Implementation Guide
27.0.0 - R4 APIs

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: PAS Beneficiary Patient Example - JSON Representation

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{
  "resourceType" : "Patient",
  "id" : "PAS-Beneficiary-Example1",
  "meta" : {
    "lastUpdated" : "2025-12-12T01:26:33.060-06:00",
    "profile" : [
      🔗 "https://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-pas-beneficiary-patient-profile"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table width=\"100%\"><tbody><tr><td width=\"25%\"><span class=\"text-muted\">Cheryl L. Johnson suffix F DOB: 1976/06/30</span></td><td width=\"42%\"><span class=\"text-muted\">2590 SW Evans Portland, IL 60229 USAadd1 city2, null 567890 Vanuatu Phone: 5036179046 Phone: 5032452697 Fax: 5036179047 Email: cljohson@owl.com</span></td></tr></tbody></table></div>"
  },
  "extension" : [
    {
      "extension" : [
        {
          "url" : "ombCategory",
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.6.238",
            "code" : "2106-3",
            "display" : "White"
          }
        },
        {
          "url" : "text",
          "valueString" : "White"
        }
      ],
      "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" : "2186-5",
            "display" : "Not Hispanic or Latino"
          }
        },
        {
          "url" : "text",
          "valueString" : "Not 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"
    },
    {
      "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex",
      "valueCode" : "248152002"
    },
    {
      "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-genderIdentity",
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "446141000124107",
            "display" : "Identifies as Female"
          }
        ],
        "text" : "Identifies as Female"
      }
    },
    {
      "extension" : [
        {
          "url" : "tribalAffiliation",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/v3-TribalEntityUS",
                "code" : "345",
                "display" : "Alatna Village"
              }
            ],
            "text" : "Alatna Village"
          }
        }
      ],
      "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-tribal-affiliation"
    }
  ],
  "identifier" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "PI",
            "display" : "Patient Internal Identifier"
          }
        ],
        "text" : "Patient Internal Identifier"
      },
      "system" : "https://docs.mydata.athenahealth.com/fhir-r4/athenaFlex/namingsystem/PatientId/1000-4-9390",
      "value" : "670"
    },
    {
      "use" : "secondary",
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "SB"
          }
        ]
      },
      "system" : "http://hl7.org/fhir/sid/us-ssn",
      "value" : "753745187"
    },
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "MR",
            "display" : "Medical record number"
          }
        ],
        "text" : "Medical record number"
      },
      "system" : "https://docs.mydata.athenahealth.com/fhir-r4/athenaFlex/namingsystem/MRN/1000-4-9390",
      "value" : "MR-000-090"
    }
  ],
  "name" : [
    {
      "use" : "official",
      "family" : "Johnson",
      "given" : [
        "Cheryl",
        "L."
      ],
      "prefix" : [
        "Mrs"
      ],
      "suffix" : [
        "suffix"
      ]
    }
  ],
  "telecom" : [
    {
      "system" : "phone",
      "value" : "5036179046",
      "use" : "work"
    },
    {
      "system" : "phone",
      "value" : "5032452697",
      "use" : "home"
    },
    {
      "system" : "fax",
      "value" : "5036179047"
    },
    {
      "system" : "email",
      "value" : "cljohson@owl.com",
      "use" : "home"
    }
  ],
  "gender" : "female",
  "birthDate" : "1976-06-30",
  "address" : [
    {
      "line" : [
        "2590 SW Evans"
      ],
      "city" : "Portland",
      "district" : "county",
      "state" : "IL",
      "postalCode" : "60229",
      "country" : "USA"
    },
    {
      "use" : "old",
      "line" : [
        "add1"
      ],
      "city" : "city2",
      "postalCode" : "567890",
      "country" : "Vanuatu",
      "period" : {
        "start" : "2025-08-11T00:00:00-06:00",
        "end" : "2025-12-10T00:00:00-06:00"
      }
    }
  ],
  "multipleBirthInteger" : 1,
  "communication" : [
    {
      "language" : {
        "coding" : [
          {
            "system" : "urn:ietf:bcp:47",
            "code" : "en",
            "display" : "English"
          }
        ],
        "text" : "English"
      },
      "preferred" : true
    }
  ]
}