https://fhir.developer.gene.com/Bundle/4fd42cc9-559c-463e-8968-3e291ba91066
type: Bundle
node role: treeRoot
meta:
  profile:
    v: https://fhir.developer.gene.com/StructureDefinition/uapi-as-enrollment-bundle
    link: https://fhir.developer.gene.com/StructureDefinition/uapi-as-enrollment-bundle
identifier:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: RI
      display:
        v: Resource identifier
  system:
    v: http://vendor.com/ab
  assigner:
    display:
      v: Alpha Beta
type:
  v: message
timestamp:
  v: 2020-03-11T08:10:13-05:00

urn:…
type: MessageHeader
meta:
  profile:
    v: https://fhir.developer.gene.com/StructureDefinition/uapi-messageheader
    link: https://fhir.developer.gene.com/StructureDefinition/uapi-messageheader
text:
  status:
    v: generated
  div: Generated Narrative: MessageHeader feab241d-1706-494b-9d32-8f13a084ea2b Profile: UAPI MessageHeader event: uapi-event-type enrollment-with-consent: enrollment-with-consent Destinations - Name Endpoint * UAPI-ENR-V2.1 https://test-us-e1.apis.roche.com/pharma-cmg-ehr-fhir-exp-test/v2/enrollment sender: Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 Sources - Name Endpoint * Vendor_AB http://vendor.com/fhir/enrollmentID/ENR-00001 focus: Bundle: identifier = Resource identifier: 4fd42cc9-559c-463e-8968-3e291ba91066; type = message; timestamp = 2020-03-11 08:10:13-0500
event: Coding
  system:
    v: http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-event-type
  code:
    v: enrollment-with-consent
destination:
  name:
    v: UAPI-ENR-V2.1
  endpoint:
    v: https://test-us-e1.apis.roche.com/pharma-cmg-ehr-fhir-exp-test/v2/enrollment
sender:
  type:
    v: Organization
source:
  name:
    v: Vendor_AB
  endpoint:
    v: http://vendor.com/fhir/enrollmentID/ENR-00001
focus:
  type:
    v: List

urn:…
type: List
text:
  status:
    v: generated
  div: Generated Narrative: List b5449749-6568-4958-8edf-4e96401f7af1 messageContext Mode: Change List Status: Current Items Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 Bundle: identifier = Resource identifier: 4fd42cc9-559c-463e-8968-3e291ba91066; type = message; timestamp = 2020-03-11 08:10:13-0500 Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 Bundle: identifier = Resource identifier: 4fd42cc9-559c-463e-8968-3e291ba91066; type = message; timestamp = 2020-03-11 08:10:13-0500 Bundle: identifier = Resource identifier: 4fd42cc9-559c-463e-8968-3e291ba91066; type = message; timestamp = 2020-03-11 08:10:13-0500 Bundle: identifier = Resource identifier: 4fd42cc9-559c-463e-8968-3e291ba91066; type = message; timestamp = 2020-03-11 08:10:13-0500 Bundle: identifier = Resource identifier: 4fd42cc9-559c-463e-8968-3e291ba91066; type = message; timestamp = 2020-03-11 08:10:13-0500 Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500
status:
  v: current
mode:
  v: changes
title:
  v: messageContext
entry:
  item:
    type:
      v: Patient
entry:
  item:
    type:
      v: Organization
entry:
  item:
    type:
      v: Practitioner
entry:
  item:
    type:
      v: Coverage
entry:
  item:
    type:
      v: RelatedPerson
entry:
  item:
    type:
      v: QuestionnaireResponse
entry:
  item:
    type:
      v: Consent
entry:
  item:
    type:
      v: Consent
entry:
  item:
    type:
      v: Provenance
entry:
  item:
    type:
      v: ServiceRequest
entry:
  item:
    type:
      v: MedicationRequest
entry:
  item:
    type:
      v: Organization
entry:
  item:
    type:
      v: Organization
entry:
  item:
    type:
      v: Condition

