345\",\n \"code\": \"2\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeLevelOfCare\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://valueset.x12.org/x217/005010/response/2000F/NX1/1/02/00/1306\",\n \"code\": \"2\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-productOrServiceCodeEnd\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1365\",\n \"code\": \"G0153\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueCode\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://www.nubc.org/CodeSystem/RevenueCodes\",\n \"code\": \"0300\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueUnitRateLimit\",\n \"valueDecimal\": 100.0\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService\",\n \"valueReference\": {\n \"display\": \"Mock Requested Service\"\n }\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\": \"SC\",\n \"display\": \"Specialty Care 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-admissionDates\",\n \"valuePeriod\": {\n \"start\": \"2023-01-01\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-dischargeDate\",\n \"valueDate\": \"2023-01-10\"\n }\n ],\n \"itemSequence\": [\n 1\n ],\n \"provider\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizedProviderType\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/98\",\n \"code\": \"IL\"\n }\n ]\n }\n }\n ],\n \"display\": \"Mock AddItem Provider\"\n }\n ],\n \"productOrService\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1365\",\n \"code\": \"G0153\"\n }\n ]\n },\n \"modifier\": [\n {\n \"coding\": [\n {\n \"system\": \"http://www.ama-assn.org/go/cpt\",\n \"code\": \"25\"\n }\n ]\n }\n ],\n \"servicedDate\": \"2024-01-30\",\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 \"quantity\": {\n \"value\": 1,\n \"unit\": \"visit\"\n },\n \"unitPrice\": {\n \"value\": 100.0,\n \"currency\": \"USD\"\n },\n \"adjudication\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction\",\n \"extension\": [\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 }\n ],\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/adjudication\",\n \"code\": \"submitted\"\n }\n ]\n }\n }\n ]\n }\n ],\n \"adjudication\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction\",\n \"extension\": [\n {\n \"url\": \"number\",\n \"valueString\": \"1\"\n }\n ]\n }\n ],\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/adjudication\",\n \"code\": \"submitted\"\n }\n ]\n }\n }\n ],\n \"processNote\": [\n {\n \"number\": 1,\n \"text\": \"Prior authorization processing note\"\n }\n ],\n \"error\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorFollowupAction\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/889\",\n \"code\": \"N\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorElement\",\n \"extension\": [\n {\n \"url\": \"error\",\n \"valueString\": \"ClaimResponse.status\"\n }\n ]\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorPath\",\n \"valueString\": \"ClaimResponse.status\"\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/901\",\n \"code\": \"04\"\n }\n ]\n }\n }\n ],\n \"resourceType\": \"ClaimResponse\"\n }\n },\n {\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0002-0000-0000-000000000001\",\n \"resource\": {\n \"id\": \"a1b2c3d4-0002-0000-0000-000000000001\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-communicationrequest\"\n ]\n },\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber\",\n \"valuePositiveInt\": 1\n }\n ],\n \"identifier\": [\n {\n \"system\": \"http://davinci-pas.org/fhir/comm-req-id\",\n \"value\": \"COMM001\"\n }\n ],\n \"status\": \"active\",\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/755\",\n \"code\": \"15\",\n \"display\": \"Justification for Admissions\"\n }\n ]\n }\n ],\n \"medium\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/v3-ParticipationMode\",\n \"code\": \"WRITTEN\"\n }\n ]\n }\n ],\n \"subject\": {\n \"display\": \"Mock Patient\"\n },\n \"payload\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/icd-10-cm\",\n \"code\": \"J06.9\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-contentModifier\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"18804-5\"\n }\n ]\n }\n }\n ],\n \"contentString\": \"18776-5\"\n }\n ],\n \"requester\": {\n \"display\": \"Mock Requester\"\n },\n \"recipient\": [\n {\n \"display\": \"Mock Recipient\"\n }\n ],\n \"sender\": {\n \"display\": \"Mock Sender\"\n },\n \"resourceType\": \"CommunicationRequest\"\n }\n },\n {\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0003-0000-0000-000000000001\",\n \"resource\": {\n \"id\": \"a1b2c3d4-0003-0000-0000-000000000001\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner\"\n ]\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"7644195407\"\n }\n ],\n \"name\": [\n {\n \"family\": \"WATSON\",\n \"given\": [\n \"SUSAN\"\n ]\n }\n ],\n \"address\": [\n {\n \"line\": [\n \"123 Main St\"\n ],\n \"city\": \"Springfield\",\n \"state\": \"IL\",\n \"postalCode\": \"62701\",\n \"country\": \"US\"\n }\n ],\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5555550100\"\n }\n ],\n \"resourceType\": \"Practitioner\"\n }\n },\n {\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0004-0000-0000-000000000001\",\n \"resource\": {\n \"id\": \"a1b2c3d4-0004-0000-0000-000000000001\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole\"\n ]\n },\n \"practitioner\": {\n \"reference\": \"urn:uuid:a1b2c3d4-0003-0000-0000-000000000001\"\n },\n \"organization\": {\n \"display\": \"Mock Organization\"\n },\n \"code\": [\n {\n \"coding\": [\n {\n \"system\": \"http://nucc.org/provider-taxonomy\",\n \"code\": \"208D00000X\",\n \"display\": \"General Practice Physician\"\n }\n ]\n }\n ],\n \"specialty\": [\n {\n \"coding\": [\n {\n \"system\": \"http://nucc.org/provider-taxonomy\",\n \"code\": \"208D00000X\",\n \"display\": \"General Practice Physician\"\n }\n ]\n }\n ],\n \"location\": [\n {\n \"display\": \"Mock Location\"\n }\n ],\n \"endpoint\": [\n {\n \"display\": \"Mock Endpoint\"\n }\n ],\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5555550100\"\n }\n ],\n \"resourceType\": \"PractitionerRole\"\n }\n },\n {\n \"fullUrl\": \"urn:uuid:a1b2c3d4-0005-0000-0000-000000000001\",\n \"resource\": {\n \"id\": \"a1b2c3d4-0005-0000-0000-000000000001\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-task\"\n ]\n },\n \"identifier\": [\n {\n \"system\": \"https://prior-auth.davinci.hl7.org/fhir/ITEM_TRACE_NUMBER\",\n \"value\": \"TASK001\"\n }\n ],\n \"status\": \"requested\",\n \"statusReason\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"priorAuthorization\"\n }\n ]\n },\n \"intent\": \"order\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"attachment-request-code\"\n }\n ]\n },\n \"for\": {\n \"display\": \"Mock Patient\"\n },\n \"requester\": {\n \"identifier\": {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"1234567893\"\n }\n },\n \"owner\": {\n \"identifier\": {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"1234567893\"\n }\n },\n \"reasonCode\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"priorAuthorization\"\n }\n ]\n },\n \"reasonReference\": {\n \"display\": \"Mock Claim\"\n },\n \"restriction\": {\n \"period\": {\n \"start\": \"2023-01-01\",\n \"end\": \"2023-12-31\"\n }\n },\n \"input\": [\n {\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"payer-url\"\n }\n ]\n },\n \"valueUrl\": \"https://prior-auth.davinci.hl7.org/fhir/payer\"\n },\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber\",\n \"valuePositiveInt\": 1\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-contentModifier\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"18804-5\"\n }\n ]\n }\n }\n ],\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"attachments-needed\"\n }\n ]\n },\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"28570-0\"\n }\n ]\n }\n },\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber\",\n \"valuePositiveInt\": 1\n }\n ],\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes\",\n \"code\": \"questionnaire-context\"\n }\n ]\n },\n \"valueString\": \"http://example.org/questionnaire\"\n }\n ],\n \"resourceType\": \"Task\"\n }\n },\n {\n \"fullUrl\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\",\n \"resource\": {\n \"id\": \"0b321e9e-571b-4f83-8cea-fa23424383bb\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary\"\n ]\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 \"identifier\": [\n {\n \"system\": \"http://notreal.com/MIN\",\n \"value\": \"12345678901\"\n }\n ],\n \"name\": [\n {\n \"family\": \"SMITH\",\n \"given\": [\n \"JOE\"\n ],\n \"prefix\": [\n \"Ms.\"\n ],\n \"suffix\": [\n \"Jr.\"\n ]\n }\n ],\n \"gender\": \"male\",\n \"resourceType\": \"Patient\",\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5551234567\",\n \"use\": \"home\"\n }\n ],\n \"birthDate\": \"1980-06-15\",\n \"address\": [\n {\n \"line\": [\n \"456 OAK AVE\"\n ],\n \"city\": \"CHICAGO\",\n \"district\": \"COOK\",\n \"state\": \"IL\",\n \"postalCode\": \"60601\",\n \"country\": \"US\"\n }\n ],\n \"communication\": [\n {\n \"language\": {\n \"coding\": [\n {\n \"system\": \"urn:ietf:bcp:47\",\n \"code\": \"en\"\n }\n ]\n }\n }\n ],\n \"multipleBirthInteger\": 1\n }\n },\n {\n \"fullUrl\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\",\n \"resource\": {\n \"id\": \"ff7adc9d-8854-4947-874a-8b61bca953c1\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer\"\n ]\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"7893120007\"\n },\n {\n \"system\": \"http://terminology.hl7.org/NamingSystem/USEIN\",\n \"value\": \"123456789\"\n },\n {\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType\",\n \"code\": \"payerid\"\n }\n ]\n },\n \"system\": \"http://notreal.com/payerid\",\n \"value\": \"PAYER001\"\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 \"name\": \"MARYLAND CAPITAL INSURANCE COMPANY\",\n \"resourceType\": \"Organization\",\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5552223333\"\n }\n ],\n \"address\": [\n {\n \"line\": [\n \"789 INSURANCE BLVD\"\n ],\n \"city\": \"BALTIMORE\",\n \"state\": \"MD\",\n \"postalCode\": \"21201\",\n \"country\": \"US\"\n }\n ]\n }\n },\n {\n \"fullUrl\": \"urn:uuid:b0881003-0d22-499d-840b-91dc7f6f4479\",\n \"resource\": {\n \"id\": \"b0881003-0d22-499d-840b-91dc7f6f4479\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor\"\n ]\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\": \"987654321\"\n },\n {\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType\",\n \"code\": \"payerid\"\n }\n ]\n },\n \"system\": \"http://notreal.com/providerid\",\n \"value\": \"PROV001\"\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 \"resourceType\": \"Organization\",\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5554445555\"\n }\n ],\n \"contact\": [\n {\n \"name\": {\n \"text\": \"Jane Contact\"\n },\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"5556667777\"\n }\n ]\n }\n ]\n }\n }\n ],\n \"resourceType\": \"Bundle\"\n }\n]"
53
53
  },
54
54
  {
55
55
  "name": "operation_failure_operation_outcome",