<ReferralRequest xmlns="http://hl7.org/fhir">
  <id value="ReferralRequestTransaction Instance Example" />
  <meta>
    <profile value="http://hl7.org/fhir/us/bser/StructureDefinition/ReferralRequestTransaction" />
  </meta>
  <identifier>
    <type value="ACSN" />
    <value value="71949668" />
  </identifier>
  <status value="active" />
  <serviceRequested>
    <coding>
      <system value="http://snomed.info/sct" />
      <code value="275920008" />
      <display value="Arthritis monitoring (regime/therapy)" />
    </coding>
  </serviceRequested>
  <subject>
    <referemce value="http://hl7.org/fhir/us/bser/PatientRole/InstanceExample" />
  </subject>
  <authoredOn value="2018-09-15" />
  <requester>
    <agent>
      <reference value="http://hl7.org/fhir/us/bser/ReferralInitiatorProviderRole/InstanceExample" />
    </agent>
  </requester>
  <recipient>
    <reference value="http://hl7.org/fhir/us/bser/ReferralRecipientProviderRole/InstanceExample" />
  </recipient>
  <reasonCode>
    <coding>
      <system value="http://snomed.info/sct" />
      <code value=" 3723001" />
      <display value="Arthritis" />
    </coding>
  </reasonCode>
  <supportingInfo>
    <reference value="http://hl7.org/fhir/us/bser/ReferralRequestSupportingBundle/InstanceExample" />
  </supportingInfo>
</ReferralRequest>