urn:…
type: Patient
meta:
  profile:
    v: https://fhir.developer.gene.com/StructureDefinition/uapi-patient
    link: https://fhir.developer.gene.com/StructureDefinition/uapi-patient
text:
  status:
    v: generated
  div: Generated Narrative: Patient 1b315218-49b7-4264-816e-05d4b92ecbaa Profile: UAPI Patient Ryan Michaelson (official) Male, DoB: 1972-10-29 ( Patient internal identifier: 6bcd8467-0473-4836-9128-2e7972f23177 (use: official, )) Contact Detail ph: 1231231234(Home) ph: 1234561234(Mobile) bobster83@example.com 1234 Main St San Francisco CA 94105 US Language: English (preferred) Links: General Practitioner: Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 Managing Organization: Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500
identifier:
  use:
    v: official
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: PI
      display:
        v: Patient internal identifier
  system:
    v: http://vendor.com/ab
  assigner:
    display:
      v: AB Vendor
name:
  use:
    v: official
  family:
    v: Michaelson
  given:
    v: Ryan
telecom:
  system:
    v: phone
  value:
    v: 1231231234
  use:
    v: home
  rank:
    v: 1
telecom:
  system:
    v: phone
  value:
    v: 1234561234
  use:
    v: mobile
  rank:
    v: 2
telecom:
  system:
    v: email
  use:
    v: home
  rank:
    v: 3
gender:
  v: male
birth date:
  v: 1972-10-29
address:
  line:
    v: 1234 Main St
  city:
    v: San Francisco
  state:
    v: CA
  postal code:
    v: 94105
  country:
    v: US
communication:
  language:
    coding:
      system:
        v: urn:ietf:bcp:47
      code:
        v: en
      display:
        v: English
  preferred:
    v: true

urn:…
type: Organization
meta:
  profile:
    v: https://fhir.developer.gene.com/StructureDefinition/uapi-organization
    link: https://fhir.developer.gene.com/StructureDefinition/uapi-organization
text:
  status:
    v: generated
  div: Generated Narrative: Organization e69e5e73-0723-4f42-bfdd-b69f181160bf Profile: UAPI Organization identifier: http://vendor.com/ab/HOSP-12345 (use: usual, ) type: Healthcare Provider name: Mid Atlantic Retina telecom: mar@example.com address: 8 Ranoldo Terrace Cherry Hill NJ 08034 US contact name: Venus Yardav (Official) telecom: ph: 8882704882(Work), fax: 8179974042(Work)
identifier:
  use:
    v: usual
  system:
    v: http://vendor.com/ab
  value:
    v: HOSP-12345
  assigner:
    display:
      v: AB Vendor
type:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/organization-type
    code:
      v: prov
    display:
      v: Healthcare Provider
name:
  v: Mid Atlantic Retina
telecom:
  system:
    v: email
address:
  line:
    v: 8 Ranoldo Terrace
  city:
    v: Cherry Hill
  state:
    v: NJ
  postal code:
    v: 08034
  country:
    v: US
contact:
  name:
    use:
      v: official
    family:
      v: Yardav
    given:
      v: Venus
  telecom:
    system:
      v: phone
    value:
      v: 8882704882
    use:
      v: work
    rank:
      v: 1
  telecom:
    system:
      v: fax
    value:
      v: 8179974042
    use:
      v: work
    rank:
      v: 2

urn:…
type: Practitioner
meta:
  profile:
    v: https://fhir.developer.gene.com/StructureDefinition/uapi-practitioner
    link: https://fhir.developer.gene.com/StructureDefinition/uapi-practitioner
text:
  status:
    v: generated
  div: Generated Narrative: Practitioner 78ef1b71-b14a-44a1-a1e8-c9c9efcc157c Profile: UAPI Practitioner identifier: Provider number/1922071448 (use: official, ), Tax ID number/00000000 (use: official, ), National provider identifier/1639285034 (use: official, ) name: MARISSA CRUZ (Official)
identifier:
  use:
    v: official
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: PRN
      display:
        v: Provider number
  system:
    v: http://hl7.org/fhir/sid/us-npi
  value:
    v: 1922071448
  assigner:
    display:
      v: Centers for Medicare & Medicaid Services
identifier:
  use:
    v: official
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: TAX
      display:
        v: Tax ID number
  system:
    v: http://hl7.org/fhir/sid/us-npi
  value:
    v: 00000000
identifier:
  use:
    v: official
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: NPI
      display:
        v: National provider identifier
  system:
    v: http://hl7.org/fhir/sid/us-npi
  value:
    v: 1639285034
name:
  use:
    v: official
  family:
    v: CRUZ
  given:
    v: MARISSA

