<Patient xmlns="http://hl7.org/fhir">
  <id value="20140000000001" />
  <extension url="https://bluebutton.cms.gov/resources/variables/race">
    <valueCoding>
      <system value="https://bluebutton.cms.gov/resources/variables/race" />
      <code value="1" />
      <display value="White" />
    </valueCoding>
  </extension>
  <identifier>
    <system value="https://bluebutton.cms.gov/resources/variables/bene_id" />
    <value value="20140000000001" />
  </identifier>
  <identifier>
    <system value="https://bluebutton.cms.gov/resources/identifier/hicn-hash" />
    <value value="03849e7a2c2e2fe7a046b330e50cc9a68af0c1229ab996592e30a60da89986ed" />
  </identifier>
  <name>
    <use value="usual" />
    <family value="Doe" />
    <given value="Jane" />
    <given value="X" />
  </name>
  <gender value="unknown" />
  <birthDate value="2014-06-01" />
  <address>
    <district value="999" />
    <state value="22" />
    <postalCode value="99999" />
  </address>
</Patient>