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Testdatensatz_uniVersa.xml
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129 lines (129 loc) · 6.93 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/1f7b3550-33e1-48b8-a273-949cc76183cc"/>
</focus>
<focus>
<reference value="Coverage/55acaeb8-881b-427b-831a-3c288fec5bdd"/>
</focus>
</MessageHeader>
</resource>
</entry>
<entry>
<fullUrl value="https://gematik.de/fhir/Patient/1f7b3550-33e1-48b8-a273-949cc76183cc"/>
<resource>
<Patient xmlns="http://hl7.org/fhir">
<id value="1f7b3550-33e1-48b8-a273-949cc76183cc"/>
<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="H458745873"/>
</identifier>
<name>
<use value="official"/>
<family value="Wurst">
<extension url="http://hl7.org/fhir/StructureDefinition/humanname-own-name">
<valueString value="Hans"/>
</extension>
</family>
<given value="Hans"/>
</name>
<birthDate value="1957-09-01"/>
<address>
<type value="both"/>
<line value="Nelson-Mandela-Platz 2">
<extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName">
<valueString value="Nelson-Mandela-Platz 2"/>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber">
<valueString value="2"/>
</extension>
</line>
<line value="Etage 16">
<extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator">
<valueString value="Etage 16"/>
</extension>
</line>
<city value="Nürnberg"/>
<postalCode value="90459"/>
<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="H4sIAAAAAAAAA42TUW+CMBSF3/0VpO9SMLLoUmqcLsY45zIzt+zFdHAFIlwWWtjmr19xZgNlczyU5J7T7/ReChu8J7FRQCajFF1imxYxAL3UjzBwyXS5aPd6Tr9tO8SQSqAv4hTBJR8gyYC32MNoPYzjABKIEFYlxQshyzGQvlCAT/MbYzSer1fX98vp4tYljtkpE3QmSpeESr1eUvomTU0QKtqaPtCNoIX0k3KhhfYT3jL0w77pCrKvUr1chkovzNXuR907riCIEHnH6jhW37IZPRTqrlkq9YFVJiCo8pv1LSDqPG5f9Oyu1XX6jDbqZzCxAPQh09MGPj5CVLVTzK1IgOcYld0LY5YJ1JFFZRSGMCcmo3tfvVH6S6eM/jlK9pxLoXYRblJ5RKwok9mq4bSVT4ciU9yuZB1Kp5sq1PXwJQMvLEe6bkzYb3hc3HHLYrR8n+Lof3k1Z02tKYdbSevXktHzfwRvfQI3sVHwdQMAAA=="/>
</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/1f7b3550-33e1-48b8-a273-949cc76183cc"/>
</beneficiary>
<period>
<start value="2025-09-01"/>
<end value="2025-09-01"/>
</period>
<payor>
<identifier>
<system value="http://fhir.de/sid/arge-ik/iknr"/>
<value value="168140459"/>
</identifier>
<display value="uniVersa Krankenversicherung a.G."/>
</payor>
</Coverage>
</resource>
</entry>
</Bundle>