Bundle_SRxDataResponse Example
JSON Format: Bundle
Download Raw Bundle json example
An example of Bundle used in an SRxDataResponse.{ "resourceType": "Bundle", "id": "4b0bdefccac248fb81f6ec4161d771fa", "language": "en-US", "type": "message", "entry": [ { "resource": { "resourceType": "MessageHeader", "id": "SRxResponse-24951221-3626598-1151958", "eventCoding": { "system": "http://surescripts.net/fhir/specialty/message-events", "code": "specialty-data-response" }, "sender": { "reference": "urn:uuid:86dc932a-8387-4b4c-835f-cb917f1ecbf4", "type": "Practitioner" }, "source": { "name": "Surescripts, LLC", "software": "Specialty Patient Enrollment (SPE)", "version": "1.0", "endpoint": "088a10bd33ca43989ced71ba95231a50" }, "focus": [ { "reference": "urn:uuid:e3a6eea9-7f5a-421a-b1f2-ba07096ed701", "type": "MedicationRequest" } ] } }, { "fullUrl": "urn:uuid:a2327d24-4c12-426a-9312-683c01db1646", "resource": { "resourceType": "RelatedPerson", "id": "a2327d24-4c12-426a-9312-683c01db1646", "patient": { "reference": "urn:uuid:2a04d614-080b-4668-905e-091d17218900", "type": "Patient" }, "relationship": [ { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode", "code": "SPS" } ] } ], "name": [ { "use": "official", "family": "Ramanujan", "given": [ "Janakiammal" ] } ], "birthDate": "1983-06-01" } }, { "fullUrl": "urn:uuid:172dd21f-a7ff-4596-8449-3603a49f6caf", "resource": { "resourceType": "Organization", "id": "172dd21f-a7ff-4596-8449-3603a49f6caf", "identifier": [ { "use": "official", "type": { "text": "Payer ID" }, "value": "111" } ], "type": [ { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/organization-type", "code": "ins", "display": "Insurance Company" } ], "text": "Insurance Company" } ], "name": "General Medical Insurance", "telecom": [ { "system": "phone", "value": "8002234333", "rank": 1 }, { "system": "email", "value": "benefits@coordination.com", "rank": 1 }, { "system": "fax", "value": "0", "rank": 1 } ], "address": [ { "type": "postal", "line": [ "1 Main Street" ], "city": "Anytown", "state": "OR", "postalCode": "97215", "country": "US" } ] } }, { "fullUrl": "urn:uuid:2d637a4f-87af-4aae-b18c-175a0aa86e98", "resource": { "resourceType": "Organization", "id": "2d637a4f-87af-4aae-b18c-175a0aa86e98", "identifier": [ { "use": "official", "type": { "text": "Payer ID" }, "value": "228" }, { "use": "official", "type": { "text": "PCN" }, "value": "229" }, { "use": "official", "type": { "text": "BIN" }, "value": "230" } ], "type": [ { "text": "Pharmacy Benefit Manager" } ], "name": "General Pharmacy Benefit Company", "telecom": [ { "system": "phone", "value": "0", "rank": 1 }, { "system": "email", "value": "coverage@generalpharmacyPBM", "rank": 1 } ], "address": [ { "type": "postal", "line": [ "1 Chestnut Boulevard" ], "city": "AnotherTown", "state": "OR", "postalCode": "97127", "country": "US" } ] } }, { "fullUrl": "urn:uuid:12e31635-6fbc-4cc9-b2f8-4b1babf0de03", "resource": { "resourceType": "Coverage", "id": "12e31635-6fbc-4cc9-b2f8-4b1babf0de03", "extension": [ { "url": "http://www.surescripts.net/fhir/InsuranceCardImage", "valueAttachment": { "contentType": "image/jpeg", "data": "UjBsR09EbGhjZ0dTQUxNQUFBUUNBRU1tQ1p0dU1GUXhEUzhi" } }, { "url": "http://www.surescripts.net/fhir/rx-group", "valueString": "240" }, { "url": "http://www.surescripts.net/fhir/rx-member", "valueString": "123P" } ], "identifier": [ { "use": "official", "type": { "text": "Member ID" }, "value": "Primary" } ], "status": "active", "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", "code": "HIP" } ], "text": "Health Insurance