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Testdatensatz_Signal-Iduna.xml
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129 lines (129 loc) · 6.92 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/4d269aeb-5b47-413a-bd06-cdcda55149bc"/>
</focus>
<focus>
<reference value="Coverage/55acaeb8-881b-427b-831a-3c288fec5bdd"/>
</focus>
</MessageHeader>
</resource>
</entry>
<entry>
<fullUrl value="https://gematik.de/fhir/Patient/4d269aeb-5b47-413a-bd06-cdcda55149bc"/>
<resource>
<Patient xmlns="http://hl7.org/fhir">
<id value="4d269aeb-5b47-413a-bd06-cdcda55149bc"/>
<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="A003286493"/>
</identifier>
<name>
<use value="official"/>
<family value="Leuchtfackel">
<extension url="http://hl7.org/fhir/StructureDefinition/humanname-own-name">
<valueString value="Louis"/>
</extension>
</family>
<given value="Louis"/>
</name>
<birthDate value="2009-12-19"/>
<address>
<type value="both"/>
<line value="Strobelallee 50 ">
<extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName">
<valueString value="Strobelallee"/>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber">
<valueString value="50"/>
</extension>
</line>
<line value="VIP Loge">
<extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator">
<valueString value="VIP Loge"/>
</extension>
</line>
<city value="Dortmund"/>
<postalCode value="44139"/>
<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/4d269aeb-5b47-413a-bd06-cdcda55149bc"/>
</beneficiary>
<period>
<start value="2025-09-19"/>
<end value="2025-09-19"/>
</period>
<payor>
<identifier>
<system value="http://fhir.de/sid/arge-ik/iknr"/>
<value value="168140028"/>
</identifier>
<display value="SIGNAL IDUNA Krankenversicherung a. G."/>
</payor>
</Coverage>
</resource>
</entry>
</Bundle>