urn:…
type: Coverage
meta:
  profile:
    v: https://fhir.developer.gene.com/StructureDefinition/uapi-coverage
    link: https://fhir.developer.gene.com/StructureDefinition/uapi-coverage
text:
  status:
    v: generated
  div: Generated Narrative: Coverage 2722d5ae-1658-4d7f-8f64-de1299a1fb7f Profile: UAPI Coverage status: Active type: health insurance plan policy subscriber: Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 subscriberId: 4353 beneficiary: Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 payor: Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 Classes - Type Value Name * Group 12344frgr Group Number order: 1 network: Dakotacare
status:
  v: active
type:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/v3-ActCode
    code:
      v: HIP
    display:
      v: health insurance plan policy
subscriber:
  type:
    v: RelatedPerson
subscriber id:
  v: 4353
beneficiary:
  type:
    v: Patient
payor:
  type:
    v: Organization
class:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/coverage-class
      code:
        v: group
      display:
        v: Group
  value:
    v: 12344frgr
  name:
    v: Group Number
order:
  v: 1
network:
  v: Dakotacare

urn:…
type: RelatedPerson
meta:
  profile:
    v: https://fhir.developer.gene.com/StructureDefinition/uapi-relatedPerson
    link: https://fhir.developer.gene.com/StructureDefinition/uapi-relatedPerson
text:
  status:
    v: generated
  div: Generated Narrative: RelatedPerson 0ec0f18c-5869-4d10-9752-79ea39e1f7ac Profile: UAPI RelatedPerson patient: Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 relationship: significant other name: Bob Paul Smith (Official) telecom: ph: 1234567890(Mobile) birthDate: 1972-10-29
patient:
  type:
    v: Patient
relationship:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/v3-RoleCode
    code:
      v: SIGOTHR
    display:
      v: significant other
name:
  use:
    v: official
  family:
    v: Smith
  given:
    v: Bob Paul
telecom:
  system:
    v: phone
  value:
    v: 1234567890
  use:
    v: mobile
birth date:
  v: 1972-10-29

