{
  "resourceType": "Observation",
  "id": "FeedbackReferralStatusObservation Intance Example",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/us/bser/StructureDefinition/FeedbackReferralStatusObservation"
    ]
  },
  "status": "final",
  "code": {
    "coding": [
      {
        "system": "http://hl7.org/fhir/v3/NullFlavor",
        "code": "UNC",
        "display": "Feedback Referral Status Observation"
      }
    ]
  },
  "component": [
    {
      "ReferralActivityStatus": {
        "code": {
          "coding": {
            "system": "http://hl7.org/fhir/v3/NullFlavor",
            "code": "UNC",
            "display": "Referral Activity Status"
          }
        },
        "valueCodeableConcept": {
          "coding": {
            "system": "http://hl7.org/fhir/v3/NullFlavor",
            "code": "UNC",
            "display": "Intake Completed"
          }
        }
      }
    },
    {
      "ReferralActivityStatusReason": {
        "code": {
          "coding": {
            "system": "http://hl7.org/fhir/v3/NullFlavor",
            "code": "UNC",
            "display": "Referral Activity Status Reason"
          }
        },
        "valueCodeableConcept": {
          "coding": {
            "system": "http://hl7.org/fhir/v3/NullFlavor",
            "code": "UNC",
            "display": "Patient met all intake requirements"
          }
        }
      }
    },
    {
      "ReferralType": {
        "code": {
          "coding": {
            "system": "http://hl7.org/fhir/v3/NullFlavor",
            "code": "UNC",
            "display": "Referral Type"
          }
        },
        "valueCodeableConcept": {
          "coding": {
            "system": "http://hl7.org/fhir/v3/NullFlavor",
            "code": "UNC",
            "display": "Arthritis"
          }
        }
      }
    },
    {
      "ReferralStatus": {
        "code": {
          "coding": {
            "system": "http://hl7.org/fhir/v3/NullFlavor",
            "code": "UNC",
            "display": "Referral Status"
          }
        },
        "valueCodeableConcept": {
          "coding": {
            "system": "http://hl7.org/fhir/v3/NullFlavor",
            "code": "UNC",
            "display": "Active"
          }
        }
      }
    },
    {
      "ReferralIdentifier": {
        "valueString": {
          "value": "44552"
        }
      }
    }
  ]
}