{ "resourceType": "Bundle", "id": "7a4613cc-b306-49b2-a428-9f8e67e67a85", "meta": { "versionId": "39", "lastUpdated": "2020-08-12T18:59:34.898+00:00", "source": "#OlEHlfWnqGy5aapi", "profile": [ "http://hl7.org/fhir/us/vrdr/StructureDefinition/VRDR-Death-Certificate-Document" ] }, "identifier": { "system": "urn:oid:2.16.724.4.8.10.200.10", "value": "7a4613cc-b306-49b2-a428-9f8e67e67a85" }, "type": "document", "timestamp": "2017-12-11T14:30:00+01:00", "entry": [ { "fullUrl": "urn:uuid:54fd9b4c-7633-4e34-bf6b-6fbe9d48fd30", "resource": { "resourceType": "Composition", "id": "Inline-Instance-for-7a4613cc-b306-49b2-a428-9f8e67e67a85-1", "text": { "status": "generated", "div": "

Generated Narrative

status: final

type: Death certificate

date: Dec 11, 2017, 1:30:00 PM

author: See above (Practitioner/cb1219bc-785f-431c-9f56-b8fbbe78bc4d)

title: Death Certificate

Attesters

-ModeTimeParty
*legalDec 11, 2017, 1:30:00 PMSee above (Practitioner/cb1219bc-785f-431c-9f56-b8fbbe78bc4d)

Events

-CodeDetail
*Diagnostic procedure (procedure)See above (Procedure/219ef5e3-ed0c-4dab-88eb-b114daaebd73)
" }, "status": "final", "type": { "coding": [ { "system": "http://loinc.org", "code": "64297-5", "display": "Death certificate" } ] }, "subject": { "reference": "Patient/51b806c8-566f-463e-8783-9fbf6be8161d" }, "date": "2017-12-11T14:30:00+01:00", "author": [ { "reference": "Practitioner/cb1219bc-785f-431c-9f56-b8fbbe78bc4d" } ], "title": "Death Certificate", "attester": [ { "mode": "legal", "time": "2017-12-11T14:30:00+01:00", "party": { "reference": "Practitioner/cb1219bc-785f-431c-9f56-b8fbbe78bc4d" } } ], "event": [ { "code": [ { "coding": [ { "system": "http://snomed.info/sct", "code": "103693007", "display": "Diagnostic procedure (procedure)" } ] } ], "detail": [ { "reference": "Procedure/219ef5e3-ed0c-4dab-88eb-b114daaebd73" } ] } ] } }, { "fullUrl": "urn:uuid:Patient/51b806c8-566f-463e-8783-9fbf6be8161d", "resource": { "resourceType": "Patient", "id": "51b806c8-566f-463e-8783-9fbf6be8161d", "text": { "status": "extensions", "div": "

Generated Narrative

US Core Race Extension

value: White

value: American Indian or Alaska Native

value: Asian

value: Shoshone

value: Filipino

value: Mixed

US Core Ethnicity Extension

value: Hispanic or Latino

value: Dominican

value: Mexican

value: Hispanic or Latino

US Core Birth Sex Extension: F

identifier: Social Beneficiary Identifier: 123456789

name: Example Something Middle Last (OFFICIAL), FirstNameAlias MiddleAlias LastNameAlias (NICKNAME)

