6.3. Scenario 2
6.3.1. Patient data
| NameInformation.FirstNames | Anita |
| NameInformation.Initials | |
| NameInformation.GivenName | |
| NameInformation.NameUsage | |
| NameInformation.LastName.Prefix | |
| NameInformation.LastName.LastName | Jansen |
| NameInformation.LastNamePartner.PartnerPrefix | |
| NameInformation.LastNamePartner.PartnerLastName | |
| NameInformation.Titles | |
| AddressInformation.Street | Achillesstraat |
| AddressInformation.HouseNumber | 12 |
| AddressInformation.HouseNumberLetter | |
| AddressInformation.HouseNumberAddition | |
| AddressInformation.HouseNumberIndication | |
| AddressInformation.Postcode | 1234 AA |
| AddressInformation.PlaceOfResidence | Amsterdam |
| AddressInformation.Municipality | |
| AddressInformation.Country | Netherlands (code 'NL' from code system 'ISO 3166-1 (alpha-2)') |
| AddressInformation.AdditionalInformation | |
| AddressInformation.AddressType | Officieel adres (code 'HP' from code system 'AddressUse') |
| ContactInformation.TelephoneNumbers.TelephoneNumber | +31612345678 |
| ContactInformation.TelephoneNumbers.TelecomType | Mobiel telefoonnummer (code 'MC' from code system 'AddressUse') |
| ContactInformation.TelephoneNumbers.NumberType | Telefoonnummer thuis (code 'HP' from code system 'AddressUse') |
| ContactInformation.TelephoneNumbers.Comment | |
| ContactInformation.EmailAddresses.EmailAddress | anitajansen@icloud.com |
| ContactInformation.EmailAddresses.EmailAddressType | Privé e-mailadres (code 'HP' from code system 'AddressUse') |
| PatientIdentificationNumber | 999998298 (in identifier system 'Burgerservicenummer') |
| DateOfBirth | 15-03-2010 |
| Gender | Vrouw (code 'F' from code system 'AdministrativeGender') |
| MultipleBirthIndicator | |
| DeathIndicator | |
| DateOfDeath |
6.3.2. Health Professional data
| HealthProfessionalIdentificationNumber | 12101002 (in identifier system 'BIG register inschrijvingsnummer') |
| NameInformation.FirstNames | |
| NameInformation.Initials | D. |
| NameInformation.GivenName | |
| NameInformation.NameUsage | |
| NameInformation.LastName.Prefix | de |
| NameInformation.LastName.LastName | Ruiter |
| NameInformation.LastNamePartner.PartnerPrefix | |
| NameInformation.LastNamePartner.PartnerLastName | |
| NameInformation.Titles | |
| Speciality | Tandartsen, algemeen practicus (code '1200' from code system 'Vektis AGB-medische specialismen') |
| Gender | |
| AddressInformation.Street | Simon Smitweg |
| AddressInformation.HouseNumber | 1 |
| AddressInformation.HouseNumberLetter | |
| AddressInformation.HouseNumberAddition | |
| AddressInformation.HouseNumberIndication | |
| AddressInformation.Postcode | 2353 GA |
| AddressInformation.PlaceOfResidence | Leiderdorp |
| AddressInformation.Municipality | |
| AddressInformation.Country | Netherlands (code 'NL' from code system 'ISO 3166-1 (alpha-2)') |
| AddressInformation.AdditionalInformation | |
| AddressInformation.AddressType | |
| ContactInformation.TelephoneNumbers.TelephoneNumber | +31612345678 |
| ContactInformation.TelephoneNumbers.TelecomType | Mobiel telefoonnummer (code 'MC' from code system 'AddressUse') |
| ContactInformation.TelephoneNumbers.NumberType | Zakelijk telefoonnummer (code 'WP' from code system 'AddressUse') |
| ContactInformation.TelephoneNumbers.Comment | |
| ContactInformation.EmailAddresses.EmailAddress | deruiter@tandarts.nl |
