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Testdatensatz_Gothaer.xml
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129 lines (129 loc) · 6.94 KB
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<Bundle xmlns="http://hl7.org/fhir">
<id value="bcb6e562-ea4c-40a0-adee-d8ababb73f7f"/>
<meta>
<profile value="https://gematik.de/fhir/eeb/StructureDefinition/EEBBescheinigungBundle"/>
</meta>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:bcb6e562-ea4c-40a0-adee-d8ababb73f7f"/>
</identifier>
<type value="message"/>
<timestamp value="2025-07-02T16:19:45+02:00"/>
<entry>
<fullUrl value="https://gematik.de/fhir/MessageHeader/7f17157d-1a87-432a-b851-c3d7996cfc48"/>
<resource>
<MessageHeader xmlns="http://hl7.org/fhir">
<id value="7f17157d-1a87-432a-b851-c3d7996cfc48"/>
<meta>
<profile value="https://gematik.de/fhir/eeb/StructureDefinition/EEBBescheinigungHeader"/>
</meta>
<eventCoding>
<system value="https://gematik.de/fhir/directory/CodeSystem/OrganizationProfessionOID"/>
<code value="1.2.276.0.76.4.59"/>
<display value="Betriebsstätte Kostenträger"/>
</eventCoding>
<source>
<endpoint value="https://kbvbc-appliance01-ru-rz05.app.rtu.kbvbc.vrz0506.riseops.de/KIM/risePkvDemo"/>
</source>
<focus>
<reference value="Patient/fd52cbee-b633-4fcf-abc1-5fae2e6996d5"/>
</focus>
<focus>
<reference value="Coverage/55acaeb8-881b-427b-831a-3c288fec5bdd"/>
</focus>
</MessageHeader>
</resource>
</entry>
<entry>
<fullUrl value="https://gematik.de/fhir/Patient/fd52cbee-b633-4fcf-abc1-5fae2e6996d5"/>
<resource>
<Patient xmlns="http://hl7.org/fhir">
<id value="fd52cbee-b633-4fcf-abc1-5fae2e6996d5"/>
<meta>
<profile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_FOR_Patient|1.1.0"/>
</meta>
<identifier>
<type>
<coding>
<system value="http://fhir.de/CodeSystem/identifier-type-de-basis"/>
<code value="PKV"/>
</coding>
</type>
<system value="http://fhir.de/sid/pkv/kvid-10"/>
<value value="A003291012"/>
</identifier>
<name>
<use value="official"/>
<family value="Goethe">
<extension url="http://hl7.org/fhir/StructureDefinition/humanname-own-name">
<valueString value="Johann Wolfgang"/>
</extension>
</family>
<given value="Johann Wolfgang"/>
</name>
<birthDate value="1942-06-12"/>
<address>
<type value="both"/>
<line value="Mozartstr. 121b">
<extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName">
<valueString value="Mozartstr."/>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber">
<valueString value="121b"/>
</extension>
</line>
<line value="Sonate 2">
<extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator">
<valueString value="Sonate 2"/>
</extension>
</line>
<city value="Köln"/>
<postalCode value="50674"/>
<country value="D"/>
</address>
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="https://gematik.de/fhir/Coverage/55acaeb8-881b-427b-831a-3c288fec5bdd"/>
<resource>
<Coverage xmlns="http://hl7.org/fhir">
<id value="55acaeb8-881b-427b-831a-3c288fec5bdd"/>
<meta>
<profile value="https://gematik.de/fhir/eeb/StructureDefinition/EEBCoverageEgk"/>
</meta>
<extension url="http://fhir.de/StructureDefinition/gkv/version-vsdm">
<valueString value="5.2.0"/>
</extension>
<extension url="https://gematik.de/fhir/eeb/StructureDefinition/PersoenlicheVersichertendaten">
<valueBase64Binary value="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"/>
</extension>
<extension url="https://gematik.de/fhir/eeb/StructureDefinition/AllgemeineVersicherungsdaten">
<valueBase64Binary value="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"/>
</extension>
<status value="active"/>
<type>
<coding>
<system value="http://fhir.de/CodeSystem/versicherungsart-de-basis"/>
<code value="PKV"/>
<display value="private Krankenversicherung"/>
</coding>
</type>
<beneficiary>
<reference value="Patient/fd52cbee-b633-4fcf-abc1-5fae2e6996d5"/>
</beneficiary>
<period>
<start value="2025-09-02"/>
<end value="2025-09-02"/>
</period>
<payor>
<identifier>
<system value="http://fhir.de/sid/arge-ik/iknr"/>
<value value="168141198"/>
</identifier>
<display value="GOTHAER KRANKENVERSICHERUNG AG"/>
</payor>
</Coverage>
</resource>
</entry>
</Bundle>