gender: male

birthDate: 1941-02-19

address: 101 Example Street Line 2 Bedford MA 01730 United States

maritalStatus: Never Married

" }, "extension": [ { "extension": [ { "url": "ombCategory", "valueCoding": { "system": "urn:oid:2.16.840.1.113883.6.238", "code": "2106-3", "display": "White" } }, { "url": "ombCategory", "valueCoding": { "system": "urn:oid:2.16.840.1.113883.6.238", "code": "1002-5", "display": "American Indian or Alaska Native" } }, { "url": "ombCategory", "valueCoding": { "system": "urn:oid:2.16.840.1.113883.6.238", "code": "2028-9", "display": "Asian" } }, { "url": "detailed", "valueCoding": { "system": "urn:oid:2.16.840.1.113883.6.238", "code": "1586-7", "display": "Shoshone" } }, { "url": "detailed", "valueCoding": { "system": "urn:oid:2.16.840.1.113883.6.238", "code": "2036-2", "display": "Filipino" } }, { "url": "text", "valueString": "Mixed" } ], "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race" }, { "extension": [ { "url": "ombCategory", "valueCoding": { "system": "urn:oid:2.16.840.1.113883.6.238", "code": "2135-2", "display": "Hispanic or Latino" } }, { "url": "detailed", "valueCoding": { "system": "urn:oid:2.16.840.1.113883.6.238", "code": "2184-0", "display": "Dominican" } }, { "url": "detailed", "valueCoding": { "system": "urn:oid:2.16.840.1.113883.6.238", "code": "2148-5", "display": "Mexican" } }, { "url": "text", "valueString": "Hispanic or Latino" } ], "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity" }, { "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex", "valueCode": "F" } ], "identifier": [ { "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "SB", "display": "Social Beneficiary Identifier" } ] }, "system": "http://hl7.org/fhir/sid/us-ssn", "value": "123456789" } ], "name": [ { "use": "official", "family": "Last", "given": [ "Example", "Something", "Middle" ], "suffix": [ "Jr." ] }, { "use": "nickname", "family": "LastNameAlias", "given": [ "FirstNameAlias", "MiddleAlias" ], "suffix": [ "Jr." ] } ], "gender": "male", "birthDate": "1941-02-19", "address": [ { "extension": [ { "url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/Within-City-Limits-Indicator", "valueCoding": { "system": "http://terminology.hl7.org/CodeSystem/v2-0136", "code": "N", "display": "No" } } ], "line": [ "101 Example Street", "Line 2" ], "city": "Bedford", "district": "Middlesex", "state": "MA", "postalCode": "01730", "country": "United States" } ], "maritalStatus": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus", "code": "S", "display": "Never Married" } ] } } }, { "fullUrl": "Practitioner/urn:cb1219bc-785f-431c-9f56-b8fbbe78bc4d", "resource": { "resourceType": "Practitioner", "id": "cb1219bc-785f-431c-9f56-b8fbbe78bc4d", "text": { "status": "generated", "div": "

Generated Narrative

identifier: id: 2233445511

name: Doctor Middle Last (OFFICIAL)

address: 11 Example Street Line 2 Bedford MA 01730 United States

Qualifications

-IdentifierCode
*id: 789123456Physician
" }, "identifier": [ { "system": "http://hl7.org/fhir/sid/us-npi", "value": "2233445511" } ], "name": [ { "use": "official", "family": "Last", "given": [ "Doctor", "Middle" ], "suffix": [ "Jr." ] } ], "address": [ { "line": [ "11 Example Street", "Line 2" ], "city": "Bedford", "district": "Middlesex", "state": "MA", "postalCode": "01730", "country": "United States" } ], "qualification": [ { "identifier": [ { "value": "789123456" } ], "code": { "coding": [ { "system": "http://snomed.info/sct", "code": "309343006", "display": "Physician" } ] } } ] } }, { "fullUrl": "urn:uuid:Procedure/219ef5e3-ed0c-4dab-88eb-b114daaebd73", "resource": { "resourceType": "Procedure", "id": "219ef5e3-ed0c-4dab-88eb-b114daaebd73", "text": { "status": "generated", "div": "

Generated Narrative

identifier: id: aabcde9876543210

status: completed

category: Diagnostic procedure (procedure)

code: Death certification

subject: See above (Patient/51b806c8-566f-463e-8783-9fbf6be8161d)

performed: Jan 29, 2019, 9:48:06 PM

Performers

-FunctionActor
*PhysicianSee above (Practitioner/cb1219bc-785f-431c-9f56-b8fbbe78bc4d)
" }, "identifier": [ { "value": "aabcde9876543210" } ], "status": "completed", "category": { "coding": [ { "system": "http://snomed.info/sct", "code": "103693007", "display": "Diagnostic procedure (procedure)" } ] }, "code": { "coding": [ { "system": "http://snomed.info/sct", "code": "308646001", "display": "Death certification" } ] }, "subject": { "reference": "Patient/51b806c8-566f-463e-8783-9fbf6be8161d" }, "performedDateTime": "2019-01-29T16:48:06-05:00", "performer": [ { "function": { "coding": [ { "system": "http://snomed.info/sct", "code": "309343006", "display": "Physician" } ] }, "actor": { "reference": "Practitioner/cb1219bc-785f-431c-9f56-b8fbbe78bc4d" } } ] } } ] }