| ContactInformation.EmailAddresses.EmailAddressType | Zakelijk e-mailadres (code 'WP' from code system 'AddressUse') |
| HealthcareProvider | Defensie Tandheelkundige Dienst |
| HealthProfessionalRole |
6.3.3. Healthcare Provider data
6.3.3.1. Healthcare Provider - Defensie Tandheelkundige Dienst
| HealthProviderIdentificationNumber | 12095095 (in identifier system 'Vektis AGB-zorgverlener tabel') |
| OrganizationName | Defensie Tandheelkundige Dienst |
| DepartmentSpeciality | |
| ContactInformation.TelephoneNumbers.TelephoneNumber | +31653603740 |
| ContactInformation.TelephoneNumbers.TelecomType | Mobiel telefoonnummer (code 'MC' from code system 'AddressUse') |
| ContactInformation.TelephoneNumbers.NumberType | Zakelijk telefoonnummer (code 'WP' from code system 'AddressUse') |
| ContactInformation.TelephoneNumbers.Comment | |
| ContactInformation.EmailAddresses.EmailAddress | PJ.Jumpertz.01@mindef.nl |
| ContactInformation.EmailAddresses.EmailAddressType | Zakelijk e-mailadres (code 'WP' from code system 'AddressUse') |
| AddressInformation.Street | Herculeslaan |
| AddressInformation.HouseNumber | 1 |
| AddressInformation.HouseNumberLetter | |
| AddressInformation.HouseNumberAddition | |
| AddressInformation.HouseNumberIndication | |
| AddressInformation.Postcode | 3584 AB |
| AddressInformation.PlaceOfResidence | Utrecht |
| AddressInformation.Municipality | |
| AddressInformation.Country | Netherlands (code 'NL' from code system 'ISO 3166-1 (alpha-2)') |
| AddressInformation.AdditionalInformation | |
| AddressInformation.AddressType | Werkadres (code 'WP' from code system 'AddressUse') |
| OrganizationType | |
| OrganizationLocation.LocationName | |
| OrganizationLocation.LocationNumber |
6.3.3.2. Healthcare Provider - Vliegbasis Gilze-Rijen
| HealthProviderIdentificationNumber | |
| OrganizationName | Vliegbasis Gilze-Rijen |
| DepartmentSpeciality | |
| ContactInformation.TelephoneNumbers.TelephoneNumber | 0889502753 |
| ContactInformation.TelephoneNumbers.TelecomType | Vast telefoonnummer (code 'LL' from code system 'TelecomDeviceTypes') |
| ContactInformation.TelephoneNumbers.NumberType | Zakelijk telefoonnummer (code 'WP' from code system 'AddressUse') |
| ContactInformation.TelephoneNumbers.Comment | |
| ContactInformation.EmailAddresses.EmailAddress | |
| ContactInformation.EmailAddresses.EmailAddressType | |
| AddressInformation.Street | Rijksweg |
| AddressInformation.HouseNumber | 121 |
| AddressInformation.HouseNumberLetter | |
| AddressInformation.HouseNumberAddition | |
| AddressInformation.HouseNumberIndication | |
| AddressInformation.Postcode | 5120 AA |
| AddressInformation.PlaceOfResidence | Rijen |
| AddressInformation.Municipality | |
| AddressInformation.Country | Netherlands (code 'NL' from code system 'ISO 3166-1 (alpha-2)') |
| AddressInformation.AdditionalInformation | |
| AddressInformation.AddressType | Werkadres (code 'WP' from code system 'AddressUse') |
| OrganizationType | |
| OrganizationLocation.LocationName | |
| OrganizationLocation.LocationNumber |
6.3.4. Contact Person data
| NameInformation.FirstNames | |
| NameInformation.Initials | J.M. |
| NameInformation.GivenName | |
| NameInformation.NameUsage | |
| NameInformation.LastName.Prefix | |
| NameInformation.LastName.LastName | Curator |
| NameInformation.LastNamePartner.PartnerPrefix | |
| NameInformation.LastNamePartner.PartnerLastName | |
| NameInformation.Titles | |
| ContactInformation.TelephoneNumbers.TelephoneNumber | |