Policy" }, "subscriber": { "reference": "urn:uuid:a2327d24-4c12-426a-9312-683c01db1646", "type": "RelatedPerson" }, "subscriberId": "BenefitsCoordinationPracticeSubscriberID", "beneficiary": { "reference": "urn:uuid:2a04d614-080b-4668-905e-091d17218900", "type": "Patient" }, "relationship": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship", "code": "spouse" } ] }, "period": { "start": "1957-08-13T00:00:00+00:00", "end": "1957-08-13T00:00:00+00:00" }, "payor": [ { "reference": "urn:uuid:172dd21f-a7ff-4596-8449-3603a49f6caf", "type": "Organization" }, { "reference": "urn:uuid:2d637a4f-87af-4aae-b18c-175a0aa86e98", "type": "Organization" } ], "class": [ { "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/coverage-class", "code": "rxgroup" } ] }, "value": "240" }, { "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/coverage-class", "code": "group" } ] }, "value": "224", "name": "225" }, { "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/coverage-class", "code": "plan" } ] }, "value": "226" }, { "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/coverage-class", "code": "rxid" } ] }, "value": "123P" } ], "order": 1 } }, { "fullUrl": "urn:uuid:aeb56a7e-07c4-4814-902d-19d922cf971d", "resource": { "resourceType": "MedicationStatement", "id": "aeb56a7e-07c4-4814-902d-19d922cf971d", "status": "active", "medicationCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/sid/ndc", "code": "00280210012", "display": "aspirin 81 MG Delayed Release Oral Tablet [Bayer Aspirin]" } ] }, "subject": { "reference": "urn:uuid:2a04d614-080b-4668-905e-091d17218900", "type": "Patient" }, "dateAsserted": "2020-04-09" } }, { "fullUrl": "urn:uuid:005fcc8c-6c6e-468b-9037-ebc514e40611", "resource": { "resourceType": "MedicationStatement", "id": "005fcc8c-6c6e-468b-9037-ebc514e40611", "status": "active", "medicationCodeableConcept": { "coding": [ { "system": "http://www.nlm.nih.gov/research/umls/rxnorm", "code": "617318", "display": "Lipitor 20 MG Oral Tablet" } ] }, "subject": { "reference": "urn:uuid:2a04d614-080b-4668-905e-091d17218900", "type": "Patient" }, "effectiveDateTime": "2020-02-02T00:00:00+00:00", "dateAsserted": "2020-02-01", "reasonCode": [ { "coding": [ { "system": "http://hl7.org/fhir/sid/icd-10-cm", "code": "E78.00", "display": "Pure hypercholesterolemia, unspecified" } ] } ], "dosage": [ { "text": "1 tab PO qd", "route": { "coding": [ { "system": "http://snomed.info/sct", "code": "26643006", "display": "Oral Route" } ] }, "doseAndRate": [ { "doseQuantity": { "value": 1, "unit": "TAB", "system": "http://hl7.org/fhir/v3/orderableDrugForm", "code": "TAB" } } ] } ] } }, { "fullUrl": "urn:uuid:2acb1225-b8f1-4895-a237-6460981d8cb0", "resource": { "resourceType": "MedicationStatement", "id": "2acb1225-b8f1-4895-a237-6460981d8cb0", "status": "active", "medicationCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/sid/ndc", "code": "544360o1001", "display": "0.4 ML Methotrexate 25 MG/ML Auto-Injector [Otrexup]" } ] }, "subject": { "reference": "urn:uuid:2a04d614-080b-4668-905e-091d17218900", "type": "Patient" }, "effectiveDateTime": "2020-01-02T00:00:00+00:00", "dateAsserted": "2020-01-01", "reasonCode": [ { "coding": [ { "system": "http://snomed.info/sct", "code": "69896004", "display": "Rheumatoid arthritis (disorder)" } ] } ] } }, { "fullUrl": "urn:uuid:665b2848-5c99-48a0-b1ab-61ca8bac3f5c", "resource": { "resourceType": "AllergyIntolerance", "id": "665b2848-5c99-48a0-b1ab-61ca8bac3f5c", "clinicalStatus": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical", "code": "active" } ], "text": "Active" }, "verificationStatus": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification", "code": "confirmed" } ], "text": "Confirmed" }, "code": { "coding": [ { "system": "http://snomed.info/sct", "code": "213021008", "display": "Peanut allergy" } ], "text": "Peanut allergy" }, "patient": { "reference": "urn:uuid:2a04d614-080b-4668-905e-091d17218900", "type": "Patient" }, "recordedDate": "2007-04-22", "reaction": [ { "manifestation": [ { "coding": [ { "system": "http://snomed.info/sct", "code": "417516000", "display": "Anaphylaxis caused by substance (disorder)" } ] } ] } ] } }, { "fullUrl": "urn:uuid:49e5f4d2-2f5b-49e7-8b3f-095da6efeda9", "resource": { "resourceType": "AllergyIntolerance", "id": "49e5f4d2-2f5b-49e7-8b3f-095da6efeda9", "clinicalStatus": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical", "code": "active" } ], "text": "Active" }, "verificationStatus": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification", "code": "unconfirmed" } ], "text": "Unconfirmed" }, "category": [ "medication" ], "criticality": "high", "code": { "coding": [ { "system": "http://www.nlm.nih.gov/research/umls/rxnorm", "code": "7980", "display": "Penicillin G" } ], "text": "Penicillin G" }, "patient": { "reference": "urn:uuid:2a04d614-080b-4668-905e-091d17218900", "type": "Patient" }, "onsetAge": { "value": 2, "unit": "Year", "system": "http://unitsofmeasure.org", "code": "a" }, "recordedDate": "2010-03-01", "reaction": [ { "manifestation": [ { "coding": [ { "system": "http://snomed.info/sct", "code": "247472004", "display": "Hives" } ] } ] } ] } }, { "fullUrl": "urn:uuid:88667944-99e3-4b31-a3a6-536d8f6476d4", "resource": { "resourceType": "Condition", "id": "88667944-99e3-4b31-a3a6-536d8f6476d4", "clinicalStatus": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/condition-clinical", "code": "active" } ], "text": "Active" }, "verificationStatus": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code": "confirmed" } ], "text": "Confirmed" }, "category": [ { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/condition-category", "code": "problem-list-item" } ], "text": "Problem List Item" } ], "code": { "coding": [ { "system": "http://hl7.org/fhir/sid/icd-10", "code": "A95.9", "display": "Yellow fever, unspecified" } ] }, "subject": { "reference": "urn:uuid:2a04d614-080b-4668-905e-091d17218900", "type": "Patient" } } }, { "fullUrl": "urn:uuid:1b6b7f34-b18c-4a97-9a17-b9c28e99273d", "resource": { "resourceType": "Condition", "id": "1b6b7f34-b18c-4a97-9a17-b9c28e99273d", "text": { "status": "generated", "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: f203</p><p><b>clinicalStatus</b>: active</p><p><b>verificationStatus</b>: confirmed</p><p><b>category</b>: Problem <span>(Details : {SNOMED CT code '55607006' = 'Problem', given as 'Problem'}; {http://hl7.org/fhir/condition-category code 'problem-list-item' = 'Problem List Item)</span></p><p><b>severity</b>: Moderate to severe <span>(Details : {SNOMED CT code '371924009' = 'Moderate to severe', given as 'Moderate to severe'})</span></p><p><b>code</b>: Bacterial sepsis <span>(Details : {SNOMED CT code '10001005' = 'Bacterial septicemia', given as 'Bacterial sepsis'})</span></p><p><b>bodySite</b>: Pulmonary vascular structure <span>(Details : {SNOMED CT code '281158006' = 'Pulmonary vascular structure', given as 'Pulmonary vascular structure'})</span></p><p><b>subject</b>: <a>Roel</a></p><p><b>context</b>: <a>Roel's encounter on March eleventh</a></p><p><b>onset</b>: 08/03/2013</p><p><b>assertedDate</b>: 11/03/2013</p><h3>Evidences</h3><table><tr><td>-</td><td><b>Detail</b></td></tr><tr><td>*</td><td><a>Diagnostic report for Roel's