urn:…
type: QuestionnaireResponse
text:
  status:
    v: generated
  div: Generated Narrative: QuestionnaireResponse 55c74ddb-73fd-4f4b-acf0-25a3ed132d4b LinkID Text Definition Answer<img src="[binary]" alt="doco" style="background-color: inherit"/> 55c74ddb-73fd-4f4b-acf0-25a3ed132d4b Questionnaire:https://dev.gene.com/fhir/uapi/fhirapi/Questionnaire/1234 #xD; detailed-message Ok to leave detailed message Yes #xD; household-size Household size (including you) 2 #xD; household-income-amount Annual household income $75,000 #xD; eligibility-reason Eligibility Reason Insured: No Coverage for Medication #xD; contact-patient Do not contact patient Yes #xD; shipment-options Shipment Options Upfront #xD; ship-to Ship to: Site of Treatment #xD; site-of-treatment-2 Third-party Site of Treatment Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 #xD; prescription-plan Is this a Prescription plan? No #xD; has-treatment-started Has treatment started? No #xD; tcpa-consent TCPA Consent Provided? Yes #xD; pos Place of Service Infusion Center #xD; ins-type-1 Insurance Type 1 Comm #xD; ins-max-oop-1 Maximum out of pocket 1 5000 #xD; rituxan-for-immunology-drug-allergies Drug Allergies No Known #xD; rituxan-for-immunology-other-medicines-prescribed Other Medicines Prescribed Placeholder Drug #xD; <img src="[binary]" alt="doco" style="background-color: inherit"/> Documentation for this format
questionnaire:
  v: https://dev.gene.com/fhir/uapi/fhirapi/Questionnaire/1234
  link: https://dev.gene.com/fhir/uapi/fhirapi/Questionnaire/1234
status:
  v: completed
subject:
  type:
    v: Patient
item:
  link id:
    v: detailed-message
  text:
    v: Ok to leave detailed message
  answer:
    value: string
      v: Yes
item:
  link id:
    v: household-size
  text:
    v: Household size (including you)
  answer:
    value: string
      v: 2
item:
  link id:
    v: household-income-amount
  text:
    v: Annual household income
  answer:
    value: string
      v: $75,000
item:
  link id:
    v: eligibility-reason
  text:
    v: Eligibility Reason
  answer:
    value: string
      v: Insured: No Coverage for Medication
item:
  link id:
    v: contact-patient
  text:
    v: Do not contact patient
  answer:
    value: string
      v: Yes
item:
  link id:
    v: shipment-options
  text:
    v: Shipment Options
  answer:
    value: string
      v: Upfront
item:
  link id:
    v: ship-to
  text:
    v: Ship to:
  answer:
    value: string
      v: Site of Treatment
item:
  link id:
    v: site-of-treatment-2
  text:
    v: Third-party Site of Treatment
  answer:
    value: Reference
      type:
        v: Organization
item:
  link id:
    v: prescription-plan
  text:
    v: Is this a Prescription plan?
  answer:
    value: string
      v: No
item:
  link id:
    v: has-treatment-started
  text:
    v: Has treatment started?
  answer:
    value: string
      v: No
item:
  link id:
    v: tcpa-consent
  text:
    v: TCPA Consent Provided?
  answer:
    value: string
      v: Yes
item:
  link id:
    v: pos
  text:
    v: Place of Service
  answer:
    value: string
      v: Infusion Center
item:
  link id:
    v: ins-type-1
  text:
    v: Insurance Type 1
  answer:
    value: string
      v: Comm
item:
  link id:
    v: ins-max-oop-1
  text:
    v: Maximum out of pocket 1
  answer:
    value: decimal
      v: 5000
item:
  link id:
    v: rituxan-for-immunology-drug-allergies
  text:
    v: Drug Allergies
  answer:
    value: string
      v: No Known
item:
  link id:
    v: rituxan-for-immunology-other-medicines-prescribed
  text:
    v: Other Medicines Prescribed
  answer:
    value: string
      v: Placeholder Drug

urn:…
type: Condition
text:
  status:
    v: generated
  div: Generated Narrative: Condition 090e5caf-fdbd-4a67-8535-2983a3868f41 code: Rheumatoid lung disease w rheumatoid arthritis of unsp site subject: Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500
code:
  coding:
    system:
      v: http://hl7.org/fhir/sid/icd-10-cm
    code:
      v: M05.10
subject:
  type:
    v: Patient

urn:…
type: Consent
meta:
  profile:
    v: https://fhir.developer.gene.com/StructureDefinition/uapi-consent
    link: https://fhir.developer.gene.com/StructureDefinition/uapi-consent
text:
  status:
    v: generated
  div: Generated Narrative: Consent 7ec5069e-799f-413a-a0d2-d107acdfad3d Profile: UAPI Consent status: Active scope: Privacy Consent category: Patient Authorization Signature patient: Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 dateTime: 2016-06-16 16:24:45+0000 performer: Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 policyRule: HIPAA Authorization Provisions - Type * Opt In
status:
  v: active
scope:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/consentscope
    code:
      v: patient-privacy
    display:
      v: Privacy Consent
category:
  coding: https://loinc.org/rdf/59284-0
    system:
      v: http://loinc.org
    code:
      v: 59284-0
    display:
      v: Patient Authorization Signature
patient:
  type:
    v: Patient
date time:
  v: 2016-06-16T16:24:45Z
performer:
  type:
    v: Patient
policy rule:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/consentpolicycodes
    code:
      v: hipaa-auth
    display:
      v: HIPAA Authorization
provision:
  type:
    v: permit