| ContactInformation.TelephoneNumbers.TelecomType | |
| ContactInformation.TelephoneNumbers.NumberType | |
| ContactInformation.TelephoneNumbers.Comment | |
| ContactInformation.EmailAddresses.EmailAddress | |
| ContactInformation.EmailAddresses.EmailAddressType | |
| AddressInformation.Street | |
| AddressInformation.HouseNumber | |
| AddressInformation.HouseNumberLetter | |
| AddressInformation.HouseNumberAddition | |
| AddressInformation.HouseNumberIndication | |
| AddressInformation.Postcode | |
| AddressInformation.PlaceOfResidence | |
| AddressInformation.Municipality | |
| AddressInformation.Country | |
| AddressInformation.AdditionalInformation | |
| AddressInformation.AddressType | |
| Role | Wettelijke vertegenwoordiger (code '24' from code system 'COD821-VEKT') |
| Relationship |
6.3.5. ASA Score data
| ASAScoreDateTime | 11-02-2022 10:43 |
| ASAScoreValue | ASA-score 2 (code '413496000' from code system 'SNOMED CT') |
| Performer | D. de Ruiter, Tandarts |
| Comment | Allergisch voor hooikoorts, rookt 12 sigaretten per dag, gebruikt medicatie Cetirizine |
6.3.6. Caries Risk data
| CariesRiskDateTime | 11-02-2022 10:43 |
| CariesRiskValue | Verlaagd (code '1250004' from code system 'SNOMED CT') |
| Performer | D. de Ruiter, Tandarts |
| Comment |
6.3.7. Dental Fitness data
| DentalFitnessDateTime | 08-09-2024 11:43 |
| DentalFitnessValue | Klasse 0 (code '440351000146101' from code system 'SNOMED CT') |
| Performer | D. de Ruiter, Tandarts |
| Comment |
6.3.8. Encounter data
| ContactType | Anders (code 'OTH' from code system 'NullFlavor'): Second opinion |
| ContactWith | D. de Ruiter, Tandarts |
| Location | Vliegbasis Gilze-Rijen |
| StartDateTime | 22-07-2023 09:00 |
| EndDateTime | 22-07-2023 09:30 |
| ContactReason.Problem | |
| ContactReason.Procedure | |
| ContactReason.DeviatingResult | |
| ContactReason.CommentContactReason | |
| Origin | |
| Destination |
6.3.9. Oral Hygiene data
| OralHygieneDateTime | 11-02-2022 10:43 |
| OralHygieneValue | Zeer slecht (code '1336219002' from code system 'SNOMED CT') |
| Performer | D. de Ruiter, Tandarts |
| Comment |
6.3.10. Parafunctional Activity data
| ParafunctionalActivityDateTime | 11-02-2022 10:43 |
| ParafunctionalActivityValue | Erosie door het drinken van vruchtensap |
| Performer | D. de Ruiter, Tandarts |
| Comment |
6.3.11. Payer data
6.3.11.1. Payer - Anita Jansen
| PayerPerson.PayerName | Anita Jansen |
| PayerPerson.BankInformation.BankName | RABO |
| PayerPerson.BankInformation.BankCode | RABO21NL |
| PayerPerson.BankInformation.AccountNumber | NL21RABO0001234567 |
| InsuranceCompany.Insurance.StartDateTime | |
| InsuranceCompany.Insurance.EndDateTime | |
| InsuranceCompany.Insurance.InsuranceType | |
| InsuranceCompany.IdentificationNumber | |
| InsuranceCompany.OrganizationName | |
| InsuranceCompany.InsurantNumber | |
| AddressInformation.Street | Achillesstraat |
| AddressInformation.HouseNumber | 12 |
| AddressInformation.HouseNumberLetter | |
| AddressInformation.HouseNumberAddition | |
| AddressInformation.HouseNumberIndication | |
| AddressInformation.Postcode | 1234 AA |
| AddressInformation.PlaceOfResidence | Amsterdam |
| AddressInformation.Municipality | |
| AddressInformation.Country | Netherlands (code 'NL' from code system 'ISO 3166-1 (alpha-2)') |
| AddressInformation.AdditionalInformation | |
| AddressInformation.AddressType | Officieel adres (code 'HP' from code system 'AddressUse') |
