Publish Box goes here

• Narrative Content
• XML
• JSON
• TTL

: PAS Beneficiary Patient Example - XML Representation

Raw xml | Download

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