Milissa240_Gaylord332_db7fc62f-0f83-484f-bf84-40e85fc26c4d.json•687 kB
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{
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],
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{
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],
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"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
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]
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"currency": "USD"
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{
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{
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
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{
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{
"system": "http://hl7.org/fhir/sid/cvx",
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"display": "meningococcal MCV4P"
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{
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
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"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
"display": "Line Beneficiary Part B Deductible Amount"
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]
},
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"currency": "USD"
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},
{
"category": {
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{
"system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
"code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
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]
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],
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{
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"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/adjudication",
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],
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],
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"currency": "USD"
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"url": "ExplanationOfBenefit"
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},
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"id": "69176529-fd1f-3b3f-abce-a0a3626769eb",
"identifier": [
{
"system": "https://github.com/synthetichealth/synthea",
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"type": [
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"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/organization-type",
"code": "prov",
"display": "Healthcare Provider"
}
],
"text": "Healthcare Provider"
}
],
"name": "MOUNT AUBURN HOSPITAL",
"telecom": [
{
"system": "phone",
"value": "6174923500"
}
],
"address": [
{
"line": [
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],
"city": "CAMBRIDGE",
"state": "MA",
"postalCode": "02138",
"country": "US"
}
]
},
"request": {
"method": "POST",
"url": "Organization"
}
},
{
"fullUrl": "urn:uuid:00000199-c8f5-3ea7-0000-00000000000a",
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"value": "10"
}
],
"active": true,
"name": [
{
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"given": [
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],
"prefix": [
"Dr."
]
}
],
"telecom": [
{
"system": "email",
"value": "Domingo513.Purdy2@example.com",
"use": "work"
}
],
"address": [
{
"line": [
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],
"city": "CAMBRIDGE",
"state": "MA",
"postalCode": "02138",
"country": "US"
}
],
"gender": "male"
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"url": "Practitioner"
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},
{
"fullUrl": "urn:uuid:249a6266-8cfb-48a9-a8bd-1db7b66c6bbc",
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"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "EMER"
},
"type": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "50849002",
"display": "Emergency room admission (procedure)"
}
],
"text": "Emergency room admission (procedure)"
}
],
"subject": {
"reference": "urn:uuid:db7fc62f-0f83-484f-bf84-40e85fc26c4d",
"display": "Ms. Milissa240 Gaylord332"
},
"participant": [
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"individual": {
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"display": "Dr. Domingo513 Purdy2"
}
}
],
"period": {
"start": "2016-12-21T18:59:23+00:00",
"end": "2016-12-21T21:05:23+00:00"
},
"serviceProvider": {
"reference": "urn:uuid:69176529-fd1f-3b3f-abce-a0a3626769eb",
"display": "MOUNT AUBURN HOSPITAL"
}
},
"request": {
"method": "POST",
"url": "Encounter"
}
},
{
"fullUrl": "urn:uuid:07ceac1d-7ed3-4fd6-a298-9da5488a0ad9",
"resource": {
"resourceType": "Condition",
"id": "07ceac1d-7ed3-4fd6-a298-9da5488a0ad9",
"clinicalStatus": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "resolved"
}
]
},
"verificationStatus": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed"
}
]
},
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "263102004",
"display": "Fracture subluxation of wrist"
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