| ContactInformation.TelephoneNumbers.TelephoneNumber | |
| ContactInformation.TelephoneNumbers.TelecomType | |
| ContactInformation.TelephoneNumbers.NumberType | |
| ContactInformation.TelephoneNumbers.Comment | |
| ContactInformation.EmailAddresses.EmailAddress | |
| ContactInformation.EmailAddresses.EmailAddressType |
6.3.11.2. Payer - Menzis Zorgverzekeraar N.V.
| PayerPerson.PayerName | |
| PayerPerson.BankInformation.BankName | |
| PayerPerson.BankInformation.BankCode | |
| PayerPerson.BankInformation.AccountNumber | |
| InsuranceCompany.Insurance.StartDateTime | 01-01-2025 |
| InsuranceCompany.Insurance.EndDateTime | 01-01-2026 |
| InsuranceCompany.Insurance.InsuranceType | Aanvullend + tand (code 'AT' from code system 'Verzekeringssoort') |
| InsuranceCompany.IdentificationNumber | |
| InsuranceCompany.OrganizationName | Menzis Zorgverzekeraar N.V. |
| InsuranceCompany.InsurantNumber | 01234567 |
| AddressInformation.Street | Lawickse Allee |
| AddressInformation.HouseNumber | 130 |
| AddressInformation.HouseNumberLetter | |
| AddressInformation.HouseNumberAddition | |
| AddressInformation.HouseNumberIndication | |
| AddressInformation.Postcode | 6709 DZ |
| AddressInformation.PlaceOfResidence | Wageningen |
| AddressInformation.Municipality | |
| AddressInformation.Country | Netherlands (code 'NL' from code system 'ISO 3166-1 (alpha-2)') |
| AddressInformation.AdditionalInformation | |
| AddressInformation.AddressType | Werkadres (code 'WP' from code system 'AddressUse') |
| ContactInformation.TelephoneNumbers.TelephoneNumber | |
| ContactInformation.TelephoneNumbers.TelecomType | |
| ContactInformation.TelephoneNumbers.NumberType | |
| ContactInformation.TelephoneNumbers.Comment | |
| ContactInformation.EmailAddresses.EmailAddress | |
| ContactInformation.EmailAddresses.EmailAddressType |
6.3.12. Periodic Periodontal Screening Score data
| PeriodicPeriodontalScreeningScoreDateTime | 11-02-2022 08:43 |
| PeriodicPeriodontalScreeningScoreValue | Pockets 4-5 millimeter = mogelijk in orde (code 'ppsscore2' from code system 'PeriodicPeriodontalScreeningScore') |
| Performer | D. de Ruiter, Tandarts |
| Comment | Paro-preventietraject |
6.3.13. Procedure data
| ProcedureStartDate | 11-02-2022 |
| ProcedureEndDate | |
| ProcedureType | Maken en beoordelen kleine röntgenfoto (code 'X10' from code system 'Vektis Prestatiecodelijst Mondzorg') |
| ProcedureMethod | |
| ProcedureAnatomicalLocation.Location | |
| ProcedureAnatomicalLocation.Laterality | |
| Indication | |
| Indication.ProblemType | |
| Indication.ProblemName | |
| Indication.FurtherSpecificationProblemName | |
| Indication.ProblemAnatomicalLocation | |
| Indication.ProblemAnatomicalLocation.Location | |
| Indication.ProblemAnatomicalLocation.Laterality | |
| Indication.ProblemStartDate | |
| Indication.ProblemEndDate | |
| Indication.ProblemStatus | |
| Indication.VerificationStatus | |
| Indication.Comment | |
| Location | Vliegbasis Gilze-Rijen |
| Performer | D. de Ruiter, Tandarts |
6.3.14. Treatment Objective data
6.3.14.1. Treatment Objective - Vullen gaatjes rechterkies
| DesiredHealthcareResult | Vullen gaatjes rechterkies |
| DesiredHealthCondition | |
| Problem |
6.3.14.2. Treatment Objective - Bekijken of vullingen op kroon nog goed aansluiten
| DesiredHealthcareResult | Bekijken of vullingen op kroon nog goed aansluiten |
| DesiredHealthCondition | |
| Problem |