urn:…
type: Consent
meta:
  profile:
    v: https://fhir.developer.gene.com/StructureDefinition/uapi-consent
    link: https://fhir.developer.gene.com/StructureDefinition/uapi-consent
text:
  status:
    v: generated
  div: Generated Narrative: Consent 94a59676-0e1f-42d6-b046-3c456758b90b Profile: UAPI Consent status: Active scope: Privacy Consent category: Prescriber Signature patient: Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 policyRule: HIPAA Authorization
status:
  v: active
scope:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/consentscope
    code:
      v: patient-privacy
    display:
      v: Privacy Consent
category:
  coding: https://loinc.org/rdf/59284-0
    system:
      v: http://loinc.org
    code:
      v: 59284-0
    display:
      v: Prescriber Signature
patient:
  type:
    v: Patient
policy rule:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/consentpolicycodes
    code:
      v: hipaa-auth
    display:
      v: HIPAA Authorization

urn:…
type: Provenance
meta:
  profile:
    v: https://fhir.developer.gene.com/StructureDefinition/uapi-provenance
    link: https://fhir.developer.gene.com/StructureDefinition/uapi-provenance
text:
  status:
    v: generated
  div: Generated Narrative: Provenance b83bae44-3e47-4d5c-807e-41944016dc79 Profile: UAPI Provenance Provenance for Bundle: identifier = Resource identifier: 4fd42cc9-559c-463e-8968-3e291ba91066; type = message; timestamp = 2020-03-11 08:10:13-0500 Summary Recorded 2022-02-07 09:49:39+0000 Agents who Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500
target:
  type:
    v: Consent
recorded:
  v: 2022-02-07T09:49:39.382941+00:00
agent:
  who:
    type:
      v: Practitioner
signature:
  type:
    system:
      v: urn:iso-astm:E1762-95:2013
    code:
      v: 1.2.840.10065.1.12.1.7
    display:
      v: Consent Signature
  when:
    v: 2022-02-07T09:49:39.382897+00:00
  who:
    type:
      v: Practitioner
  sig format:
    v: image/*

urn:…
type: ServiceRequest
meta:
  profile:
    v: https://fhir.developer.gene.com/StructureDefinition/uapi-servicerequest
    link: https://fhir.developer.gene.com/StructureDefinition/uapi-servicerequest
text:
  status:
    v: generated
  div: Generated Narrative: ServiceRequest 970a569e-aeee-4c84-886d-f26c1e388214 Profile: UAPI ServiceRequest status: Active intent: Order code: Patient Foundation subject: Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500
status:
  v: active
intent:
  v: order
code:
  coding:
    system:
      v: https://fhir.developer.gene.com/CodeSystem/uapi-sr-type
    code:
      v: gpf
subject:
  type:
    v: Patient