sepsis</a></td></tr></table></div>" }, "clinicalStatus": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/condition-clinical", "code": "active" } ], "text": "Active" }, "verificationStatus": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code": "confirmed" } ], "text": "Confirmed" }, "category": [ { "coding": [ { "system": "http://snomed.info/sct", "code": "55607006", "display": "Problem" } ] }, { "coding": [ { "system": "http://hl7.org/fhir/condition-category", "code": "problem-list-item" } ] } ], "severity": { "coding": [ { "system": "http://snomed.info/sct", "code": "371924009", "display": "Moderate to severe" } ] }, "code": { "coding": [ { "system": "http://snomed.info/sct", "code": "10001005", "display": "Bacterial sepsis" } ] }, "bodySite": [ { "coding": [ { "system": "http://snomed.info/sct", "code": "281158006", "display": "Pulmonary vascular structure" } ] } ], "subject": { "reference": "urn:uuid:2a04d614-080b-4668-905e-091d17218900", "type": "Patient" }, "recordedDate": "2013-03-11" } }, { "fullUrl": "urn:uuid:9dda8504-c90a-439a-9ee3-e9b3c2ac9af3", "resource": { "resourceType": "Condition", "id": "9dda8504-c90a-439a-9ee3-e9b3c2ac9af3", "clinicalStatus": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/condition-clinical", "code": "active" } ], "text": "Active" }, "verificationStatus": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code": "confirmed" } ], "text": "Confirmed" }, "category": [ { "coding": [ { "system": "http://snomed.info/sct", "code": "55607006", "display": "Problem" } ] }, { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/condition-category", "code": "problem-list-item" } ] } ], "severity": { "coding": [ { "system": "http://snomed.info/sct", "code": "6736007", "display": "Moderate" } ] }, "code": { "coding": [ { "system": "http://hl7.org/fhir/sid/icd-9-cm", "code": "556.9", "display": "Ulcerative colitis, unspecified" } ], "text": "Colitis" }, "subject": { "reference": "urn:uuid:2a04d614-080b-4668-905e-091d17218900", "type": "Patient" }, "onsetString": "While in college at Stanford", "abatementString": "true", "recordedDate": "2020-02-20" } }, { "fullUrl": "urn:uuid:26d6eb9d-1b8c-4c4d-8a3d-f682ef209aab", "resource": { "resourceType": "Observation", "id": "26d6eb9d-1b8c-4c4d-8a3d-f682ef209aab", "status": "final", "category": [ { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/observation-category", "code": "vital-signs" } ] } ], "code": { "coding": [ { "system": "http://loinc.org", "code": "8302-2", "display": "Body height" } ] }, "subject": { "reference": "urn:uuid:2a04d614-080b-4668-905e-091d17218900", "type": "Patient" }, "effectiveDateTime": "2020-12-04T05:38:32.7624324Z", "valueQuantity": { "value": 78, "unit": "inch", "system": "http://unitsofmeasure.org", "code": "[in_i]" } } }, { "fullUrl": "urn:uuid:201dc66f-c694-40f5-9d9b-f5fcddb2ded0", "resource": { "resourceType": "Observation", "id": "201dc66f-c694-40f5-9d9b-f5fcddb2ded0", "status": "final", "category": [ { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/observation-category", "code": "vital-signs" } ] } ], "code": { "coding": [ { "system": "http://loinc.org", "code": "29463-7" } ] }, "subject": { "reference": "urn:uuid:2a04d614-080b-4668-905e-091d17218900", "type": "Patient" }, "effectiveDateTime": "2020-12-04T05:38:32.7624324Z", "valueQuantity": { "value": 112.74, "unit": "pound", "system": "http://unitsofmeasure.org", "code": "[lb_av]" } } }, { "fullUrl": "urn:uuid:a10e962f-3366-4b3e-afba-13769bd73d17", "resource": { "resourceType": "Condition", "id": "a10e962f-3366-4b3e-afba-13769bd73d17", "clinicalStatus": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/condition-clinical", "code": "active" } ], "text": "Active" }, "verificationStatus": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code": "confirmed" } ], "text": "Confirmed" }, "category": [ { "text": "Prescription Primary Diagnosis" } ], "code": { "coding": [ { "system": "http://hl7.org/fhir/sid/icd-10", "code": "M08.3", "text": "Juvenile rheumatoid polyarthritis (seronegative)" } ], "text": "Juvenile rheumatoid polyarthritis (seronegative)" }, "subject": { "reference": "urn:uuid:2a04d614-080b-4668-905e-091d17218900", "type": "Patient" } } }, { "fullUrl": "urn:uuid:e3a6eea9-7f5a-421a-b1f2-ba07096ed701", "resource": { "resourceType": "MedicationRequest", "id": "e3a6eea9-7f5a-421a-b1f2-ba07096ed701", "identifier": [ { "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "PLAC", "display": "Placer Identifier" } ], "text": "Prescriber Order Number" }, "value": "55555", "assigner": { "display": "General Hospital" } } ], "status": "active", "intent": "order", "medicationCodeableConcept": { "coding": [ { "system": "http://www.nlm.nih.gov/research/umls/rxnorm", "code": "802652", "display": "1 ML Enbrel 50 MG/ML Prefilled Syringe" }, { "system": "http://hl7.org/fhir/sid/ndc", "code": "58406043501", "display": "1 ML Enbrel 50 MG/ML Prefilled Syringe" } ], "text": "1 ML Enbrel 50 MG/ML Prefilled Syringe" }, "subject": { "reference": "urn:uuid:2a04d614-080b-4668-905e-091d17218900", "type": "Patient" }, "authoredOn": "2020-12-04T05:38:33+00:00", "requester": { "reference": "urn:uuid:86dc932a-8387-4b4c-835f-cb917f1ecbf4", "type": "Practitioner" }, "reasonReference": [ { "reference": "urn:uuid:a10e962f-3366-4b3e-afba-13769bd73d17", "type": "Condition" } ], "dosageInstruction": [ { "text": "Inject at a slow and steady rate" } ], "dispenseRequest": { "quantity": { "value": 1, "unit": "mL", "system": "http://unitsofmeasure.org", "code": "mL" }, "expectedSupplyDuration": { "value": 30, "unit": "days", "system": "http://unitsofmeasure.org", "code": "d" }, "performer": { "reference": "urn:uuid:efdecbee-a64f-4c1a-bdea-5d0907d079f7", "type": "Organization" } } } }, { "fullUrl": "urn:uuid:3b054051-0de8-4a1e-be72-84113b1650be", "resource": { "resourceType": "Patient", "id": "3b054051-0de8-4a1e-be72-84113b1650be", "identifier": [ { "use": "official", "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "MR", "display": "Medical Record Number" } ], "text": "Medical Record Number" }, "system": "urn:oid:1.2.36.146.595.217.0.1", "value": "12345", "assigner": { "display": "Acme Healthcare" } } ], "active": true, "name": [ { "use": "official", "family": "Ramanujan", "given": [ "Srinivasa", "Aiyangar" ], "prefix": [ "Mr." ] } ], "telecom": [ { "system": "email", "value": "myemail@yahoo.com", "rank": 1 }, { "system": "phone", "value": "8005551212", "rank": 1 }, { "system": "phone", "value": "5555551212", "use": "home" } ], "gender": "male", "birthDate": "1981-12-03", "address": [ { "type": "postal", "line": [ "2234 My Street", "No. 2234" ], "city": "Beaverton", "state": "OR", "postalCode": "97008", "country": "US" } ], "communication": [ { "language": { "coding": [ { "system": "urn:ietf:bcp:47", "code": "en" } ] } } ] } }, { "fullUrl": "urn:uuid:efdecbee-a64f-4c1a-bdea-5d0907d079f7", "resource": { "resourceType": "Organization", "id": "efdecbee-a64f-4c1a-bdea-5d0907d079f7", "identifier": [ { "use": "official", "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "PRN", "display": "Provider Number" } ], "text": "Provider Number" }, "system": "http://ncpdp.org/provider-id", "value": "8488848" }, { "use": "official", "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "PRN", "display": "Provider Number" } ], "text": "Provider Number" }, "system": "http://hl7.org/fhir/sid/us-npi", "value": "1131435277" } ], 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