<DeviceRequest xmlns="http://hl7.org/fhir">
    <id value="zib-medicaldevicerequest-01" />
    <meta>
        <profile value="http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDeviceRequest" />
    </meta>
    <status value="active" />
    <intent>
        <coding>
            <system value="http://hl7.org/fhir/request-intent" />
            <code value="order" />
        </coding>
    </intent>
    <codeCodeableConcept>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="405815000" />
            <display value="Procedure device" />
        </coding>
    </codeCodeableConcept>
    <subject>
        <reference value="Patient/nl-core-patient-01" />
        <display value="Johan XXX_Helleman" />
    </subject>
    <occurrencePeriod>
        <start value="2012-03-13" />
    </occurrencePeriod>
    <requester>
        <agent>
            <extension url="http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference">
                <valueReference>
                    <reference value="PractitionerRole/nl-core-practitionerrole-02" />
                    <display value="Huisartsen, niet nader gespecificeerd" />
                </valueReference>
            </extension>
            <reference value="Practitioner/nl-core-practitioner-02" />
            <display value="Vaste Huisarts 1" />
        </agent>
    </requester>
    <performer>
        <extension url="http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference">
            <valueReference>
                <reference value="PractitionerRole/nl-core-practitionerrole-01" />
                <display value="Medisch specialisten, orthopedie" />
            </valueReference>
        </extension>
        <reference value="Organization/nl-core-organization-02" />
        <display value="UMCG - Afdeling Orthopedie" />
    </performer>
</DeviceRequest>