urn:…
type: MedicationRequest
meta:
  profile:
    v: https://fhir.developer.gene.com/StructureDefinition/uapi-medicationrequest
    link: https://fhir.developer.gene.com/StructureDefinition/uapi-medicationrequest
text:
  status:
    v: extensions
  div: Generated Narrative: MedicationRequest 8ca2e059-e448-445a-be13-bbacca49b452 Profile: UAPI MedicationRequest status: Active intent: Order medication: Rituxan for Immunology subject: Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 requester: Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 insurance: Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500 note: Day 1 and Day 15 dosageInstruction DoseAndRates - Dose[x] * 700 mg dispenseRequest UAPI MedicationRequest Dispenser Instructions: Dispense Instruction: Quantity 2 of 100mg vial(s) and Quantity 1 of 500mg vial(s) UAPI MedicationRequest Dispense Quantity Detailed Breakdown dispenseQuantity: 2 dispenseUnit: 100mg vial(s) UAPI MedicationRequest Dispense Quantity Detailed Breakdown dispenseQuantity: 1 dispenseUnit: 500mg vial(s) numberOfRepeatsAllowed: 1
status:
  v: active
intent:
  v: order
medication: CodeableConcept
  coding:
    system:
      v: https://fhir.developer.gene.com/CodeSystem/uapi-product-name
    code:
      v: rituxan-for-immunology
    display:
      v: Rituxan for Immunology
subject:
  type:
    v: Patient
requester:
  type:
    v: Practitioner
insurance:
  type:
    v: Coverage
note:
  text:
    v: Day 1 and Day 15
dosage instruction:
  dose and rate:
    dose: Quantity
      value:
        v: 700
      unit:
        v: mg
dispense request:
  extension:
    url:
      v: https://fhir.developer.gene.com/StructureDefinition/dispenser-instruction
    value: Annotation
      text:
        v: Dispense Instruction: Quantity 2 of 100mg vial(s) and Quantity 1 of 500mg vial(s)
  extension:
    extension:
      url:
        v: dispenseQuantity
      value: Quantity
    extension:
      url:
        v: dispenseUnit
      value: string
        v: 100mg vial(s)
    url:
      v: https://fhir.developer.gene.com/StructureDefinition/dispense-quantity-detail
  extension:
    extension:
      url:
        v: dispenseQuantity
      value: Quantity
    extension:
      url:
        v: dispenseUnit
      value: string
        v: 500mg vial(s)
    url:
      v: https://fhir.developer.gene.com/StructureDefinition/dispense-quantity-detail
  number of repeats allowed:
    v: 1

urn:…
type: Organization
meta:
  profile:
    v: https://fhir.developer.gene.com/StructureDefinition/uapi-organization
    link: https://fhir.developer.gene.com/StructureDefinition/uapi-organization
text:
  status:
    v: generated
  div: Generated Narrative: Organization e551b51b-0646-4b23-b1ac-9ec623756ec6 Profile: UAPI Organization identifier: http://vendor.com/ab/PAY-111 (use: usual, ) type: Insurance Company name: Dakotacare telecom: ph: 8778472862(Work)
identifier:
  use:
    v: usual
  system:
    v: http://vendor.com/ab
  value:
    v: PAY-111
  assigner:
    display:
      v: AB Vendor
type:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/organization-type
    code:
      v: ins
name:
  v: Dakotacare
telecom:
  system:
    v: phone
  value:
    v: 8778472862
  use:
    v: work
  rank:
    v: 1

urn:…
type: Organization
meta:
  profile:
    v: https://fhir.developer.gene.com/StructureDefinition/uapi-organization
    link: https://fhir.developer.gene.com/StructureDefinition/uapi-organization
text:
  status:
    v: generated
  div: Generated Narrative: Organization 606bbb19-fe37-4847-b6bb-1cdac172c3ec Profile: UAPI Organization identifier: http://SOT.com/ab/Infusion Site Id (use: usual, ) type: Site of Treatment name: Infusion Centre telecom: ph: 8882704882(Work), fax: 8179974042(Work) address: 8 Ranoldo Terrace Cherry Hill NJ 08034 US Contacts - Name Telecom * Venus Yardav (Official) ph: -unknown-
identifier:
  use:
    v: usual
  system:
    v: http://SOT.com/ab
  value:
    v: Infusion Site Id
  assigner:
    display:
      v: Site of Treatment/Infusion Centre Name
type:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/organization-type
    code:
      v: other
    display:
      v: Site of Treatment
  text:
    v: Site of Treatment
name:
  v: Infusion Centre
telecom:
  system:
    v: phone
  value:
    v: 8882704882
  use:
    v: work
  rank:
    v: 1
telecom:
  system:
    v: fax
  value:
    v: 8179974042
  use:
    v: work
  rank:
    v: 2
address:
  line:
    v: 8 Ranoldo Terrace
  city:
    v: Cherry Hill
  state:
    v: NJ
  postal code:
    v: 08034
  country:
    v: US
contact:
  name:
    use:
      v: official
    family:
      v: Yardav
    given:
      v: Venus
  telecom:
    system:
      v: phone

v: 2

v: 1